How do you FIX the NHS?

[Brighton Breezy]

Record levels of spending according to the government, but resulting in poor levels of service and widespread cuts.

Is it the fault of New Labour of the people controlling the over-spending PCT's?

It seems mad that our last Chief Exec got a £200k or more pay off for being sacked but we could lose our maternity unit.

Talking to our MP today he said services had improved but I don't think many people agree.

So who is at fault and how do you fix it? It is clear throwing money at the problem does not work but how do you go about removing the countless levels of beaurocract currently in place?

 

[sten_super]

Record levels of spending according to the government, but resulting in poor levels of service and widespread cuts.

Is it the fault of New Labour of the people controlling the over-spending PCT's?

It seems mad that our last Chief Exec got a £200k or more pay off for being sacked but we could lose our maternity unit.

Talking to our MP today he said services had improved but I don't think many people agree.

So who is at fault and how do you fix it? It is clear throwing money at the problem does not work but how do you go about removing the countless levels of beaurocract currently in place?

I think the only way to do that would be to entirely redesign the management structure of the NHS (removing all the unnecessary middle-management) and then force all employees within the management to re-apply for the available positions. You would remove unneccesary jobs and useless staff in one fell swoop. Unfortunately I can't see that ever happening.

 

[Lethargic]

Also concentrate on the important aspects of healthcare not the likes of cosmetic surgery, etc.

If someone has a cold tell them to sod off and stop waste the doctors time.

 

[Brighton Breezy]

With the proposed maternity cuts in Hastings we are being told by experts it will actually IMPROVE services to have one fully staffed round the clock consultant run site in either Eastbourne or Hastings with a mid-wife run unit at the other.

They say it will mean when someone does have to use the specialist facility it will be fully staffed and they will receive the very best care.

Try telling that to someone from the rural areas around Hastings who has to travel for 45 minutes when experiencing problems during birth...

 

[Bevendean Hillbilly]

Record levels of spending according to the government, but resulting in poor levels of service and widespread cuts.

Is it the fault of New Labour of the people controlling the over-spending PCT's?

It seems mad that our last Chief Exec got a £200k or more pay off for being sacked but we could lose our maternity unit.

Talking to our MP today he said services had improved but I don't think many people agree.

So who is at fault and how do you fix it? It is clear throwing money at the problem does not work but how do you go about removing the countless levels of beaurocract currently in place?

People have a soft focus view if some rosy cheeked old matron sorting out the nasty superbugs, and a kindly alturistic old consultant with a pipe toasting crumpets on the ward fire..no need for beurocrats and accountants, leave it to the clinicians..Doctor knows best.

The reality in 2007 is that the NHS is a vast organisation, the single largest employer in Europe and responsible for billions of pounds worth of budget, some public money, some private, there is technology being used that is mind boggling and every day there is a new drug or device costing thousands of pounds that the internet using population will demand is funded for them as and when they need it regardless of cost..simply put old matron kindly and Doctor poppet would keel over dead if you asked them to administer the NHS of today.

If you run a business on this scale you need to ensure you recruit and retain managers of a high caliber who are able to negotiate with coprorations and their own staff to get the best deal, and that costs. I am not saying that the people in place at the moment are the best available, but think about it, any Chief Executive of a Multi Million pound business-which the NHS is- would command a six figure salary, that is the going rate. End of.

Anyone with any commercial savvy can recognise that the NHS will ultimately become a series of managed services under one umbrella, with the spine that currently holds it together being purely administrative, free medicine at the point of care will probably remain, but many more services will be covered by individual insurance, It cannot go any other way.

BTW, I don't want to see the NHS disappear like this any more than the next man. I gave the NHS 10 years and now work in industry so can see it from both sides. I am also a realist, and whilst I think the NHS was worth fighting for, I fear the battle is already lost.

 

[Hannibal smith]

Talking to our MP today he said services had improved but I don't think many people agree.

QUOTE]

Be Interested to see how many people who disagree that services haven't improved have regular experince of the NHS. I've been to Heartlands hospital in Birmingham every 6 months for the past 6 years. The building is almost unrecognisable, the IT is being redeveloped into something approaching the 21st century and the whole thing is less child scarey as well as an improvement in general facilities.

The service is still shit. (You get an appointment time and are often seen over an hour later) and some of the staff still need to go charm school but there is no doubt that things have improved. More consultants and less pen pushers would go a long way to improving lead times of being seen but just thank your lucky stars its not America.

 

[Hatterlovesbrighton]

I think there is too much money in the NHS. The vast increases in spending (remember 3-4 years ago there was a 1p increase in NI to pay for it) have led to more waste and inefficiency.

 

[Caveman]

National Service.

 

[DIFFBROOK]

Is it getting worse? Or would the media let you believe it has? I think when you actually ask people who use the NHs, they say that it has improved. Certainly my own experience i.e waits, treatment etc is that its better than say 5 years ago.

More re-organisation of the NHS. Its had that over the past 10 years. It needs time now for the changes to bed down. The problem over the past few years, is that there have been so many changes, some contradicting others that the NHS is totally confused.

