Pray you don’t fall...
 

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Pray you don’t fall off and need a&e anytime soon.....

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DrP - thanks for writing that. A very thought provoking post.


 
Posted : 04/01/2023 12:40 pm
 ji
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There’s a lot of waste and poor procurement in the NHS as well.

And people who make that same argument about all parts of the public sector are also the ones who call for senior managers to be paid far lower wages than in the private sector, as if properly experienced and trained/qualified management was unimportant in tackling poor performance and waste. And are also often the champions of poorly thought through political point scoring measures such as league tables that have been demonstrated to reduce actual positive outcomes for the public.

Private sector companies can justify paying high salaries for senior positions, so why do we expect the pulbic sector to make do?


 
Posted : 04/01/2023 12:41 pm
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Opticians probably provides another example of why its not necessarily in the country’s best interests, or maybe even the patients to privatise care.

You only have to look at the state of NHS Dentistry - non-existent now in many parts of the country - to understand what tends to happen during creeping, self-regulated privatisation.


 
Posted : 04/01/2023 12:43 pm
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Yes although NHS dentistry is a clear example of what happens when you promise the moon to everyone and make no attempt to fund providing the moon to anyone while never admitting that it’s not possible to afford giving the moon to everyone.

Even in the “good old days” when “everyone” had an nhs Dentist, in reality only 50% of the population used the service so the funding was never enough to cover 100%, and also at that time, the patients were providing around 80% of the funding over the counter themselves. NHS dentistry has had patient charges since about three years after the NHS was formed.

It’s a separate thread but the “creeping privatisation” has been driven by many of the same pay, working condition and inflating cost factors that the rest of the NHS faces. It’s also blame that is equally shared by new labour who were the architects of the last new dental contract that caused a huge shift away from NHS provision (admittedly the Tories haven’t done anything to reverse or mitigate this)

@DrP makes a good point that echoes what my GP friend told me last week.


 
Posted : 04/01/2023 1:03 pm
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Make me health minister and I'll sort it all out in a couple of years.  Whats needed is pretty obvious but it takes both money and political will neither of which either labour or the tories have on offer


 
Posted : 04/01/2023 1:09 pm
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And people who make that same argument about all parts of the public sector are also the ones who call for senior managers to be paid far lower wages than in the private sector, as if properly experienced and trained/qualified management was unimportant in tackling poor performance and waste. And are also often the champions of poorly thought through political point scoring measures such as league tables that have been demonstrated to reduce actual positive outcomes for the public.

The 'too many managers in the NHS' argument is utter, utter, bullshit.

It is the UK's largest employer, has a budget the same as the GDP of a small country, and delivers a vast array of complex services. The % of managers within it is significantly lower than most private corporations. If anything, it is vastly undermanaged. The quality of managers is variable, a fair few are advanced from clinical roles by default rather being trained and well-suited to management.

I'm sure there is waste/duplication in an organisation of this size and complexity, but I'm willing to bet that the scale of it has declined significantly in recent years, and aiming at that will not produce the miraculous uplift in resources that some think.

https://www.nhsconfed.org/long-reads/nhs-overmanaged#:~:text=NHS%20managers%20make%20up%20circa,cent%20of%20the%20UK%20workforce

Make me health minister and I’ll sort it all out in a couple of years.

You can have infinite cash and you wouldn't be able to even make a dent in the workforce issues in that time. You'll also need to be the Secretary of State for Education, and Local Government Minister too.


 
Posted : 04/01/2023 1:11 pm
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I think loads of people could sort it out as you are spot on with "money and political will" being what is required.


 
Posted : 04/01/2023 1:12 pm
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@DrP Very well said.
@tjagain I look forward to seeing you at the despatch box or in Holyrood


 
Posted : 04/01/2023 1:19 pm
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'Money and political will' is a great starting point, but the rebuilding of the NHS is a long-term project, and should be viewed as such. A couple of electoral cycles is the bare minimum to see meaningful improvements.

Behind the facade of a functioning NHS, we are approaching the 'Dresden in 1945' stage, with the Tories piloting the bombers, and we need a similar post-war mentality to start putting it back together.


 
Posted : 04/01/2023 1:20 pm
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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.

Nope. But assuming that to be true - so what? $3m is pocket change in government / NHS budget terms.

I wouldn’t trust FullFact as far as I can throw them. An organisation with dubious funding and motivations.

