Johnson's Social Care statement

[IanSuth]

Because you exclude a significant portion of the population who aren't homeowners.

But if you allow all housing wealth to pass down generations you (through the current house prices) are ensuring that only those whose families already hold property can afford to own property in future

Basically you have

1. People with capital invested in property for income via an LTD (not really taxed under this system)

2. People who are owner occupiers who are taxed 1.5% on their earned income but whose property capital is safe (few hit IHT thresholds)

3. People without property who unless wages rise by 1.5% more than rent are going to be paying for this from their takehome and will have even less chance of buying property

I don't think 10% of property value at death (in fact i would go with death of last owning dependant to protect spouses and dependant children) is an onerous or exorbitant amount to expect people to pay up

Harmonising various different taxes such as CGT & Income tax (inc NI) would also make things much simpler for all

 

[UKSBD]

Different grades of rooms - but same staff providing same service, same meals, same medication, same bathing etc.

Why?

 

[thetiger2015]

Without ability to make a profit then you are restricting a service / goods.
Really bad idea - the state paying is one thing, the state being able to provide what is needed and in an efficient manner is another matter entirely.

The state is paying...the state being the taxpayer that is.

Private companies in the care sector don't make much profit from individuals. The tax payer tops everything up or pays for the full care of certain people in our community. These services had previously been handled by NHS affiliated teams, under the taxpayers direct control, through local authority distribution. Over the last 10+ years these same services have been moved to profit making care providers. Pay £30 for 3 nurses 10 years ago, now you pay £60 for 2 nurses, because the rest is used for administrative costs and profit provision.

The staff wages have risen in line with government requirements but providers charge the tax payer (government/local authority) for provision of these services - including admin/management/HR etc. In theory, that should lead to a cost reduction but, it doesn't. Because the private companies run at a profit, which is fine but why is the government outsourcing things at a higher cost?

Now, if it was government run, we would see the problem of mismanagement, because there is no drive to generate profit, you get wastefulness. Which is why Conservatives adore privatisation and the US insurance based health care systems. Max profits, only those with money get care, the poor are kept poor with ridiculous health care/insurance costs, poor performance of frontline staff leads to dismissal...perfection!

The current NHS crisis (every winter it's falling apart a little more) is caused by poor management. The government throw more money at it, the NHS hires more administrative staff and it strangles itself with red tape and confusion. Who's in charge of what? Nobody knows. There's so many layers that nobody can even work out what to do with it. The government will look to privatise, that will cut costs of admin staff but the privatisation will require profits to be made eventually, so costs will rise for the most simple of things. Then you'll end up back to square one again, lots of managers and paper carriers, no actual frontline staff.

Exactly the same problem with mental health care. It's diabolical. Nobody knows who's in charge, there are various care teams with multiple tiers of staff and managers, nobody is actually responsible for anything, they just pass things around the offices like some kind of sick joke. Privatisation doesn't solve that problem, it exacerbates it by seeing individuals as walking piggy banks.

What it really needs is someone to cut the BS and chop off the top 1/3 of management/directorship/administrative roles in government/local authority run departments/organisations.

 

[IanSuth]

What it really needs is someone to cut the BS and chop off the top 1/3 of management/directorship/administrative roles in government/local authority run departments/organisations.

Actually I think a lot of the problem is the process of trying to create an internal market as a sort of quasi privatisation has created vast amounts of duplication. The same with outsourcing

Take as a very small example 111 call administration - that is outsourced separately by most trusts, now once you know that EVERY call to 111 no matter what provider is triaged through the same IT system known as NHS Pathways, you soon realise there is very little opportunity to save costs and really it is obvious that the most efficient solution would be a single massive national call centre (could be spread over different locations) with minimal management levels, it would be the most efficient for call routing & staffing purposes rather than multiple independent bodies all needing to make their own profit and with duplication - economies of scale is day 1 economics

All the tinkering to try and make the nhs "market led" has done is create unnecessary roles, duplication and layers of bureaucracy

Have a look here at the variety of organisations recruiting
https://uk.indeed.com/111-Call-Handler-jobs

 

[japancool]

But if you allow all housing wealth to pass down generations you (through the current house prices) are ensuring that only those whose families already hold property can afford to own property in future

Those are two different issues, but two sides of the same coin.

You can't base a system (in this case, the care system) on the fact that people will own homes that they can sell to pay for it.

The fact of only people who already own property can afford to own property is the reason why you can't base a system on property ownership.

