An unusual letter from King's College Hospital

[ondined]

As has just been pointed out, 6000 people earning over 140,000 is not many at all. I work in the NHS and see the incredibly long hours which many hosptial consultants put in, working weekends and evenings. They carry an incredible amount of responsibility. The same is true of the senior hospital management (and it's usually just the chief exec who earns this much, except in the very large hospitals). These are people who could earn a lot more money in industry, especially those who work in London hospitals. Does anyone know how much you have to earn to get a mortgage on a 4 bed family home in East Dulwich these days?

The King's charity trustess clearly have a responsibilty to keep the funds looking as healthy as possible, and like most charities I would imagine over the past few years their investments have suffered and donations are down. Possibly this is the reason for them trying to raise some more awareness of their work, which may in turn lead to increased donations. I imagine the reason that they wrote to recent patients, rather than just did a bulk mail drop locally is because many people choose to come to Kings from outside of the local area, and many people in the local area may not go to Kings because instead they have their hospital appointments closer to their work. As patients of King's who may benefit from the work of the charity, this makes everyone "stakeholders" in the charities work, and as such should be given the opportunity to be kept up to date or to become more involved if they wish.

On the subject of "the intrusion" that receiving such a letter would cause, in the past few weeks I have two very persuasive and passionate individuals from different charities knock on my door asking me to make a regular direct debit payment. Whilst I don't like this intrusion, they are doing what they have to do to raise funds in a competitive environment, and do not object to them doing this. However I know what I think would be more upsetting and confusing to all those vulnerable people that previous posters have been so worried about receiving the now infamous letter.

[Mick Mac]

Sean steams in......people run scared.

[Brendan]

rahrahrah Wrote:

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> Marmora Man Wrote:

> --------------------------------------------------

> -----

> > However, my suggestion of a part tax payer

> funded NHS

> > supplemented by local fund raising efforts

> would

> > mean that the quality of the local hospital

> would

> > depend upon the quality of local support.

>

> The reality of this model would be poor hospitals

> in poor areas.

It's a conservative standpoint so that is actually the whole idea really.

[Ladymuck]

SeanMacGabhann Wrote:

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> Ladymuck - your post at 11:46 is well out of

> order. For someone so keen to accuse Keef of

> creating ill-feeling, there are enough posts from

> the people he named over the last couple of pages

> to create plenty of ill-feeling

I agree it is far from kind. However, you are wrong to assume that I was "keen to accuse" - I was not. Indeed, until that post, I had actually been holding back until I eventually lost my cool.

As for the other posts you mention, they did not mention me.

> Instead of high-horses let's talk about mountains

> and mole-hills. The few (often hypothetical)

> negatives people have raised about the letter in

> question are in effect very small beer compared to

> the bigger issues.

Sean, what one person considers important, another may view as trivial (even frivolous). So what you may deem "small beer" may in fact be a really big deal to someone else. I think it is arrogant to suggest otherwise.

>But going around calling people "bizarre" for saying as much isn't likely to engender much good feeling yourself

I didn't call anyone "bizarre". Go back and read that post. What I said was that many of those who [didn't give a toss] appeared to be completely missing the point. The "bizarre" referred to the fact that (IMO) many appeared to be doing so. I.e. I found this odd.

> And as for people according Keef's opinions

> respect - he and I have often clashed on here, but

> as he has been here from the year dot, posted more

> than anyone else, any one of us can get a general

> vibe of where Keef is coming from, and no matter

> how many times I clash with him, I respect his

> opinions regardless. The same can't be said for

> everyone else

That is your opinion and I respect that.

[annaj]

Mick Mac, please. Do you really not get it?

6000 is a tiny number in context of the total number of people employed by the NHS

6000 out of around 1.5 million NHS employees.

That's <0.5% of NHS employees who earn over ?140,000.

What percentage of employees in your organisation or industry earn that amount or more?

[Mick Mac]

75%

[annaj]

Ok.

And how many of them would accept a pay cut for the good of the organisation or the people it serves?

Staff salaries are a major part of NHS budgets, but that it because thousands of people are needed to work for each organisation, not because the individual salaries are too high.

What ever the rights and wrongs of the original debate (and for what it's worth I'm sorry that some people found this letter unsetting or intrusive, but I can't think of a better way to raise awareness and don't think King's have done anything wrong) I am now getting sick and tired of people with no actual knowledge of NHS funding, with the notable exception of Mamora Man, arogantly thinking they could do better.