And again, assuming this to be true (and I don't believe it is), does that make them wrong? This is the same argument just in different pyjamas that the anti-vaxers roll out against "Big Pharma."


 
Posted : 04/01/2023 1:55 pm
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I think loads of people could sort it out as you are spot on with “money and political will” being what is required

For me its is much more than political will. It is societies will to pay for it.

When it gets to the point that the population are prepared to be worse off to support Health & Social Care then thigs Politicians will bend over backwards as at that point it will win them votes.

It doesnt matter who your politician is, this will cost us all a lot of money to sort, and I think people are only prepared to put their hands in their pockets when friends and relatives start dying.


 
Posted : 04/01/2023 2:08 pm
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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?

Yep. Percentage wise, more "foreigners" work in the NHS than use it (or at least, they did pre-brexit). If we 'send them all back where they came from' or otherwise drive them away, waiting times go up not down. Immigration is a net positive for the health service.

Still, part of the reason we are in this sorry mess is the lack of awareness of preventative measures.

The vast tract of pseudoscience aside, I've thought this for a while. We're told that early diagnosis can be critical in treating severe illness yet there's no appetite to do so. Regular healthchecks every, what, five, ten years might dramatically reduce the incidence of chronic conditions. It has to be less of a drain than patching up properly broken people, no?

This ties in with:

You only have to look at the state of NHS Dentistry – non-existent now in many parts of the country – to understand what tends to happen during creeping, self-regulated privatisation.

I've written about this before but, I've been trying to get dental treatment. The only way I can get seen on the NHS is if it's an emergency. So I can't get a simple filling done, but if I'm in absolute agony and needing antibiotics and a root canal then they will fit me in. This is surely arse-backwards insanity.


 
Posted : 04/01/2023 2:08 pm
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Good post @DrP

My dad died of cancer. But he was 90. The options and side effect etc were explained and treatment offered. He declined. His one big concern in his last months was that he did not want to die in hospital.

He died at home with three of his children with him after being active still driving and playing golf up to 89. As good a death as any of us can hope for. Nobody lives forever.

A painkilling injection from a McMillan nurse a few minutes before he died possibly pushed him over the edge. I'm fine with that. A couple of weeks earlier he had asked his GP to put him to sleep which of course he couldn't.


 
Posted : 04/01/2023 2:13 pm
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There has been a couple of times I should have gone to at least the GP this year, but haven't

A mate of ours crashed in the Clywdian Hills recently. Fairly big OTB. We offered to get him to A&E, but knowing what the Hospital in question was like (same one I should have popped to) he decided not to, and get checked out at home a few days later - 4 broken ribs and a punctured lung !

Don't go smashing yourself up too much.

That said, the last time I had a proper crash, I was straight in, ambulance, bypassed A&E and straight into Resus ! Service was fabulous. I can't recommend breaking your spine though !


 
Posted : 04/01/2023 2:19 pm
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@cougar yes it is insanity but see my reply a few posts up.

Incidentally, almost all dental disease is preventable. This has been known for over 30 years & it really isn't hard but we still see kids of 5 having general anaesthetic to have 10 teeth out due to decay. Parents (& adults) either aren't educated or often, are told but don't listen / aren't interested


 
Posted : 04/01/2023 3:28 pm
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The problem facing NHS will take sometime to be sorted so unless the next govt or whoever are determined to stick their political neck out, it will just be another prolong agony for the public. i.e. politician(s) getting the NHS portfolio then pump some money in, grab some positive headlines then move on and leave it to the next person. The long term strategy for NHS is appalling considering the only way is to keep pumping money in as a solution. As I said, NHS is the largest employer in the world and should be an exception to the rules (very low tax) if govt wishes to really deal with the issue. Everyone regardless will have to go through NHS in their lifetime (birth, aged, sickness and death) and it is simply poor for a govt not to set NHS as the top priority. All parties should sit down to solve the problem rather than using it as a political football. Sort NHS out first then they can argue about other matters. Health and well-being comes first while the rest come second.


 
Posted : 04/01/2023 3:52 pm
 Drac
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DrP has absolutely nailed it. I’ve had this countless times and trying to explain to homes that the patient is old and their time has come can be a battle. Relatives seem to grasp this now, getting emergency health care plans can be sporadic and then getting them to follow it too.

We get old, we get frail and we die.


 
Posted : 04/01/2023 5:08 pm
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.


