[Closed] NHS - where should it stop paying for services

How about the granny with poor mobility - how is she supposed to get to the hospital?

I am sure there are many reasons, both financial and medical that a patient can't make there own way to the hospital.

I was offered a taxi after my knee OP.

You're not allowed to even take the bus, it has to be either a friend/relative pick you up or a taxi to make sure you're compos mentis when you get home.

£30million in the grand scheme of things isn't that much, 40p each? What they don't say is how much the ambulances cost to do the same job, I'm guessing someone did a sum and decided it was better paying for taxis for those who needed it and getting as many people to phone as friend/relative as possible than to offer free minibuses to every outpaitient?

It isn't necessarily bad value for money to send a cab instead of a 4-tonne ambulance. And for people who are genuinely immobile I think that should be covered under the NHS as part of treatment, but only for those who cannot get there themselves.

Translators? We should be billing anyone who needs one. And not just for health provision....my local authority falls over backwards to provide free translators for anyone who doesnt speak English. Want to live here? You are very welcome, but learn the lingo or show us the colour of your money.

and those deaf and blind people... don't they just waste money by requiring extra resources to allow communication with [i]them[/i]... 🙄

Eight pages? Nine? This ones going to run a bit isn't it?

I love a bit of (not very) thinly veiled racism in the morning.

taxis are cheaper, quicker, more reliable than ambulances usually.

who is being racist?

Sometimes there are good reasons why people can't i for follow ups - after the operation on my arm I had to go in for quite a lot of appointments but wasn't allowed drive (and wouldn't have been able to even if they'd said I could!), my mum doesn't drive and my dad couldn't get anymore time off (having already been given extra to get me to previous hospital appointments!), I managed to get lifts from friends and relatives, and got the bus a couple of times as well but I can definitely see why its difficult for people to get in!

And as has been mentioned - you're not allowed to get the bus home if you've had surgery so they need to provide an alternative for people that can't get a lift - cheaper than providing overnight care so that they can then be let out in the morning...

Translators is an entirely different one - IMO if you can't speak the language or come with a friend/relative that can then you should foot the bill. Not the same if you're blind/deaf etc. as that's a disability - the NHS should obviously continue paying for any support they need to receive treatment!!

http://www.bbc.co.uk/news/health-15115652

The figures cover the transfer of patients who are too ill to travel by themselves, such as those with broken limbs or receiving chemotherapy.

I feel that in the tradition of STW I should launch in with an ill thought-out opinion based on nothing more than prejudice and this morning's Daily Mail.

But I can't be bothered.

It gets very difficult for people to make truly objective decisions on what is appropriate funding of NHS services and what is not.

Speaking as someone receiving expensive treatment that some might see as unnecessary at best, I know how much of a battle my specialist has getting funding - and that's dealing with experts never mind the public!

NHS Funding is a subject very close to my heart and I do not envy the people that have to make the decisions - they know every day that there are consequences to all the people that get to hear "No".

Rachel

Eight pages? Nine? This ones going to run a bit isn't it?
I love a bit of (not very) thinly veiled racism in the morning.

I was recently in hospital and I couldn't understand a word of what the nurse was saying as she didn't speak English. Should I have had to pay for a translator?

A translator cost £60 per request and up.

If you dont have a translator though it stops the Doctor/Nurse treating the patient efficiently/Correctly, which costs the NHS more money....

Again I cant recall the exact figures for Ambulance Patient transport, but about £80 rings a bell. So a taxi is cheaper. I wouldnt dream of getting the NHS to pay for a taxi to get me to hospital, but thats because I can afford it and I am happy to lessen the burden on the NHS. Some people can not afford the cost of a taxi, or are happy to get as much as they can out of the NHS...

Again if you delay treatment of a patient because they cant get in to hospital it will end up costing the NHS more in the long term.

People need to realise the NHS doesn't have a bottomless pit of money and expect every thing they want at no cost, but you also need to look at the bigger picture!

30 million on Taxi's for people to get appointments?

