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

[Herr Tubthumper]

I don't think that your quality of life care argument is controversial.

How do you judge quality of life? There’s people I know who lead dull lives…..not sure I want them exterminated though.

 

[dazzer6666]

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.

Lost my brother in law last year to bowel cancer. He never responded to the regular screening requests he got. Aside from the human cost of the illness, the cost of screening relative to the treatment required is miniscule.

 

[Herr Tubthumper]

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.

Lost my brother in law last year to bowel cancer. He never responded to the regular screening requests he got. Aside from the human cost of the illness, the cost of screening relative to the treatment required is miniscule.

This. The more cost effective approach is to be checked regularly. I get vouchers every year over here to be checked for numerous things.

 

[Nobby]

The answer to the OP's question is never ever let the Conservative Party loose with the NHS again.

It will take generations now to fix what they have done

Liars, charlatans, crooks, avaricious, uncaring bastards the lot of them

 

[warmleyseagull]

Some good points on here that I won’t repeat; just to say I’m general that the free at point of entry model no longer works, and politicians of all colours should be hones and say so. It has never been case for dentistry or opticians.

I have two sons in NHS, one a haematology consultant, the other an A&E registrar. There are three things they believe would make a colossal difference:

1. Understanding and reacting to risk. A&E doctor says he could see twice as many patients per shift as he does currently if he had less work to do after seeing each patient, particularly if they are discharged. The ‘formalities’ are required to minimise the chance of a complaint/legal fight afterwards (like most A&E doctors he has suffered the problem of complaint after sending someone home who later died; they would have done anyway but never mind). His view is simply that if either it is just accepted that mistakes do occasionally happen or that patients/relatives actually sign a waiver to this effect, then the far bigger risk of patients waiting hours would be much reduced;

2, Use of technology. The process of keeping patient notes is painstakingly 1970s, for example. One of them spent an hour trying to get something printed at weekend because there are no IT personnel available then (the printer needed ink!). Far more can be done via video conferencing; a very simple change would be to record patient notes and download them as audio files end of shift. Think about the comparison with the commercial world where productivity is so important and generally improved with technological solutions;

3. Our perception of NHS as our servant that is always there however small our need. All I need to say on this is A&E doctors quote that he liked the sessions when England were playing as less than half the usual number of people came in. Funny how emergencies reduce when there is something good on telly. We must take some responsibility too: responsibility to look ourselves better; responsibility to seek help elsewhere sometimes (we had a case near us when a woman complained that it took 7 hours for ambulance to arrive. All she needed was help getting up, and admitted later she could have asked her son instead); responsibility to others whose needs maybe greater.

I am pleased to see this has not developed into a political thread; bar one or two outliers we have not the ‘get rid of Tories and all will be alright’ posts. It won’t because the system is not fit for purpose any longer and pretending a change of government will change everything is delusional. My sons are not Conservative supporters but are saying the same thing.

 

[Harry Wilson's tackle]

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

You are mixing me up with another poster. I didn't say that.

I am not sure what is new in Kier's 'plan'. Recently the NHS sent me to a private hospital for a scan so we are already using the private sector 'free at the point of use'. The problem with this is that it is not free, and the private hospital will charge the NHS at the going private rate. If Kier's plan is to use private resources and not pay for them, the plan won't work. If he is going down the Blair 'public/private partnership' route I will oppose it. This is a distraction from the core problem which, despite what you say (happening since Callaghan) is a new and acute problem of NHS failure, which is to my mind, forseen and condoned by those tories who want the NHS destroyed.

 

[fly high]

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,

Unfortunately out of hours GP care from your own GP went when they were given a new improved contracts by the Blair government.