 
Posted : 04/01/2023 5:19 pm
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@cougar yes it is insanity but see my reply a few posts up.

Incidentally, almost all dental disease is preventable. This has been known for over 30 years & it really isn’t hard but we still see kids of 5 having general anaesthetic to have 10 teeth out due to decay. Parents (& adults) either aren’t educated or often, are told but don’t listen / aren’t interested

Ah, I missed that, thanks for the nudge.

Preventable how? Less sugar, better brushing, sort of thing? (Sorry, I know that sounds stupid, it's the "almost all" I got hung up on.)


 
Posted : 04/01/2023 5:27 pm
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@cougar

At the risk of a thread derail and in very simple terms.

For 99.9% of people there’s nothing wrong with their teeth when they arrive in the mouth.

There’s basically two disease processes that affect your teeth, tooth decay and gum disease.

Gum disease means that the ligament and bone that joins tour teeth to your head gets progressively destroyed over the years. Each tooth only has a certain amount of ligament so if it disappears it eventually leads to teeth getting wobbly, painful and eventually falling out. It happens because the bugs that naturally live in your mouth ( in simple terms) attack and destroy the ligament starting in your mid 30s onwards.

Whether you are at risk of this happening or not is a lot to do with your genetic make up (although smoking greatly increases your risk too). Some people are genetically lucky and have bomb proof ligament, some have very susceptible ligaments and there is a whole spectrum in between.

BUT, regardless of your genetic luck, if you don’t let the bugs sit on your teeth for any period of the time the they can’t cause any damage. So if you are good at brushing and you are good at using something like floss or interdental brushes to clean the areas between the teeth that your brush can’t reach, EVERY day, even if you have dodgy genes you can prevent or severely limit the occurrence of gum problems. Especially if you start doing it in your 20s and keep it up.

So preventable......

The second disease is dental decay. Contrary to popular belief, almost no-one inherits “weak teeth” ( ignoring a few genetic disorders but you would know if you had one of those and you wouldn’t have normal looking teeth) pregnancy also doesn’t have any irreversible effect on teeth or gums.

Decay works like this. The naturally occurring bugs that live in our mouth eat sugar. That can be processed sugar that’s added to foods like in chocolate / sweets or it can be naturally occurring sugar in fruit and fruit juice. ( but not true artificial sweeteners ). When you feed them sugar ( by putting it in your mouth ) they produce an acid as their waste product ( their wee if you like) This acid dissolves the crystals that make up the enamel of your teeth eventually causing holes either in a virgin tooth surface or at the edge of an existing filling or crown.

The important point is that the amount of sugar they can eat in one go is minute ( they are bacteria) so it really doesn’t matter how much sugar is in your mouth at one time, they can only produce a certain amount of acid. So stuff all 10 polos from a pack in your gob at once and the bugs are only using a bit of the sugar from one polo, the other 9 are irrelevant. BUT if you eat the packet one at a time, that’s 10 times you’ve fed them and ten times the amount of attack.

I.e it’s the number of times you eat not the amount ( or type) of sugar in each snack that’s important. If you only eat 3 meals a day and drink water you’re quite safe but if you have snacks or drink juice or “graze” you are stacking the cards against yourself and will get holes.

The aforementioned bugs that live in your mouth like to live actually on your teeth and the nasty ones need to be attached to cause damage, they start to build up on your teeth about 20 mins after they have been cleaned off each time but the nasty ones can’t attach and cause damage until the first few layers have already become established. so if you are good at cleaning them off ( as outlined above) your chance of getting decay is greatly reduced.

If you have a low number of sugar attack’s as well as good cleaning you can effectively stop decay occurring. If you have a high number of sugar attack’s daily, you are likely to get holes even with good cleaning.

Lastly, Fluoride reduces the rate at which decay progresses by making the crystals in your enamel stronger so using a fluoride toothpaste both when you are young and your teeth are forming and also when brushing as an adult helps further. It’s even better if there’s a bit in the water but there isn’t much in most of our water supplies.

So TL:Dr decay is preventable by good cleaning and minimising the number of sugar attack’s each day.

