Who hates the NHS

Monica some men find it difficult to even make a doctor’s appointment so I am pleased that a system which encourages a more informed and rational approach is an improvement for some men in accessing medical care. Can’t win them all it seems.

MaizieD

^Effectively the base budget is slashed to fund the pay award, and the only way to pay is to employ less staff.^

Which is exactly what the govt. is aiming for, isn't it? Fewer staff = greater inefficiency, more mistakes made and more staff leaving or going on long term sick because of the stress.

Death to the NHS through budget cuts and let's welcome in a service run by the private sector..

Or, in reality, leave the next government with as much c..p to deal with as possible.

MOnica So what did you expect from a rehabilitation package? Was it online during lockdown? When I did mine, there were people who had had bypasses and could hardly walk. Some had breathing problems. There were about 15 of us and we had circuit training tasks. About 3 or 4 people really struggled with them, but we had individual progress cards, so it was the improvement which mattered. The important thing was that people did as much as they could.

The reason I tend to get what I want from my GP is because I take responsibility for my health and try to work with the GP as a partner. I don't go to the GP very often - only when I know I can't buy over-the-counter meds or do something myself. I get called up every year for a diabetic check up and many of my appointments are follow ups from that. I don't initiate the appointments myself. I've also had follow ups from breast cancer surgery over the last year - again initiated by the hospital or GP.

Yes, I do think the e-consult system is better than the 8am queues. The only people who could queue up were the ones who didn't work or have family commitments. Triaging means the receptionists don't get bullied by the "regulars" and people are prioritised according to clinical need.

You are still describing localised issues and haven't explained how a nationwide reorganisation could have prevented any of them.

ronib I agree with your point about men accessing healthcare.

A lot of localised issues in healtth authorities all over the country adds up to a national problem.

How about the probkems with the maternity units? Shrewsbury, Kent, Nottingham, Staffordshire. Are those 'localised' problems national enough?

I like e-consult. I agree that the 8am queues were awful, both for the reasons described, and also as if you have been up all night because of illness, having to set an alarm to catch the queue is likely to do more harm than good.

I used it recently and got a callback within the hour to check my availability to speak to a doctor, and again to ask for a FBC because of some test results that pointed in a direction different from the condition for which I was being treated. This time the callback was to arrange the blood count, after which I got a text from a GP saying that she had sent a prescription to the chemist. So much easier than queues and phone calls, or surgery consultations.

I never liked the telephone consultations that came before the new system. They are useless for people at work (unless they have a private office) or those who share living space with no privacy (and even then, people don't always want to have private conversations in front of others). If e-consult frees up time for face-to-face consultations for those who need them, so much the better.

So how would national reorganisation help?

What about all the systems which do work well?

As I'm sure you know, massive reorganisation nearly always causes problems as people need to be retrained to become familiar with new systems and protocols.

There have been umpteen threads about the NHS on GN, but the kind of changes people come up with are about charging for appointments. Nobody ever suggests real organic change.

Until there has been a major study looking into the causes of the number of failures that taken place and highlighted the area where everything is working very well. Until comparative studies have been made comparing the UK with health systems overseas. we cannot possibly know whether we have an efficient cost-effective health system.

But your current inability to believe that there is any fault in the health system reminds me of those still saying that our water industry is currently being run well and efficiently and the system of governance needs no improvement.

It all needs root and branch reform. It goes from bad to farce.

Not sure any party will be brave enough to do it though.🥴

I'm not sure that asking the woman in the street what she thinks should be done with something like the NHS is helpful, and it is particularly unhelpful to suggest that unless we have a solution we shouldn't moan about the problems.

I have no clue about the pragmatics of running a massive organisation such as the NHS - how could I have? What I do know is that I support the principle of the strong paying for the weak (and the well for the ill), that I see the funding of that as the responsibility of governments, and that I do not accept that it is somehow the fault of all of us that we generally live longer than before.

Yes, the NHS can now do far more than it once could, and yes, we have an aging population, so demands on it are greater. But this could have been foreseen decades ago, and funding issues should never have been allowed to become a problem. Governments have allowed this to happen, and governments should sort it out.

DiamondLily

It all needs root and branch reform. It goes from bad to farce.

Not sure any party will be brave enough to do it though.🥴

You write it needs root and branch reform. What do you suggest?

growstuff None of us are experts, we see a failing health service. It is failing staff and patients. We need those who are experts in the field, who have studied the operation of health systems for decades, those with experience of foreign systems, we need technology experts, plus input from those working in the service. It might even be an idea to talk to patients and bodies representing them.

You flatter me when you think I encompass all the expertise mentioned above so can come up with solutions. But i can't.

