The New Cabinet

My cataracts haven,t been treated Dapnedill,I have been told to wait until they worsen.
I do very detailed work for my income so am in no hurry as I dread it not working.
A friend had hers done on the NHS,one eye is worse and the other is perfect vision which she finds very frustrating.

I did read your link.....not good at all.

I don't live in a big city, but I DO live near one of the biggest teaching hospitals in the country. I spent a couple of hours in A & E two weeks ago with my son, who dislocated his knee cap on a Saturday evening. A & E wasn't full of drunks.

Locums can be employed for long periods, because vacancies can't be filled and because there is no budget for full-time staff due to uncertainty and cuts. It can work out cheaper for the NHS, because they don't have on costs such as NI and pension contributions nor do they have to pay redundancy pay, if they have to make cuts. My daughter shares a flat with three medics. One was a locum for four months after being made redundant as a result of cuts.

By the way, you should be grateful your cataract wasn't dealt with by these people...

www.theguardian.com/society/2014/oct/23/family-investigation-cataract-surgery-private-vanguard

Private isn't always best and the NHS ended up picking up the pieces of the botched operations.

@ Daphnedill,I don,t blame drunks for the state of the NHS,but they are a nuisance and do clutter up A&E.A bill might sober them up a bit,and allow staff to look after those who need attention.
I take it that you don,t live in one of our major cities where Friday and Saturday evenings are one long pub crawl and people are flat out on the pavements!
Our hospital,which is a large teaching one,informed me that locums can be employed from 1 day to 6 months.

@Trisher,I believe that NHS doctors are paid very well in the private sector,but you are correct,they are trained by the NHS ,also they do use NHS facilities for private work.
My daughter was very ill some years ago and was given a 6 to 8 weeks wait for investigative X-rays. I asked the hospital when she could have a private X -ray
and was told the following day !!
I then asked to book that appointment for my daughter,but on the NHS.
After consideration by the department manager,she was given the appointment ,the results took a few days and her 6 months of treatment began.

Though I disapprove of private care impacting on NHS patients,I do not blame anyone who choses it.

The PAC has given them until December to come up with figures for staffing a 27/7 NHS. What happens between now and then?
More locums?

Thousands of permanent posts have been axed, so when somebody's ill or on holiday or there are more patients than expected, locums have to be employed. There are also some specialisms, where it's not possible to fill vacancies quickly enough, because there are shortages.

No, Tegan, you should be angry at it, not sad. It's government policy.

'The reason agency nurses and locums are used is because hospitals have budget constraints and aren't allowed to employ enough full-time staff'..I didn't realise that dd. .

But Granny2016 without the NHS there would be no doctors in private medicine. Anyone who uses private healthcare benefits from the NHS hospitals that train staff. They do use the NHS, just don't join the waiting lists for operations and appointments. I am not saying private medicine is wrong only that the people using it owe a debt to the NHS as well. Private medicine also sets limits to the amount of treatment someone is entitled to, when the money runs out good old NHS steps in.

I don't support the argument about people who pay for private healthcare not wanting to pay higher taxes. Yes, they do use the NHS when it suits them. They use A and E and emergency services. I believe even David Cameron's last child was born in an NHS maternity unit, because the baby was early.

We need to face up to the real problem, which is that the NHS is a victim of its own success and people are living longer, not blaming drunks and locums.

The reason agency nurses and locums are used is because hospitals have budget constraints and aren't allowed to employ enough full-time staff.

I support a national health service,sick people should be treated whether they can afford to pay or not.
Many in the UK now pay for private health care,yet also pay NI and taxes which are used for an NHS which they do not use.I don,t think many of those would be happy to see a rise in taxes .
Certain uses should be chargeable i.e. Friday night drunks.

Someone has previously mentioned the price of agency nurses and lack of training for our own.I signed a petition a few weeks ago as bursaries for our trainee nurses are under threat.We need more career nurses of our own with fair pay.
We also need to crack down on the fees paid to NHS hospital locums.
Before posting this,I have found various websites advertising tax saving services to NHS locums,boasting up to £25,000 p.a. tax SAVING.....more than lots of people earn.
I think many people would be willing to pay slightly more tax to improve the NHS,after they have seen the NHS put their own house in order.
I first looked into this when I had an unsatisfactory appointment with a locum consultant 4 years ago.
I was given a further appointment with a full time consultant who was astonished that I was not told I have cataracts,let alone,no opinion at all on the actual problem under investigation.
The agency www.click4locums.co.uk has a list of hourly rates,but they are not the highest.

Sounds very well organised MargaretX. I agree with others that this constant fire fighting and damage limitation approach to and by NHS should be replaced by a good, very long term strategy not one that lurches from election to election.

I agree Anya - turn NI into NHSI and separate it completely. As we both agree on 'a long term NHS plan' (can we start a call for such a thing) that is a lovely start to the week .

Thank you for the details MargaretX. The more we can know and compare the better.