Obviously people get problems because dental work fails but fillings etc lasts longer if you keep them clean and if you do the right stuff from a young enough age, you won’t ever need fillings in the first place (& honestly the number of “cowboys” who do fillings that aren’t needed is tiny despite what almost everyone says about Dentists)


 
Posted : 04/01/2023 6:26 pm
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(& honestly the number of “cowboys” who do fillings that aren’t needed is tiny despite what almost everyone says about Dentists)

I think that is true now but not when I was a kid.  My teeth were wrecked by an overenthusiastic dentist back in the 70s when IIRC they were paid per filling


 
Posted : 04/01/2023 6:32 pm
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Most dentists still are but the philosophy behind how treatment is planned has changed. Ie much less aggressively and less invasive/ interventive

The prevention I outlined above is better understood and dentists spend more time educating people now.

Remember The 70s was 50 years ago, attitudes have changed a lot but back then the vast majority of dentists were following the best practice / knowledge base of the time, things have changed a lot like they have in all of medicine. No one even back then was filling teeth that didn’t look like they had a hole in I promise you, or were you one of the few people doing all the right stuff I outlined above?


 
Posted : 04/01/2023 6:37 pm
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@ji

I'm not saying pay them less. Get value for money is my point

Same way good Charity's have expensive ceos....


 
Posted : 04/01/2023 6:45 pm
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At the risk of further thread drift all my adult molars were filled pretty much as soon as they appeared.  Not had any time to decay.  No holes in any of them - just brown marks ( 50 yr old memory)  there is no way every adult molar had to be filled by the time I was 14.  In hindsight the dentist was a cowboy and its caused me issues all my life


 
Posted : 04/01/2023 6:46 pm
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I think that is true now but not when I was a kid. My teeth were wrecked by an overenthusiastic dentist back in the 70s when IIRC they were paid per filling

Definitely the case for me too. No outward signs of any problems or any pain yet every visit unto the age of around 16 would find something. Strangely since I left that dentist I've had no new fillings or problems apart from a root canal under an existing filling.


 
Posted : 04/01/2023 6:47 pm
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Definitely the case for me too. No outward signs of any problems or any pain yet every visit unto the age of around 16 would find something. Strangely since I left that dentist I’ve had no new fillings or problems apart from a root canal under an existing filling.

Sounds familiar. My last few dentists have been keen to avoid any intervention unless absolutely necessary, and that's pleasantly rare.


 
Posted : 04/01/2023 6:51 pm
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@ceepers That's absolutely brilliant, thanks for taking the time to write it.

I'd reply further but, ironically, I need to go eat something...


 
Posted : 04/01/2023 6:51 pm
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As I said, NHS is the largest employer in the world

It really isn’t.


 
Posted : 04/01/2023 7:09 pm
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So the PM today outlined how he was going to save the NHS, except he didn’t say anything

Let’s see if Keir comes up with any better idea’s tomorrow


 
Posted : 04/01/2023 7:10 pm
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My teeth were wrecked by an overenthusiastic dentist back in the 70s when IIRC they were paid per filling

Ditto, though it was the 80's and the offender was an orthodontist.

Wisdom teeth out aged 12, lower canines out aged 12. Two upper premolars removed aged 12 to allow my mouth to 'relax' and space everything out.

Bastard was a gorilla, i ended up with him capping some, aged about 14. Ended up going caps, then bridges when it became apparent all the roots had been damaged.

Basically doing far more work than was required at that age because it was private and he was a crook.

Eventually he was caught, struck off and imprisoned,  which is fine and right, only we had nobody to sue, couldnt sue the health board to get something like remedial implants because he was private and for my life all teeth eventually went the way of the dinosaurs.

Due to homelessness and not having a dentist during that time i had to extract 3 myself.

If i met him today(though likely long deceased, I'd push him under the first bus that came along.


 
Posted : 04/01/2023 7:11 pm
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As I said, NHS is the largest employer in the world

US DoD is the largest, it employs almost 3 million people.


 
Posted : 04/01/2023 7:12 pm
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It really isn’t.

What is bigger?  Armies don't count.  Indian railways maybe?


 
Posted : 04/01/2023 7:13 pm
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What is bigger? Armies don’t count.

Says who? They are a public sector employer. But the NHS is still behind McDonalds & Walmart.


 
Posted : 04/01/2023 7:16 pm
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70s kid, mid 50s now. Dentist every six months. All my teeth, one filling dating back to when I was a kid. Keen to keep it that way when I went to do a degree in the late 80s, I registered with a local dentist who told me I needed six fillings. Riiight.... sacked him off, and still fine 35 years later...


 
Posted : 04/01/2023 7:17 pm
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BTW, like many of you I completely agree with Dr P - but how do you square that with the response to Covid, which was all part of the same hand wringing response to the fact old people are unfortunately rather prone to getting sick and dying?