I'm sure we could probably save more than that on gender reassignment surgery for prison inmates...

http://www.****/news/article-1363490/Ministry-Justice-issues-20-page-guidebook-rights-sex-change-inmates.html

😀

oldnpastit, if you cant contribute and say you cant be bothered, then why put a comment like that up.
seems odd.
Opinions are freely expressed and that is why I put the post up.
Not to get a solution.

who is being racist?

Yes please show us where?

oh zulu-eleven - I think you have just proved my point for me really rather well...

Rachel

As the nhs is forced to become ever more efficient, the distances involved will increase as smaller hospitals do less and more specialised services are concentrated in fewer larger places. We will be using a lot more taxis in the future as small local hospitals are closed or reduced.

mcboo - Member

"who is being racist?"

Yes please show us where?

mcboo

Translators? We should be billing anyone who needs one. And not just for health provision....my local authority falls over backwards to provide free translators for anyone who doesnt speak English. Want to live here? You are very welcome, but learn the lingo or show us the colour of your money.

🙄

I'm more concerned about the bloody waste of time and money all these health services would have been put to to answer the stupid freedom of information request asking for the info in the first place.

Daily Wail was it?

Crikey not entirely sure I agree with your statement there. The move is to get more services delivered in your local community so they are easier to access, only leaving journeys to tertiary centres for specialised treatment.

...whether it will work is a different matter.

Right-oh

I can read my own post TJ.

Tell me what is racist in there. Specifically.

[b]Sancho[/b] - you've made me agree with TJ...

There is a certain irony in residents of a country where people are getting worse at speaking others' languages, and yet are themselves travelling more, complaining about the cost of translators...

If you cannot understand then its impossible for me to tell you

The whole tone and post is racist - thinly disguised

"I'm more concerned about the bloody waste of time and money all these health services would have been put to to answer the stupid freedom of information request asking for the info in the first place."

It can take literally days to answer some of the FOI requests, and this is where the NHS inefficiency comes in.

The systems are normally that poor that to get the correct data out takes forever. The organisation will then check that data with other NHS organisations in the area to make sure the values are not too high or too low, and the best bit, rather than a junior employee doing all this and having it checked off by a senior staff member, some one circa £80k will do all the work!

I saw an interview with Tony Blair, and he said his biggest regret whilst in office was changing the FOI Act.

and those deaf and blind people... don't they just waste money

...but they sure play a mean pinball.

TandemJeremy - Member
If you cannot understand then its impossible for me to tell you

The whole tone and post is racist - thinly disguised

OK. So not racist then. You pompous little fart.

I'm talking about the reorganization of hospital services really. There is now, and will be more so in the future, a move towards centralizing specialist services like vascular surgery, maternity, orthopaedics, children's and so on. There will also be the development of trauma centres, with a consequent closure or downgrading of local A&E facilities.
Some care may be easier to access, but for anything major, travel will become more likely.

<wrings hands>

Yes, this will be fun to see the usual battle formations re-drawn on new/old ground.

Yesterday (I think) someone commented that "bigot" was an over-used cliche that is used when people have run out of things to say. Ditto, "racist". Whether anyone agrees with mcboo's sentiments or not, to claim that 'learn the lingo" is racist is stretching the boundaries of sensible argument. And is frankly lazy debating.

I have lived in many different countries and have received medical treatment in some of them. I would not expect that they should provide me with a translator services at their expense. I have made the decision to live in those societies and it is my responsibility to adapt to their society, culture, language etc. It would be patently absurd for me to argue that because a Japanese or French doctor couldn't speak English to me, that they were being racist.

Back to lurking/observing...

Will page 10 be the time for the tread to be pulled?

"How about the granny with poor mobility - how is she supposed to get to the hospital?"

Seems to be a question of whether she has relatives with money and time, or not.

but Im just concerned with where the NHS draws the line.

A problem with translators is that operations are cancelled or delayed if for example they have wandered off to get lunch, or get to the hospital late, seems like a lot of money is being paid out and the NHS seems to be getting the bill more and more.

McBoo- its clearly racist - just in the lazy unintentional way not the overt intentional way

"negative stereotyping on grounds of race, nationality or ethnic origin"

Resorting to insults shows you lost the argument - again.

Is resorting to repeating yourself in an increasing dogmatic manner - bullying?.