Walk in Centres were a great idea [we've used them several times] but they are closing down in many areas. I'm sure they took a lot of pressure of A&E departments and doctors surgeries. Chemists seem to be offering more and more services although they're not cheap [I saw an add for mole checking the other day] and I've often had bad advice from pharmacists. Eye tests should be free again as they are such a good health check. Good nutrition should be taught in schools [maybe it is ?].Companies that provide medication for dispensing doctors should automatically provide the cheapest generic [again,that might be happening now].We should all be responsible for our own health, but at the same time help should be there when needed. I don't know what the answer is though. I read once the Japan has a 'ministry of forward planning department'; I've often felt that we don't think ahead in this country.

Totally agree Tegan

Gracesgran what I mean is, with rising costs and demand, taxes would surely have to increase. I'm quite happy to pay extra, if it was guaranteed to be ring-fenced to go to the NHS, as would I suspect many others.

But yes, rather than this piecemeal approach I'd be delighted to see the government, ANY government, set out its 50 year plan for the NHS, spelling it out clearly and honestly.

In Germany pensioners pay a lot less than when they were working. As to shortage of Doctors there isn't one its just that they don't want to work in country areas. There has been talk of making them work in the country for 5 years but no government wants to start it as it is not popular. It is expected that with increased retirement there will be short fall.

I live in a middle class market town and we have loads of doctors. They have nice houses, good schools, middle class patients, Golf and Tennis, The GPs, dentists and Consultants in the area share the 48 hours emergency service with a rota at weekends, so the A&E is used but not over used.
On the other hand a gastroenterologist is not the best person for sprained ankle but he keeps his hand in.

I'm sure if I lived in Berlin I would not be so optimistic about the Health Service here......

Bye the way Germans and their pensioners still pay 1.8% of their income for the reunification of Germany. Then they pay 2% for the care of the elderly who are then divided into 5 classes and depending on how frail or dement you are, you get more money.This money is paid in cash.

So you see the Health System is just part of a way of life for Germans which says you get what you pay for and no nonsense about things being free.
There is no such thing as a free lunch.

Anya I don't understand why you have concern about the sustainability of funding from taxes. We have a pool of money which is currently in peoples pockets and we have to transfer it from there to pay for medical treatment and care for the population. We either do this via private insurance or pooled insurance; to me that is just a choice.

I do understand your concerns about it "... doubtless getting more expensive as new treatments are developed and cost more. And the population is not a particularly healthy one, so demand is going to increase." However, to me this seems not to do with funding but with organisation. I have no personal objection to the idea of re-organising the NHS to suit the present day but I would like a declared re-organisation plan. Do any of us really know exactly why the government want Junior Doctors to work the 7 day week they are trying to achieve? Where does this fit in to an update of the organisation of the NHS. I feel the politicians in power are treating us like mushrooms yet again.

When they closed our surgery down we were told the NHS was bankrupt, although I'm sure the personal service we provided saved money long term. But the NHS is clogged up with people who see Dr's for the slightest thing [and they're usually the ones who return time and time again]. Obesity is a ticking time bomb and A&E departments have to deal with alcohol fuelled problems. We need to train up more nurses [without them having to pay for the pleasure, I might add] as agency staff must be costing the NHS a fortune, although a lot of agency staff [or so I've heard] do so because it fits in better with family commitments as the NHS is not flexible enough to help in that way. When the S.O.'s mother was in and out of hospital a lot in her last years she was often clogging up the system by not being allowed home due to inefficiency with the social services [even though she had privately paid carers coming in twice a day]. I don't know what I'd do if I had to pay health insurance now, as my pension is miniscule .

What's the tax gap?
How many billions are tax payers being cheated out of each year?
Even private health companies take their profits offshore.
Of course we can afford it, if everybody is made to pay their taxes properly.

www.taxresearch.org.uk/Blog/2016/03/29/why-hmrc-have-got-the-tax-gap-wrong/

The PAC says that the NHS has not costed staffing into any of its financial forecasts for the 7 day NHS. Rather remiss of them.

www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news-parliament-2015/nhs-staff-numbers-report-published-15-16

What I am utterly against is ending up with a two tier system. We so need a conversation in this country. But stealth is the name of the game by those who can see vast profits. They have no intention of accepting anything other than a free market.

But can we sustain it from taxes alone in the long term? It is doubtless getting more expensive as new treatments are developed and cost more. And the population is not a particularly healthy one, so demand is going to increase.

nhap.org/the-biggest-attack-on-the-nhs/

Stop this as well. It isn't going to be an NHS at all soon.

Anya, the future is to go back, get rid of the purchaser/provider split. All the money spent on the health service to be used in the health service. Get rid of the privatisation that has happened, and stop pretending that the health service is ring-fenced whilst asking it to save £22 billion.
The money is in the system to make the health sevice better. However, when you have almost all the top ministers standing to gain from privatisation, it isn't going to happen, is it?

I thought I might be DD. I share your fears about the difference of provision but the government needs to take care as we have seen what happens when people feel they are not getting a fare deal.

You're preaching to the converted, gracesgran. I've thought for a long time that there should be separate ring-fenced funds for healthcare. Germans receive the same level of healthcare, no matter how much they've paid.

I fear that in the UK we're heading for a healthcare system where very basic services are provided by the NHS, while those who can afford it will take out private insurance, but only to pay for themselves.