Who hates the NHS

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

ronib

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

What exactly do you mean ronib, as I presume you aren’t suggesting we only have procedures that were available in 1948 done by the NHS? Do you have specific treatments in mind that you think the NHS shouldn’t fund?

Norah

MaizieD

I stated facts as well.

No one is doubting that you have stated facts Norah. All that growstuff and I are saying is that it's not the method of funding that is significant, it's the amount of funding that is key.

And I am saying, which is also a fact, that taxation doesn't have to precede spending.

Good. We agree.

Let's try to fund by spending well on an insurance scheme. As you note "taxation doesn't have to precede spending."

I don't really see why a change to an insurance scheme is needed. It costs more to administer and the transition would cost billions and cause massive disruption to the systems already in place. It wouldn't deliver better outcomes anyway, unless there were a commitment to spending more.

ronib

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

Well, we could stop trying to save premature babies, people with dementia and terminal illnesses. In fact, there's not much point treating anybody who's economically inactive. That would save the NHS a few pounds!

PS. I'm not serious (in case anybody thought I was).

growstuff

ronib

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

Well, we could stop trying to save premature babies, people with dementia and terminal illnesses. In fact, there's not much point treating anybody who's economically inactive. That would save the NHS a few pounds!

PS. I'm not serious (in case anybody thought I was).

Perhaps ronib thinks we're 'spoilt', too...

Maizie D What I meant by ‘spoilt’ is purely that the majority of the population has not experienced life without the NHS. It is now taken for granted that the care will be there without having to worry about being able to afford it. It was not meant in any derogatory way.

I am very aware that there are problems now and I have tried to explain some of the reasons.

In general there’s been a revision of medication and treatment once available for free. The list of conditions is available online.
Terminal illness is an interesting one - by definition there’s no cure and it remains for the disease to be managed and made less painful. This is both reasonable and desirable.
Do patients need breast implants/enlargement surgery? Does the Nhs need to perform gender reassignment on young people? I think there’s a conversation to be had about how patients use 999 as I was reliably informed that only 25 percent of people ringing it need to be admitted to hospital. I doubt that the Nhs in 1948 suffered from this problem. There are many conversations to be had!

How much per year does the NHS spend on breast implants and gender reassignment?

I've also been told that many (don't know what percentage) of people ringing 999 don't need to be admitted to hospital, but that's because many people can be treated by paramedics in the ambulance or in A&E. How much do time-wasters cost?

Personally, I think the idea of killing off premature babies and oldies would save more.

PS. Playing Devil's Advocate again - not serious.

I’m amazed you would even consider that terminal care could be on the table ronib, it’s always been one of the fundamental things the NHS does.
Other treatments which are non life changing are always valid to consider for NHS funding, and there are already processes in place to do that, based on both political funding and clinical decisions.
Your point about A&E is erroneous. Of course, there is a level of abuse of the system - but A&E is not, and was never intended to be the gateway for hospital admission. The vast majority of admissions are organised between GPs and the relevant hospital clinical team. People who are involved in traumatic or emergency events go to A&E. you don’t need to be admitted to hospital if you have broken your wrist, or have a saucepan stuck on your head, or you’ve burned your arm on the iron, or whatever, you might if you have collapsed in the street, but after assessment you might not - that’s what A&E departments do, the clue is in the name.

I should have said there’s a call handling process employed by Ambulance Control, and these days they will often send a paramedic or accord a low priority, or refuse to transport people to hospital based on what the caller tells them. The service is abused, but both 999 and A&E are the last recourse for people who are vulnerable - a lot could be avoided if there was more funding of or other supporting services.

growstuff

How much per year does the NHS spend on breast implants and gender reassignment?

I've also been told that many (don't know what percentage) of people ringing 999 don't need to be admitted to hospital, but that's because many people can be treated by paramedics in the ambulance or in A&E. How much do time-wasters cost?

Personally, I think the idea of killing off premature babies and oldies would save more.

PS. Playing Devil's Advocate again - not serious.

I’ve said it before growstuff if some people get their way we can rename the NHS Logan’s Run.

Life expectancy in 1948 was between 60 and 65. Death in childbirth and the death of young children was still quite common. Is that what you want ronib?

I was treated by a paramedic when I fell and fractured shoulder and arm. I was seen in our local Minor Injuries Unit, having been taken there by a friend. I did not need an ambulance to take me there, but I did need the paramedic’s help with the pain.