IV your suggestions, a few pages back now, for cutting costs just show that you really don't understand how hospitals are funded or where most of the costs lie. IVF, for example, when it is NHS funded, is paid for by the Primary Care Trusts (PCTs) not the hospitals. In some hospitals IVF may even be one of the ways a hospital can earn money.

There is waste within hospitals and there are ways that costs could be, and are being, cut, but there are also managers, executives and clinicians working really hard to do the best they can, for the most people, with very limited money.

[Mick Mac]

I was not aware I made any comment on cost cutting anna. You may be confusing me with someone else.

I have commented in general on the appropriatness of the letter.

[annaj]

more than 6000 people in the nhs earn more than the prime minister at ?142k.

this suggests the nhs may not be short of money - until it pays all these salaries. And then it will be short of money and will write another load of letters.

I took this to mean that you thought they could save a bit by paying those 6000 people less. As I think you know.

[intexasatthe moment]

Hugenot - nothing "to get out there " ,I said early on in this thread that my mother's care at Kings had fallen short of their normal high standards ,so no revelations there .

I'm not sure why you're talking about " unique requirements " ,my mother's health issues are fairly standard for elderly people .

I'm also not sure why you're saying that treating patients with the tablets they bring in with them is a receipe for disaster - patients are asked to bring their medication in and it is dispensed to them. .All my mother's tablets were in blister packs - no bottles with unidentifiable tablets .

I'm not "trying to take down the NHS " I was responding to comments about how money could be saved .

But you're not really interested in discussion or other people's views are you ?

Just in trying to whip up hysteria and make personal remarks about people .

I have tried not to respond in like way ,but my resolve is obviously weakening .

[annaj]

And my other comments about cost cutting were in reply to ImpetousVrouw, adressed as IV for short, who suggested a few pages ago that costs could be cut by restricting non-essential treaments like IVF, generic prescribing (already standard in most trusts I've worked in for years) and banning smoking.

[Mick Mac]

annaj Wrote:

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> more than 6000 people in the nhs earn more than

> the prime minister at ?142k.

>

> this suggests the nhs may not be short of money -

> until it pays all these salaries. And then it will

> be short of money and will write another load of

> letters.

>

>

> I took this to mean that you thought they could

> save a bit by paying those 6000 people less. As I

> think you know.

I threw the salaries bit in as a bit of a tease anna. I'm sure you are all worth it.

[SeanMacGabhann]

I wonder if anyone who ever gets or asks for a pay rise tells their boss - "no don't worry mate, I earn enough and I've earmarked some savings in the household budget"

[annaj]

Don't for a moment think I'm in, or even close to, that top 0.5%, but yes, I am more than worth what I'm paid, thank you.

[Mick Mac]

annaj Wrote:

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> Don't for a moment think I'm in, or even close to,

> that top 0.5%, but yes, I am more than worth what

> I'm paid, thank you.

Don't mention it. The little bit that you get from me, spend it wisely.

[Marmora Man]

> rahrahrah Wrote:

> --------------------------------------------------

> -----

> > Marmora Man Wrote:

> >

> --------------------------------------------------

>

> > -----

> > > However, my suggestion of a part tax payer

> > funded NHS

> > > supplemented by local fund raising efforts

> > would

> > > mean that the quality of the local hospital

> > would

> > > depend upon the quality of local support.

> >

> > The reality of this model would be poor

> hospitals

> > in poor areas.

It's a conservative standpoint so that is actually the whole idea really

Brendan - your relentless opposition to all or any ideas that emanate from right of centre and your characterisation of all conservatives / Tories as evil toffs intent on doing down the "poor" tends to become boring. You need to move on from student yah boo politics to the more elevated arena of rational discussion.

Plenty of poor areas have benefitted from the efforts of their own community to improve matters - a close friend of mine, a Tory, has spent most of the last ten years living in and facilitating such efforts in a run down, drug & crime ridden area of south London. Your views, and those of rahrahrah seem patronising, implying as they do that the poor or poor areas are not capable of organising themselves to support a local charity / hospital / facility

[Brendan]

Mamora Man, as a student I was rather sympathetic to right of centre ideas. I was still na?ve enough back then to think that everyone thought that a fair and equal society was the ultimate goal but we just had different ideas on how this could best be achieved.