There are countries such as France where renting is more the norm. What do they do?

 

[IanSuth]

Those are two different issues, but two sides of the same coin.

You can't base a system (in this case, the care system) on the fact that people will own homes that they can sell to pay for it.

The fact of only people who already own property can afford to own property is the reason why you can't base a system on property ownership.

There are countries such as France where renting is more the norm. What do they do?

They have higher taxation and a thing called viager occupé which is a sort of equity release. Also when in hospital patients pay E18 towards their board and lodging - i don't know much about elderly care but i suspect that may be similar with regard to contribution. I know they have a large number of council/state run old peoples homes like we had in the 70's/80's and also private homes which cost about 50% more but have a shorter waiting list, people get put on the list and move in when a place becomes available leaving their rental property to be rented to someone else

Edit found a precis
https://www.connexionfrance.com/Practical/Money/price-of-a-French-retirement-home

However, in French law descendants have an obligation towards needy parents and grandparents to help with their essential needs and the council can request they contribute. Recipients of council help must spend 90% of their own incomes on the fees and council benefit can be recuperated from a person’s estate after they die.

 

[Mr D]

Why should the care home nurse pay more (on her already low wages) and yet her landlords income be unnafected? On top of that, her landlord can pass down more of their wealth to their family.

It's a direct tax on the younger, working people in order that the fortunate,who have done sweet FA to 'earn' that housing equity can be 'taxed' less when they pass it on to their children. That's what's wrong with it.

You do know the vote has been done?

 

[Mr D]

The state is paying...the state being the taxpayer that is.

Private companies in the care sector don't make much profit from individuals. The tax payer tops everything up or pays for the full care of certain people in our community. These services had previously been handled by NHS affiliated teams, under the taxpayers direct control, through local authority distribution. Over the last 10+ years these same services have been moved to profit making care providers. Pay £30 for 3 nurses 10 years ago, now you pay £60 for 2 nurses, because the rest is used for administrative costs and profit provision.

The staff wages have risen in line with government requirements but providers charge the tax payer (government/local authority) for provision of these services - including admin/management/HR etc. In theory, that should lead to a cost reduction but, it doesn't. Because the private companies run at a profit, which is fine but why is the government outsourcing things at a higher cost?

Now, if it was government run, we would see the problem of mismanagement, because there is no drive to generate profit, you get wastefulness. Which is why Conservatives adore privatisation and the US insurance based health care systems. Max profits, only those with money get care, the poor are kept poor with ridiculous health care/insurance costs, poor performance of frontline staff leads to dismissal...perfection!

The current NHS crisis (every winter it's falling apart a little more) is caused by poor management. The government throw more money at it, the NHS hires more administrative staff and it strangles itself with red tape and confusion. Who's in charge of what? Nobody knows. There's so many layers that nobody can even work out what to do with it. The government will look to privatise, that will cut costs of admin staff but the privatisation will require profits to be made eventually, so costs will rise for the most simple of things. Then you'll end up back to square one again, lots of managers and paper carriers, no actual frontline staff.

Exactly the same problem with mental health care. It's diabolical. Nobody knows who's in charge, there are various care teams with multiple tiers of staff and managers, nobody is actually responsible for anything, they just pass things around the offices like some kind of sick joke. Privatisation doesn't solve that problem, it exacerbates it by seeing individuals as walking piggy banks.

What it really needs is someone to cut the BS and chop off the top 1/3 of management/directorship/administrative roles in government/local authority run departments/organisations.

I think you will find if you examine it that the care provider can only charge what is in the contract.
That may well include limits on how much any aspect is increased each year.

Having been on the other side of those contracts multiple times they tended to be rigged to cover the costs and make a profit. If agreed then the payment was made in accordance with the contract and the services set down in the contract were provided.
With usually large penalties when contract was breached.

Is the staff doing the work employed by the state doing any different than the staff doing the work employed by a business? May well be the same rate of pay, may well be the same terms and conditions.
Just one has less risk for the state....

 

[UKSBD]

One of the problems with mixing people is it leads to jealousy and a sense of entitlement.

There has to be a minimum service level;
Not so nice room, adequate care, adequate food, adequate comforts

Those who have a bit of money, or house to sell, and are prepared to use this for a nice life, rather than feel as though they should pass it on to children, can afford to have a nicer room, pay a bit extra for more care/companionship, have nicer food, their own furniture/bedding/etc.