 
Posted : 04/01/2023 7:24 pm
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If you think a global response to a global pandemic is "hand-wringing" then I square that by thinking you're an idiot.

Any further questions? Would you like a list of people I know (of varying ages) who it killed?

****'s sake, really?


 
Posted : 04/01/2023 7:29 pm
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I’m not going to get into a big argument but….

Yes there have been cowboys that have been prosecuted like there are in every profession but I promise you they are much rarer than you (& everyone over the age of 50) all seem to think.

Like I said attitudes have changed - the orthodontic tale outlined above was a genuine mode of treatment that has now been discredited and outdated as brace technology progressed. ( you didn’t have any wisdom teeth at age 12 to have taken out though so must have been your 6’a maybe?)

Dentistry believed it needed to be more invasive and everything “suspect” was filled rather than monitored as we would now.

Each filling had a prescribed “shape” rather than following the actual hole so fillings tended to be larger than they would be now ( material advances have allowed much less invasive treatment also.)

You are all talking about medical thinking that is 40 years out of date. Knowledge and treatment improves like everything.

Also two final points, diagnosis in dentistry like all medicine is often a matter of opinion and educated guesswork. Some people are better at it than others, guidelines and opinions have evolved over time.

Lastly, people like to think that there’s nothing wrong with a tooth that’s not hurting. This is NOT true. A hole will only cause pain once it gets close to the nerve of a tooth. Filling at that stage leads to more trauma to the nerve of the tooth ( which is already irritated by the decay being close ) and more chance of the tooth not settling and needing root canal or extraction. MUCH better to do small fillings on small holes picked up early to stop them getting to a stage that might risk nerve death / toothache ( which look like small brown spots or shadows on the surface of the tooth - the hole is always much bigger on the inside as the inside of the tooth is softer and decays more quickly - you will only get a true “hole” the patient will notice once enough tooth has been destroyed inside that the outer layer collapses in on top of it )

Anyway let’s get back to bashing the Tories, some dentists even vote labour……


 
Posted : 04/01/2023 7:31 pm
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On DrPs post.  It actually goes against much of how nurses are trained to say " this person is old and dying, don't investigate or treat"  It takes a fair bit of confidence to say it and to do it and it can be very difficult if you don't know why they are actually dying

The ward I worked on was rehab / long term care of the elderly.  Wehad a new charge nurse from the acute sector.  One patient was showing signs of stroke and she was thinking F.A.S.T as we are trained to for stroke and wanted to send the patient by 999 to the general hospital for testing.  I went to get the patients notes and to check the advanced care plan which clearly stated not for transfer to acute, ward based care only.  I still had to argue with her not to call 999


 
Posted : 04/01/2023 7:33 pm
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To add to that TJ, I would imagine clinicians in the current age are very aware of their decisions being scrutinised by lawyers for the family later - it’s always safer to go to the ends of the earth from a personal jeopardy pint of view no?


 
Posted : 04/01/2023 7:38 pm
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Would you like a list of people I know (of varying ages) who it killed?

I worked like a **** all the way through it, as did my sister in her mid 50s. Don't know a single person who died or suffered long term effects, through personal contact or at several removes, apart from a couple of people who were already totally ****ed. Anecdotes, eh?

Fully vaxed up, isolated for five days and wore a mask last week after testing positive on Xmas Eve. I'm not some wingnut denier. I just hoped we might have a serious discussion about attitudes to life and death, and the quality of life in the wake of this. But we've just gone back to the defaults, nothing ever changes. Never voted Tory, on board with all the comments about needing to reform social care etc - but equally, I don't have much time for people banging on about 'our NHS' while eating, drinking and idling themselves into a state of chronic ill health (y'know, like some of the ebike riding ****s on here).

My 80 year old dad also had Covid recently, too. Fit as, worked in construction all his life, he's fine. Got all his own teeth, too...


 
Posted : 04/01/2023 7:52 pm
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ceepers

Not in reality but the myths are powerful

the key thing is to get the advanced care plans / advanced directives in place so there is no ambiguity but even then it does not always work  this is a case where it went wrong

https://www.theguardian.com/news/2021/apr/06/letting-go-my-battle-to-help-my-parents-die-a-good-death


 
Posted : 04/01/2023 8:00 pm
 Drac
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it’s always safer to go to the ends of the earth from a personal jeopardy pint of view no?

