[Misc] How can the NHS survive in its current form ?

wellquickwoody · Jan 10, 2023

Biscuit said:
Only the Tories will convince you it can't: because they want to privatise it.

The UK without an NHS is a horrifying thought.
In the USA, 500,000 families a year go bankrupt due to medical bills. Imagine that? Nice house, car, money for holidays.. all gone because you got cancer and didn't have the correct insurance.

Or maybe do it like Aus, life threatening/serious health issues treated brilliantly by the public sector but you are encouraged to use private insurance for far less serious problems (ie long wait times). Combine this an element of being initially charged up front by many GPS (can be reclaimed later) and you have wheedled out a huge proportion of those who do not actually need a doctor but clog up the system. Can only say that so far I have been very impressed by health provision over here, puts the NHS to shame.

beorhthelm · Jan 10, 2023

Bold Seagull said:
Where's the data / info. coming for that?

I know we have one of the lowest number of hospital beds per 1000 people compared to EU countries, currently at around 2.7.

probably standard published data from each country, same place you get number of beds per 1000. i expect both are crude numbers from (number of nurses/number of beds), without consideration of what defines beds and nurses between countries. we have fewer beds than peers but have a stricter definition than others.

also, i note Italy, Spain, Portugal spend a fair bit less than us on healthcare. dont know what the comparisons are for clincial outcomes though. last time i checked its all very variable by different conditions or other measures.

dazzer6666 · Jan 10, 2023

fly high said:
Think you find most people do, shorter waiting times.

Not always that simple……the insurance company will often push you down the NHS route first, excesses and max allowances per year and/or condition usually apply, certain things aren’t covered etc etc. I had a potential heart defect picked up in a routine (private) annual medical, ended up having apps with a senior consultant on the NHS because he ‘couldn’t be arsed with the insurance company admin, they make life too difficult’.

Bold Seagull · Jan 10, 2023

beorhthelm said:
probably standard published data from each country, same place you get number of beds per 1000. i expect both are crude numbers from (number of nurses/number of beds), without consideration of what defines beds and nurses between countries. we have fewer beds than peers but have a stricter definition than others.

also, i note Italy, Spain, Portugal spend a fair bit less than us on healthcare. dont know what the comparisons are for clincial outcomes though. last time i checked its all very variable by different conditions or other measures.

Yes I found it, so interesting that we have one of the lowest numbers of beds per 1000 people of EU countries. Undoubtedly that skews the ratio of nurses to beds. Germany has 8 hospital beds per 1000 people, we have 2.7. It actually means we have a similar number of nurses per 1000 people, just not available beds.

Harry Wilson's tackle · Jan 10, 2023

king Wombat said:
you don't actually know that though do you. The % of GDP funding to the NHS has been cut by the tory party. Under the Labour admin 97-2010 it was consistently higher.

In 2010, the NHS had it's highest satisfaction ratings ever. Now its' probably the lowest it's ever been. The Lansley reforms done around 2012 were dreadful and are have made it far worse.

Our ratio of beds/Doctors/Nurses to patients is far lower than many other similar sized countries.
The Tory party decimated social care, and now surprise surprise we're finding that it's causing knock on issues with the NHS.

In the run up to this winter, various high up NHS chiefs were saying they weren't going to be able to cope with the Winter rush . The tory party were too busy running their own internal battles to actually do anything about it rather than chuck out a few vague platitudes.

It definitely does need more money, get the workforce back on side and as an aid to boost recruitment.
It also needs a cross party consensus to remove the political element from it and put in a long time plan to make it function properly.

I would just like to say that you are replying to the person who was replying to me, not no me.

A1X · Jan 10, 2023

Amazing how people will keep voting Tory then wonder why the NHS doesn’t work anymore.

nickbrighton · Jan 10, 2023

I see that a "only call 999 if you really have to" request has gone out for Wednesdays strike. nothing wrong in that, however surely you should only be calling 999 when you really have to anyway?
Part of the problem is the number of people using A&E , calling Ambulances as a first point of contact with the NHS rather than as an emergency.
Its the same with Drs surgeries, how many people go to the Dr when a quick visit to a pharmacy for advice would sufice?

Obviously the problems run much deeper than simple misuse of the various parts of the NHS, but last time I visited A&E there were posters all over indicating that well over a third (it may have been two thirds) of people should be elsewhere. Imagine your local A&E with a third less patients, the freeing up of staff time would be enourmous, or your Drs surgery with I assume similar numbers. Of course it wouldn't solve the crisis in the NHS, but it would certainly relieve the pressure

A1X · Jan 10, 2023

FIVESTEPS · Jan 10, 2023

The only way forward is preventative medicine(yes i know im pissing in the wind) but imagine if people took a little more care of their health.Years ago a renowned oncologist Jan de Winter after retiring set up a shop in new road attempting to educate people because after years of treating cancers he felt many where avoidable.

