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I won't profess to have the answer, But I can say we have to get the tories out of government... this is the common denominator, and the common cause of continual frustration.
BE you labour, or lib dem, an another, just don't vote conservative.
I won’t profess to have the answer, But I can say we have to get the tories out of government… this is the common denominator, and the common cause of continual frustration.
BE you labour, or lib dem, an another, just don’t vote conservative.
With the situation of the world now I know whoever becomes the govt will not have a smooth sailing, that I am sure.
Longer term the solution is to get people out of poverty and get the minimum wage up. To educate and enable people to look after their own health. This will need a huge change throughout our society. We are nowhere near it yet.
The NHS has been underfunded for decades by all governments, and social care is also terribly underfunded and very poorly payed. People know this and have done for a long time,I'd like to think that things are going to change this time I really would like to but I don't (I am a social care worker)
I’d like to think that things are going to change this time I really would like to but I don’t (I am a social care worker)
It’s guaranteed that nothing will change under a Tory government. Especially this gang of grifters
They have an agenda and they’re funded by private healthcare companies
The reason you’ve heard nothing from them and they’re refusing to acknowledge the crisis, let alone address it is because all this chaos is intentional and fits in with their agenda to privatise the NHS
Never waste a good crisis - the disaster capitalist mantra - will be applied for the ‘we had no alternative’ policies that will be along shortly
ConservativeHome website reports:
"Conservative voters overwhelmingly believe their party has failed in its management of the NHS during their time in Government, a poll suggests. A vast majority (73 per cent) said they thought NHS management had been a failure in the last decade, compared to just 16 per cent who said it had been a success, according to the Opinium survey for Compassion In Politics, shared exclusively with i. Of voters who backed the Tories in 2019, more also believe their party’s austerity policies have been a failure (47 per cent) than those who believe they were a success (16 per cent). Underlining the grim electoral situation facing Rishi Sunak, more Tory 2019 voters believe education reform has been a failure (46 per cent) than a success (22 per cent).”
https://conservativehome.com/2023/01/02/newslinks-for-monday-2nd-january-2023/
73% of Tory voters claiming that the management of the NHS has been a failure for the last 10 years is a staggering amount.
And when you combine it with the surprising amount of Tory voters who think austerity, a strategy which even the LibDems supported, was a failure, it starts to explain Labour's huge lead in the polls.
It would appear that on some issues many if not most Tory voters are significantly to the left of the Tory Party.
Part of the problem is old codgers like my old man....
Moans about the rail strikes despite not seeing neither the connection orvl reliance he had whilst commuting to his city job.... "well I started on 15k a year and had no bonus", "I never went on strike", "how are people supposed to get to work?"
You tard.... You were earning x times the national average whilst playing with pretend money, without any risk to your own wellbeing, without having to make a life or death decision.... You complained when you had to pay tax on your bonus.
Yet happy to complain that the nurses get paid x whilst doing z.... All the while reading the Daily ****ing Mail. **** you!
It would appear that on some issues many if not most Tory voters are significantly to the left of the Tory Party
Mussolini would probably be on the left of the present Tory party but he didn’t vote for them and they did, so *’em’!
They should make you fill in a quick questionnaire when you get in to A&E to see how fast you get treated
1. Did you vote Tory at the last election?
2. Did you vote for Brexit?
Answer yes to both and you get thrown into the car park with some Peppa Pig plasters and a packet of paracetamol because THIS IS ALL YOUR *ING FAULT!!!
What has caused the huge increase in a&e demand? I’m not sure I’ve seen an explanation.
1) People are idiots. We go to A&E because that's what we've always done.
2) Everything else is bollocksed and it has a knock-on effect. 111 has a queue of hours just to talk to someone. Getting a GP appointment, if you're late enough to ring at 8:31am you're three hundred and ninety-forth in the queue.
3) We voted to send them all back where they came from. So that's what the NHS staff did.
We reap what we sow, it's party time in Toryland. Zero shits given by private-healthcare-enjoying motherlovers, old people are a net drain on the economy. I give it 12 months before we sell off the NHS to Elon Musk.
They have an agenda and they’re funded by private healthcare companies
As is Wes Streeting who oddly enough thinks privatization is the answer
It's not just a Tory issue, the SNP have screwed the Scottish NHS up in the same way. Perhaps not as extreme but certainly along the same path.
I waited 6 hours for a scan after I went into A&E with kidney stones and another 2 hours for results. I was doing well, one woman had waited 8 hours for an ambulance with a broken arm, another had been in triage for about 6 hours. The previous day every single ambulance in the entire health board (16-18 iirc) was at Crosshouse.
Staff shortages, social care issues and lack of ambulances are all still happening up here. One guy at my work was a part time firefighter and was getting sent on call outs to attend stroke victims and such as they had nobody else. Phoning for appointments at the GP is an exercise in frustration (instantly blocked at 0830) as well. Don't get me started on mental health.
