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

[Notters]

I don’t disagree. It was a simple example. How much tax do smokers and drinkers pay? Loads. I expect they use more than they pay but I have no idea. Some will and some won’t. It is why it is so tricky.

It's definitely tricky, but I think it would be pretty hard to argue that smoking has a health benefit (other than via tax).

 

[BBassic]

I'm no doctor but I am pretty sure it wasn't 35 stone of water retention. I think the general point in any case is that people need to take some personal responsibility for their lives (and not just health). The difficult part is operating this principle in practice fairly.

I tend to agree. There should be an element of personal responsibility for your own well being. Let's suppose this woman has an eating disorder though. How much personal responsibility can one person take for a mental health issue beyond trying to get treatment for it? And given the state of mental health care she'd be lucky to get seen this side of 2030.

 

[Flagship]

Two things.

In the short term, in order to alleviate the shortage of beds, why not bring back the Nightingale hospitals that were used during Covid. These could be used for social care thus freeing up beds in hospitals.

In the long term, make it easier for people to get into nursing. Do nurses really need a degree qualification to care for someone. You could make two years in social care compulsory training for nursing. This would help alleviate the shortage of care staff and provide 'on the job's training for less academic student nurses.

 

[Berty23]

It's definitely tricky, but I think it would be pretty hard to argue that smoking has a health benefit (other than via tax).

But if someone stopped smoking and got angry with life and got violent etc and so it goes on. Everything is linked. It is why insurance would be so hard to sort out so inevitably we would all overpay.

I have no idea how to solve this.

 

[goldstone]

The answer to your question is "It Can't". It needs to be dismantled and a better scheme devised.

And incidentally I am completely bored and fed up with the news constantly being about the NHS. It's almost as though there is no other news. And it's a repeat of the same old stuff every single day. The same boring interviews with people whose mothers have spent an hour on a trolley. I know of no other country where the national news is dominated by health issues in the same way.

WE'VE HAD ENOUGH. STOP IT.

 

[wellquickwoody]

The answer to the original question should include the following:

‘By people continually resisting change no matter whether good or bad’

Makes no odds what flavour the government is for some people, those with extreme political dogma or others with vested interests within the NHS, they will resist change whatever. It suits their agenda. The reality is that the NHS is a busted flush, artificially bloated by extreme wastefulness, and shackled by archaic practices. The intentions are perfect, the reality is no longer achievable.

 

[dazzer6666]

Two things.

In the short term, in order to alleviate the shortage of beds, why not bring back the Nightingale hospitals that were used during Covid. These could be used for social care thus freeing up beds in hospitals.

In the long term, make it easier for people to get into nursing. Do nurses really need a degree qualification to care for someone. You could make two years in social care compulsory training for nursing. This would help alleviate the shortage of care staff and provide 'on the job's training for less academic student nurses.

Nightingales - who is going to staff them ? There is a massive shortage of care staff already in all settings.

Given what nurses have to do a degree is absolutely necessary - two years in ‘social care’ wouldn’t enable an individual to be remotely qualified to be a nurse……however the degrees should be publicly funded as they used to be, with additional bursaries paid to students, rather than making them pay for the course.

 

[Cotton Socks]

How do you judge quality of life? There’s people I know who lead dull lives…..not sure I want them exterminated though.

There's a big difference between a 'dull life' (I have one) and someone that has terminal cancer and doesn't want to go through the pain and suffering that it brings but would prefer instead to make their decision in their own time as to weather they wish to have the pain and suffering for a couple of months or would prefer to leave this world while they have the chance to leave with a smile (not the best terminology, apologies).

 

[Hamilton]

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 ?

Maybe it would survive with proper funding rather than a decade of under investment.

 

[warmleyseagull]

Regarding your first point, how do you then deal with situations when people have suffered or died due to actual negligence. It's easy for your sons to say they could deal with twice as many but they still need to record what treatments etc have been given. You could apply that to all walks of life. How would you feel if it was decided that road accidents would have no liability attached to them because 'accidents happen'. If you lost a family member, possibly the wage earner due to an accident that wasn't their fault, how would you feel about not being able to get compensations.

As for records, you can't quickly scan audio notes. If there is a technical issue regarding access to them then you still need an IT technician to resolve it!! As for the reference about the England games, of course you're going to see less because people are generally sitting down not doing anything so less likely to have an accident. People with strokes, heart attacks etc are still going to call for an ambulance.

