[Misc] How can the NHS survive in its current form ?

[Binney on acid]

Controversial !
A former neighbour of mine was admitted to hospital at Christmas. Apparently she weighs around 35 stone, which equates to 222 kilos. She doesn't get out of bed. It took 3 ambulances and 2 fire engines, one with a platform, to get her out of her property. This involved removing a 1st floor window. Within less than a week, the fire engines and ambulances got her back into her property via the bedroom window. Presumably, because of the pressure on hospital beds, she was discharged too early. Yesterday evening, she was readmitted to hospital. This process involved 3 ambulances, 2 fire engines, a platform, the removal of her window, and I suspect that the road was closed off again. Only god knows how many personnel have been involved so far in the ongoing removal / reinstatement processes.
How much is this costing and who foots the bill ? Is there a financial cut off point, or does this go on until the NHS is bled dry ? I appreciate that the NHS strives to do everything to enable the individual to stay in their own home, but surely this is unsustainable. Shouldn't she be encouraged to sell her property, and use the proceeds from the sale to fund her nursing home fees ?

 

[juliant]

My mum was blue lighted into the Princess Royal 7pm NY eve with suspected stroke or sepsis. At 3am she was admitted to a ward after being on a trolley in the waiting area. Thankfully it was nether and she was diagnosed with Pneumonia and the flu. For the next 4 days had to go in at 8am for IV anti biotics and then sent back home for the day and night. They said we simply don't have the room for you to stay in.

Just shows you again what a shit show this country is currently

 

[BBassic]

How much is this costing and who foots the bill ? Is there a financial cut off point, or does this go on until the NHS is bled dry ?

We all (including the 35st woman) foot the bill via tax. As for being bled dry - don't blame her. Blame over a decade of piss poor funding and austerity.

 

[Biscuit]

Only the Tories will convince you it can't: because they want to privatise it.

The UK without an NHS is a horrifying thought.
In the USA, 500,000 families a year go bankrupt due to medical bills. Imagine that? Nice house, car, money for holidays.. all gone because you got cancer and didn't have the correct insurance.

 

[dazzer6666]

Very difficult to draw a line on who to treat………..hence all people treated equally (in theory anyway). Underfunding, wasting billions on crap admin/IT/processes/management etc, increasing UK population (not matched by increasing NHS resources over many years), increasingly aged population impacting demand, massive inflationary pressures on cost of drugs, equipment and salaries etc, lack of staff (Brexit, morale, wages, working conditions), questionable procurement practices etc etc etc. Problem of cumulative years of all of those factors (and others) to various degrees in an organisation that is simply too big to manage effectively mean it’s a colossal shitshow. Genuinely don’t know what the answer is - simply chucking more money at it won’t be enough.

 

[happypig]

Only one thing needs changing, the government.
And a Labour (or preferably a Lib/lab coalition) government needs time to fix it.

 

[beorhthelm]

time to accept it doesn't work in exactly the current form. even Labour is saying needs reform and transformation. built around populations and problems of 1940's, must need to update. obvious changes to how we enter the system (GP is archaic throwback to the local doctor from before NHS; A&E is daft single catch all) and how we manage people after treatment (same staffing whether acute pain 1 day after an op, or 3 weeks convalescing).

we do not need to lurch to an American insurance/provider split model, which doesn't even exist in the way some imagine (a lot of non-profit and state providers), as the alternative. there are dozens of other examples to learn from.

 

[dazzer6666]

Only one thing needs changing, the government.
And a Labour (or preferably a Lib/lab coalition) government needs time to fix it.

Fixing it will take way, way longer than a parliamentary term - it’ll take a full term just to get plans approved and in place (including all the arguments that will happen based on whatever reforms are suggested). Won’t happen but should be a cross-party group that transcends whoever is in charge for continuity.

 

[drew]

The first big step will be a pay rise.
Secondly, sort out social care so you get rid of the bed blockers.

As for the case cited by the OP, I going to make the assumption that she didn't chose to live like that. It's probably the culmination of events in her life, lack of the right support etc etc. No doubt some bright spark will pipe up and say she should just stop eating!.

 

[Rdodge30]

The problems with NHS funding are decades old, not just the last decade. Every government I can remember going back to Callaghan has endured the same headlines of NHS in crisis and underfunding.

The model is indeed archaic.

The taxpayers NHS pension bill is in the £billions.
Every 1% wage increase is £16m pa added to the wage bill.

How many other countries in the world have copied our model in the last 80 years?

 

[Justice]

The assisting emergency staff are on shift anyway, why it cost anymore than normal to help the lady?