The scots government do not have the financial ability to do anything much about it. they did offer a better pay deal but NHS and social care is around half the total scots government budget. With no real way to raise money any increase in funding for the NHS means cuts elsewhere - and of course cuts in government spending from Westminster mean cuts in Scottish government block grant
Also the SNP have at least made sure that the scots NHS is managed far better than in England by getting rid of all the fake market bollox then not interfering much. Admin costs in Scotland are half englands. also of course we have the huge financial millstone of the ERI
yes Scots NHS faces many of the same issues as England but the blame for that lies with Westminster not Holyrood
Two reasons I can think of privatization:
1. The govt wash their hands off a difficult portfolio (then retired as one of the Board of Director)
2. They genuinely think it is a good idea (can't think out of the box and fear of political career demise)
oh ya why don't SNP reduce or cut the tax for Scottish NHS workers? (not sure if Scotland is allowed to set different tax rate but let's assume they can)
Surely if they (SNP) don't have money they can "compensate" in another way by reducing or cutting the tax?
Unless, Govt is afraid that they will go "bankrupt" or will have domino effect on other sectors (also demand tax cut) or they give in one hand and take back in the other hand?
(if other sectors/industries also demand a tax cut no they cannot because only the doctors/nurses can stick their fingers up my arse to check me)
It’s guaranteed that nothing will change under a Tory government.
Its worse because every 15-20 years the tories have caused so much damage through what is basically their corruption, that the entire country needs to go into a deep recession. It's almost like clockwork.
The destroy all the industry, the unions there to help the workers, the entire care industry is screwed beyond help. The daily mail or the express coined the phrase 'bed blocking' placing the blame on the patients themselves, when the actual reason for people unable to leave hospital is because the tories shut down all the out patient and after care units and sacked all the staff.
Thats one example, but there are dozens ranging right across society.
I remember when the tories used people on sickness benefits as an excuse and reason, with the express and mail coining the phrase 'benefit scroungers' .
The truth there was the tories placed normal claimants on this benefit for one single reason. If you receive sickness benefit, you are no longer classed as unemployed, so at a stroke they slashed the numbers of UK unemployed from the bonks, only they were all still there, only the facts had been hidden. They then show the electorate they have cut unemployment when in fact they haven't.
I remember when i was put on that benefit. I was dossing in North Wales at the time and the letter that came through told me in plain language that i was now on the new benefit system and it was enforced by law, i couldnt claim anything but this benefit.
Then some years down the line when they're looking for someone to blame for all thee costs, because they made it beneficial for all the claimants by increasing how much they got paid. Naturally people on a low income would jump at this(not that they truly had a say in it). It got the tories out the mass unemployment hole, and when they needed to find someone to shift the blame to, the headlines of 'benefit scroungers' started.
Currently there is 10% or less of the social security offices there used to be and pretty much zero job centers. The tories shut them all down and embarked on a crusade to throw everyone but the recognized disabled off their benefits.
They even tried to throw seriously disabled off their benefits but unfortunately for the tories, many have access to advocacy groups so the tories couldn't easily do it.
Their latest is an old dodge- change the name of the benefit and place everyone with a legitimate claim onto that. There are subtle differences in eligibility criteria, and its through that that they are forcing people off or on to lower and lower incomes.
To my mind and in my opinion, we should sweep through parliament and everyone suspected of corruption should be sacked, those found to engage in it should get 10 years in prison.
But that will never happen because we are a nation of losers. We'll accept whatever is handed down ,the scraps from the table and be satisfied.
Point 1 - Get rid of the Royal Family. Thats by far is 100% part of the system that is destroying the UK.
Point 1 – Get rid of the Royal Family. Thats by far is 100% part of the system that is destroying the UK.
I disagree with this point. I prefer to keep the immediate family only. i.e. crown prince and his family. The rest can get off the bandwagon.
Aside from the last sentence which is an abject non sequitur, you're 100% on the money. (I'm not a royalist, I couldn't care less, it's just not relevant to the discussion here.)
The Tories have been massaging statistics for years. Waiting list times have fallen, because there's now waiting lists for waiting lists. Take money away and then give it back, "look how much money we've given!" PIP (disability benefit) qualification is outright evil. How do you get someone off a benefit, just rename it.
The Tories have been massaging statistics for years.
I seriously doubt there are any politicians from any party who are willing to stick their political neck out to sort out the problem. The problem is so huge (largest employer in the world!) it is best given to the political rival to kill off their political dream.
Any politician that can turn it around and solve the problem is worthy of becoming the PM.
The problem is so huge (largest employer in the world!) it is best given to the political rival to kill off their political dream.
Or, it could be the most magnificent thing a (UK ... lol) politiciatan could do, a game changer, a paradigm shift.
I disagree with this point.
Fine, fair enough you are entitled to such an opinion, but I will say that having them 'legitimizes' the way the country is run and by whom.
Remember those big bags of cash given to 'king' Charles by the incorruptible Qatari politician(Panama leaks). Handed $3m in a series of suitcases, bags and holdalls, purportedly for his charities.
Ever hear about any sort of inquiry to determine exactly where that money went ?.
In fact ever hear anything of it ever again.
Society needs to accept that more resources need to be spent on healthcare including social care. This is needed due to an ageing population and advances in medicine meaning people are living longer and thus having more complex needs.
Changes in lifestyles could reduce NHS demand but it is unrealistic to think this is the solution.
It is also unrealistic to think that growth in the UK economy could provide the expected resources.
