NHS

[Sith Happens]

I think the NHS is clearly under immense strain, which is why I think they should start to come down hard on people who don't show for appointments. This is estimated to cost 1billion a year, there is no excuse for not showing.

Something like 13 million gp appointments are not attended. Can't tell me all of them got delayed in traffic.

 

[Coneheadjohn]

18 minutes ago, 1of4 said:

Lets just scrap the NHS shall we and make all the rightright-wing Tory MPs with shares in private health care companies happy. Then we can all go down the same road as the USA, get our health care from private medical companies, paid for through insurance schemes that a large percentage of the country won't be able to get full cover for, because the premiums will be to high. 

This is undoubtedly what the Tories want.

It is certainly going to need everyone putting more in.

 

[King Kevin]

11 minutes ago, HantsRam said:

https://www.nursingtimes.net/opinion/nhs-nursing-in-the-1950s/461928.article

I found this article which I found fascinating as both a window into attitudes in the 1950s,  the role of matron, and a comparison with nursing today.

I'm not rubbishing your views but it's clearly a big topic.

Interesting ,bears out a lot of I think about hygiene modern hospitals are filthy compared with years ago. Also explains why people die ot thirst and neglect now days as this was all under the matron /ward sister remit .

I can also see why a modern nurse is verging on the skill set of a 50/60's doctor  it cannot be beyound the wit of man to get an ideal situation in today's age.

Some of the scandals that have emerged in recent years of deaths through neglect [Staffs I think was one of the worst] is a disgrace to a civilised society .To me the most vunerable people in that situation should never be treated like that.

To see senior managers leave with large pension pots having presided over scandals such as that makes my piss boil

.http://www.telegraph.co.uk/news/health/news/9851763/Mid-Staffordshire-Trust-inquiry-how-the-care-scandal-unfolded.html

 

[Sith Happens]

I don't understand who decides where money should be spent. Take the fact that east midlands ambulance service replaced 252 ambulances in order to ensure every one could carry passengers who weigh more than 50 stone. Must have cost millions, surely would have been better spending most of that money on nurses. Surely we can't have that many 50 stone plus people.

[Van der MoodHoover]

Just now, Paul71 said:

I don't understand who decides where money should be spent. Take the fact that east midlands ambulance service replaced 252 ambulances in order to ensure every one could carry passengers who weigh more than 50 stone. Must have cost millions, surely would have been better spending most of that money on nurses. Surely we can't have that many 50 stone plus people.

Or would it be out of the question just not to have that facility? 

How far does one go? 

[Sith Happens]

Just now, HantsRam said:

Or would it be out of the question just not to have that facility? 

How far does one go? 

You clearly need some, but surely a handful would suffice.

[Joe.]

Can be both fantastic and awful, virtually impossible to be only fantastic when they have to cater for the whole population of 60+ million, that said it's still better than most if not all health services across the world imo.

[Angry Ram]

1 hour ago, HantsRam said:

What would you consider to be a "gold standard" system of healthcare provision - if it exists - and why?

Dunno, no expert that’s why I threw this out there. Agreed we don’t want a US system. A ‘gold’ standard as you out it would be short appointment times, good quality care when you are there and quality care afterwards.. All at a cost I know but you asked... 

Can we achieve that within the current set up? Not a chance in my opinion..

[PistoldPete2]

1 hour ago, GboroRam said:

I think it's very mixed what service you receive. Sometimes it's amazing and sometimes total dog droppings.

Undoubtedly in my mind part of the problem is the fast turnaround times that are expected. 5 minutes per person is not enough for a doctor to fully understand what is wrong and deal with it.

I agree. When they are good, they are very very good the best thing ever. When they are bad they are absolutely terrible. It's pretty clear they can't cope with the demand. 

[Angry Ram]

1 hour ago, coneheadjohn said:

Completely unsustainable as it is,I really don’t know what the answer is.

It is a rare old mess.

Considering the circumstances they operate under it is amazing the work they do.

We can never thank them enough for what they’ve done for us.

The Cones are in your corner Angry.

Alright mate, hope Joel is good...

My experience with the NHS comes from care for the old. Luckily for me I have never had to use it personally.. There will always be good and bad I guess but every time my mum went Into hospital it was a disaster.. She was even assaulted by a temp nurse who was continually observed mistreating the old. Her assumption was that they all had dementia and would not report anything... Even after the assault for awhile the hospital denied it ever happened despite a witness at the time.. Eventually they conceded and the nurse was suspended.. Even that aside at her age she was a frequent visitor to hospital, simple things like a bed pan were a real struggle. How does it take 60 mins to get a pensioner a bloody bed pan.. The obvious happened on numerous occasions so nappies were the answer.. on occasions they were busy, I get that but on many they weren’t and the was no sense of urgency. 

