I just stated it will be a readymade excuse, are you confident Labour or their supporters will not use this excuse?

No, I’ve never worked for the Border Force. Yes, we should charge those who don’t contribute to the NHS and who don’t habitually live here. In advance except under exceptional circumstances. Yes we should collect fees for anyone from whom we didn’t recover in advance.

Of course they will, as supporters of every new government do - it's just a moot point.

It's particularly amusing in the context of the current government and the length of time they have been using the line.

I hope we can all agree that this is just plain crazy and what the NHS management need to address

ByLaura Donnelly, HEALTH EDITOR
“Pointless” bureaucracy is helping hospitals grind to a halt, a leading doctor has warned.
Dr Gordon Caldwell, who has just retired after 40 years as an NHS hospital consultant, said “horribly inefficient” paperwork around patients moving in and out of wards is fuelling record delays.
The senior doctor took a photograph of all the forms required for one medical admission to an NHS hospital, laid against his 5ft 10in frame.
Dr Caldwell said promises by the NHS to “digitise” the health service had simply seen needless bureaucracy transferred on to poor computer systems that were often incompatible with each other.
The specialist in general medicine and diabetes endocrinology said: “A few years ago there were estimates that nurses were spending around 50 per cent of their time on paperwork; now I’d say it’s closer to 70 per cent.”
“It’s bureaucratic and it’s very slow and horribly inefficient,” he said.
NHS hospital, which
Dr Caldwell said the rise of unthinking officialdom was one of the factors that led to his recent retirement.
Too often, dozens of forms were produced with little thought given to duplication, or how to obtain the key information quickly. He said the issue is one of the reasons why whole days are lost to admission and discharge of patients.
Latest figures show almost six in 10 patients who were well enough to be discharged were stuck in hospital in the week ending Jan 15.
Meanwhile, monthly data shows more than 55,000 A&E patients endured trolley waits of more than 12 hours to get a bed, after the decision was taken to admit them.
Dr Caldwell said time spent completing forms that duplicate each other, and waiting for pharmacies to issue prescriptions, was slowing down processes at every turn.
“Even when they are replaced with digital forms the problem is the same, there is very bad software that often doesn’t link up with other software – so there’s time wasted with pharmacists typing in information and then having to retype into another system for the labels. As well as being a waste of time it’s adding risks at every stage.”
“A lot of hospitals are washing their hands of responsibility for the delays, saying that it’s all people who can’t get social care. But, in fact, the vast majority of patients go home independently; even if you get them home in two to four hours, that could have a big effect on the number of people held in the system.
“I would have patients ready to go home at 9am but because they need a prescription they would be left waiting until 3pm, just for that,” he said.
“Why are we wasting hours and hours filling in pointless forms?” said Dr Caldwell, who has long campaigned on the issue.
“Generally all they do is take those horrible papers and make them into a digital form, without anyone asking if this is the best way to do it. And there is so much information in so many different places that it increases the risk that something important gets missed.”
Poor design of systems
The leading consultant said poor design of systems meant staff were forced to answer a catalogue of questions, however irrelevant.
In 2019, when working at Lorn and Islands hospital, Oban, Argyll, Scotland, Dr Caldwell took a photograph of all the forms required for one medical admission with diabetes in need of intravenous antibiotics.
When he laid against them on the floor, even one side of each two-sided sheet stretched long beyond his frame.
He said the bureaucratic demands were typical for an NHS hospital – and getting worse.
When working in Worthing hospital, nurses complained it was taking them 40 minutes to document their assessment of an admission to the acute medical unit. The senior consultant introduced an alternative format, which cut the process to around 10 minutes.
Dr Caldwell said the spiralling bureaucracy was getting worse, with little oversight to streamline demands, and instead a separate form for each issue.
“Too often there is a new form for everything. We don’t want deep-vein thrombosis, we don’t want pressure sores, we don’t want falls, of course we don’t. But each has been allowed to throw a new form into the system until you could literally spend all your time filling in forms,” he said.
“I used to carry a stopwatch around with me but I’ve never known anybody measure time other than myself. The NHS doesn’t seem to indulge in the simplest forms of time-and-motion studies,” added Dr Caldwell.

One more point

Having to do ridiculous amount of paperwork, which deflects from actually doing the job, seems to be rife in the Oubkic Sector

It is rife in any healthcare setting, because getting stuff right is a matter of life or death. For example everyone in a care home should have a care plan, medicines management is critical, CQC requires data and judges sites upon it etc. Do you really think the private sector has less? If so, in my experience you would be wrong. And by the way, I have run two private hospitals and loads of care homes.

Furthermore, the alternative to a centrally run system which requires data to operate is a privately run system which... requires data to operate.

From Reuters

Over one third of all healthcare costs in the U.S. were due to insurance company overhead and provider time spent on billing, versus about 17% spent on administration in Canada, researchers reported in Annals of Internal Medicine.

Cutting U.S. administrative costs to the $550 per capita (in 2017 U.S. dollars) level seen in Canada could save more than $600 billion, the researchers say.

Edited by Mapletree (26 Jan 2023 1.30pm)

As a matter of interest, according to The Kings Fund, best estimates suggest that the NHS spends roughly £8 billion of its £100 billion budget on management and administration.

Edited by Mapletree (26 Jan 2023 2.53pm)

Edited by Mapletree (26 Jan 2023 2.55pm)