So as a society we will need to accept that resources need to move out of less productive parts of the economy. For example the hospitality sector and retail. Less people employed in take away food and coffee shops and more in social care.
With global warming we need less consumption of imported consumer goods, and money redirected to healthcare.
Same applies to expenditure on leisure travel, and resulting expenditure on aircraft, fuel etc.
Government should cut vanity projects such as nuclear weapons, aircraft carriers and high speed rail. But cutting these programs will probably not give enough money or resources alone. But it would be a signal that government has recognised that change is required.
Since the shift from hospitality to health care will move expenditure from personal consumption to public expenditure it has to be matched by an increase in taxation.
These taxes need to be targeted at hospitality sector, leisure travel, consumer durables (including mountain bikes). Maybe this needs to be phased so private sector investors stop investing in these activities.
Just taxing the rich and wealthy is unlikely to produce the required revenue and changes in resource allocation.
However because we are a democracy a government has to be elected, and this stops political parties proposing a realistic policies. There is an incentive for 'having your cake and eating it' policies which applied to both Johnston and Corbyn in their different ways.
That is not to let the Torries off for their incompetence, and the impact of austerity on the NHS.
So the key is sort out social care
Yep and that has been known as the main issue for years. I notice the additional funding yesterday was not aimed at helping that in any way at all.
111 also has its triage issues
Yep. Wife was very ill after kidney op and getting worse so had no option but to go to A+E on Saturday evening a few weeks back. Phoned 111 first but gave ups after waiting an hour as knew they would just tell us to go to A+E anyway. Good job we did as she had sepsis and was in a hospital bed on antibiotic drip within 6 hours.
73% of Tory voters claiming that the management of the NHS has been a failure for the last 10 years is a staggering amount.
even more staggering is that 16% think that the management has been a success!
Alternate view - from this I deduce 1 in 6 of Tory voters have shares or interests in private healthcare
Ok I will humour those people on here that feel that the ambition of the Tories is to privatise the NHS. Also be aware that Labour have done more of their fair share to try and privatise the NHS by stealth in the past
Yes there is some capacity in the private sector for elective care but not enough to absorb any NHS capacity. Indeed consultant private’s practice is shrinking as the costs have significantly increased in the last decade
Name me one private acute care hospital in the UK? They simply don’t exist.
So to privatise the NHS would require 5-10 years to build private acute hospitals and the same time to find and train staff
No private organisations are going to take on existing NHS hospitals as they wouldn’t make money.
which then means it would be political suicide to even try and bring in privatisation
Dont blame politicians, blame society and its want to look after the vulnerable in society. That costs money and it’s now that people are starting to die that society is taking notice
Name me one private acute care hospital in the UK? They simply don’t exist.
Yet...
but it's a gap in the market for the 1% with the wealth who don't want to rub shoulders with the riff raff in their local a&e and could top up their workload by accepting some NHS work.
If one opened in London tomorrow as a walk in / a&e I'm sure they'd have trade enough to make it work. Add in a private ambulance service to "collect" and return patients and you further opt out if current services and waits.
"stay at home to protect the NHS"
That went well then!
To be fair, things in Wales seem worse and our NHS is controlled by Labour. So I would say both the Tories and Labour are equally to blame. Tories a self-serving, incompetent shower of bar-stewards. Labour an ideologically driven and clueless shambles. But at least we didn't shoot ourselves in the foot here in Wales and fire 40,000 care workers for not getting vaccinated. No wonder there are thousands now stuck in English hospitals because of the lack of onward care.
The NHS in the UK needs grass roots reform, not just a load of money chucking at it. There has been a shortage of clinical staff for years yet we have done little about it. There are plenty of countries who have a free at the point of use healthcare system yet which produce far better results for patients across the board than we do here in the UK. Perhaps it is time to learn from some of them?
even more staggering is that 16% think that the management has been a success!
All depends what your experience of it has been I suppose. Some of that 16% have probably not used the NHS for 10 years and those that have may have had a positive experience. Standard appointments can be fine and my wife has been for quite a few reasons over the last few years and most of the time it has been very good. Appointments on time, easily arranged, good results etc,.
The only difficult thing was getting a date for her operation which took 7 months as although we have private cover the type of operation could not be performed in private hospital so was in NHS queue.
A+E is another matter but again those 16% may not has used A+E and just think it is the same as always has been (pretty long waits depending on when you turn up and how critical your condition is)
Recently when the lad did his collar bone it was a Sunday afternoon, we were there 4 hours give or take... with a decent chunk of that just waiting... but 4 hours isn't a complete disaster.
Point 1 – Get rid of the Royal Family. Thats by far is 100% part of the system that is destroying the UK.
Wow, you fell for that one. For all its many faults, the Royal family has not had direct control of government for a couple of hundred years, and is not, in any way, responsible for the current state of public services.
The cost of the Royals is the equivalent of running the NHS for what....an hour maybe, if that?
There are plenty of reasons for wanting rid of them, but if you think that will have any meaningful impact on public services, you have been misled.