Someone comes in sees one old person being looked after adequately and another being looked after far more confortably and this leads to resentment.

 

[thetiger2015]

pay a bit extra for more care/companionship, have nicer food, their own furniture/bedding/etc.

do you mean prison..or...social care?

Everyone should be equal. Gardens to wander in, luxurious quilts, bright and open bay windows, country and sea views. It should be granted to all and money should cease to be of any issue when people enter care. It doesn't work like that but...

 

[thetiger2015]

I think you will find if you examine it that the care provider can only charge what is in the contract.
That may well include limits on how much any aspect is increased each year.

Having been on the other side of those contracts multiple times they tended to be rigged to cover the costs and make a profit. If agreed then the payment was made in accordance with the contract and the services set down in the contract were provided.
With usually large penalties when contract was breached.

Is the staff doing the work employed by the state doing any different than the staff doing the work employed by a business? May well be the same rate of pay, may well be the same terms and conditions.
Just one has less risk for the state....

Oh I know but any contracts are in the favour of the supplier. They've got local authorities over a barrel and they know it. There is a lot of pressure to privatise every inch of the social care system and NHS. Services are being cut all over the place and redirected through private companies, at great cost to the tax payer, because local authorities have no alternative. They cannot leave the elderly or unwell lying around on the streets, so they have to put them with private suppliers. The cost is many multiples more than it was previously, due to the way private companies are organised.

The staff are doing the same job, if anything, under worse conditions right now. Many are excluded from the working time directive, the use of the word 'emergency' has meant a lot of staff are now working excessive hours and things are starting to break. Staff are quitting, Brexit is limiting getting people from outside the UK and COVID 'pings' are seeing thousands of care staff unable to work. However, it seems more like this is planned, rather than by accident. The government are sticking to their guns on this. There is no room to flex. If staff have to work 90+ hours per week, fine. If they drop dead, fine, replace them with a stuffed toy or something. The lack of support, direction or plan is intolerable. That's why this whole Social Care statement is nothing short of hot air and fluff. Just throwing numbers around again.

 

[UKSBD]

do you mean prison..or...social care?

Everyone should be equal. Gardens to wander in, luxurious quilts, bright and open bay windows, country and sea views. It should be granted to all and money should cease to be of any issue when people enter care. It doesn't work like that but...

I was in hospital for a couple of months not long ago

1st few days I was in there I used the perfectly adequate little bars of hospital provided soap, I was given the perfectly adequate little tubs of fruit juice, the ward had perfectly adequate books we could read.

Top of my list for things to bring in when I had visitors were; bars of dove soap, cartons of Tropicanna orange juice, some books from home.

Are you saying the hospital should be providing this, or if not, patients shouldn't be allowed to bring their own in, so as to keep everyone equal?

 

[IanSuth]

Oh I know but any contracts are in the favour of the supplier. They've got local authorities over a barrel and they know it. There is a lot of pressure to privatise every inch of the social care system and NHS. Services are being cut all over the place and redirected through private companies, at great cost to the tax payer, because local authorities have no alternative. They cannot leave the elderly or unwell lying around on the streets, so they have to put them with private suppliers. The cost is many multiples more than it was previously, due to the way private companies are organised.

The staff are doing the same job, if anything, under worse conditions right now. Many are excluded from the working time directive, the use of the word 'emergency' has meant a lot of staff are now working excessive hours and things are starting to break. Staff are quitting, Brexit is limiting getting people from outside the UK and COVID 'pings' are seeing thousands of care staff unable to work. However, it seems more like this is planned, rather than by accident. The government are sticking to their guns on this. There is no room to flex. If staff have to work 90+ hours per week, fine. If they drop dead, fine, replace them with a stuffed toy or something. The lack of support, direction or plan is intolerable. That's why this whole Social Care statement is nothing short of hot air and fluff. Just throwing numbers around again.

So much so that when a few years ago a court case changed how care staff were paid for travel between clients some care providers just handed the contracts back to the councils saying "sorry non profitable" they then had to be re-contracted out at a higher rate. The same will happen here if private providers decide that Employers NI (or payrises required to keep staff) don't leave enough meat on the bone they just walk away and wait for a higher rate

There is no risk to the providers so they are not really removing risk from the state

Found a story about it
https://www.homecare.co.uk/news/art...ravel-time-to-visit-vulnerable-in-their-homes
“UKHCA has consistently highlighted the implications of the way that home care services are purchased by councils and the NHS, usually at extremely low hourly rates, and often calculated solely according to the number of minutes of care delivered.

