I don’t know who hacks me off more…

Laura Kuenssberg or that stupid boy.

Put the two together on Sunday morning and I have to tell you… my TV is at serious risk of having a coffee-cup thrown through it.

I doubt Kuenssberg could ask convincing questions at a pub quiz and as for Silly-Boy he must hold the Guinness record for trotting out the most tropes in ten minutes.

Today Charmer joins in the nonsense. 

He will be visiting a hospital in Yorkshire where they are operating on patients at weekends. 

Like it’s unique… it’s not and has been a ‘thing’ since 2015.

In 2020 it kicked off and fizzled out when the money ran out.

In 2022 London started Super-Saturdays. Scything their way through lists.

Since then many extra surgical lists are added to weekends, across the NHS.

Despite industrial action, Covid (still and issue) and workforce problems (Staff absences up to an average of 49,020 each day) the NHS is making progress...

... the average waiting time falling to 13.8 weeks, with the number of patients waiting for elective care in October down to 6.44 million.

It’s important to remember, four in five people who are waiting for treatment do not require an admission to hospital. They need either a diagnostic test or outpatient care.

Given a clear run, waits will fall surprisingly quickly, which is why Sunak chose it as one of his five. The stumbling block, hosptials are very efficient. They accelerate performance and run out of money.

Starmer thinks he can get the NHS running 24/7. Good luck. 

Apart from the need for down-time for cleaning and recalibration of kit, we don’t have enough people… 160,000 vacancies. 

Weekend working is not just about surgeons and nurses. Pretty-well every other part of the system has to be involved.

Start with carparks, porters, canteen, cleaning, diagnostics, pathology, AHPs, estates and go from there. End with social care to facilitate discharge.

As they'll tell him in Yorkshire; it costs a lot of brass. Charmer is going to change the non-Dom tax rules to pay for it.

Well…  

• Of the 2,100 non-doms paying a lump sum to avoid UK tax; only 500 paid the top whack of £60,000. 
• From HMRC’s statistics; the vast majority of non-doms in the UK don’t have significant wealth overseas, they just work there.
• Charmer will be relying on the 500 wealthiest, each of whom would have to pay additional taxes of £6.4m each, in order to generate £3.2bn in taxes. Unlikely…
• … these are the people who generally have homes in other jurisdictions and are unlikely to stay.
• Should the existing rules be maintained but limited to five years, (Labour’s plan) the additional tax generated will be reduced by half to £1.6bn. 

Not enough money...

Today Charmer is also going to highlight the work at Guy’s and Tommy’s… a surgeon working across two theatres at once.

It’s called overlapping surgery; a single senior surgeon operates across two parallel operating theatres; anaesthesia is induced and surgery commenced by junior surgeons in the second operating theatre while the lead surgeon completes the operation in the first… then the juniors close-up.

Pioneered in the US, where…

… one of the world's leading hospitals, the Massachusetts General Hospital has paid out £26 million (without liability) to settle cases in relation to its … use of overlapping surgery.

In the NHS the ‘Getting It Right First Time’ initiative has set explicit targets for specialties to achieve a certain number of operations, through reductions in turnaround time, on certain ‘high‐volume, low‐complexity’ lists.

If overlapping surgery reduces or eliminates turnaround time, then the theory is that productivity should increase.

However Pandit et al, tell us…

‘… turnover time, expressed as a percentage of scheduled list-time, sets the limits of what any scheduling method can theoretically achieve.

The median turnover times across lists approximate 15% of the total list time, this is the maximum improvement in additional operating time that is achievable.

This equates to only 72 min in an 8 hour list, which generally is at best sufficient for just one additional case.’

Charmer and Silly-Boy are fooled by gimmicks and they use them to try and fool us. 

They don’t understand the real issues and appear not to have anyone near them who will tell them the truth…

…or perhaps they do.

Perhaps they are content to pull the wool over people’s eyes. 

The solution to the NHS’s problems is simple, gimmick-free and easy.

Look after the frontline, fund it properly, make it fun to work there, stand back and watch the rest fall into place.

No policy shake-up required… just a wake-up to reality.