Edit - on a practical personal level, today I'm doing the shopping for my parents,both in their 80s and hit badly by the Christmas cold, which has gone on my dad's chest, so I'm not sure if he needs to be checked out by "someone". And then I want to get a ride in, but I'm very conscious now is not the time to hurt myself doing it@
They have an agenda and they’re funded by private healthcare companies
Well, they've been in power for 12 years already, and they're likely to lose the next election, and here doesn't seem to be a plan to privatise any more of the NHS than already exists ready to go through parliament. For me the problem is just a simple funding one. The Tories just don't want to pay for it, but I don't think they have plans to radically change it, they just want the NHS to cope with less money.
The numbers of appointments at GP practices has remained largely stable for the last 5 years or so - largely as practices has increasingly taken on other clinical staff such as specialist nurses or complimentary professionals such as direct access physiotherapists, or having tasks like medicine management given to clinical pharmacists. It is however still an educational process to support patients to accept that they'll still get good care despite perhaps not seeing a GP
The issue for me (I'm a PM at a just outside city centre practice) is that we're just seeing the sorts of folks for whom SLS and old age with increasingly complex issues that can only be managed rather than "cured" are coming to the GP more and more. Our contract is drawn on the idea that "average" patient comes to the GP 3 times a year. I have a significant percentage of my patients (7-8%) who are coming over 20 times a year and a further 30% or so who come at least twice as much as the average, the effect of this is that is that my cost/patient has gone up while my income/patient remains unchanged. We can't afford to recruit or expand or increase the staff salaries well enough. Being a receptionist right now is mega stress, and you can get the same sort of wages stuffing shelves without some-one on the phone telling you that if they die [because they can't get an appt today] it's your fault.
My tuppance (for what it's worth)
Reform Social Care,
Funded primary healthcare at a level for the patient load we have rather than the fantasy of the contract suggests. Give us some autonomy to treat patients as we see fit, stop micro managing us
Likewise secondary care: fund it properly to reflect the burden of an increasingly elderly population, manage it properly, stop artificially holding down the numbers of medical training places at university, pay students while they learn, increase wages to better reflect the level of professionalism throughout the service
None of this is unknowable or impossible, it just needs politicians to bite the bullet and tell people honestly how much of their taxes it's going to cost if they (the public) continue to insist on living longer while (mostly) eating shit, drinking too much and not doing any exercise.
Off to do another 10 hour shift. Stay safe everyone.
It's always been claimed its underfunded, can't help but feel however much money is thrown at it it'll never be enough.
It just seems a mismanaged broken system really?
As good as it can be in a lot of scenarios.
WOUld one answer be a 'Private A&E' for all the people with health insurance ?
That could and likely would take a certain level of load off the standard national health service ?
Maybe if people had to pay an excess each time they went to the doctors then that would make things a bit different ?
Sure it's a little Eliteist... but the benefits to the people who don't have Private cover would also be that their waiting time should go down too.
can’t help but feel however much money is thrown at it it’ll never be enough.
Quick post before I have to go, last Labour govt essentially said, we'll give you all the money you want, if you tell us what's the biggest impact on healthcare is and stick to it. The NHS had a target of 18 weeks for treatment, and largely met it, and pretty much ignored every thing else. By about 2008, we could honesty say that we had one of the best, (if not the best) publicly funded healthcare systems in the world. It's mostly been downhill ever since.
Spoke to my 70+ year old parents about this as they need the nhs, but depressingly they went on a rant about it all being the fault of immigration.
I see Sunak's total bollocks about making kids do maths until 18 has had the desired effect - the media are talking about that, not about strikes, the NHS on its knees, cost of living through the roof...
Meanwhile...
https://twitter.com/LiamThorpECHO/status/1610540582421630976?t=Sq1XX-4qLkaJ705OkBhBhw&s=19
9hrs for an ambulance for my mum with a broken hip.
I think the NHS should be removed from party control.
Make it a true cross party responsibility so we have stability and joined up policies. Rather than a political tug of war.
Stop people in Parliament using it as a points scheme to win votes or private jobs.
Also if I had the option to pay more tax that was dedicated for the NHS I would on the provision it didn't get eaten up by some middle management sponges.
There's a lot of waste and poor procurement in the NHS as well.
It's not the poor bastards at the front line that are causing this but they are the ones carrying these decisions
alpin
Free Member
@saucemerlinWhen’s the revolution…. I’ll be coming back for it.
2016. The bad guys won.
23 ambulances queued up outside the hospital I work at on a recent bad day.
Chatting to my neighbour yesterday and he said "don't know why they think they're special, no one else is getting a pay rise, we're all struggling." He's self-employed. Think that sums up a lot of people attitudes. Ignorant to the fact that public sector pay on average lags way behind private sector pay and other people actually are getting pay rises (mate at British gas just got 19%)
Who would staff it?
You'd pull the front line staff out of the NHS making it even more like a 2 tier system.
He’s self-employed.
Ask him how much of his income goes through the books - that usually shuts them up.
Spoke to my 70+ year old parents about this as they need the nhs, but depressingly they went on a rant about it all being the fault of immigration.
Surely it's the opposite problem as don't we rely on an awful lot of health service staff from abroad to make up the numbers we seem to be unable (or unwilling) to train in the UK?
Still, part of the reason we are in this sorry mess is the lack of awareness of preventative measures. Our use of pharmaceutical products and drugs is at an all time high and our intake of ultra processed foods and refined carbs and unhealthy corn oils is growing exponentially. Yet we wonder why chronic disease (often amplified by obesity) are also at the highest levels they have ever been despite us spending more and more on healthcare and prescription medication each year.