As for the reference to politics, like it or not, this is a political decision and the state of the NHS is due to decisions taken by the Tories over the last 12 years. Starting with Lansbury's unnecessary restructuring. Take pay, in 2010 there was a pay freeze for public sector workers which as seen them fall behind in real terms. At that time, MPs pay was also frozen. However they have since had pay rises that have put them slightly ahead in real terms. The rest of the public sector have not!

It is well known that many senior conservatives have promoted a different system, even writing about it. Jeremy Hunt was one of those calling for an insurance system and he was put in charge of the NHS!

I'm surprised that your son in A&E has made no reference to the throughput of patients; bed blockers. Improve social care and ensure there are places for people to go for aftercare then that helps resolve many issues, crowed A&Es, queuing ambulances etc. Improve access to GPs and that would reduce those going straight to A&E, Increase the number of minor injury centres etc.

Unfortunately, a lot of problems are due to money but we have one party that, not long ago, thought it was ok to borrow money to give rich people a tax break..

I am not talking about negligence, just balance of risk. A report in Times today refers specifically to excess deaths partially caused by people not being seen in A&E quickly enough. The irony is that a negligence claim is much harder to prove if death is caused by delay due to space than one resulting after a patient has been seen. He is not saying no recording should be done (it has to be for follow up in many cases) but that the AMOUNT of work involved in documenting many very minor cases is disproportionate to the risk involved and that the consequent risk to waiting patients could be reduced.

The audio notes point is his and he works in A&E; I cant comment but he believes it could work. I think his point is that most of his notes are never looked at because the issues for the patient are so minor.

To a degree it is political, but both sons consider that is only one of many issues. They both work in different hospitals and comment on the very varied experiences they have. Both get rather tired of hearing the NHS disaster stories; in their experiences as frontline doctors service levels depend more on the communication and organisation of the local trust than political or other considerations. Everyone loves a bad news story, but actually even at the moment with the added stress of flu and time of year, the hospitals they are currently in are coping. It is not one uniformly bad story across the whole NHS.

Using the NHS bad news stories just to beat up politicians is not enough. Labour has said it will not borrow for day to day spending. Good on them, but that hardly bodes well for oodles more for NHS.

 

[drew]

I am not talking about negligence, just balance of risk. A report in Times today refers specifically to excess deaths partially caused by people not being seen in A&E quickly enough. The irony is that a negligence claim is much harder to prove if death is caused by delay due to space than one resulting after a patient has been seen. He is not saying no recording should be done (it has to be for follow up in many cases) but that the AMOUNT of work involved in documenting many very minor cases is disproportionate to the risk involved and that the consequent risk to waiting patients could be reduced.

The audio notes point is his and he works in A&E; I cant comment but he believes it could work. I think his point is that most of his notes are never looked at because the issues for the patient are so minor.

To a degree it is political, but both sons consider that is only one of many issues. They both work in different hospitals and comment on the very varied experiences they have. Both get rather tired of hearing the NHS disaster stories; in their experiences as frontline doctors service levels depend more on the communication and organisation of the local trust than political or other considerations. Everyone loves a bad news story, but actually even at the moment with the added stress of flu and time of year, the hospitals they are currently in are coping. It is not one uniformly bad story across the whole NHS.

Using the NHS bad news stories just to beat up politicians is not enough. Labour has said it will not borrow for day to day spending. Good on them, but that hardly bodes well for oodles more for NHS.

The point is that, unfortunately, you need the paperwork in most cases as it can be evidence against a negligence claim, ie protecting the medic. I'd stand by my comment re audio notes been far slower for the next person to scan through. It would of course be quicker for the person producing the notes.

I appreciate your sons can only comment on their own experiences but I know from discussions with my wife who runs several wards at a very busy hospital that they spend most of their time fire fighting. I don't think anyone believes the NHS couldn't be more efficient in some areas but the reality is that it is where it is because of the political will of the current incumbents in Parliament.

 

[drew]

Two things.

In the short term, in order to alleviate the shortage of beds, why not bring back the Nightingale hospitals that were used during Covid. These could be used for social care thus freeing up beds in hospitals.

