Education Random Observations

Yesterday as I travelled to ST John's Hospital my bus had two USB ports at each seat. Found one useful this morning on ly journey home. It also had faux laminate flooring.

I spotted a very busy McDonald's at 7am, what are they eating at they time of the morning?

I passed a place called Hilly Cow Wigwams.

More seriously I feel I came across another instance of how the NHS is getting ripped off. They used a combined pulse, oxygen level and blood pressure machine. All three items bought using decent brands would probably be little over 2/300 pounds yet the machine is on sale for £1800 but you have to add another £250 for a stand. So two grand or ten times the price of separates and the machine does not have Bluetooth or wireless capability. I suspect the clever bods here could probably knock something up incorporating these three instruments for mush less. So why the, what seems to me, the exorbitant price.

You probably think that surely the NHS with it's buying power will pay far less unfortunately due to the very odd buying protocols used by purchasing officers or whatever they call themselves this is often not the case. In my own health board i discovered via a freedom of information request that for instance lightbulbs cost 3 times what you and I would pay, toilet rolls twice. So buying these machines for all wards across a health board would be huge and this is just one machine out of, I suspect, thousands covering all sorts of disciplines.

Unit in question. https://www.medisave.co.uk/welch-al...4QcRViKBYbG1Zok61uBxsGKJ_I-T_dgfxoRoCGhTw_wcB

Why did I look up this? The reason being I have the separates and find them useful as we both have medical issues and the information provided can be useful to GP's ETC, so I wondered what one would cost, almost choked on my Fortisip.

 

Seriously overspend on items -> meet budget -> budget stays high -> NHS happy

 

Sausage muffins I expect.
Or bagels.
Or pancakes.

I'm so getting a Maccys breakfast tomorrow......

 

I am almost to scared to ask what a sausage muffin is and feel positive that it would not be something I would like to put in my mouth. Mind you I have only purchased twice from MacDonald's and was extremly disappointed with the quality and flavour.

 

Also the beauty of large corporation supply chains means that the NHS trust may not be able to buy direct from the supplier so may have to go through one or maybe more resellers to purchase.

My company supplies to the NHS and often we see 2 or 3 resellers in the chain before it gets to the buyer.
It can turn an £800 software licence into £1200 very easily.

 

What sort of buses are those, i consider myself lucky if the bus i get on has heating.

McDonald's breakfast is way better than their normal junk.

Hilly Cow Wigwams sounds like a great name if we're talking about a place that's hilly with cows and wigwams.

Medical equipment needs certification, certification costs, added to that are some awful PFI contracts.

 

First Bus up here.

Stretching the imagination a bit walling them Wigwams look more like fancy sheds and not a cow in sight. http://www.hillycowwigwams.co.uk/wigwams.html

I'll take your word for it.

I agree with PFI as we have a newly built hospital that was poorly designed and built but will cost NHS Lothian a not so small fortune over the contracts life time but we do have one of the worst performing health boards on so many levels.

 

Up here Go Ahead, Stagecoach and Arriva all offer wifi and/or charging sockets on some routes [sockets is typically the longer routes, though Go Ahead at least were aiming to have wifi installed on most of their fleet]. Don't think the metro has WiFi, but they have installed gubbinz so you can get cellular reception in the main underground sections, it's been a while since i used the Metro so that might've changed.

As for why the NHS/Govt gets fleeced... partly because suppliers know they can, they have glass doors and see the ****ers coming knowing they won't [or can't in some cases] go anywhere else for one reason or other.

Also as Evolutionsic points out - often it's overspend to justify continued budget, then make 'efficiency savings' [ie pay what it was supposed to cost in the first place] to justify their continued employment.

 

Some folks I know call them identity theft ports. Beware of plugging your phone into public USB ports. You don't know what they're connected to.

I've lost count of the number of times I've rolled up to the drive-thru of a McDonald's at that time of the morning after a long night of work and ordered a full meal because I haven't had anything since dinner time the night before, if even then. You have to understand that there are people who work night shifts and even worse some like myself who work up to and over 20 hours at a time!

 

That did occur to me but the area where this particular MacDonalds was is not in a particularly industrial area. I suppose I could go and have a look at one which is relatively close to me but don't think I will bother.
I personally used to go for a pint or several after a night shift as quite a few pubs opened at 6 am here.

 

the buses here have the usb ports [which is often broken anyway as some lil **** has jammed something into it] but they also have the regular 3-pin power sockets...

basically each row of seats has one of these:

 

Sausage patty (two for the double), cheese in an english muffin.
Meal it and get a hash brown to throw in there too.

Probably the best thing they do to be honest.

Or go full fatso and rock up at 10:25, order double sausage muffin, wait 5 minutes, order a double cheesburger.
Combine for the Mc10:35

(Never done it, am reliably informed it's awesome).

 

Dammit, now I have a craving for one too. I'm in 'merica atm, and I think they serve all day breakfast, so I may just have to pop over and grab one.

But in all seriousness, Tim Hortons sausage BELT's are where its at.

 

Yuk on all accounts. I think I will leave it.

 

For a number of years I worked in an abattoir that supplied beef to McKeys, the manufacturing arm of McDonalds that supplies the burgers.

I have not visited a McDonalds since.

 

What happens if your home appliance fails? Say, your TV packs up, your washing machine eats your pants or floods the kitchen. You claim on warranty. Perhaps you claim for some damages.

What happens if a hospital appliance fails? A patient may come to harm, even die.

Hospital equipment costs so much party because it is over-engineered and exhaustively tested to destruction, and partly because the manufacturer is insured to the eyeballs for liability claims.

 

Which is fair enough for an MRI scanner [where even the 'cheap option' is ~£300k if memory serves...], you don't want to cheap out on that kinda thing... but govt depts, not just the NHS do get shafted on stuff... Office supplies and IT mainly...

I'd also wager the NHS doesn't buy the stuff direct from GE, Philips, Siemens or whoever and buy from an intermediary [who will add markup because, they're a business and not doing that **** for free]... and the middlemen are where most of the price bloat comes... also factor in upkeep and maintenance which you also don't wanna skimp on yet can still be a source of cost inflation and bloat, esp as the machines get near the end of their working lives.


Also given the CMA have just fined Pfizer for ripping the NHS off over an epilepsy drug and other, similar, high profile incidents *cough*Shkreli*cough* gouging in healthcare can and does happen.

 

Just because a item is listed for £1800 doesn't mean that's what its sold for. Frequently these devices are loaned on the condition the X quantity of pads / probes / sensors are brought over time frame y.

The company loaning them to the hospital is still responsible for maintaining the device including service. The disposables sales are where the money is.

Source: I work for a med device firm.

 

Also [yay no coffee and not reading the posts]... Re: Kronos' original example... 3 separate machines = 3 lots of maintenance, potentially 3 lots of training, 3 supply contracts for any consumables and you have to find space to store 3 devices instead of 1. All on top of the things nexxo points out.

Also wireless/bluetooth sounds awesome... but then you have the ballache of connecting them to whatever thing you need to connect them to... securing those connections... etc. etc.


tl-dr: as Nexxo is fond of saying - 'It's a bit more complicated than that...'