Most prescription drugs only mask the symptoms of illness, they do not address the root cause of the problems which ultimately stem from poor diet, lack of excersize and an unhealthy lifestyle. We have been told for years that a high carb, low fat diet is healthy yet the latest research shows exactly the opposite. A diet high in meat, fat and vegetables and low in processed foods/sugar has been shown to actually reverse the progression of diabetes in many subjects. Yet lobbying from the pharmaceutical industry and food manufacturers maintain the status quo because this is exactly how they make their money. They make money from keeping people sick (and on long term medication), unhealthy and unable to think for themselves.
You can see the evidence of this double-think in action all around us over the last few years. Instead of promoting a healthy diet and lifestyle as an urgent priority, our government closed the gyms, restricted our access to excersize by keeping us at home and made it far more difficult for people to see their GP or access healthcare etc. Did you notice though that they kept the fast food takeaways open throughout the pandemic?
As a result, we have left lockdowns as a nation more unhealthy, more overweight, having drunk far more and taken more drugs, and in far worse mental health than we ever have been before. The current crisis in our NHS is testament in part to this. Yet still we seem to be going the same route, pumping people full of ever more sophisticated pharmaceutical products rather than addressing the root causes of chronic illness. Have we even learned anything these last few years?
Who would staff it?
WEll it could either be an out of hours thing for some staff or the fact it's privately funded would mean 'we' are paying better wages and getting the staff from the fact the pay is better.
Although of course that could be counter-productive though as that means some staff would leave the NHS positions, maybe.
It was more a question than a defined solution lol.
My daughter lost her part time job in a hotel in a city recently because 2 floors of the hotel have been turned into a temporary hospital beds and the hotel no longer needs the staff.
I guess it's one way to free up beds in the main hospital
There’s a lot of waste and poor procurement in the NHS as well.
As has been pointed out previously, does it have enough money to deliver all it needs to deliver if there was no waste?
Unless you genuinely believe the answer to that is "yes", then the problem is overall funding, not mismanagement. And when you are underfunded and under immense pressure, its a lot harder to make the "right" decisions. As in every other aspect of public services.
pumping people full of ever more sophisticated pharmaceutical products
Welcome to the forum.
You do make some valid points about prevention, but, you know, funding, rocks and hard places.
Brain dump while I cycled in this morning.
I've been in Private Healthcare for a number of decades and been in meetings with Junior Heath ministers and their civil servants. I can attest that Ministers of both stripes are not really interested in the lobbying of private healthcare. Their voice is not not nearly loud enough or wealthy enough to change policy direction in the UK. Why? Because the private healthcare market in the UK is largely mature and settled, it isn't really growing, that's because the NHS is very good at what it does and ministers of both parties recognise that there is votes in maintaining the NHS. The Labour votes for spending money on it, the Tory vote for making it do more with less money (a fantasy but works). A Junior health minister candidly told me that there is very little political mileage for any Health minister to affect reform (selling shit off the private sector) because 1. it is a political nightmare (see Andrew Lansley) and 2. they know full well the private healthcare industry's outcomes would be worse, and again, political nightmare
The industries that do have a direct impact on the health of the nation and have got the ear of ministers are the huge agro-industries, the food industries including the massive alcohol sector and the supermarkets. All those folks are having a great time making huge profits while selling us cheap processed shit that they know is bad for our health. They've all seen what's happened to the tobacco industry and they sure as shit don't want that to happen to them. Their lobbying to make sure that alcohol is both cheap and widely available and food is full of unregulated sugar and salt is having a direct impact on how our healthcare is both paid for and what the outcomes is after a lifetime of living unhealthily.
/Brain dump.
you want people to get better you need competent trained doctors, and people simply are not being attracted to the profession at the minute due to poor doctor pay and conditions
This is effecting many doctors !
Make up your mind, it can't be both 😉
Dont blame politicians, blame society and its want to look after the vulnerable in society.
No I will blame the politicians not society.
Right at the very start of the severe austerity programme imposed by the Tory-Liberal Democrat government it was announced that NHS spending would be ring-fenced.
Precisely because the Tories and LibDems knew that even if the public swallowed the austerity lie cuts in NHS funding would never be acceptable to voters.
However they got round that by slashing funding in council support, social care, etc, and also not increasing NHS funding in line with an aging population and new available medical procedures, which had the same effect as directly slashing the NHS budget but avoided awkward and damning headlines.
I blame the duplicity of politicians.
I can attest that Ministers of both stripes are not really interested in the lobbying of private healthcare.
Publicly
Given how many of the current tory party and a few critical labour party members are trousering bribes from the private medical companies and then deciding those private companies are the answer to NHS woes.....................
ou want people to get better you need competent trained doctors, and people simply are not being attracted to the profession at the minute due to poor doctor pay and conditions
This is effecting many doctors !
Make up your mind, it can’t be both 😉
Posted 48 minutes ago
@thegeneralist yes it can.