This morning I received an appointment letter for my routine 2 yearly Breast screening service.
It stated if you have any changes ie Pacemaker please let them know
I now have one.
I emailed them with the info.. Within 8 minuted I received a reply, noted with thanks.
That worked..!!

M0nica

growstuff None of us are experts, we see a failing health service. It is failing staff and patients. We need those who are experts in the field, who have studied the operation of health systems for decades, those with experience of foreign systems, we need technology experts, plus input from those working in the service. It might even be an idea to talk to patients and bodies representing them.

You flatter me when you think I encompass all the expertise mentioned above so can come up with solutions. But i can't.

Do you ever read any of the King's Fund reports?

Interesting.

This is a link to a Thread reader compilation of a twitter thread reporting on evidence from Monday's Covid Inquiry session (you don't have to subscribe to twitter to be able to access it)

It includes a video clip of part of the evidence of the CEO of The Health Foundation, Next was the CEO of The Health Foundation. A politically neutral, independent research body that provides data and analysis on the state of the UK's health and health systems.

Note what she says about UK capital investment in the NHS compared with Germany and France (2 systems which have been praised on this thread)

threadreaderapp.com/thread/1681625486395424771.html

DiamondLily

It all needs root and branch reform. It goes from bad to farce.

Not sure any party will be brave enough to do it though.🥴

Start from the bottom up. It's not serving staff or patients at the moment.

And, yes, I am talking from experience.🙁

growstuff the measure of the success of a health system is whether it is serving its patients and staff efficiently and well.

There are many ways of doing this. If the French and Germans can do that with less capital investment then there is clearly something to be learnt from them.

One of the key indicators of a country’s health is life expectancy from birth. 2019 data from the World Health Organisation (WHO) placed the UK 17th out of 39 European countries. This puts the UK behind similar-sized economies such as Austria, Germany, France, Spain, and Italy – as well as the Scandinavian countries Norway, Sweden and Finland, and smaller economies such as Cyprus, Malta, and Ireland.

The nations ranked below the UK tended to be in Eastern Europe, including former members of the USSR, with Ukraine ranked lowest at 73.02 years. bylinetimes.com/2022/07/11/how-britains-healthcare-system-stopped-being-the-best-in-the-world/

The above report was based on the report issued by The Commonwealth Fund www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly

In their report where they discuss Avoidable Deaths and 10-Year Reduction in Avoidable Mortality Across Countries, we come last but 1, only the US does worst. Surely that is a clear sign the NHS is failing and needs reform

There are many ways of doing this. If the French and Germans can do that with less capital investment then there is clearly something to be learnt from them

Did you follow my link, MOnica?
Where is this belief that France & Germany have less capital investment than the UK coming from?

Also, MOnica, had it passed you by that the tories drastically cut funding to the NHS in real terms since 2010?

I'm glad you wrote that Maizie because I'm baffled. MOnica Germany and France both spend a significant amount more per head than the UK. They have different systems, but what they do have in common is greater investment.

If I'm interpreting this correctly, the figures that the CEO gave were that, in 2019 (or by 2019, it's not quite clear), the UK capital spend was £70billion less than Germany and £40billion less than France

Money alone is not enough. Throwing money at a problem is often a recipe for waste and inefficiency.

I simply think the time has come for a massive and extensive review of every aspect of the service.

MaizieD

If I'm interpreting this correctly, the figures that the CEO gave were that, in 2019 (or by 2019, it's not quite clear), the UK capital spend was £70billion less than Germany and £40billion less than France

Are population numbers considered in leveling the spend?

Populations of Germany at 83.4 million, the United Kingdom at 67.4 million, and France at 65.6 million.

Norah

MaizieD

If I'm interpreting this correctly, the figures that the CEO gave were that, in 2019 (or by 2019, it's not quite clear), the UK capital spend was £70billion less than Germany and £40billion less than France

Are population numbers considered in leveling the spend?

Populations of Germany at 83.4 million, the United Kingdom at 67.4 million, and France at 65.6 million.

Yes, that's why I wrote "per head".

M0nica

Money alone is not enough. Throwing money at a problem is often a recipe for waste and inefficiency.

I simply think the time has come for a massive and extensive review of every aspect of the service.

Oh, do stop saying that, MOnica, it's so tedious.

If you bought an old house in dire need of repair and were perfectly able to finance the repairs I doubt you'd sit on your hands moaning about having to throw more money at it..

There are plenty of NHS areas, such as staffing and the aforementioned capital spend, where the injection of some cash is not only badly needed but could be the biggest driver of improvement.

And you damn well know that the NHS has been kept short of money since 2010. How was that supposed to improve the service?