The old man had similar experiences... Basic neglect IMO.. Maybe we have just been unlucky but hand on heart I can only think of one occasion where I would give the care a thumbs up.. 

I have no idea what you can do to make the mess we have better. Maybe the US have got it right to a degree and they just need a system that caters for the poor.

[Coneheadjohn]

31 minutes ago, Angry Ram said:

Alright mate, hope Joel is good...

My experience with the NHS comes from care for the old. Luckily for me I have never had to use it personally.. There will always be good and bad I guess but every time my mum went Into hospital it was a disaster.. She was even assaulted by a temp nurse who was continually observed mistreating the old. Her assumption was that they all had dementia and would not report anything... Even after the assault for awhile the hospital denied it ever happened despite a witness at the time.. Eventually they conceded and the nurse was suspended.. Even that aside at her age she was a frequent visitor to hospital, simple things like a bed pan were a real struggle. How does it take 60 mins to get a pensioner a bloody bed pan.. The obvious happened on numerous occasions so nappies were the answer.. on occasions they were busy, I get that but on many they weren’t and the was no sense of urgency. 

The old man had similar experiences... Basic neglect IMO.. Maybe we have just been unlucky but hand on heart I can only think of one occasion where I would give the care a thumbs up.. 

I have no idea what you can do to make the mess we have better. Maybe the US have got it right to a degree and they just need a system that caters for the poor.

Cheers,

I think the treatment of elderly relatives,the care system and everything else associated with it could do with a thread of its own.

My mum was supposed to be moving in with us but deteriorated and we have had to put her in a home up the road recently,I find the whole process difficult to deal with.

[TigerTedd]

From my experience working in the back offices of the Nhs, it’s so ridiculously top heavy in terms of management. 

I was working in a mental health trust when they had just merged with another trust. They literally had two very senior managers in my team doing exactly the same job with a combined wage of about £100k. 

One manager in the team I only met once. She went on sick leave for 6 months with ‘stress’, while her Facebook feed showed she was clearly setting up her own nail salon. She’d been in work for less than 18 months of the past 3 years, apparently. 

Even I was a consultant on what I thought were fairly hefty wages (although they actually encouraged me to up my wage), for what was really quite a pointless job. I set out to achieve stuff, but before long I realised that once it had passed through all the layers of management, no one really cared what I was doing. It really matters your self worth. So I just pottered about til the end of my contract, mainly working on my own travel agency business. 

 

My own personal experience of Nhs vs private (as a patient) is that I recently had a run of 4 or 5 gastroscopies over the course of a couple of years. 

2 of these were scheduled at the Nuffield, because they just didn’t have capacity at the hospital. The hospital was a case of in and out in about 45mins. Not so much as a biscuit to send me on my way.sat in a waiting room watching itv 3 to prepare, and then the whole thing happened in a little room, where the endoscope broke so they had to do it twice!

in the Nuffield I was given a private room to get dressed for my procedure in proper theatre attire (including diasposable pants). I had to wait around a bit, but I had my own tele. The procedure took place in a proper theatre, and I was given a proper amount of time to recover back in my room, with a sandwich. If anything, the only criticism is that it all too a bit too long, I could’ve done with getting back home sooner to help with bath time (although I appreciate the evening off, and my wife couldn’t really moan). 

And that was consistent per two endoscopes at both places. 

It convinced me that, the moment I’m financially able, I’m going private. You get what you pay for.

Now I’m waiting for an operation, who I will be done in the hospital, and I’m interested to see what that will be like. 

The birthing unit at the hospital is very nice though (but you expect that from a new hospital, as part of my jobs ive been to a lot of maternity wards around the be country, and some of them are right old s*** holes). 

[Ewe Ram]

My aunt went private as she worked at one time in the DRI and knew how bad hospitals are. She went to Nuffield, got a lovely room, a nice menu and it was like a hotel. The nurse was nowhere to be seen when she was crawling on the floor in pain. After discharge she had complications and her fixed fee op didn’t cover that so the same surgeon had another go on the NHS. NHS district nurses went out to her daily for a while. £6k fixed fee to the surgeon. 

I know of someone who is coming back from the USA because her care there is not a patch on NHS care and she has a serious illness.  But she will have to pay as she’s been away so long  I believe  

A lot of care is given to people (health tourists if you like) that is chargeable but at the point of use it’s just so hard to enforce and complicated to administer NHS staff just don’t bother. 

