ChezGiven

I cant believe your seriously putting up this sort of rhetoric :) What do you think the defecit is? The difference between money in to the government and money out. If we have a defecit then surely its because we havent got enough to pay our bills. We have money to spend and the deficit is funded by the lowest rates of interest in history. If we grow the economy we can pay it back. The point is, we have access to capital to fund the deficit and have a huge budget to spend. 'There is no money left' is rubbish.

The phrase 'there is no money left' is bollocks. We are a very rich country. We might not be growing but we stopped shrinking and the level we stopped at is still one of the richest countries in the world. This year we will continue to spend mind-boggling amounts of money on defence, social security, health etc. The idea that there is no money left is stupid.

Apparently we only have one world class player (who is out of form) so lets not get our hopes up too high, sit back and just enjoy it. If we lose, try not to react like too badly and look forward to the rest of the competition. If we win, count our blessings and look on with interest for the outcome of Group D. I know we are all 'winners' inside, so the thought of us losing in any walk of life is hard to take. Sometimes its important to remember its the 'taking part' that counts not the result.

It's not really my concern but I fail to see how you can improve quality of care without having objective targets. The NHS is certain to decline under this government. Of more interest to me from a personal point of view is what happens to NICE. Rumours are afoot big changes are coming, none of which will be good imo. Fair enough I was mainly asking from an insiders point of view as to how the targets culture over the last few years had gone down. Thought it may have been the sort of stuff you discussed with the nurses and doctors in the canteen over lunch. Naah, I'm quite detached from the clinical realities of the NHS really. I'm more involved with clinical effectivenss of interventions, and more recently cost effectiveness. Seriously though, I'm not being partisan here when I say this government doesn't seem to have a clue what its doing regarding healthcare. For instance, before the election, Cameron promised a chest of money for the provision of cancer treatments. This just sounds like popularist bullshit to me. Early days still, we'll see soon enough. If your not been partisan then you'll agree their decisions have being reduced somewhat by the state of the countries finances. Have you also noted that Asda is to start selling all Cancer drugs at cost. aye right. Cost to whom? The cost to ASDA? Then you mean at their wholesale price. Which is what the NHS currently pays.

Coming from a business background Im all too familiar with being able to "measure" as much as possible, be it sales persons performance, product performance or ruturn on advertising spend etc etc. But... We there are some truths that need adding in to your logical argument. 1. There is no money left. Somethings going to have to give. Frontline or backroom? 2. As in all walks of life there will be good targets and stupid targets. Anyone who has worked for a company will know all about departmental empire builders. Just look at your average Personnel department over the last 15 years or so. Staffing laws, health and safety, risk assesment, training.....an endless list that increases year on year as "managers" think up something else we should be "measuring". 3. The cost to taxpayer / patients and health workers time on meeting those targets. I would never have taken by best salesperson off the shop floor to stand at the door and count the number of customers coming in or walking by...It used to happen. Similarly how much of a health workers time is taken up filling out targets, monitoring timespans etc. The same is very often mentioned by police officers. In 2010, we will spend 9% of GDP on healthcare, thats a lot of money. So point 1 is just gibberish. Point 2 is about economic choices, the reason why you need to related inputs (money) to outputs (health) so that the choice is the best for the taxpayer. Point 3 is vaild and is in line with my last sentence, its about which targets are used and how they are used. Its not 'targets' that are the problems its 'bad targets'. To be very clear on this, let me ask the question. If Osborne promised to reduce spending without affecting frontline services, how are you going to prove that this statement is right, that he is not a liar, in 12 or 24 months time? Are you going to ask frontline staff what they think?

My last Adidas purchase were these.

Targets are absolutely utterly essential in any public service. This is why: When you are an investor with capital looking at a range of alternative choice of where to put your money (a new factory, a new machine, a new company, a stock etc), you perform a return on investment calculation. Just like the virtually unlimited choices faced by the private investor, a public investor (ie. a public service) is also faced with a range of choices. For example the Dept of Transport has a number of alternative choices regarding new motorway investments. The decision over which to take (we cant do them all) will be based on a cost-benefit appraisal looking to maximise economic benefits from a given level of investment (the term used is technical efficiency). How do you measure the benefits of the new motorway? Well, probably a lot easier than you think as most of the benefits can be measure using economic variables and indicators. Now apply the same desire to use money in an efficient way to healthcare spending. What metrics are you going to use to determine how well money is being spent? If you have a choice between building a hospital or investing in 3 new outpatient clinics, which one would you choose and why? (this question was the first i was asked when i was interviewed by the head of the Govt economic service) The question was first posed by Archie Cochrane and Alan Williams when they were both seconded to the DoH in the 60s. They proposed that decisions taken in the DoH should be consistent with those taken in the Dept of Transport. That public expenditure should be formally related to its benefits. The intractable problem in healthcare is measuring benefits (and for the purposes of investment putting them into the same currency so that alternatives could be compared). Targets are one way of ensuring that money spent is related to what the healthcare system is trying to acheive, ie better health. Therefore, a healthcare system that does not measure its activity and relate that activity to its cost base is one that is run by retards who should not be in charge of spending our taxes. In short, there is no debate (in the DoH anyway) on whether to use them but only on which ones to use and how.

What a prick. He doesnt have the intelligence to speak on behalf of anyone.

So far they are the only two who look like they want to win it and can. Has Maradona had some additional coaching assistance drafted in? Watched them a few times in qualifying and they were all over the place. Need to wait and see how Spain perform next.

Italy in virtually the same position as England now.

For a bunch of people who dont like this Corden character you dont half go on about him. Stop talking about him then you fucking Hello-generation, celebrity-commentating tosspots. Anyway the football. None of the big european teams performing, Netherlands functional, England shit, France out, Germany erratic, Italy struggling here, Spain lost their first. When you see the criticism of the england players and the view that only one or two of them are top class, then you wonder why people arent just enjoying being at the finals, being in with a very good chance of progressing and doing no worse really than other teams of similar standing.

Aaron Lennon - eyebrow worrier

We deserve to go out for the stupidity and arrogance of that.

Its one of the blokes out of TV on the Radio. The music, not the bird.

This is lush, cant get it yet only out in US i think. http://misspeakmusic.wordpress.com/2010/06...balloons-tiger/ Great video too...

Aye, those two are arguably not exactly 'world class' but certainly excellent players who would get a shout at starting for many other countries. Both good enough to play in the world cup so that sort of is world class.

* scribbles down notes.

I think Rooney, Lampard, Gerrard, Joe Cole, Ashley Cole, Barry and Terry and genuinely world class players. The squad is shit but the core of the team is very good.

Feeling a bit more optimistic today, was having a large dump earlier and was thinking maybe Capello wants to work out which team will win Germany's group and avoid them by coming second. If Germany dont win their group, USA beat Algeria and we beat Slovenia, we play Serbia or Ghana. Which, if you'd offered me before the tournament, i would have taken over any other outcome. France drew first two games on way to final last time too.

Well that's patently nonsense given their performances in the qualifiers. Using Aston Villa's reserve striker is asking for criticism. He has always had the option to put Gerrard off Rooney and or use Joe Cole, a proven world cup player. The reality is that our two biggest hopes of doing well in this competition are not providing us with what we believe they can do. Rooney and Capello are falling massively short.

Rooney largely to blame for me as the spark is meant to come from him. You give him the ball and he takes players on, thats what he does. He couldnt keep the ball under control for more than 2 seconds. Our game plan involves getting the ball into him in decent positions, no wonder we looked clueless as he was atrocious.

x3

I knew he was going to miss that for some reason.