Don't like racism or bullying.

TJ and Rachel +1

As for the 'learn the language' brigade - maybe you need to think a bit first. I worked as a volunteer TEFL teacher for a while, teaching women basic English. Most of these were trying to learn as quickly as they could, but it takes quite a while to learn a new language well enough to use in a hospital situation. So what are people supposed to do while they are still learning the language and they get ill / injured / pregnant etc? Many people can't afford to pay for a translator - should they be just left to suffer?

The lack of basic humanity amongst some of you amazes me sometimes.

PS - I've got a pot of coffee on - anyone fancy a panad? Got any biscuits to share 🙂

I'm pretty sure I can't explain to a Doctor in any country I visit the exact symptoms of Apendixitis(sp?) if I needed to.

So my E111(or whatever the cards called) will have to pay for a translator, which is billed to the NHS..........

And what about Mrs Evans from Wales who doesn't speek English and can no longer drive? Should she not get NHS tratment becasue she's not exactly like you?

Ohhh, and I agree with TJ, I don't even thing it's thinly hidden, it's pretty overt.

It would be patently absurd for me to argue that because a Japanese or French doctor couldn't speak English to me, that they were being racist.

However - as the nhs is supposed to provide equal care for all and all patients are supposed to be able to give informed consent how can this be done with people who are not english speakers?

to refuse translators is to give second class treatment - and because this only effects a distinct part of society it is prejudicial - and prejudiced based on race is racist.

Edit - I think a part of the issue here is some folk will not accept that acts of ommissin can be racist - not just acts of commission - and that racism does not require intent. Its the effect it has that makes it racist not what the intent was.

Raism comes in many varieties however many folk only think of the overt racism - "****s go home" not the insidious racism that is unintended such as this topic

TJ I really think you are going way OTT. I think if you spent a while working in our local hospital it may change your opinion abit, all the local doctors dread having to work there because of the positive discrimination that goes on.

I was disgusted at the attitude of many of the patients who were gunning for positive discrimination whenever they could. They had rights, and were not going to be discriminated against.

They would either just sit there and shrug their shoulders at staff in a very rude manor, or shout out stuff like "Get me punjab" and then rant and rave in their own language. It was all very intimedating and I felt very sorry for the staff who had to deal with it.

Anne Cryer MP has always called for other language signing to be removed from public service signing in her constituency as it only encourages other language speakers to remain isolated in their communitys etc etc.

So no its not racists suggesting that people learn the language where they live is realistic.

Funkydunc - but removing all translators from the NHS is racist - as it disadvantages people on the grounds of race. Thats the point.

I'm with McBoo - TJ your just trying to get a reaction.

Please identify one point from this statement here: "negative stereotyping on grounds of race, nationality or ethnic origin" that was raised in the original post.

So no its not racists suggesting that people learn the language where they live is realistic.

And if a Brit went overseas and demanded that others spoke English to them it would be called "arrogant"!!

To equate the awful "****s go home" with an expectation that people have their own responsibility to make themselves understood in another country (not the other way around) merely illustrates that the "racist' card is over-used and sloppy.

Bother - I am repeating myself again.....I must be a cyber bully!!! 😉

The whole post FFS - I am not the only one to see it.
it makes a series of assumptions that are sterotypical based on race.

Do I really need to deconstruction the whole statement? Its a waste of time as you will still consider me and the others who agree with me to be wrong. Will you listen with an open mind?

for people who do 'extreme' sports, like riding fast & jumping bicycles 😉

Hell, any sports actually. Got friends who are constantly in and out of hospital due to football injuries.

glitchy bump

I dont want to get in to a debate on racism, just wanted to garner opinions on NHS costs and where it should draw the line,
The BBC put out a statement that on first reading to me, thought what a waste of money.
fortunately there are one or two people on here that can make a reasoned comment that has made me think further on the issue.