Junior doctors ( remember many doctors are "juniors" for long periods of their career) are actually pretty badly paid for the hours they work. Its possible for them to technically be on below minimum wage at the start of their carreers)
Consultants are better paid, although arguably their wages have not kept pace with other careers that involve similar levels of seniority, responsibility and knowledge / education - in relative terms, all healthcare jobs have fallen down the league tables for pay rates in the last 20 years)
However, there is a well known "tax trap" related to pensions that the poster above refers too where providing extar hours worked yields a large unpredctable tax bill and often leaves the consultant worse off than if they hadnt worked the hours. see here
So to privatise the NHS would require 5-10 years to build private acute hospitals and the same time to find and train staff
Not at all. You simply give the private healthcare companies the NHS hospitals and / or the work and the staff. tories have privatised large chunks of healthcare in England with private clinics now doing NHS work ( more expensive and worse outcomes)
@thegeneralist yes it can.
...
Consultants are better paid, ...
However, there is a well known “tax trap” related to ..
Whoosh !
PS, the point I was making is trivially unimportant in the scheme of things.
I can attest that Ministers of both stripes are not really interested in the lobbying of private healthcare. Their voice is not not nearly loud enough or wealthy enough to change policy direction in the UK.
But do ministers even need to be involved in lobbying for the pharmaceutical industry and other corporate bodies to exert undue pressure on the NHS and it's regulators?
From a BMJ article it says that:
"In Europe, industry fees funded 20% of the new EU-wide regulator, the European Medicines Agency (EMA), in 1995. By 2010 that had risen to 75%; today it is 89%".
https://www.bmj.com/content/377/bmj.o1538.full
In the UK I believe that the funding of the MHRA is made up of 86% or thereabouts of industry funding including some funders outside the immediate scope of the industry such as the Bill & Melinda Gates Foundation. The same Bill Gates who is invested heavily in Pfizer and BioNTech.
https://www.europarl.europa.eu/doceo/document/E-9-2021-004558_EN.html
For the World Health Organisation, it is over 70% of funding that comes with 'strings attached' as confirmed by Margaret Chan, ex Director General of the WHO. Very, very sorry for the dubious twitter link but was the only source for the video I could find: https://twitter.com/i/status/1609065417879785472
Whether all this corporate funding would unduly influence public health policy is up for debate. Ultimately, who should the MHRA, the FDA and the EMA be accountable to? The public, or the people who fund it? Is this a good or a bad thing. I'll let you decide.
" I can attest that Ministers of both stripes are not really interested in the lobbying of private healthcare. "
Sorry I am calling bollocks on that.
The Tories wet dream is to delete the NHS and replace it with 100% priovate health care.
They are doing it by stealth at the moment and they are all getting a back hander somewhere along the line. Some of them even have their family menebers as the private healt care lobbyitsts!!
As has been said further up, its a deliberate strategy to run the NHS down to the point where they will get the public to acceopt privitisation is the only solution.
They are absolute monsters and don't give a flying fox about any of us.
Don't vote Tory if you want o keep the NHS!!
If you do you can f off all the over there, and then when you get there you can f off some more.
Had a long chat with a long serving A&E nurse over the holidays, who has worked in two different health boards over the last few years so probably has useful real “hands on” experience / insight where the problems lie. He suggested it isn’t one thing that is the problem, but a mix of several things any one of which had the potential to break an already struggling system.
1. Demand from patients who really should be in a&e hasn’t gone up that much compared to pre-Covid but had been creeping up for years. Many factors involved in this. No political party seems able to think more than 5 yr cycles so happier to throw money at a shiny new hospital than a long term strategy to make people fitter and healthier.
2. Staffing within the hospital - either in A&E or depts they need to admit patients to or get patients assessed by. Covid, Brexit, cost of living, screwed up pension arrangements for consultants, overworked people, all contribute to a shortage of people doing stuff so it takes longer to get patients out of a&e to their next destination.
3. Social care bottlenecks. “Bed blocking” in hospitals because there’s nobody suitable to care for the person when they leave. Whether in care homes or the community. So new patient is stuck in A&E because the outgoing patient is unable to leave. Funding boosts for NHS rarely includes useful funding to fix social care. And it’s not just old folk - mental health etc are also an issue, and even “district nursing”.
4. Patients who should never have been in a&e in the first place. He attributes this to several factors: difficulty (real or perceived) in getting a GP appointment. Out of hrs GP services often being at the same location and with some element of telephone screening first - why go through those hoops if you can go to same building and walk through the front door. Parents worried about strep A are adding to this just now. A&e is one of the few nhs services marketed as open 24/7
5. Seasonal fluctuations - slips on ice, flu/Covid, etc. issues with cost of living probably worse in winter too.
6. People within the NHS are very bad at understanding how the public want to interact with their services and adapting to them rather than how the nhs want to deal with the public. The vast majority of nhs staff have only worked in the nhs and many of them only within one hospital so the way it has always been done is how it should be done. We live in a world where people can do most stuff 24/7, we can order stuff on Amazon and get it in <24hrs, I can track an Uber as it drives to collect me, and the NHS hasn’t kept pace with that. There’s one bit of the nhs which has its doors open 24/7. Things are disjointed and funding doesn’t flow to places that could relieve pressure on A&E (nor are places that increase pressure on a&e “punished” for offloading their work that way).