No, document history, findings, observations, care plan and justification.


 
Posted : 04/01/2023 8:08 pm
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I worked like a * all the way through it, as did my sister in her mid 50s.

As did a lot of people.

Don’t know a single person who died or suffered long term effects,

How fortunate for you.

I’m not some wingnut denier.

Perhaps not, but you're trivialising a life-changing (and in some cases, life-ending) event.

(y’know, like some of the ebike riding * on here).

Wow.

What's your narrative here? That the people who died were either ancient and due to go anyway, or were just lazy bastards who didn't try hard enough?


 
Posted : 04/01/2023 8:30 pm
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My 80 year old dad also had Covid recently, too. Fit as, worked in construction all his life, he’s fine.

Was he sufficiently hand-wringy to not bother with vaccines?


 
Posted : 04/01/2023 8:32 pm
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No, like me he weighed up the evidence and got jabbed. But he also recognises he's an old guy who's had a decent life. He could do with getting knee replacements but has made the decision not to pursue it rather than clog up the system and deny that avenue to younger people who can make better use of those options. Like I say, realistic assessment of life, death and quality of life. We all make our choices.


 
Posted : 04/01/2023 8:37 pm
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So your 80-year old dad wasn't hospitalised or worse by covid because he was vaccinated.

Am I missing something here? Where does hand-wringing, working in construction and e-bikes come into this equation?


 
Posted : 04/01/2023 8:44 pm
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Nurses are obviously very underpaid. We also haven’t trained enough doctors for decades due to claims that training is too expensive! It seems to be far cheaper to train doctors than lawyers.
I guess that’s partly why medical colleges set ludicrously high grade requirements for students. The NHS pension scheme is a joke . It encourages many senior staff not to work or reduce hours otherwise they would have to start paying penal rates of tax on arbitrary pension contributions.


 
Posted : 04/01/2023 8:51 pm
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I worked like a * all the way through it, as did my sister in her mid 50s. Don’t know a single person who died or suffered long term effects, through personal contact or at several removes, apart from a couple of people who were already totally *. Anecdotes, eh?

what does this even mean? I was fit as a fiddle, worked outside, on building sites and in a mill at various points in my life. Not that it matters in the slightest. Had Covid three times and never really recovered from the first bout. Fitness ruined, get lethargic and brain fog and my stamina is shot to shit. My name’s Phill, I’m 45. Well done, you’ve just met someone at several removes who is suffering long term effects. I don’t even own an eBike either!


 
Posted : 04/01/2023 8:59 pm
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@radioman ironically the grades are set high partly to cut the numbers applying for medical school down to manageable numbers for the unis to make their selections.

@drac fair enough.

I do know of a max fax surgeon who had a patient have an “episode” in his waiting room. He and his team started CPR, the patients relative started filming them with a phone in case they made a mistake!


 
Posted : 04/01/2023 9:00 pm
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Don’t know a single person who died or suffered long term effects,

You can have some of mine then. Knew 7 people who died directly due to COVID-19 and know of another 6 who are living with long-term effects. The mental toll on the majority of people I know, including myself, won't become clear for another few years.

Don't trivialize a major event that has affected the whole country in unprecedented ways and has shown us the true value of the NHS at the very point where it's fighting for it's survival.


 
Posted : 04/01/2023 9:08 pm
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So your 80-year old dad wasn’t hospitalised or worse by covid because he was vaccinated.

We'll never know, will we? You, like others, seem to be confusing population level effects with individual responses. It's about taking personal responsibility for your health, and (as Dr P pointed out) realistic expectations for an ageing population. I look at things in the bigger picture. Like my dad, I agreed that individual Covid vaccination was better for the population as a whole. However, I actually don't agree with his decision about his knees on an individual level, because I think he'd get more quality of life from new knees than many people 20 years his junior. But, hey, it's his decision, and seen in the wider context (an ageing society unwilling to fund unlimited healthcare), it's maybe the right one.

As someone in my mid 50s, I've already made my choices. I've protected the NHS by keeping myself healthy all my life, and I absolutely will not add to society's burden in my latter years by turning into someone sitting in front of Teletubbies and Homes Under the Hammer, p!ssing myself into an adult nappie in a residential home, with family members absolving themselves of financial responsibility while simultaneously berating the caring professions.

Nope, that's not for me. My strategy is already in place, everyone who needs to know notified accordingly. Quality of life. Complicated, isn't it?


