Pareto approximately


Dr Gordon Brown thought investment meant expenditure of borrowed, fraudulent money.

He “invested” copiously in the NHS amongst other places.  One aspect of it was the Private Finance Initiative (PFI). The concept was initiated by Conservatives to enable the current government to claim it was benefiting the community while shifting responsibility for payment to future administrations.  Business builds what the government cannot afford.  Future governments pay very high rates for the asset; well above the risk premium that should have been necessary.  The Conservatives intended it to be used seldom.  Widespread use of PFI is monstrously stupid in itself, yet it is but a small element in Dr Brown’s legacy of ruination.

The director and bankster friends of every government drew their dues from PFI.  They continued to rob customers through an intricate series of immoral, fraudulent, legal and illegal systems.  It has suited governments to create the illusion of national growth through devices of fraud and debt .

What if that long period of growth is an historical aberration that is ending?

PFI debt may be part of the explanation of why the merged Trusts commandeered the charitable and research funds held by their component departments:

According to KMPG, the accountancy firm, NHS trusts are now investigating ways of concealing their debt by setting up charities which would ‘own’ the PFI contract. The NHS would hide debt from the taxpayer in precisely the same way as Enron once did its liabilities from its shareholders.”

We need advice from forensic accountants on whether funds from sources such as legacies, research funds and departmental income generation are being reallocated to cover the debts and shortfalls arising from poor Trust management.

VanguardInHealth tells us where some of it went and how badly it is misallocated:

All consuming

“Quantification is the description of reality with numbers.  These numbers make you feel secure; provide you with a sense of precision.  We accept, uncritically, the underlying mathematical assumptions behind very complex situations, assuming in the process that reality is identical to our rational reconstruction of reality…
“…I have been trying to stitch together person shaped consumption, end-to-end over time.  It’s not an easy thing to do.  The NHS does not look at information in this way.  It is very revealing.  For hospital data though, the pattern is unequivocal.  In every system I have studied:
  • about 1.5% of people consume roughly one quarter of hospital inpatient and day case resources
  • 5% of people consume about 50%
  • under 20% of people consume over 80%…  
“….I have seen that wellbeing economies are systemically incapable of understanding how to respond to knowledge about people.  The system does not see people as people.  This is a major design flaw and the main reason driving costs in the system.  I would argue that it’s also a main driver of harm to patients as well.”

A sort of unquality then?

VanguardInHealth is a blog you should read if you think that healthcare should be about people not records and numbers .  

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