Im still unsure on many things with the NHS, I have my op tomorrow and think the NHS is wonderful and rubbish at the same time.
MY GP is a **** who misdiagnosed my condition, the Bradford Royal are legends, and they have a lot of race issues to deal with.

however back on track I am interested in reasoned arguments on where NHS costs can be saved.

mcboo

Translators? We should be billing anyone who needs one. And not just for health provision....my local authority falls over backwards to provide free translators for anyone who doesnt speak English. Want to live here? You are very welcome, but learn the lingo or show us the colour of your money.

"We should be billing anyone who needs one"
No allowing for circumstances - including all people who need translators as a homogeneous group. So sterotyping on grounds of race and disadvataging those who do not have english as their first language

"my local authority [i]falls over backwards[/i] to provide free translators for anyone who doesnt speak English"
Pejorative use of terms

"Want to live here? You are very welcome, but learn the lingo or show us the colour of your money. "

Making sterotypical assumptions that people who don't speak english don't want to learn, thinly veiled " ****s go home" sentiment,

singletracksurfer are these people getting taxis paid for by the NHS?

is it a service only afforded to the poor or is it a general service?

And what about Mrs Evans from Wales who doesn't speek English and can no longer drive? Should she not get NHS tratment becasue she's not exactly like you?

The national languages of Wales are Welsh and English. So in the microscopic liklihood of someone in 2011 being able to speak Welsh but not English I'm sure the taxpayers of Wales would be happy to stump up for translators.

So let me get this straight. To question the right-on consensus on not bothering to require immigrants into the UK to learn the language BEFORE they come here I'm being overtly racist, is that what we're saying? And we wonder why parts of the country have communities living parralel lives* and white working class Labour voters voting BNP.

*Copyright Jack Straw MP

Sancho

however back on track I am interested in reasoned arguments on where NHS costs can be saved.

Concentration of services into larger units will save money and improve outcomes, return to a universally managed and planned set up will save cost ( no more foundation hospitals) end all private involvement will save costs and improve outcomes

close small A&E units will save costs and improve outcomes

Get effective management in place, stop political interference

To question the right-on consensus on not bothering to require immigrants into the UK to learn the language BEFORE they come here I'm being overtly racist, is that what we're saying?

Not overtly IMO - although others on here disagree - just the unthinking insidious racism that runs as a common undercurrent.

No refugees that don't speak english? What about the boy from afghanistan who did some guiding for the UK forces and is now in fear of his life? Should he be refused entry because he does not speak english?

how about the wife of a Gurka Soldier? who has never learnt english even tho her husband gave his all for ourt country?

Sancho - My own experiences of BRI have been pretty poor 😯

The taxi thing can be pretty hit and miss and can litteraly depend at a local level whether that service has 'asked' for a budget for it. So one service in one region may offer it, another may not. Again shows up the inefficiencies of the NHS. Still it is cheaper the getting the local ambulance trust to do patient transport.

TJ - Are you saying that it is right that 3rd generation immigrants still can not speak English and therefore never step out of their house? Theres multicultural integrated Britain for you. IMO all the PC brigade and agenda that goes on in the UK is doing nothing to help social integration in the UK and will lead to social unrest in the future.

"close small A&E units will save costs and improve outcomes

Get effective management in place, stop political interference"

God I actually agree with 2 things TJ has said!

Get effective management in place, [b]stop political interference[/b]

return to a universally managed and planned set up...end all private involvement

If I understand this point correctly, you are advocating no private sector involvement and a return to a universally managed and planned model. I assume therefore that this would be a public sector model. I don't want to debate the =/- of the idea, merely want to understand how this would eradicate political interference?

This is a non-controversial question BTW (even though you are still absurdly overplaying the racist card)

No I am not saying that at all. I have explained my position. where did I say it was acceptable? What I am saying is a blanket ban on translators is discriminatory

Do you know of any 3rd generation immigrants who don't speak english?

I've rarely heard Mrs mW talk about using translators at work (NHS). Outpatients tend to bring an English speaker with them if they think they are likely to have difficulties and most other problems are solved by finding a member of staff that also speaks the same language. One of the benefits of recruiting from the local community is you tend to get staff that have a similar ethnic background to your patients.

