Nathan Gill, former leader of Reform UK in Wales, sentenced to 10.5 years for bribery and corruption

@SW-User It needs to be widely reported and discussed.

@SunshineGirl Unfortunately I still think Reform will win the next election. People are angry, and although the Greens are getting to the REAL root causes (the super rich) Reform offers people an easy target: immigrants. Something can be done. Deport them. It won't make a blind bit of difference, but people will feel good about it :(

@SW-User In three years time, the impact of tighter immigration on staffing levels in the NHS will be difficult to mask. Perhaps then people will start to consider the consequences of their demands.

@SunshineGirl The trouble is that Labour are simply aping the far-right, thinking that will win back voters. It won't. Not a single one.

@SunshineGirl The NHS will be hit by the abolition of NHS England and jobs in the ICBs as much if not more as by fewer immigrants. Strangely the Labour government are copying what the coalition did when Lansley as Health Secretary removed the Strategic Health Authorities, which is to assume that the NHS is simply doctors and nurses. It isn't for example the piping of gases into the theatres is Estates, the keeping of medical records is IT etc. Generally doctors don't want to run the NHS they want managers to do that hence the common riposte to Lansley and the coalition - "..... I went to medical school to be a doctor, had I wanted to be a manager i would have gone to Business School." The abolition of those roles in NHS England and the ICB's will take a few years to show for sure but come the next General Election the NHS will still be inefficient and Labour will get the blame for it.

@gandalf1957 Waiting lists are already falling significantly.

@SW-User So they are at least in the short term. Further resident doctors industrial action and the threat of consultant industrial action based on eroded salary differentials between consultants and resident doctors poses a severe threat to the ongoing falling waiting lists. Also as I said above it isn't just doctors and nurses needed to make the NHS work it is both them and a conglomerate of essential back room staff. Theatres are on just in time ordering so that procurement or finance as in procuring and paying for drugs and consumables respectively can effectively close the theatres in 3 working days.

@gandalf1957 NHS England is an arm's length agency of the Department for Health and Social Care. Wes Streeting is concerned that it is not sufficiently accountable to ministers and it may be duplicating effort. It did not exactly cover itself in glory over emergency procurement during Covid.

@SunshineGirl I don't suppose it would cover itself in glory over procurement during the pandemic as in England procurement is the responsibility of the individual NHS trusts.

@gandalf1957 NHS England was responsible for buying PPE and has faced criticism for poor supervision and audit of the contracts.

@SunshineGirl NHSE was only responsible for buying some PPE equipment late on during the pandemic for volume buying discounts. I did happen to be working in procurement in a NHS Acute hospital trust throughout the pandemic, on the premises on a daily basis, when if we couldn't complete (as in pay for) PPE purchases in around 20 minutes at one point the PPE was bought by A N Other often outside the UK, and i do know the Trust I worked for bought PPE during the pandemic directly form the suppliers - as I said NHSE had no prior major procurement experience of PPE so little surprise they were not good at it. As a norm Acute hospitals buy in their own PPE equipment directly, they always have a stock of it - just not in sufficient volumes for the Covid pandemic. Also, it has been very easy for lawyers with hindsight to say what and how things should have been done they were all sat at home furloughed whilst Hospital Trusts & NHSE were desperately trying to buy PPE equipment in a worldwide shortage of same.

@gandalf1957 You have strong views on the subject! Streeting will be accountable for what happens next. I think the claims of "waste and duplication" are overstated for the press, but he feels the department is not as responsive as it should be and is rebuilding it.

Yes, it is easy to criticise in hindsight. Personally speaking, I think some blame must be attached to those ministers who set up the "VIP lane" and decided that some favoured companies could mark their own homework.

@SunshineGirl It just wasn't that simple we needed PPE at huge quantities and as i said above we had to pay for it up front driving a coach and horses through the normal purchasing controls and procedures, paying on ordering before knowing the quality of the equipment, otherwise another organisation somewhere in the world got the PPE. Some British suppliers were also supplying foreign countries at astronomical prices ahead of the British needs. Many private nursing and rest homes had no PPE stocks at all and thought the government should be supplying them when in actual fact their directors and shareholders should have been paying themselves less and properly equipping their nursing homes. Some organisations were hurriedly making ventilators from bits from scrap cars supplying those to hospitals as we couldn't purchase ventilators, and amongst all of that we also had the fraudsters sending in invoices for alleged PPE purchases where no purchases had been made. The medics, nurses and back room staff whether in the Hospitals or NHSE worked their arses off. Decisions had to be made in minutes not days. Yes some of those decisions were wrong as were some in government, but I would really wish to have seen how well those lawyers would have done making decisions on the first world wide pandemic for 100 years if they had to make the decisions against the back drop of dying patients including in some cases the Hospital Trusts' own doctors, nurses and backroom staff. My trust lost an electrician, who probably picked up Covid servicing electrical equipment in the theatres. I think there are very few Acute trusts that didn't lose at least one member of staff.

@gandalf1957 My wife was working as a district nurse throughout 2020-21, I have some notion of the pressures you were under.