"This judgement adds weight to the need to correct the unacceptable purchasing methods used in state-funded home care.”

 

[IanSuth]

I was in hospital for a couple of months not long ago

1st few days I was in there I used the perfectly adequate little bars of hospital provided soap, I was given the perfectly adequate little tubs of fruit juice, the ward had perfectly adequate books we could read.

Top of my list for things to bring in when I had visitors were; bars of dove soap, cartons of Tropicanna orange juice, some books from home.

Are you saying the hospital should be providing this, or if not, patients shouldn't be allowed to bring their own in, so as to keep everyone equal?

I would agree, unless yo are a snob standard hospital provision if fine, even the food is pretty good. Only issue my wife had last time she was in was the fact her 1st meal was chosen by last patient and one day her "quiche" was the hugest 3" deep cheese and egg pie you have ever seen which wasnt good when she was a bit bunged up. Definitely better than what we used to get as school food in the 70's and 80's. Linen was clean, toilets were close and clean and other than being a bit stuffy as you couldnt open the windows much is was a nice environment

 

[Alyson Dyer]

Isn't that why those who do have the money end up paying top dollar for the same care, in the same home, with the same staff?

It's not a dig at care homes, they've got wages and bills to pay.

The LA have to suck it up or insist on a cheaper home if there is one. And yes, the care home freely admit that the self funders, supplement the LA funded

 

[Alyson Dyer]

The other side of the coin is where someone is watching the savings he worked bloody hard to get disappearing at a rate of knots and his kids facing little or no inheritance, sitting in the care home chair next to someone who could have worked but didnt, could have saves but didnt, could have bought a home but spent his money on other things and is getting exactly the same care at no cost to him at all.
That can’t be fair can it? It is rewarding the feckless.

 

[japancool]

1st few days I was in there I used the perfectly adequate little bars of hospital provided soap, I was given the perfectly adequate little tubs of fruit juice, the ward had perfectly adequate books we could read.

When I was in hospital for several months, I lost a lot of weight due to inadequate and borderline inedible food. I virtually stopped eating for a while because I just couldn't stomach it.

That is, until I discovered the ethnic menus. So while my wardmates got cheap and nasty sausage sandwiches, horrible dry fish and chips on Fridays and other similar dishes, I got chicken chasseur and roast chicken from the kosher menu, curried goat from the Afro-Caribbean menu amongst other things. Of course, I am neither Jewish nor Afro-Carribbean.

I didn't bother to let everyone else know about the ethnic menus.

Definitely better than what we used to get as school food in the 70's and 80's.

The desserts were exactly what we used to get in halls as students. Apple crumble, fruit salad, custard with everything.

I'll admit, hospital food is fine if you're only in for a few days. If you're in for a month, not so much.

But, you can order takeaways to be delivered to your ward!

 

[Mr D]

do you mean prison..or...social care?

Everyone should be equal. Gardens to wander in, luxurious quilts, bright and open bay windows, country and sea views. It should be granted to all and money should cease to be of any issue when people enter care. It doesn't work like that but...

Be a very isolated place to have both sea and country views.

Seriously we should provide decent care for our senior citizens when they cannot care for themselves.
Just we don't want to pay for it and we don't want them to pay for it themselves.

 

[Mr D]

Oh I know but any contracts are in the favour of the supplier. They've got local authorities over a barrel and they know it. There is a lot of pressure to privatise every inch of the social care system and NHS. Services are being cut all over the place and redirected through private companies, at great cost to the tax payer, because local authorities have no alternative. They cannot leave the elderly or unwell lying around on the streets, so they have to put them with private suppliers. The cost is many multiples more than it was previously, due to the way private companies are organised.

The staff are doing the same job, if anything, under worse conditions right now. Many are excluded from the working time directive, the use of the word 'emergency' has meant a lot of staff are now working excessive hours and things are starting to break. Staff are quitting, Brexit is limiting getting people from outside the UK and COVID 'pings' are seeing thousands of care staff unable to work. However, it seems more like this is planned, rather than by accident. The government are sticking to their guns on this. There is no room to flex. If staff have to work 90+ hours per week, fine. If they drop dead, fine, replace them with a stuffed toy or something. The lack of support, direction or plan is intolerable. That's why this whole Social Care statement is nothing short of hot air and fluff. Just throwing numbers around again.