 

[BLOCK F]

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,

I agree with this.
When my mother and father were alive (retired nurse and GP), I have to say, that on the whole, the 111 service was at best poor and at worst abysmal.
There may be a number of reasons for it, but I fundamentally believe that if the GP service hadn’t become a shadow of what it was, only a few years ago, then many of the problems we are experiencing with the NHS today would not be as bad.
No, we will never go back to the golden age of family doctors, like my father, and I wouldn’t expect anyone to work has hard as he did, but he was dedicated to his vocation and his patients and never complained. However, I do wonder sometimes whether those joining the medical profession are always in the right job.
In his latter years, my old man grumbled about about both the Government of the day and some of the doctors in the NHS. I think he had a point, but to be fair, he always sang the praises of those he considered worthy!

 

[portlock seagull]

How do you judge quality of life? There’s people I know who lead dull lives…..not sure I want them exterminated though.

Precisely. Gates at Selhurst would drop dramatically for example

 

[BLOCK F]

The answer to the OP's question is never ever let the Conservative Party loose with the NHS again.

It will take generations now to fix what they have done

Liars, charlatans, crooks, avaricious, uncaring bastards the lot of them

Simplistic bollocks.

 

[nicko31]

When you underfund a health system this is what you get...

Extra deaths in 2022 close to highest level in 70 years - how much are NHS failings to blame?

Over a thousand more people are dying every week than expected, and many of these extra deaths are happening at home. Are NHS delays the problem? Or is it the long tail of the COVID pandemic? Sky News breaks down the numbers - and how they compare to what's happening in other countries.

news.sky.com

 

[Kinky Gerbil]

When you underfund a health system this is what you get...

Extra deaths in 2022 close to highest level in 70 years - how much are NHS failings to blame?

Over a thousand more people are dying every week than expected, and many of these extra deaths are happening at home. Are NHS delays the problem? Or is it the long tail of the COVID pandemic? Sky News breaks down the numbers - and how they compare to what's happening in other countries.

news.sky.com

Well that and when you actively encourage people to stay away for almost 2 years, cancel some treatment and some GPs refused to see anyone.

 

[Titanic]

Nuffield Trust analysis of NHS spending....

The past, present and future of government spending on the NHS

With the Chancellor making further updates to government spending plans and the health service facing crisis on several fronts, there is uncertainty over what the future will hold for health care finances amid such instability. How much is this government really spending on the NHS per person...

www.nuffieldtrust.org.uk

 

[nicko31]

Well that and when you actively encourage people to stay away for almost 2 years, cancel some treatment and some GPs refused to see anyone.

Yeah, with a decade plus of underfunding in the bag, maybe we should have gone for more Covid deaths to ease the current situation.

 

[BLOCK F]

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

Some people are going to A&E because of the difficulties in getting to see a GP.
I may be at odds with some on here, but I don’t get this ‘pop down to your local pharmacy’ thing. Yes, they can advise on a limited number of conditions, but they are not doctors, do not have the expertise to examine or advise in many instances and talking to a friend who works in a pharmacy , simply don’t have the time to advise all those who are told to go to the pharmacy.
Finally, as regards visiting your local GP, how many don’t bother with the hassle of trying to get an appointment and end up neglecting their condition with the result that it gets worse than it should!

 

[drew]

Some good points on here that I won’t repeat; just to say I’m general that the free at point of entry model no longer works, and politicians of all colours should be hones and say so. It has never been case for dentistry or opticians.

I have two sons in NHS, one a haematology consultant, the other an A&E registrar. There are three things they believe would make a colossal difference:

1. Understanding and reacting to risk. A&E doctor says he could see twice as many patients per shift as he does currently if he had less work to do after seeing each patient, particularly if they are discharged. The ‘formalities’ are required to minimise the chance of a complaint/legal fight afterwards (like most A&E doctors he has suffered the problem of complaint after sending someone home who later died; they would have done anyway but never mind). His view is simply that if either it is just accepted that mistakes do occasionally happen or that patients/relatives actually sign a waiver to this effect, then the far bigger risk of patients waiting hours would be much reduced;

2, Use of technology. The process of keeping patient notes is painstakingly 1970s, for example. One of them spent an hour trying to get something printed at weekend because there are no IT personnel available then (the printer needed ink!). Far more can be done via video conferencing; a very simple change would be to record patient notes and download them as audio files end of shift. Think about the comparison with the commercial world where productivity is so important and generally improved with technological solutions;

