I'm assuming some of these savings are achieved through the procurement chain etc. I've never understood why the Police, Fire, NHS......... don't have a centrally managed & incentivised (privatised if it takes that) procurement/sourcing group.

There must be millions of savings to be had there

Equally privatising back office staff........

My experiences of 'nationalised' public sector organisations is one of incompetence brought about by 'shuffling' staff around/upwards and wastefulness underpinned by a lack of accountability.

That's a masterful way to win an argument; I bow to your superior debating technique.

I don't work in procurement but we do have a specialised team that will search high and low across all providers to source things at the lowest cost.

So if you can get it off amazon cheapest that's where we get it.

The issue with procurement comes higher up the chain. It appears that if you want a bit of specialist kit. For example I was after some respirators and other such kit for treating contaminated patients. The only place you could get this was via the NHS Supply Chain and the providers into that charge what seems to be a fortune. They also set up long contracts to service equipment that can be eye wateringly expensive but with no other supplier available you're stuck. The costs of this goes up every time they're negotiated. The money from government hasn't gone up in 7 years.

That may be because it's specialised kit and they can get away with it because we can't go anywhere else.

What do you do? Enforce pricing limits on private companies? It looks like some sort or regulation is needed. It's all very well blaming the NHS but often I think the private sector takes so much out simply because it can get away with it.

Elsewhere there's a similar scenario in higher education. My wife works for a well known university. Various subjects must have certain electronic journals available to students for them to be a degree subject - e.g. some health degrees and some law degrees.

The companies that own these journals put them in bundles of say 20 or 30 so you may want 3 or 4 but have to take the others too you don't want. Each bundle costs maybe around £50k.

The companies are savvy so they make sure universities have to but many bundles so you can offer the degree so spend millions.

There is no competition amongst these companies. One called Elsevier puts up subscriptions each year by several grand. They are able to do what they like.

The result is universities get out of pocket and have to charge higher fees or stop offering certain degrees. That leads to fewer qualified people eventually. At least the fat cats clear up though.

Interesting analysis. When I joined the civil service in the early 90s a lot of that was true. A lot has been done to streamline things since. Once you do take the plunge and make it slicker you can make big savings but often they’ll only be made once as once you go private companies tend to offer the same services for similar prices so whenever contracts are up there’s no immediate bonus. When I re-trained and moved into the NHS I’ve seen how an initial saving can often have unintended consequences. For example you’ll get people on minimum wage doing jobs that they have no stake in so service standards get worse, e.g. in terms of catering, building maintenance, IT or cleaning. People don’t go the extra mile anymore and if you need anything out of the ordinary then forget it.

I think a lot of public sector people are hopeless at contracting too so get screwed on the SLAs.

Where I work all the support services apart from domestic cleaners is done in house. It’s a heck of a lot easier to organise when you’re all under the same management structure. It just needs effective management. We’re one of the few still in the black financially….for now. It’s no coincidence that this was achieved with minimum PFI involvement.

So,you're proving my point, the NHS is as corrupt as inefficient, time everyone was sacked and privatisation paid for the best of the best. I know doctors and dentists from the Maldives, India that don't even have the right qualifications, all just waved through, the UK has become an embarrassment, Mrs May is taking control back, maybe we can charter a boat for all the lefties to the Falklands, no return ticket required

No further comment for almost 4 hours, says everything about the Labour nut jobs, can't face anyone when being shown up for the idiots they are. Hope the Wethers Originals and Sanatogen go well with the blanket and hot water bottle.

Hahaha

I can only assume you're laughing at yourself??

Regarding Brexiteers, I believe they will get what they deserve, though that may not be what they actually want or "think" what they are going to get.

Agree, we'd have been better off staying on and making changes, we're not going to achieve much by being out.