[1of4]

3 hours ago, Angry Ram said:

Dunno, no expert that’s why I threw this out there. Agreed we don’t want a US system. A ‘gold’ standard as you out it would be short appointment times, good quality care when you are there and quality care afterwards.. All at a cost I know but you asked... 

Can we achieve that within the current set up? Not a chance in my opinion..

So you don't want a health care system that is run by market forces private companies and entrepreneurial businessmen as happens in the USA. Is that a tinge of red I can see appearing ??

[Van der MoodHoover]

3 hours ago, Angry Ram said:

Dunno, no expert that’s why I threw this out there. Agreed we don’t want a US system. A ‘gold’ standard as you out it would be short appointment times, good quality care when you are there and quality care afterwards.. All at a cost I know but you asked... 

Can we achieve that within the current set up? Not a chance in my opinion..

Was really wondering if you knew of a health care system that "worked" that you think is a good example.

No matter - there are surely some principles that all can agree on - and judging by your mother's experience would be fairly uncontroversial. 

Ultimately however,  we have to have a mechanism for rationing - or rather matching infinite demand to a finite supply.

[Grimbeard]

As with almost every problem that this country faces, the root cause is over population. More and more people wanting a slice of an ever diminishing pie.

Time for a cull. Logan's Run anyone?

[Angry Ram]

7 hours ago, 1of4 said:

So you don't want a health care system that is run by market forces private companies and entrepreneurial businessmen as happens in the USA. Is that a tinge of red I can see appearing ??

I think if you read my post to Mr Cone you might think again.. All the red has been erased..

[Stive Pesley]

14 hours ago, Angry Ram said:

Agreed we don’t want a US system. A ‘gold’ standard as you out it would be short appointment times, good quality care when you are there and quality care afterwards.. All at a cost I know but you asked... 

Can we achieve that within the current set up? Not a chance in my opinion..

I think that's a fair analysis .I doubt there are many people in the UK who want a US-style system and we probably all agree that the level of NHS we do want is not achievable without a massive cash injection

So would people be supportive of slightly higher taxes if it was transparently ring-fenced for the NHS?

Because that's the only real solution - yet as soon as you look at it in the cold light of day, I'm sure a lot of people would say "well if I'm having to pay (say) £50 a month extra in taxes for the NHS, I could just get a BUPA contract and go private instead"

Which is sadly where I think it will end up

[ramsbottom]

On a GP level things seemed to have gone down hill over the last 10 years or so, but that's mainly due to the fact that I moved from a small country practice in Brailsford to Long Eaton and the demand is much greater.  There's a lot of divvy pikeys around that'd book an appointment for a stubbed toe, just so they could get signed off for a couple of weeks.  In fairness, I'm told my old practice is in the same boat

On a hospital level, I can't fault it.  They've delivered my son into the world, continue to treat my Mrs' arthritis, sent the prostate & lung cancers my Dad had into remission, treated my eldest brother for pneumonia, and always treated my lad when his overbearing parents have thought he had meningitis.  Yes we've to wait from time to time, but it isn't McDonalds...

[Phoenix]

Disturbing incident yesterday. Still in shock, of sorts. Got back from the gym to find the wife flat out,  unconscious on the floor, Could get no response, foaming at the mouth, bleeding (Bit her tongue it turned out). Phoned 999. Lady talked me through several questions (breathing pattern etc.)

In what seemed only 5 mins, the paramedics were knocking on the door. She slowly came round, didn't know where she was, who she was, who I was, but after about 10 mins had eventually got her memory back. The paras put her in the ambulance and told me to follow on with a change of clothes, toiletries etc, as they sped off to the Leicester RI.

Except they didn't. They went to Walsgrave (Coventry), a decision they made 'on the hoof' in the ambulance unbeknown to me). As luck would have it my step-daughter ( a nurse) was on a day off, so I picked her up and we drove to Leicester and eventually managed to park (LRI is a renowned nightmare). A long walk to A&E reception revealed(after a plolonged search) she wasn't there. Stepdaughter happened to have phone number of both Nuneaton (No, not here) and Coventry (Oh yes, she's here. Where are you, thought you'd had an accident on the way). WTF.

Two hours and more  wasted. Upshot was, she'd had a seizure. They'd done a brain scan and revealed no abnormality, but told her she mustn't drive (time unspecified) dont lock the bathroom door and don't be unattended. Any road up, got her home in one piece, very frightened.

My observations are that the NHS works very hard and very well, but is overwhelmed with sheer volumes. The A&E departments (both) were crammed, with estimated waiting times of 2 1/2 hours+. The queues of trollys in the corridors had to be seen to be believed. My step-daughter said that it was about normal, it's much worse at busy times!

If it wasn't for the blip in communication of destination (perhaps unavoidable) I'd give them 10/10.