3. Our perception of NHS as our servant that is always there however small our need. All I need to say on this is A&E doctors quote that he liked the sessions when England were playing as less than half the usual number of people came in. Funny how emergencies reduce when there is something good on telly. We must take some responsibility too: responsibility to look ourselves better; responsibility to seek help elsewhere sometimes (we had a case near us when a woman complained that it took 7 hours for ambulance to arrive. All she needed was help getting up, and admitted later she could have asked her son instead); responsibility to others whose needs maybe greater.

I am pleased to see this has not developed into a political thread; bar one or two outliers we have not the ‘get rid of Tories and all will be alright’ posts. It won’t because the system is not fit for purpose any longer and pretending a change of government will change everything is delusional. My sons are not Conservative supporters but are saying the same thing.

Regarding your first point, how do you then deal with situations when people have suffered or died due to actual negligence. It's easy for your sons to say they could deal with twice as many but they still need to record what treatments etc have been given. You could apply that to all walks of life. How would you feel if it was decided that road accidents would have no liability attached to them because 'accidents happen'. If you lost a family member, possibly the wage earner due to an accident that wasn't their fault, how would you feel about not being able to get compensations.

As for records, you can't quickly scan audio notes. If there is a technical issue regarding access to them then you still need an IT technician to resolve it!! As for the reference about the England games, of course you're going to see less because people are generally sitting down not doing anything so less likely to have an accident. People with strokes, heart attacks etc are still going to call for an ambulance.

As for the reference to politics, like it or not, this is a political decision and the state of the NHS is due to decisions taken by the Tories over the last 12 years. Starting with Lansbury's unnecessary restructuring. Take pay, in 2010 there was a pay freeze for public sector workers which as seen them fall behind in real terms. At that time, MPs pay was also frozen. However they have since had pay rises that have put them slightly ahead in real terms. The rest of the public sector have not!

It is well known that many senior conservatives have promoted a different system, even writing about it. Jeremy Hunt was one of those calling for an insurance system and he was put in charge of the NHS!

I'm surprised that your son in A&E has made no reference to the throughput of patients; bed blockers. Improve social care and ensure there are places for people to go for aftercare then that helps resolve many issues, crowed A&Es, queuing ambulances etc. Improve access to GPs and that would reduce those going straight to A&E, Increase the number of minor injury centres etc.

Unfortunately, a lot of problems are due to money but we have one party that, not long ago, thought it was ok to borrow money to give rich people a tax break..

 

[Kinky Gerbil]

Yeah, with a decade plus of underfunding in the bag, maybe we should have gone for more Covid deaths to ease the current situation.

Because there was no other way around it? If only there was a test someone could take.

Like it or not, shutting down the NHS mostly is one of the reason there is a mess now.

Deaths at home was high during that 2 years as well, just no one reported it.

 

[pure_white]

Controversial !
A former neighbour of mine was admitted to hospital at Christmas. Apparently she weighs around 35 stone, which equates to 222 kilos. She doesn't get out of bed. It took 3 ambulances and 2 fire engines, one with a platform, to get her out of her property. This involved removing a 1st floor window. Within less than a week, the fire engines and ambulances got her back into her property via the bedroom window. Presumably, because of the pressure on hospital beds, she was discharged too early. Yesterday evening, she was readmitted to hospital. This process involved 3 ambulances, 2 fire engines, a platform, the removal of her window, and I suspect that the road was closed off again. Only god knows how many personnel have been involved so far in the ongoing removal / reinstatement processes.
How much is this costing and who foots the bill ? Is there a financial cut off point, or does this go on until the NHS is bled dry ? I appreciate that the NHS strives to do everything to enable the individual to stay in their own home, but surely this is unsustainable. Shouldn't she be encouraged to sell her property, and use the proceeds from the sale to fund her nursing ho

me fees ?