 

[Reagulls]

Controversial !
A former neighbour of mine was admitted to hospital at Christmas. Apparently she weighs around 35 stone, which equates to 222 kilos. She doesn't get out of bed. It took 3 ambulances and 2 fire engines, one with a platform, to get her out of her property. This involved removing a 1st floor window. Within less than a week, the fire engines and ambulances got her back into her property via the bedroom window. Presumably, because of the pressure on hospital beds, she was discharged too early. Yesterday evening, she was readmitted to hospital. This process involved 3 ambulances, 2 fire engines, a platform, the removal of her window, and I suspect that the road was closed off again. Only god knows how many personnel have been involved so far in the ongoing removal / reinstatement processes.
How much is this costing and who foots the bill ? Is there a financial cut off point, or does this go on until the NHS is bled dry ? I appreciate that the NHS strives do everything to enable the individual to stay in their own home, but surely this is unsustainable. Shouldn't she be encouraged to sell her property, and use the proceeds from the sale to fund her nursing home fees ?

would this have been in the Portslade area? I work very close by and was diverted around something that looked like this just before Christmas

 

[Herr Tubthumper]

There’s been a lot of coverage of the collapse of the NHS in the German press. On comment common to a number of articles it’s far too centralized and therefore unwieldy. Funding is obvs another.

 

[Herr Tubthumper]

Very difficult to draw a line on who to treat

Treat everyone on medical need and without prejudice.

 

[Harry Wilson's tackle]

Very difficult to draw a line on who to treat………..hence all people treated equally (in theory anyway). Underfunding, wasting billions on crap admin/IT/processes/management etc, increasing UK population (not matched by increasing NHS resources over many years), increasingly aged population impacting demand, massive inflationary pressures on cost of drugs, equipment and salaries etc, lack of staff (Brexit, morale, wages, working conditions), questionable procurement practices etc etc etc. Problem of cumulative years of all of those factors (and others) to various degrees in an organisation that is simply too big to manage effectively mean it’s a colossal shitshow. Genuinely don’t know what the answer is - simply chucking more money at it won’t be enough.

Yes. And never forget there is a cabal in the tory party (a minority I hope, but fear not) that are implacably opposed to 'state-funded' anything, and want the NHS sold off. The best way to achieve that aim is to make people hate it, be angry with 'greedy' nurses, junior doctors and ambulance staff, while offering tax breaks and wheezes for private insurance (including making the NHS 'outsource' to private hospitals like the did for me a few months ago), making private health care appear to be affordable and even 'the right way forward for those that can afford it' - to take 'pressure' off the NHS.

I'm not a medic but I work with them (and train some of them) as a university academic with a lab and office in a London teaching hospital. everything dazzer says above is correct. What concerns me is that the system is now so dependent on its own processes that it may now be impossible to fix. There are so many administrators now, in charge of various different silos, that no one person has an overview of what needs to be fixed and how. Those running the silos are not likely to vote for sacking half their number and reducing the paperwork, are they?

So this is how the parallel system, the private hospitals that can pick and choose what to treat, based on profitability, can thrive.

If there ever was anything that epitomizes socialism, it is the NHS - free at the point of use. This is why it has to go. After all, why should I have to pay for lazy fat people to be treated for preventable diseases? Other narratives are of course available, but who doesn't enjoy a bit of scapegoating?

The reality is a great load of money together with a reduction in the amount of process (which will have to be enforced and which will result in job losses) is the only way of 'fixing' the NHS. I am not sure Labour have the courage to tackle the problem. There may be some sort of half way house that allows people to bimble on, but I fear that we may have already crossed what Douglas Adams called 'the shoe event horizon' where the product becomes so expensive and employs so many people that eventually the whole nation will be working in the 'industry'. Blair tried a half way house and ironically this opened the door to the 'tendering' for bloody everything that enshrines 'practice' in the NHS now. His second biggest error, in my view.

 

[Harry Wilson's tackle]

The problems with NHS funding are decades old, not just the last decade. Every government I can remember going back to Callaghan has endured the same headlines of NHS in crisis and underfunding.

The model is indeed archaic.

The taxpayers NHS pension bill is in the £billions.
Every 1% wage increase is £16m pa added to the wage bill.

How many other countries in the world have copied our model in the last 80 years?

And your solution is?

 

[GT49er]

The first big step will be a pay rise.
Secondly, sort out social care so you get rid of the bed blockers.

As for the case cited by the OP, I going to make the assumption that she didn't chose to live like that. It's probably the culmination of events in her life, lack of the right support etc etc. No doubt some bright spark will pipe up and say she should just stop eating!.

Both causes of her obesity are possible, and no facts are known as to which applies - so why make assumptions at all?

 

[Rdodge30]

Harry Wilson’s Tackle

I don’t have a solution- I don’t believe anyone does but the model of the NHS is broken and to continue without drastic reform will not solve the problem. You could pretty much throw £Xbillion at it now and the problems will continue

 

[Lenny Rider]

Too many middle managers totally out of touch.

Sorry to talk shop, but who in their 'inifinite wisdom' sanctioned a refit for the Mortuary at Worthing in the middle of winter?

Families now having to wait a minimum of 2 and half weeks for post mortems which would have normally taken place at Worthing, and usually within 5 working days, now have to go as far as Portsmouth or Eastbourne, creating an extremely upsetting backlog.

I'm sure just one stupid decision of many.

 

[Berty23]

The example of obese people is often used but the issue is where to draw the line. What about people injured playing sport? Take part in high risk activity then tough. And the debate rages.

Agree with the poster about private rinsing the cheap stuff for profit leaving expensive to nhs. Due to how operations are funded the nhs can’t cope. My mate is a director at a hospital and can talk for hours about this. His view is that It is mostly linked to government funding policy.