7. Managing the numbers. Every management trailing course will tell you if you don’t measure it you can’t manage it / tell if your fix is working. What they don’t tell you is that adding processes just to measure stuff may cost more than any improvement might bring, and that as soon as metrics get targets you create an artificial game to manipulate the metrics.
on their own any one of those could have tipped a&e from its knife edge to being headline worthy. When they all happen together it’s a perfect storm. I’m not quite as cynical as others, I don’t believe the leadership of the Tory party actually want to privatise the whole of the NHS. I don’t actually believe it’s a conspiracy - it’s just simple incompetence and treating the NHS like it’s some special case (helped by the media). Society is an eco system - funding the NHS but not funding housing, or justice, or social care, or education, or active transport, etc doesn’t help the NHS. It would take a bold politician though to say “the NHS is in crisis so we are going to give more money to police, housing associations and schools”.
We also have Wes Streeting ( trousers bribes from private healthcare) stating that privatisation is the only answer.
Poly - its outright corruption. clearly so. Private healthcare companies bribed UK politicians with many millions of pounds and in return have now captured around 10% of NHS care being done by private providers at a higher cost and with worse outcomes
at a higher cost and with worse outcomes
Which the NHS get the 'blame' for but have no way of influencing the situation. This then further feeds that narrative.
https://fullfact.org/election-2019/nhs-private-spending//blockquote >
I wouldn't trust FullFact as far as I can throw them. An organisation with dubious funding and motivations. Funded mostly by the Big Tech industry to further their sphere of influence. I'm not saying your figures are wrong on this occasion, as they might indeed be correct, I don't know, but stating FullFact as any sort of authority on anything is naive in the extreme, especially considering who their funders are and how much they have got badly wrong over the last few years.
Private care. Includes most GPs, Pharmacies, and opticians. And the problem there is?
From the Full Fact link above.
Added to that is the £14 billion the NHS spent on commissioning primary care from the private sector. This includes things like GP services, pharmacies, and opticians
Let us assume for the sake of argument that Wes Streeting and Steve Barclay are equally ideoligically committed to privatising the NHS.
Which one do we think will be reigned in more by the rest of their party?
Its not ideological committment from streeting. Its plain corruption.
Its not ideological committment from streeting. Its plain corruption.
That's the answer to a different question, though.
Do we think a Tory or Labour Health secretary would come under more internal fire from their own party for privatising the NHS? Ergo - which party would be better for us in NHS terms?
with Streeting as health secretary I doubt it makes much differnce
wouldn’t trust FullFact as far as I can throw them. An organisation with dubious funding and motivations.
Hmmm.
I dunno, but that sounds like extreme tinfoiledhattery to me. Mediabiasfactcheck.com provides referenced facts that suggest that Fullfact is as close to unbiased as you can get and the funding is pretty transparent, it has to be to be granted charitable status, after all.
From that site;
‘ Full Fact is a very well-sourced, thorough fact-checker. We consider them to be a top fact-checker in the genre, with the likes of Politifact and Factcheck.org. MBFC endorses Full Fact as a highly credible fact-checker. (D. Van Zandt 11/29/2016) Updated (11/18/2022)’
And;
‘ In review, Full Fact is a signatory of the International Fact-Checking Network (IFCN). They do not use loaded words in their fact checks and always source properly. A factual search reveals they have not failed a fact check and are, in fact, a certified fact-checker.’
If there’re bending the truth to influence your thinking, then they are exceedingly good at it. More likely that your thinking has already been influenced to such a point that things like ‘truth’ and ‘facts’ don’t line up with your world view.
with Streeting as health secretary I doubt it makes much differnce
I respectfully disagree.
SO as an 'insider' I'm happy to give my tuppance worth via several points:
- "Private provider" isn't always a bad thing... care is essentially commissioned. Most of the time this commisioning process works well adn seeks to provide healthcare/investigations via the most financially appropriate route. Simple example..our NHS hospital charges (made up figure) £200 for an ultrasound. A local PRIVATE provider offers it for £120. They both comply to the same regs etc etc, so the local commisioners choose the private provider. It's quicker, cheaper, and therefore better. When I had my vasectomy, it was provided by a local PRIVATE provider service commisioned to perform it. It was actually an NHS surgeon, in a GP practice locally, but it's PRIVATE. ergo, private provision isn't always bad. Mostly it's good. It's innapropriate private provision that's spunking NHS money away (see track'n'trace etc etc)
-I would honestly say one of the biggest issues the NHS is facing is the inapropriate care of the ever growing 'frail and ageing population'. This is a HUGE concern of mine, and something that neither the state nor the patients are actually open to an honest conversation about. Simply put - We as a nation can NOT afford, nor is it appropriate, to manage the frail and ageing population in thesame way we manage the general adult population. I'll say it again:
We as a nation can NOT afford, nor is it appropriate, to manage the frail and ageing population in thesame way we manage the general adult population
In reality, the 'frail and ageing population' is a fairly new cohort of patients.
We've always had:
Neonates, paediatrics, and pregnant women - it would be 'criminal' and i'd be struck off if i manages a 2kg neonate as "one 50th" of a 100kg 45 year old man!!! They are a different patient population, with different medical needs and different treatments.
In the same way, a 36 year olf women who is 4 onths pregnant received vastly different care than a non-pregnant woman.