Its a bit of both - the bidder has to factor in known costs and expected unknown costs and profit. The higher the risk the higher the price. The council decides based on multiple factors however price has a higher weighting for decision making than some other aspects. Price too high and you put weeks of work into a bid to have it rejected. Waste of time and money.
The council often has limits in the contract about increases, plus penalties (you do NOT usually risk getting to pay penalties unless HM Government).

Local authorities have plenty of other options. Rather than pay someone else to do it for a fee they can instead do the work themselves. With the associated risks, cost overruns, staffing, union involvement etc.
Not necessarily cheaper.

My younger brother is currently working at an NHS hospital in A & E, an aux nurse with many years experience. He was doing a 72 hour week until 3 weeks ago, when he dropped down to a 60 hour week temporarily due to his son being quite ill. Been many months since he last did his contracted hours, his employer had no choice but to use up the staff.
State employee that he is, he can't really tell them where to get off.

An employer is not always in a position to stick to working time directive. Certainly can't see many people insisting the staff should stick to the working time directive in A&E places with 9 hour waiting time...

Staff are often quitting low paid jobs - when paid minimum wage and replacement job pays the exact same wage then it comes down to other factors than pay that attract people to move jobs.
The current shortage has had knock on effects on HGV driver pay - its also impacted pay elsewhere.
Was reading the other day, a care home manager complaining that a long serving member of staff on £10 odd an hour had left to go work at amazon on £13.50 an hour. That is a big boost in take home pay....

My missus has been on minimum wage the past couple of years. Today she got a letter, 20% pay rise. She works in the private sector as a key worker....
Pretty sure if she worked for the state she wouldn't get much. I hear the lowest levels state workers at national level got 1 to 2 percent while most of the rest got no pay rise this year. Work dead hard for a year and get no reward....

 

[Mr D]

When I was in hospital for several months, I lost a lot of weight due to inadequate and borderline inedible food. I virtually stopped eating for a while because I just couldn't stomach it.

That is, until I discovered the ethnic menus. So while my wardmates got cheap and nasty sausage sandwiches, horrible dry fish and chips on Fridays and other similar dishes, I got chicken chasseur and roast chicken from the kosher menu, curried goat from the Afro-Caribbean menu amongst other things. Of course, I am neither Jewish nor Afro-Carribbean.

I didn't bother to let everyone else know about the ethnic menus.



The desserts were exactly what we used to get in halls as students. Apple crumble, fruit salad, custard with everything.

I'll admit, hospital food is fine if you're only in for a few days. If you're in for a month, not so much.

But, you can order takeaways to be delivered to your ward!

Ah the fun of hospital food.
500 calories a day intake if pushed, as you say lots of the food inedible.

I keep suggesting to my wife next time I'm rushed to hospital she should do me a bag of food to go. Snacks and sauces and half a bucket of KFC chicken....

 

[Mr D]

The other side of the coin is where someone is watching the savings he worked bloody hard to get disappearing at a rate of knots and his kids facing little or no inheritance, sitting in the care home chair next to someone who could have worked but didnt, could have saves but didnt, could have bought a home but spent his money on other things and is getting exactly the same care at no cost to him at all.
That can’t be fair can it? It is rewarding the feckless.

This has been happening for many years.
Some pensioners put money away in private pension schemes or paid into employer pension schemes. Some did not.

Some ended up in a nice bungalow say, having worked and spent considerable money over the years on a mortgage on house after house, eventually retiring and getting a bungalow.
Just down the street can be housing association bungalows for those unable to buy one.

You can work hard all your life and end up on state pension plus pension credit.
Or work hard all your life, put a bit of money aside when you can and end up on state pension plus pension credit.
Two people, one spending all he had, one spending a large chunk but putting some away into a pension which of course cost him at the time.

And near enough same weekly income in retirement....

 

[Ian J]

Whatever happened to people looking after their own parents and grandparents?

What a quaint old fashioned idea.

 

[Ian J]

Economic reality:

- Pouring money into an inefficient system will make it less, not more efficient
- The NHS isn't under-funded, it is corrupt, monumentally inefficient and in need of a complete overhaul.
- Some nurses are wonderful, some are lazy and useless. (A few deliberately kill patents)

Whatever your political leanings, the actual problem is one of democracy. No political leader could ever survive standing up and telling the truth about the NHS!