As for transport, again it's a rarity and only really used when necessary. In her old role she had to do a lot of assessments of elderly patients in their homes in order to see how they would cope when released from the hospital and what could be put in place to make things a little easier for them. For these visits they would generally use a black cab as they have wheelchair ramps. From the outside looking in it looks like a luxury but it was the most effective and practical tool for the job and far cheaper than keeping a vehicle on permanent standby.

Having served alongside the Gurkhas I can assure you that translation services are built in to the military covenant we are bound by. All Nepali families have constant access to English translators via the Unit Families Office.

And refugees, yes I do think we have an obligation to provide translators for them.

Some of my [s]best friends[/s] parents-in-law/wife/kids are black/Indian/mixed race.

"Do you know of any 3rd generation immigrants who don't speak english?"

Personally no, but apparently it is very common in the region where I live (and experienced daily by hospital and primary care staff) and hence why Anne Cryer was trying to do some thing about it. Alot of folk tried to call her racist too.

As I say come out of your ivory tower in Edinburgh and you might be surprised how different other parts of the real world are 🙂

Muppet - "Outpatients tend to bring an English speaker with them if they think they are likely to have difficulties"

Legally staff are not allowed to use friends or relatives as translators, even if the patient gives consent, its a big no no.

So McBoo- you don't want to stop all translators then - only to some people that you judge to be underserving? Dunno if thats better than you stated earlier or not.

Funkydunc - apparently? 🙄 lets see some actual evidence please.

I have lived all over the UK and in other parts of the world - and have worked with some of the most disadvantaged people around. I am in no ivory tower.

Legally staff are not allowed to use friends or relatives as translators, even if the patient gives consent, its a big no no.

What - where do you get that idea from?

so in the scheme of things translators and taxis are small change.
But still we all have an opinion.

Still think there should be some charge for translators.
I just dont see it as the job of the NHS to provide this.
(it may help in the handling of the patient, but its not part of the treatment and thats where the NHS should concentrate its funds.)
In my non-racist opinion.

sancho - so its ok for non english speaker to have inferior service?

The local PCT and practicing Doctors. You might see nurses doing it but not Doctors.

As I say come out of your ivory tower in Edinburgh

Out of interest, is the fact that Scottish universities are applying different pricing depending on nationality descriminatory and/or racist?

As this appears to be going down the all to familiar racism route........

IME there is huge abuse of the taxi and PTS system in taking people to and from hospitals. I have first hand of experience of people telling me that they [b]had[/b] to get a PTS ambulance to take them to and from, when they would have been quite happy getting a lift from a relative.

The taxi system is also widely abused. I see 'regulars' and drunks stepping into taxis all the time. You may not be aware but hospitals will provide a taxi if you (supposedly) have no way of getting home and have no money to pay. Fine if it is genuine but there is a % of people who will never repay the debt.

Don't get me started on women in labour who look upon ambulances as taxis. No money for a taxi and yet new baby about to be brought into the world, car on drive and husband/partner/relative who couldn't lay off the booze for a few days just in case he needed to drive. 👿

BTW regarding wasting money - a rather obvious basic requirement in my job is the ability to speak, read and write English. Can anyone tell me the point of a recruitment leaflet which is available in 8 different languages?

They wouldnt get inferior service,
But would need to pay for a translator.

A comment earlier said that if in an EU country and you needed a translator that service would be provided and charged to the NHS via E111.
I think that makes sense.

we have no idea about racism in this country. i have a few friends from Malaysia, they laugh at our pathetic attempts at racism.

"the NHS is a bit squeezed, should it be financially responsible for translation?"

doesn't even come close.

so its ok for non english speaker to have inferior service?

Is it arrogant of a Brit to demand that English is spoken in a hospital abroad? Frankly, yes in my opinion. Yes, we would have an inferior service in a linguistic sense, but that would be my/our choice. I doubt that the medical outcome would differ though.

double post

I inurjed myself whilst on holiday in France, I know basic French but not medical standard and struggled to converse with the doctor who only spoke French, I was not offered a translator.

Who was more apologetic, me because I couldn't speak French or the doctor becuase there was no one to help me? Well me, obviously, because I am in France where they speak French, the doctor, frankly, couldn't care less.

Was this racist? No, in France I would expect to need to speak French to make myself understood. In the UK English is the national language so to expect people to undertand English is neither unreasonable or racist.