 
Posted : 04/01/2023 9:11 pm
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Care Homes are now accepting those from the NHS, but along with that they are bringing in covid, which, given the health of the folk there is causing more deaths. It's a terrible situation, but beds are blocked. I know this as I know somone working in a care home and 'floors' are being isolated dut to cases being brought in and of additionla deaths. Don't forget, flu is just as bad for the elderly and frail. You can't keep a hosptial bed full of people that can't really be 'improved' enough - we need more 'halfway homes' to take those that don't need intensive care.


 
Posted : 04/01/2023 9:13 pm
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I do know of a max fax surgeon who had a patient have an “episode” in his waiting room. He and his team started CPR, the patients relative started filming them with a phone in case they made a mistake!

A sad sign of the times... sureley they would be more likley to make a mistake with relatives interfering...just let them get on with it is the best thing you can do in that scenario?


 
Posted : 04/01/2023 9:14 pm
 Drac
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I do know of a max fax surgeon who had a patient have an “episode” in his waiting room. He and his team started CPR, the patients relative started filming them with a phone in case they made a mistake!

Cool story.


 
Posted : 04/01/2023 9:14 pm
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As someone in my mid 50s, I’ve already made my choices. I’ve protected the NHS by keeping myself healthy all my life

what if you get hit by a car, beaten up, break a limb, get cancer, have a stroke, come down with the bad cat aids. You’ve not protected anything, you’ve been lucky. I know plenty of healthy people that have become ill or had accidents. Hell, I knew a couple who just dropped down dead.


 
Posted : 04/01/2023 9:19 pm
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what if you get hit by a car, beaten up, break a limb, get cancer, have a stroke, come down with the bad cat aids. You’ve not protected anything, you’ve been lucky.

No, I've been careful, stayed healthy, and, on the two occasions when I've broken bones, been very proactive in making a full and quick recovery (aided by being fit and healthy in the first place). In my mid 50s, I've already decided that if/when I get cancer, I'll turn down invasive treatment and go down the palliative care route. Like I say, realistic expectations and quality of life. You lot get too emotional about this stuff.


 
Posted : 04/01/2023 9:27 pm
 DrP
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It actually goes against much of how nurses are trained to say ” this person is old and dying, don’t investigate or treat”

Agreed, and I think this is because the frail and elderly are, as far as medical training goes, a fairly new 'patient cohort'....
As such, the med profession aren't used to managing them....
We need global training, public awareness that there medical profession are NOT negligent for managing a bedbound 96 year old in a much less aggressive way when they get very ill, compared to a 56 year old with a potential recovery ahead of them!

DrP


 
Posted : 04/01/2023 9:30 pm
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Not emotional in the slightest. You’re just coming across as a bit condescending to be honest. As per above, you’ve been lucky is all. Yes, keeping fit will help but, as I’ve found out, it doesn’t always work out that way.


 
Posted : 04/01/2023 9:31 pm
 Drac
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No, I’ve been careful, stayed healthy, and, on the two occasions when I’ve broken bones, been very proactive in making a full and quick recovery

What a Ledge


 
Posted : 04/01/2023 9:33 pm
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I have never had issues with the public on this issue - and the unit I used to work in was in general " no escalation".  good medical team managing expectations helped as did a very strong proactive use of advanced care plans

IME is more the staff than the families that can't grasp this.  It is not easy tho when asked.  "whats wrong with them?" and you have to say " I don't know"  I have had that conversation many times and had various techniques for guiding it in the right way


 
Posted : 04/01/2023 9:34 pm
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What a Ledge

Not the hero we want, but the hero we need. 🙄


 
Posted : 04/01/2023 9:39 pm
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No, I’ve been careful, stayed healthy, and, on the two occasions when I’ve broken bones, been very proactive in making a full and quick recovery

What a Ledge

The physio who helped me with the first break liked working on me because I didn't complain, just told her to get on with it. She also said 50-60% of her patients were suffering extended complications because they were overweight. Get as personal as you want, helps avoiding the real issues, right?


 
Posted : 04/01/2023 9:44 pm
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Just watching 'Ambulance' and you can see the time wasters - fuming.


 
Posted : 04/01/2023 9:45 pm
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Montgomery.  when in a hole stop digging.