Controversial !
A former neighbour of mine was admitted to hospital at Christmas. Apparently she weighs around 35 stone, which equates to 222 kilos. She doesn't get out of bed. It took 3 ambulances and 2 fire engines, one with a platform, to get her out of her property. This involved removing a 1st floor window. Within less than a week, the fire engines and ambulances got her back into her property via the bedroom window. Presumably, because of the pressure on hospital beds, she was discharged too early. Yesterday evening, she was readmitted to hospital. This process involved 3 ambulances, 2 fire engines, a platform, the removal of her window, and I suspect that the road was closed off again. Only god knows how many personnel have been involved so far in the ongoing removal / reinstatement processes.
How much is this costing and who foots the bill ? Is there a financial cut off point, or does this go on until the NHS is bled dry ? I appreciate that the NHS strives to do everything to enable the individual to stay in their own home, but surely this is unsustainable. Shouldn't she be encouraged to sell her property, and use the proceeds from the sale to fund her nursing home fees ?

What has her size got to with anything? Sum ppl increase size e.g. due to water retention. How many ppl need all that stuff to go into Hospital anyway. Its isolated and if you went through with your plan its peanuts the NHS saves.

 

[nicko31]

Because there was no other way around it? If only there was a test someone could take.

Like it or not, shutting down the NHS mostly is one of the reason there is a mess now.

Deaths at home was high during that 2 years as well, just no one reported it.

Well I have one member of one family has died in the past 12 months because the NHS was overloaded and another on my brothers side of the family just before Christmas, without going into detail they were negligent simply due to lack of resources.

From my experience not dealing with social care crisis is also part of the problem. I seem to recall the PM before last promised to deal with it (that bloke that got all the big calls right), nothing happened.

 

[sydney]

Some good points on here that I won’t repeat; just to say I’m general that the free at point of entry model no longer works, and politicians of all colours should be hones and say so. It has never been case for dentistry or opticians.

I have two sons in NHS, one a haematology consultant, the other an A&E registrar. There are three things they believe would make a colossal difference:

1. Understanding and reacting to risk. A&E doctor says he could see twice as many patients per shift as he does currently if he had less work to do after seeing each patient, particularly if they are discharged. The ‘formalities’ are required to minimise the chance of a complaint/legal fight afterwards (like most A&E doctors he has suffered the problem of complaint after sending someone home who later died; they would have done anyway but never mind). His view is simply that if either it is just accepted that mistakes do occasionally happen or that patients/relatives actually sign a waiver to this effect, then the far bigger risk of patients waiting hours would be much reduced;

2, Use of technology. The process of keeping patient notes is painstakingly 1970s, for example. One of them spent an hour trying to get something printed at weekend because there are no IT personnel available then (the printer needed ink!). Far more can be done via video conferencing; a very simple change would be to record patient notes and download them as audio files end of shift. Think about the comparison with the commercial world where productivity is so important and generally improved with technological solutions;

3. Our perception of NHS as our servant that is always there however small our need. All I need to say on this is A&E doctors quote that he liked the sessions when England were playing as less than half the usual number of people came in. Funny how emergencies reduce when there is something good on telly. We must take some responsibility too: responsibility to look ourselves better; responsibility to seek help elsewhere sometimes (we had a case near us when a woman complained that it took 7 hours for ambulance to arrive. All she needed was help getting up, and admitted later she could have asked her son instead); responsibility to others whose needs maybe greater.

I am pleased to see this has not developed into a political thread; bar one or two outliers we have not the ‘get rid of Tories and all will be alright’ posts. It won’t because the system is not fit for purpose any longer and pretending a change of government will change everything is delusional. My sons are not Conservative supporters but are saying the same thing.

rapidly ageing population , lots of very un fit people around with nasty habits , a lot of idiots about , drug users and mental health patients are the things that are severely hampering health systems in the western world.

2 nurse in our household , my daughter works in a metro hospital in Perth A & E is a bloody tragedy , particularly at weekends.