I have worked in A&E and know that not all patients need hospital admission, but do need urgent help. Unfortunately, it seems that difficulty in getting a GP appointment is driving some, who strictly speaking should not need the hospital, there. I hear people complaining about the NHS and are surprised when it is suggested they speak to their pharmacist or ring 111. Maybe an information campaign would help?

Tweedle24

*Maizie D* What I meant by ‘spoilt’ is purely that the majority of the population has not experienced life without the NHS. It is now taken for granted that the care will be there without having to worry about being able to afford it. It was not meant in any derogatory way.

I am very aware that there are problems now and I have tried to explain some of the reasons.

It did sound so shocking, Tweedle24. As though we didn't deserve it and needed a dose of tough love..

Thanks for explaining.

I would never want to revert to pre NHS conditions, nor would I want it for my children and grandchildren.

Casdon I was told directly by an ambulance driver that only 25 percent of callers actually needed to go to hospital and he implied that they didn’t need to call an ambulance. I prefer the information given to me from the medical staff on the ground. One ambulance driver thought that a lot of older people were living alone and unsupported and that calls to 999 were because of a lack of care in the community. Also because of the vulnerability of the Nhs in that it could be sued for negligence etc, that ambulance staff would always err on the side of caution.
Also Casdon I did not raise the question of terminal care - it was in response to another comment.

Growstuff please don’t insult me.

ronib

Casdon I was told directly by an ambulance driver that only 25 percent of callers actually needed to go to hospital and he implied that they didn’t need to call an ambulance. I prefer the information given to me from the medical staff on the ground. One ambulance driver thought that a lot of older people were living alone and unsupported and that calls to 999 were because of a lack of care in the community. Also because of the vulnerability of the Nhs in that it could be sued for negligence etc, that ambulance staff would always err on the side of caution.
Also Casdon I did not raise the question of terminal care - it was in response to another comment.

It’s a rabbit hole ronib, if you’re really interested all the England Ambulance Service stats are here.
www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/
Just to clarify, the ambulance staff on the ground don’t receive the calls, so somebody will have told him information which he processed and relayed to you, with some of his personal experience playing into the conversation. The information is always open to interpretation - the reality is that people call for an ambulance because they need help. For many of them there is no alternative service, or if there is they don’t know how to access it. Ambulance crews see that as wasting their time, but it’s a sign that peoples needs aren’t being met. That’s why the numbers are increasing. In my experience there are very high numbers of calls from people with mental health issues, some older, but many not. 999 and attending A&E are the only guaranteed services, and therein is the issue.

ronib

Growstuff please don’t insult me.

I wasn't.

Apologies ronib on the terminal care issue, it was clear to me the growstuff was joking, I thought your comment meant that you had considered it, but clearly not.

Thanks for that Casdon.

According to the spreadsheet for June, 52.5% were taken to ED (A&E). 4.7% were taken somewhere else. 42.8% were treated by ambulance staff.

Casdon

Apologies ronib on the terminal care issue, it was clear to me the growstuff was joking, I thought your comment meant that you had considered it, but clearly not.

I hope I'm joking.

Heaven forbid that we should reach a time when someone is scared to phone 999 in what they perceive to be an emergency

ronib, your chat with one ambulance driver is precisely that, it provides no research or statistics based in reality.
It’s widely acknowledged that as a consequence of the devastation of support services due to ‘austerity’ , the emergency services are stretched to breaking point.

As for terminal illness. My husband’s diagnosis was of extensive stage 4 mets, resulting in palliative care only. He was prescribed very expensive infusions, alongside other drugs and pain relief. Sadly, he died with 6 months. End of life care was good. Thank you nhs

ronib

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

I said much the same thing earlier on in the thread. I fail to see how gender reassignment surgery, fertility treatment and body dysmorphia treatments, to name but a few, can take up NHS resources while cancer patients and those with other life limiting conditions are denied effective treatment because of costs. We have our priorities all wrong.

Pammie1

ronib

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

I said much the same thing earlier on in the thread. I fail to see how gender reassignment surgery, fertility treatment and body dysmorphia treatments, to name but a few, can take up NHS resources while cancer patients and those with other life limiting conditions are denied effective treatment because of costs. We have our priorities all wrong.

How much does gender reassignment surgery, fertility treatment and treatment for body dysmorphia cost the NHS and as a percentage of the total budget?