Has East Germany reverted to communism then? The communist world - what does that consist of these days.

I understand that. The problem is that many potential students don’t, so it disincentives them. It’s really another tax on the highest earners, those who benefit most from a degree, but it’s widely misunderstood.

For the avoidance of doubt any comments in response to a previous post are directed to its ideas and not at any, or all, posters personally.

I recall that the NHS sent managers to Cuba to study how their health care worked.

Also that the staff of a hospital actually built it from scratch!

Obligation. A mate is married to a Cuban girl and lives there he is always going about Obligation (not sure what the Cuban word is). Basically everybody has to pull their weight for the community.

One more point

Does she eerr ya no bring her ummm uniform home some times. Ummm ya no just so like you can like umm look at her and make sure it like fits ok like ya no

Edited by cryrst (15 Dec 2022 7.02pm)

In many ways the student loan system is a way of the government funding the qualifications as only the highest earners will ever pay it back. However, it's not well understood, and it puts off people, as who wants a large debt around your neck increasing with high interest rates for your working life?

I am conflicted as my wife is a nurse who works in the way we all hope to be cared for, with devotion, skill and compassion. She deserves more money, but I also know that we cannot afford to give her it at the moment. She works in a clinic, but also does bank shifts on wards. How anyone can handle the pressures on some wards is a wonder. Only today I saw three security officers having to restrain a patient. In my youth you would not see a security officer in a hospital! Imagine the Emergency Department at midnight on Saturday, already overrun with delays, having to deal with abusive, aggressive, drunken men and women who have injured one another. Who wants to willingly care for them, let alone show compassion? Yet they do.

I also hear of situations which are very wasteful. Low quality administration managed by unimpressive people. This isn't so unusual in any big organisation, but it still irks to see it.

I don't see a quick and easy solution to any of the issues. Each one will need its own new long term strategy, with an overall destination as the aim. I do though wonder if the current banding system for pay rates needs to be revisited. There are already higher rates in London and the SE. Maybe we need to pay much higher rates to those who work in the most challenging areas, like the ED and neurological wards? Thus reducing the need to pay agency staff at even higher rates. The qualifications are equal, but the work isn't.

I am sure that some costs can be saved by better management, efficient use of resources and technology, but ultimately we are going to have to pay more. I stopped paying NI 13 years ago, but use the NHS more now than ever. That seems to me to be an obvious change that will have to be made before too long.

For the avoidance of doubt any comments in response to a previous post are directed to its ideas and not at any, or all, posters personally.