NHS - where should it stop paying for services

How about IVF, Not trolling just curious for views. I've no kids and no interest in having any. But is IVF a matter of life and death or even an essential service, I know people who wanted to but were not able to have kids and they've had happy lives, either through adoption or just reconciling themselves to not having kids. Thoughts

Woody - Agree with you completely. Unfortunately people see the NHS as a right, and that it doesnt cost them any thing so it doesnt matter. IMO people need to realise that it does cost them.

Getting back to the question about providing taxis ...

A few months ago I moved to another part of the country and unfortunately a few weeks ago I had a bike accident that resulted in a stay in hospital.

When I was due to be discharged, I asked if a taxi could be organised and they would need to take a cheque as I had no cash in the house. A taxi was arranged to take me the 30 miles home and I did not have to pay. The ignorant taxi driver made no attempt to open a door for me, or to put my bags in the car, despite my having an arm in a sling and being wobbly.

Two weeks later I had a follow-up appointment so checked out public transport which would have involved several buses and a train. Due to the head injury, I ended up getting a taxi there and back at a cost of £70.

Thing is, it's not always possible for folk to help out so what's wrong with taking responsibility for yourself? I never dreamt of asking the NHS to take me to and from for the follow-up appointment.

But what I would question is why I was sent to a hospital so far away when there was one nearer.

As regards the elderly, my mother has needed regular operations for many years and it's always been me that takes her despite the considerable driving it necessitates.

Sancho - Member

They wouldnt get inferior service,
But would need to pay for a translator.

breathtaking in its stupidity.

What happens if you can't pay? And it clearly is an inferior service as they have to pay to get information others get for free - so as far as you are concerned discriminating against people on grounds of ethic origin is acceptable?

woody good point on the taxi thing, I still cant understand where the NHS draws the line.
and any free offer will be abused by some and not used by others who maybe should use the service.

The whole post FFS - I am not the only one to see it.
it makes a series of assumptions that are sterotypical based on race.
 
Do I really need to deconstruction the whole statement? Its a waste of time as you will still consider me and the others who agree with me to be wrong. Will you listen with an open mind?
 

OP asked where the NHS should stop their services. Thought it meant all their services (including health care), not just taxi's & translation costs.

Sorry, will leave you all talking about racism then and I won't mention translators needed to interpret the hospital staff before I leave then 😉

lunge - team hurtmore

do you not understand the differnce between going on holiday to a county and emigration?

"But what I would question is why I was sent to a hospital so far away when there was one nearer"

Probably because the centre you were taken to had more specialist experience in your type of injury. Or it could be that the local hospital had no spare beds...

McBoo - I did deconstruct it, Note several other people have said that yoru stetment is racist as well as it clearly is

TandemJeremy - Member

mcboo

Translators? We should be billing anyone who needs one. And not just for health provision....my local authority falls over backwards to provide free translators for anyone who doesnt speak English. Want to live here? You are very welcome, but learn the lingo or show us the colour of your money.

"We should be billing anyone who needs one"
No allowing for circumstances - including all people who need translators as a homogeneous group. So sterotyping on grounds of race and disadvataging those who do not have english as their first language

"my local authority falls over backwards to provide free translators for anyone who doesnt speak English"
Pejorative use of terms

"Want to live here? You are very welcome, but learn the lingo or show us the colour of your money. "

Making sterotypical assumptions that people who don't speak english don't want to learn, thinly veiled " ****s go home" sentiment,

thisisnotaspoon - Member

Ohhh, and I agree with TJ, I don't even thing it's thinly hidden, it's pretty overt.

Sue_W - Member

TJ and Rachel +1

As for the 'learn the language' brigade - maybe you need to think a bit first. I worked as a volunteer TEFL teacher for a while, teaching women basic English. Most of these were trying to learn as quickly as they could, but it takes quite a while to learn a new language well enough to use in a hospital situation. So what are people supposed to do while they are still learning the language and they get ill / injured / pregnant etc? Many people can't afford to pay for a translator - should they be just left to suffer?

The lack of basic humanity amongst some of you amazes me sometimes.