In the long term, make it easier for people to get into nursing. Do nurses really need a degree qualification to care for someone. You could make two years in social care compulsory training for nursing. This would help alleviate the shortage of care staff and provide 'on the job's training for less academic student nurses.

I think you'll find the role of the nurse has changed hence the degree status. You now have Health Care Assistants that perform the more mundane (but important) roles like washing patients, feeding them etc etc. As Dazzer6666 states, nurse training should not lead to a poorly paid nurse having a student debt.

As for the nightingales, they were hardly used during covid because there was no one to staff them.

 

[sydney]

Rubbish. No vindication whatsoever.

yes there is , why should people take shit in to their blood stream to keep their jobs , the mandate was flipped at the last minute otherwise the attrition of health workers would have been much worse.

 

[jcdenton08]

Nursing in particular relies on people looking at it as a “calling” and choosing to get in huge debt to study, then work horrible hours, in a stressful job for extremely low pay comparative to responsibility. There is absolutely zero incentive to become a nurse unless it was a lifelong dream. Or you’re coming from abroad and it provides the opportunity to live and work in the UK.

The way the NHS has been treated is absolutely appalling. Shocking lack of investment. It can’t continue.

Horrible stories daily about NHS failings on an absolutely base level. All over the country, with Wales being the worst of a terrible lot.

'We couldn't get an ambulance for my husband then he died'

Heart attack victim Martin Clark died after family drove him to hospital themselves after 45-minute wait.

www.bbc.co.uk

Top story on the BBC News website.

Could the family sue for wrongful death by gross negligence?

 

[One Teddy Maybank]

Maybe it would survive with proper funding rather than a decade of under investment.

Yes, but longer than a decade.

 

[nicko31]

....

 

[beorhthelm]

I think you'll find the role of the nurse has changed hence the degree status. You now have Health Care Assistants that perform the more mundane (but important) roles like washing patients, feeding them etc etc. As Dazzer6666 states, nurse training should not lead to a poorly paid nurse having a student debt.

As for the nightingales, they were hardly used during covid because there was no one to staff them.

the Nightingales were planned to be staffed by mix of army, bank nurses and student nurses (sister was offered option to go there in lieu of training). they weren't used be they cleared out the hospitals and lockdown worked, so they weren't needed.

degrees are a curious issue, came in during mid 90's. were they necessary because of role change, or did the role change because they all had degrees? i gather more the latter.

 

[nicko31]

Nursing in particular relies on people looking at it as a “calling” and choosing to get in huge debt to study, then work horrible hours, in a stressful job for extremely low pay comparative to responsibility. There is absolutely zero incentive to become a nurse unless it was a lifelong dream. Or you’re coming from abroad and it provides the opportunity to live and work in the UK.

The way the NHS has been treated is absolutely appalling. Shocking lack of investment. It can’t continue.

Horrible stories daily about NHS failings on an absolutely base level. All over the country, with Wales being the worst of a terrible lot.

'We couldn't get an ambulance for my husband then he died'

Heart attack victim Martin Clark died after family drove him to hospital themselves after 45-minute wait.

www.bbc.co.uk

Top story on the BBC News website.

Could the family sue for wrongful death by gross negligence?

I've personally only ever called am ambulance once and they came in 3 mins at 2am in what was a terrifying situation. Until recently the thought of the no one coming immediately to a heart attack or stroke has been unthinkable.

Sadly its reality and even if you have the financial resources there is nothing you can do, as someone with elderly relatives that live alone I find this very worrying when they don't live close by

 

[abc]

And your solution is?

The first part of the solution is for everyone to accept and/or admit what this poster days is true and then for everyone to put party politics aside and work together to provide a way forward for the next 50 years.

 

[Harry Wilson's tackle]

The first part of the solution is for everyone to accept and/or admit what this poster days is true and then for everyone to put party politics aside and work together to provide a way forward for the next 50 years.

That sounds lovely. I am sure the Tories will be more than keen to give Kier a bell and arrange a chat - after the next general election when they have been booted out of power. As for labour, why would a labour government invite the tory shower into the planning room? The tories have nothing to offer on the NHS - because they are in favour of low taxes, private medicine, and a subsistence NHS.

Anyway, thanks for your suggestion.

Have you contacted Putin yet to asked him to sit down with Zelenskyy, hold hands, sing "Kumbaya", and jolly well sort out their misunderstanding?