WATFORD zero · Jan 10, 2023

Bold Seagull said:
Yes I found it, so interesting that we have one of the lowest numbers of beds per 1000 people of EU countries. Undoubtedly that skews the ratio of nurses to beds. Germany has 8 hospital beds per 1000 people, we have 2.7. It actually means we have a similar number of nurses per 1000 people, just not available beds.

I have to say that in my experience on NSC, if there's anyone who can take a headline figure from somewhere obscure, accidentally completely misinterpret it and then post it as a fact, time after time (with a complete lack of capitals). I gave up long ago :shrug:

Herr Tubthumper · Jan 10, 2023

Rdodge30 said:
I don’t have a solution- I don’t believe anyone does

There are numerous solutions. A number of countries have health care services preferable to the NHS. Just copy what they do. But, it will cost you.

beorhthelm · Jan 10, 2023

Bold Seagull said:
Yes I found it, so interesting that we have one of the lowest numbers of beds per 1000 people of EU countries. Undoubtedly that skews the ratio of nurses to beds. Germany has 8 hospital beds per 1000 people, we have 2.7. It actually means we have a similar number of nurses per 1000 people, just not available beds.

right, could we deploy nurses differently?

Bold Seagull · Jan 10, 2023

beorhthelm said:
right, could we deploy nurses differently?

No, we need more beds!!

I think you’ve taken it too literally the 3 nurses per bed.

Doonhamer7 · Jan 10, 2023

I think what we have is brilliant but it cannot survive as it is— we need a new model (not the US one!). I don’t know what the answer is but we need to de-politicise the debate to make it work

1) it is not a “national health service” - it’s currently the national sick service. Think how many of you engage with the nhs before your ill - next to no one. So we all need to start having “MOTs“ and engage early
2) we have an aging population as a percentage of population so becomes harder to support and will become unsustainable as it is
3) we are an unfit nation - that doesn’t help at all
4) we may all have to take dna tests very early - so preventive medicine can happen early - yes I know all the scare stories of life assurance companies using this against you. examples - if you have higher %age neanderthal blood - this is great when young as your blood clots quicker so you heal quicker, once over 50 this is an issue as thick blood = increased risk of stroke, so what is preventive action to reduce chance.
5) most European models have some form of payment - we need to start thinking we need to pay something like we do for dentistry / eye test
6) nhs needs some form of ‘commercial’ thought - not privatisation which will be won by cheapest bidder who needs to cut to save to make profit. - but the wastage i hear from friends who work there is horrendous
7) if you don’t turn up for appointments should you be charged?

beorhthelm · Jan 10, 2023

Bold Seagull said:
No, we need more beds!!

I think you’ve taken it too literally the 3 nurses per bed.

i agree! there's obviously not literally 3 nurses to each bed.

Rdodge30 · Jan 10, 2023

Harry Wilson's tackle said:
I asked myself: What has 2014 got to do with today? How was the question worded? How was the 65% calculated?

I have now done a little research and your statements appear to be somewhat out of data. Here from the BMJ: doi: https://doi.org/10.1136/bmj.o942

"The results of the latest British Social Attitudes (BSA) Survey of satisfaction with the NHS and its services make grim reading for general practice.1 In 2021, satisfaction with GPs fell an unprecedented 30 percentage points to its lowest ever level of 38 per cent.2 This is a shocking fall: from the survey’s inception in 1983 until 2018, general practice had held the top spot over all other NHS services in every year, even if by 2018 satisfaction had already fallen from its last peak of 80% in 2009.

What’s driving this drop? It will probably be no surprise that the main reason for dissatisfaction with the NHS expressed by participants in the survey was the difficulty in getting appointments. The fall in satisfaction is not due to the quality of care received, it’s getting access to that care in the first place.

However, let’s be clear, this is not a problem caused by covid-19, even though it has been exacerbated by it. Activity has been rising and is higher than ever before, but year-on-year demand growth has outstripped available capacity. Longer term drivers of rising demand—a growing population with many experiencing long term conditions—have been magnified by covid-19 as people stayed away from the service at the beginning of the pandemic, but are now presenting with needs that must be addressed." and so on

Since the May/Johnson (and subsequent pygmy) regimen, things have been going downhill alarmingly it would

The point I tried to make when I first posted on this thread was that (as far as I can tell) the same problems with the NHS have been happening throughout every Government I can remember- NHS in crisis, underfunded…as far back as Callaghan.