I agree with having quality managers. A hospital Trust roughly has a budget of say £400m, a Private institution of that size would have a Chief Executive/Finance Director on a very big salary, certainly more than what the NHS pays. So you pays your money.

Another point, is if our health service is so crap, why do foreigners from the USA/EU want to come here and use it. Probably because its not. I cerianly would rather have our NHS, withs its faults (and yes there are many), than the US version. You just try being ill and over 65 there.

 

[Dave the OAP]

I'll ask laura...she sees it first hand!

 

[Rookie]

Get rid of the managers who run it like a business and let the doctors and nurses who know something about treating people do it. Scrap all the government targets and stop setting hospitals off against each other in some sort of contest for money

 

[Brighton Breezy]

Another point, is if our health service is so crap, why do foreigners from the USA/EU want to come here and use it. Probably because its not. I cerianly would rather have our NHS, withs its faults (and yes there are many), than the US version. You just try being ill and over 65 there.

The NHS used to be envy of the world. Just because other countries health system does not compare favourably does not mean there are not issues which should be addressed.

I think the foreigners etc who come here is just as exagerated by the media as the problems are. Tit for tat really.

I think operations and waiting times may well be down but I think people are concerned with the more dramatic issues of A and E etc. Hastings used to have four hospitals. If the campaigners are to be believed we could see our only remaining one be reduced to little more than a cottage hospital at a time when the population of the town is being increased due to regeneration.

The two do not sit comfortably together.

 

[larus]

The problem is that to really sort the NHS, it needs to have people involved with real incentives - these tend to be financial. The salaries need to reflect this.

This always causes lefties to say that the NHS is being privatised. IMO, that's what it needs. Privatise the running of the service, but keep it free at the point of delivery, but also have clear guidelines what is covered by the NHS.

When it was set-up, it was not designed to provide care for old people as this was done by the extended family, nor cosmestic surgery, fertility treatment, sex-changes, etc. It was designed to keep people alive and well. What everyone expects now is so far removed from this vision, it's no wonder that it is or appears to be failing.

Also, less people take care of their own health now; look at all of the fat people around, people abuse their bodies with alcohol/drugs/junk foods, and the population is aging, so older people also create a higher demand.

 

[withdeanwombat]

Sell it to Ken Bates,then in come the administrators and sell it back to him with its debts reduced to--say--2p in the pound owed,and soon the NHS will be great again..................

 

[Lord Bracknell]

It's their own fault.

These days, people are living much, much longer and are starting to develop very nasty diseases in their late seventies, eighties and nineties. In the old days, they would have died in their sixties and saved everyone the trouble of finding them a hospital bed (complete with doctors, nurses and a car parking space for visitors) - which is what people now seem to think they are entitled to.

Costs are therefore flying through the roof. New, expensive treatments are becoming available. Everybody wants some of that.

The only hope that this trend might be reversed lies in the hands of that nice woman, MrsA, who seems to have the right idea - kill people off when they're still young and not expecting it.

 

[pasty]

Take some the weight off them by a sort of means testing. Anyone earning say 45K+ should not be allowed to use it, but have private health insurance.

Edit - didn't think that through properly. Anyone earning that kind of money is likely to have private health care anyway

 

[Lord Bracknell]

Take some the weight off them by a sort of means testing. Anyone earning say 45K+ should not be allowed to use it, but have private health insurance.

What?

And create a market that takes even more doctors and trained nurses out of the NHS?

If you want to solve the nation's problems by making people who earn more than £45K pay, why not do the simple thing? ... TAX THEM.

 

[Simster]

I think Ed is right - it is a victim of its own success. The best way the NHS can be sorted out is to clearly define what it should be spending its money. And as is the case with students and education, people should be willing to pay for anything beyond that level of care.

Personally, I'd slap a £20 charge on anyone wanting to see a GP. If you've got a cough, use the internet or NHS direct and f*** off out of the changing room. This is what happens in Ireland (according to my dentist) and it seems to work quite well. And people who don't look after themselves should be made to pay if they abuse their body more than once. George Best's second case of liver problems were an utter utter disgrace.

 

[Brighton Breezy]

Personally, I'd slap a £20 charge on anyone wanting to see a GP.

So poor people and the elderly scraping by on a state pension or benefits but two groups MOST at risk of health problems should have to fork out £20 a time?

A sure-fire way to stop people who need treatment attending their GP because simply they cannot afford to.

This, in my opinion, would be a complete contrast to why the NHS was set up in the first place.

 

[Scoffers]

3 Main Problems, as I see it

1) People are living much longer, so there is many more people than the service can cope with
2) Science is advancing rapidly and so more and more expensive treatments are becoming available
3) There is never going to be enough money in the pot to pay for everything

So how do you resolve this?

1) Refuse any treatment that is cosmetic (you want that, great, go pay for it)
2) Reduce management costs, empower the Healthcare Trusts
3) Introduce a sliding payment scheme where folks make contributions based on how much the treatment costs, and ability to pay