My wife is a nurse and she happily confirms what you say that many nurses are lazy and useless. My feeling is that much of this is caused by the RCN who in their drive to put nurses on a par with doctors have increased the educational qualifications needed to enter the profession so that we end up with nurses who are good at getting academic qualifications rather than those who have a passion for the work.

A couple of years ago I watched a discussion between half a dozen ex Secretaries of State for Health of both red and blue hue discussing the NHS and they all agreed that one of the major problems with the NHS were the doctors who seemed to reject any proposal for change as a matter of course

 

[DavidWH]

The other side of the coin is where someone is watching the savings he worked bloody hard to get disappearing at a rate of knots and his kids facing little or no inheritance, sitting in the care home chair next to someone who could have worked but didnt, could have saves but didnt, could have bought a home but spent his money on other things and is getting exactly the same care at no cost to him at all.
That can’t be fair can it? It is rewarding the feckless.

^^ THIS ^^

I know a few feckless people, who don't really care about their future as that's someone else's problem.

"Why would I want to buy a house? Anything goes wrong on my rented house the landlord has to fix it" is their mentality, oblibious to the fact they're paying over the odds in rent, so their landlord is making a profit in their rent, all the while the asset increases.

But they simply don't care. When they retire or can't work, someone else picks up the bill.

I know people who've been laid off recently, homeowners had to pay their mortgage whilst renters got their rent paid through Universal Credit.

It does make me wonder who are the feckless ones?

I've a plan, that by the time I'm due for a care home there won't be much money left

 

[Mr D]

My wife is a nurse and she happily confirms what you say that many nurses are lazy and useless. My feeling is that much of this is caused by the RCN who in their drive to put nurses on a par with doctors have increased the educational qualifications needed to enter the profession so that we end up with nurses who are good at getting academic qualifications rather than those who have a passion for the work.

A couple of years ago I watched a discussion between half a dozen ex Secretaries of State for Health of both red and blue hue discussing the NHS and they all agreed that one of the major problems with the NHS were the doctors who seemed to reject any proposal for change as a matter of course

Yes, BMA is the doctors union and often is against change.
Come to think of it, they were against the change that saw junior doctors no longer working a 96 hour shift too....

 

[Mr D]

^^ THIS ^^

I know a few feckless people, who don't really care about their future as that's someone else's problem.

"Why would I want to buy a house? Anything goes wrong on my rented house the landlord has to fix it" is their mentality, oblibious to the fact they're paying over the odds in rent, so their landlord is making a profit in their rent, all the while the asset increases.

But they simply don't care. When they retire or can't work, someone else picks up the bill.

I know people who've been laid off recently, homeowners had to pay their mortgage whilst renters got their rent paid through Universal Credit.

It does make me wonder who are the feckless ones?

I've a plan, that by the time I'm due for a care home there won't be much money left

LOL - one of my friends has a plan. Amassed quite considerable assets over time, either they leave the assets to the family or on retirement slowly liquidate them and travel the world.
Enjoying themselves rather than making sure they still have £30k joint income when they get too old to enjoy it.
Its a workable plan for them.

 

[IanSuth]

Ah the fun of hospital food.
500 calories a day intake if pushed, as you say lots of the food inedible.

I keep suggesting to my wife next time I'm rushed to hospital she should do me a bag of food to go. Snacks and sauces and half a bucket of KFC chicken....

We are obviously lucky, the food for my wife was great, too much if anything. And the staff canteen/restaurant is so good that it is also open to ambulant patients to go to if they wish and pay the same amounts as the staff for the same choices.

I would put any of it's choices as far ahead of a McD KFC as you seem to place them above your trusts food

 

[Mr D]

We are obviously lucky, the food for my wife was great, too much if anything. And the staff canteen/restaurant is so good that it is also open to ambulant patients to go to if they wish and pay the same amounts as the staff for the same choices.

I would put any of it's choices as far ahead of a McD KFC as you seem to place them above your trusts food

I like KFC and McD for fast food - a nice treat on occasion.
I find them better than hospital cafeteria food. And they are open on weekends too, unlike the cafeteria.

Used to be a lovely cafe near the hospital that delivered to staff and patients. Charged a £3 delivery fee but could be 15 - 20 minutes walking for one order so couldn't complain.
It shut down .... and everyone else takes longer or refuses to go to the ward entrance.
A 40 minute walk to the entrance to get a meal that is cooling.... then a walk back to the ward?
Not happening for me.