When you replied that NHS satisfaction was at “the highest ever” at the end of the most recent Labour Government I checked it as it seemed unlikely. From 1948 until 2010 ?? As I said the ratings only date back to 1983 , 2010 was indeed the highest satisfaction rating since 1983. I jumped on it because it seemed like a rash statement and an unlikely one. We are similar as you yourself asked source please. However that is all a bit of a distraction to be honest

My view on the NHS is that the current model needs changing and no amount of money will make it efficient as it stands.

Sir Keir Starmer’s current view:

The Labour leader said: “A number of people do go as NHS patients to the private sector, our research shows that that’s been under-used and we could do more of it and that would clear 230,000 people off the waiting list every year.”

Although he added: “But let me be clear, we are not talking about privatising the NHS, we are talking about using the private sector effectively and free at the point of use as an absolutely governing principle as we go into this review but we do need change and reform.

I agree with this sentiment, although I’m not sure a great many dyed in the wool Labour voters will.

I think the way forward would be for the PM Chancellor and Health Secretary to meet with The opposition Leader, Shadow Chancellor and Shadow Health Secretary and develop, finance and implement Sir Keir’s plan.

I won’t hold my breath

Flagship · Jan 11, 2023

I know this is controversial but I can't understand why we spend so much money keeping people, young and old, alive when they have no quality of life. One little injection in the right circumstances would save billions.

Also I dont get it that people get free prescriptions at 60 when they are still working. People should pay for their prescriptions unless they are on benefits.

I also get fed up with getting letters from my doctor inviting me in for screening for things I have little chance of having. I'd rather they treat the sick and save money for those in urgent need.

Cotton Socks · Jan 11, 2023

Has anyone here used the 111 service or the online thing? I'd have gone to A&E 20 times for myself or family members if I took their response seriously. When I really did need to speak to someone on Xmas Day as I didn't want to call an ambulance but did actually want to speak to a Dr to put my mind at rest, I gave up after an hour on hold listening to their shite music. I didn't want to call an ambulance as I knew they'd be bloody busy & I was lucky/unlucky enough to have a good idea what was happening. What happened to the times when I could just ring the out of hours GP give an explanation of what had happened and they'd give me sensible advice. If I had eventually got through to 111, I'd have spoken to someone who reads off the sheet & if the answers don't correspond to the sheet, they either get a Dr to call you back or tell you to call an ambulance. It nearly always ends in call an ambulance or make an appt with your GP. The only time when 111 was any help was when jnr had an infected blister and I couldn't get through to my GP, 111 trusted my judgement and sent through a prescription for anti-biotic cream.
I had to trust my judgement on Xmas Day but if I had got it wrong, I would be asking some serious questions as to why I was on hold for an hour to 111 before I gave up. I knew they'd tell me to call an ambulance which would've taken at least another hour & if my judgement call was wrong it could've been very serious. I do have a bit of medical knowledge so I wasn't just guessing.
No idea how to fix it but when it's so disjointed that you have people turning up at A&E for something silly that a GP could easily deal with if you can get an appointment & on the other side people like me who wont call an ambulance just in case someone is having a heart attack and they need it more, or dismisses minor things for GP appointments (as they're so hard to come by) which end up being a major problem as we're almost being told 'not to bother' the GP. It's all a bit f**ked & the 111 service is bloody useless, no disrespect to the poor sods that have to answer the phone,

Cotton Socks · Jan 11, 2023

Flagship said:
I know this is controversial but I can't understand why we spend so much money keeping people, young and old, alive when they have no quality of life. One little injection in the right circumstances would save billions.

Also I dont get it that people get free prescriptions at 60 when they are still working. People should pay for their prescriptions unless they are on benefits.

I also get fed up with getting letters from my doctor inviting me in for screening for things I have little chance of having. I'd rather they treat the sick and save money for those in urgent need.

I don't think that your quality of life care argument is controversial. Actually I don't think any of it is controversial apart from the screening things, they must pick out a lot of things? Maybe, I've never actually gone to one as I'd be taking up time for someone who 'should' be having one! It's constant circles.

Boys 9d · Jan 11, 2023

Rdodge30 said:
Sir Keir Starmer’s current view:

The Labour leader said: “A number of people do go as NHS patients to the private sector, our research shows that that’s been under-used and we could do more of it and that would clear 230,000 people off the waiting list every year.”

When I lived in France, my then wife had two operations in a private clinic which were paid for by the French Health Service. It did however cost 5 Euros per day to cover all food and drink which typically French included 25cl. of wine with the main meal.

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