Then I grew up and befriended people who came from properly deprived communities who, although they may not want to, depend heavily on the remnants of the welfare state. I also found the realities of my life meant that I was dependent on the state for many things. This amongst other things made me realise that even thought my natural instinct is to scale back the sate to give control to the people, in places where there is large scale deprivation due to massive inequality (of which Britain and especially London is one) until the playing fields are even and people empowered to take control you have 2 choices; either provide them with services through the state on some sort of socialist model or do it through charity and return to Victorian levels of deprivation.

Now I?m all for scaling back the state and I think it can be done in certain areas at the moment but the conservative idea that you can do it without addressing inequality first is at best putting the cart before the horse and at worst an attempt to deepen the divides in society.

I have also worked amongst politicians for the last 7 years and the sentiments of conservatives on equality are abysmal. Any suggestion of policy to even the playing fields is met with contempt and often aggression.

If all tories are not intent on doing down the ?poor? (who now appear to be 2 pairs of inverted commas richer) why don?t they disassociate themselves from those who quite clearly are?

My ideas are neither unconsidered nor unfounded. They have been formed from a great deal of thought and discussion and a real attempt to understand where other people are coming from. Like all ideas they will always change as I continue to learn and experience the world. I will never limit myself subscribing too any form of ideology. It is just that recently I decided that, considering the human cost of deprivation which I cannot ignore, if someone?s political motivations are not to work towards a fair and equal society I?m just going to dismiss them as antisocial.

So it?s not cheap anti-conservative rhetoric. It?s carefully contemplated anti-conservative rhetoric.

[Keef]

Mick Mac Wrote:

> Don't mention it. The little bit that you get from

> me, spend it wisely.

You sound like the type who tells a barmaid "I pay your wages", when she tells you you've had enough.

[ImpetuousVrouw]

Marmora Man Wrote:

-------------------------------------------------------

> > rahrahrah Wrote:

> >

> --------------------------------------------------

>

> > -----

> > > Marmora Man Wrote:

> > >

> >

> --------------------------------------------------

>

> >

> > > -----

> > > > However, my suggestion of a part tax payer

> > > funded NHS

> > > > supplemented by local fund raising efforts

> > > would

> > > > mean that the quality of the local hospital

> > > would

> > > > depend upon the quality of local support.

> > >

> > > The reality of this model would be poor

> > hospitals

> > > in poor areas.

> It's a conservative standpoint so that is actually

> the whole idea really

>

> Brendan - your relentless opposition to all or any

> ideas that emanate from right of centre and your

> characterisation of all conservatives / Tories as

> evil toffs intent on doing down the "poor" tends

> to become boring. You need to move on from student

> yah boo politics to the more elevated arena of

> rational discussion.

>

> Plenty of poor areas have benefitted from the

> efforts of their own community to improve matters

> - a close friend of mine, a Tory, has spent most

> of the last ten years living in and facilitating

> such efforts in a run down, drug & crime ridden

> area of south London. Your views, and those of

> rahrahrah seem patronising, implying as they do

> that the poor or poor areas are not capable of

> organising themselves to support a local charity /

> hospital / facility

MM, you don't seem to understand what life is like when you are poor in the UK.

Poor people tend to get paid less per hour than wealthier people.

So in order to have a half decent standard of living, they have to work more hours than people who are paid more per hour than they are.

Earning the minimum wage would give you less than ?240 per week before tax and NI are taken out, so after they have paid their rent/mortgage and council tax there is not much left to use for anything more than survival spending.

If someone on minimum wage wants to earn enough to afford to treat themselves once in a while, they have to work longer hours, often in a second job. So they are not lazy or incapable of fighting for better facilities in their areas, most are too exhausted.

They don't have time to ponce about in Cafe Nero and sneer at people worse off than them, they have to work out how many more hours they need to work to replace the broken washing machine/fridge/bed/sofa etc.

[Mick Mac]

I think anna could do better than that herself Keef.

Noone's ever told me I have had enough. Not that I remember anyway........

Edited to say: It might have happened last Thursday, and Saturday. Maybe it might happen this Friday too.

[Ladymuck]

Mick Mac Wrote:

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> Noone's ever told me I have had enough.

You've had enough.

[Mick Mac]

Shuddup love.

More drink.

[Ladymuck]

Don't mind if I do...the usual please...

[RosieH]

I think we've all had enough of this thread.

[Mick Mac]

those who try to have the last word rarely are successful rosie.