We simply cannot treat a severely frail, severely ill 92 year old in the same way as a severely ill 61 year old. We just CAN'T! But we do. We admit them to hospital, we submit them to the same barage of tests and investigations, and expect the same outcome and level of response.
Yet no one is confident enough (at a high up level) to admit we are doing this all wrong, and provide 'back up cover' to tose of us on the ground floor trying our best.
Case in point - my granddad at present is dying, very ill in bed. He's 92. He's NOT going to get better. He's dying. He's receiving good care and mild nursing at home. The last thing that should EVER happen to him is that 999 are called (in fact, i got angry the carers rang 111 because his blood pressure was low... "just STOP effing measuring stuff on him!!!!"), and he should NEVER be admitted to hospital. I can acheive this on him because I am aware, and NOT afraid. Because he's dying.
But.... i can garuntee there's thousands of frail, elderly, dying men like him throught the land lying in hospital beds or A+E beds because someone has called 999, and no-one is strong enough to suggest that there is no fix for them, and staying at home and eating cake (or not) is better for them. So they get carted to hospital. Then they get stuck in hospital. It's jsut sooo sad and wrong.
I'm not saying healthcare shouldn't be provided to this group, but it should be appropriate healthcare.
I often use a good analogy.
Pensions are good, right. Pensions are appropriate. We've all got pensions cos we know they are good. But... would you start paying INTO a pension aged 92? Of course not - it's daft, you wouldn't ever benefit from it, and it would be a waste of your money. You'd be better off spending the same amount you'd be paying on C+H (probably) because your needs are different.....
DrP
Teej, I share your dislike of the rhetoric that comes from Streetings mouth, but I heard an interview with him the other day where he was allowed to clarify his position; he wants to lean on private providers in the short term, but then reduce the reliance on them massively as NHS provision is improved. I think it’s a simplistic idea, fraught with pitfalls and obvious issues, but it’s not the ‘private healthcare is the only answer’ position that he’s been painted as saying.
* the Tories, and * you if you vote for them.
This.
A change of government won't fix everything or fix many things any time soon but you can be 100% sure it'll continue to get worse as long as that self-serving bunch of ****s are in power.
I dunno, but that sounds like extreme tinfoiledhattery to me.
Be kind, it's only their second day on the forum.
Makes you think....
A change of government won’t fix everything or fix many things any time soon but you can be 100% sure it’ll continue to get worse as long as that self-serving bunch of ****s are in power.
That really is the bottom line.
“Private provider” isn’t always a bad thing… care is essentially commissioned. Most of the time this commisioning process works well adn seeks to provide healthcare/investigations via the most financially appropriate route.
trouble with that is the research shows these private providers are more expensive with poorer outcomes once you control for other factors. ( poerhaps less obvious with the snip but its well proven in general with these things.)
V8. I simply do not trust Streeting. also even the most generous assessment of his position its still stupid and counterproductive. Private care is not set up to do what is needed and is more expensive than using the NHS. Using private does not produce more capacity. It actually reduces overall capacity.
He is also corrupt. Not to be trusted. He is working for the private healthcare providers not the good of the country.
Very good point DRp about allowing the elderly to die in peace tho.
Very good point DRp about allowing the elderly to die in peace tho.
Agreed, sadly its a conversation no one seems to have the courage to have.
A change of government won’t fix everything or fix many things any time soon but you can be 100% sure it’ll continue to get worse as long as that self-serving bunch of ****s are in power.
Nothing to add to this.
Normally I can mentally chart a path of how policy changes might improve the situation, but here, everything is failing, all at once, from top to bottom.
Reversing the recruitment drain, the care capacity issue, the infrastructure problems, the education and training deficit, will take a decade, if we start now. If we wait two years, I am terrified about what will be left. The NHS is haemorrhaging its most skilled and experienced staff, that will accelerate exponentially. There is only so much that their sense of duty and care for their patients can paper over their desperate, mentally destroying, working conditions.
We are heading into a post-war situation where we will have to rebuild from the ground up, Nye Bevan style.
I don't envy a Labour government coming in to try to sort this out, last time it took the best part of three Parliamentary terms, and the situation is far more dire now.
Also, **** the tories and anyone who still votes for them.
@irc:
Private care. Includes most GPs, Pharmacies, and opticians. And the problem there is?
An interesting point. I'm not sure anyone would say GPs are in a great shape just now, they were left in the private sector when NHS was created to get the doctors on board, but they are frankly a bit of a shambles with poor integration / efficiency savings with the rest of the NHS etc. I suspect most of the public don't even realise they are private (which could be an argument for it) but would think it would be better if it was a standardised service. The usual arguments for privatisation like competition being healthy don't really make sense with GPs as there is a defacto monopoly in most areas and their contracts are standardised etc.
Opticians probably provides another example of why its not necessarily in the country's best interests, or maybe even the patients to privatise care. For routine stuff it works fine, but for anything complex (i.e. expensive) its sent back to the NHS specialist clinics. In reality I expect opticians are only financially viable if they are selling glasses and making profit from that to subsidise eye exams. Pharmacy the public see as a shop not a healthcare professional which could get them advice / care they need quicker - do they perceive they are being "sold" to?