You are coming over as patronising and condescending and very irritating and also showing a total lack of grasp of the issues


 
Posted : 04/01/2023 9:48 pm
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Just watching ‘Ambulance’ and you can see the time wasters – fuming

24 Hours in A&E last night was an emotional one. Old boy with dementia came in with sudden breathing issues, turns out had an infection in his colon, developed sepsis. Was put on an EoL pathway. Wife was in bits. Clearly see the impact on the team, especially the consultant who had to relay the bad news.


 
Posted : 04/01/2023 9:48 pm
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That’ll be his own fault for not working in construction whilst being careful and healthy.


 
Posted : 04/01/2023 9:52 pm
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I had to switch over 24H A&E when the lass came in with a broken ankle after falling off an inflateable - freak accident - that was grim, foot snapped off completely, held on with a flap of skin. Surprisingly little blood, but the bottom of her led bones sticking out - oof.


 
Posted : 04/01/2023 9:53 pm
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showing a total lack of grasp of the issues

Sister's husband was a GP (until he died of cancer in his mid 50s). Friends who are nurses and consultants. I understand the issues very well. I also won't take lessons on condescension from you, tj....


 
Posted : 04/01/2023 9:54 pm
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I had to switch over 24H A&E when the lass came in with a broken ankle after falling off an inflateable – freak accident – that was grim, foot snapped off completely, held on with a flap of skin. Surprisingly little blood, but the bottom of her led bones sticking out – oof.

You missed the best bit when they popped it back in place. A little while later while waiting for surgery, she could wiggle her toes. She made a full recovery!


 
Posted : 04/01/2023 9:56 pm
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What a Ledge

And then just to emphasis it the response comes:

The physio who helped me with the first break liked working on me because I didn’t complain, just told her to get on with it.

Why were you having physio btw?

I didn't need any physio with my breaks, I just got on with it. Mind you I have never ridden an ebike so perhaps that's something to do with it?


 
Posted : 04/01/2023 9:59 pm
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Oh god, noo !

Oh well A&E After Dark on C5 now - that really shows what goes on !


 
Posted : 04/01/2023 9:59 pm
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When I broke a bone I just put some sticking plaster on it and carried on.  Real man me!


 
Posted : 04/01/2023 10:02 pm
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I also won’t take lessons on condescension from you, tj….

you probably should though.

Yours, impartial observer.


 
Posted : 04/01/2023 10:03 pm
 Drac
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I lasted about 5 minutes with Ambulance tonight after today’s shift. Let’s just say some kids aren’t as legendary as Montgomery.


 
Posted : 04/01/2023 10:03 pm
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Drac, don't watch C5 then, started with time wasters, lots of them.


 
Posted : 04/01/2023 10:08 pm
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I lasted about 5 minutes with Ambulance tonight after today’s shift

I’m probably wrong but aren’t you a Paramedic? Seems mad to watch other people doing your job in your downtime 😀


 
Posted : 04/01/2023 10:08 pm
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The physio who helped me with the first break liked working on me because I didn’t complain, just told her to get on with it.

Why were you having physio btw? I didn’t need any physio with my breaks, I just got on with it.

Something to do with the two operations and the metal t-piece I still have in my arm (and the main point you didn't quote, about the physio's observation re: 50-60% negative outcomes due to being overweight). But, for the record, my second break in Knoydart: set the bone myself, got to the Belford next day for a quick plaster job, no physio, and whipped off the cast myself six weeks later. Just sayin,' like.


 
Posted : 04/01/2023 10:17 pm
 Drac
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I’m probably wrong but aren’t you a Paramedic? Seems mad to watch other people doing your job in your downtime

It does. My family like to watch it and while there’s some tv magic in there it catches the job well.


 
Posted : 04/01/2023 10:31 pm
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We’ll never know, will we?

Well, we will, because it's very well understood. You don't die from a viral disease because you had a bike with a battery attached to it. Being a brickie never stopped anyone from getting cancer.

You, like others, seem to be confusing population level effects with individual responses. It’s about taking personal responsibility for your health

As far as it goes, yes, alongside the state's duty of care there should be an individual responsibility on everyone to do what they can to care for their own health. On this we agree and for that I applaud you, sincerely. But the examples you've chosen to demonstrate that point are somewhere between daft and deeply offensive.


 
Posted : 04/01/2023 10:34 pm
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Something to do with the two operations and the metal t-piece I still have in my arm

I’ve protected the NHS by keeping myself healthy all my life

Hmm…


 
Posted : 04/01/2023 10:44 pm
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