[Politics] NHS today

[Harry Wilson's tackle]

thats what i put, its not 100% public, there has always been private elements. there is public perception that it is all public, and policy debate resolves around that starting point.

the bad thing is the mis-management. like your previous example of administration of administration, this seems a chronic problem with larger organisations of any type.

Apologies! I am aware on noises of from the hard left (albeit I haven't spoken to one of them for some years) about the morality of private, but I wasn't aware it is part of headline conversation any more.

You are also right about higher management. I have done a bit and been trained a bit. Most of us in work are there to implement the strategy and tactics of our managers. But there has to be a purpose and a goal. What I have seen of higher management is that all the purposes and goals are perverse.

For example, in the 'Trust' ' and 'Health Partnership' where I work, the main goal of senior management is to make our 'business' bigger and stronger. That means stuff like taking over failing trusts, rationalization, acquistition, rebranding. Success is income and turnover. This has nothing to do with health care delivery. So health care and university teaching and research make up their own strategy and tactics - to increase income and turnover - more grants, more papers, more students, more patients. That is perverse and a symptom of failure.

Like lots of organizations the NHS (and universities) muddle through and deliver quite well to 'customers' largely through the diligence and sense of duty of the frontline workers.

 

[Harry Wilson's tackle]

That is so true.
If a party was ever brave enough to promise to invest the funds required over s sustained period at the cost of increased taxes, they would not be elected.
Having said that, the NHS is very poor at use of funds and billions are wasted every year.
One of the worst mistakes, in my opinion, was the setting up of the trusts. Each has a CEO and a team of very well paid managers doing the same job as hundreds of others at huge cost. This needs to be rationalised and the money spent on the front end of services.
I am sure that the staff are great but their motivation is being destroyed.

I agree - a point I addressed in a post above from my personal experience as a training and education 'lead'. These are impressive professional people with an eye on the main chance, an expecatation of a gong and the salary to boot. But they are playing monopoly with tax payers' money.

 

[Harry Wilson's tackle]

Myth or not, as of 2021 there were 219 trusts, including 10 ambulance trusts. Do you really need that many "independent " trusts with it's own board of directors CEOs etc?

A series of separate quasi independent organizations within the large whole can be measured, values and....eventually sold. Every time there is a problem in a trust it seeds the idea that it would be better for everyone if they were run 'properly' in the private sector.

It has certainly been the case in the past that elements in the conservative party stated a wish to sell off the NHS, and creating expensive failing trusts is the perfect way to facilitate such change.

That said, this would require a degree of planning that seems far too complicated for Johnson. Gove, however....

 

[Mellor 3 Ward 4]

This is a depressing tale. The area between Faversham, Canterbury and Ashford (and surrounds) is serviced for 'acute care' (emergencies) by one hospital (Ashford). Along with several dozen people (not a huge crowd it has to be said) I spent 10 hours today waiting to be seen. I had a bloke in blue overalls try twice and fail twice to take my blood. I was referred to a clever machine that takes the blood automatically, but this was wheeled out of acute care in front of my eyes because it was needed elsewhere (for reasons that had no obvious priority - there is no oversight). Just one of these machines in a trust hospital?

At nine thirty PM we were all told there was an emergency and none of us would be seen till the morning. We had the choice of hunkering down (many of us on 'no solids') or discharging ourselves - and join the back of the queue tomorrow; I was advised to get in around 5 AM. There is no public transport at that time of day (first bus leaves Faversham from nowhere near where I live at 6.42 and takes over an hour to get to the William Harvey). In the end, I went home (thanks to my son being available to drive me - he'll be in Manchester tomorrow so I may well drive myself and risk driving under the influence of thiobarbitone on the way home, in te unlikely even I get seen and cut open).

When I was invited to leave I had to sign a waiver to say that I was taking the risk of leaving into my own hands. I said 'what if my appendix bursts?' and administrator said 'that's your decision'.

To add insult to injury, several people complained at waiting many hours (28 was the highest) only to be told 'you have that wrong, it was only 12). After some discussion we found that as you pass through each stage (triage, assessment by a nurse practitioner or generalist, to seeing the actual consultant or senior registrar doctor) the clock is restarted.

So this is how the hospitals keep their numbers in order, redifining what a waiting time means, and bullying patients into going home and restarting the clock when it's looking iffy.

I need a CT scan. I was told at 8 pm that the CT scanning is managed overnight by a private company who are very slow. They keep their own patient list and the hospital cannot tell me where I am in their queue. That's like outsourcing half time food at the Amex to 'Eateroo' who then refuse to say what food will be onsale, when it will be onsale and how much it will cost. Guv.

So I am self medicating with codeine and wine, and anticipating possibly having to call an ambulance tonight where I will be dumped back at the end of the queue I left today.

Some of the people in there with me were in a terrible state, but I was surprised by the 'wartime spirit'. There were a few comments about Gove but as far as I can see, allowing the NHS to crumble into an embarrassment has not dented the general apathy of the locals of North East Kent. If Johnson has gambled that we will take whatever NHS is rationed to us, without much complaint, I suspect that, once again he is right.

The dispicable little turd.

This sounds absolutely horrendous - I Hope you get sorted - the system is broken.

Why is the NHS in such a mess? it cannot simply be lack of people or cash - it's the WORLDS 8th largest employer (1.7 million people) and employs far more people than French/German Health providers....where it is going wrong?

Answers on a postcard please.

 

[Herr Tubthumper]

This sounds absolutely horrendous - I Hope you get sorted - the system is broken.

Why is the NHS in such a mess? it cannot simply be lack of people or cash - it's the WORLDS 8th largest employer (1.7 million people) and employs far more people than French/German Health providers....where it is going wrong?

Answers on a postcard please.

Germany employs 5.7m health care workers….almost 3 times as many as the UK.

https://www.bundesgesundheitsminist...629_BMG_Das_deutsche_Gesundheitssystem_EN.pdf

 

[Mellor 3 Ward 4]

Germany employs 5.7m health care workers….almost 3 times as many as the UK.

https://www.bundesgesundheitsminist...629_BMG_Das_deutsche_Gesundheitssystem_EN.pdf

Are they all employed by the State / a single employer?

Google lists world's largest employer as the US Dept. of defence at 2.91 million people....

 

[Weststander]

Firstly, get well soon Harry. I hope it’s sorted asap.


In the past 2 years we had to turn to the private health sector - over a knee injury, and for a formerly diagnosed “actively suicidal” adolescent. My wife & child had waited an entire day at the Royal Alex to see their resident shrink, they told us to go there, only for the professional to cowardly skulk away home at 5pm. We only found out by chance at 6:30pm!


Let’s just copy the German system.

Everyone but the poor are compelled to pay significant private insurance premiums.

It works.

I’d love Starmer to simply propose this and really mean it. But no party will. 90% of Brits have a lifelong loathing of taxes, it’s in our DNA.

Instead the Dec 2024 GE will only see parties suggesting a few % increase here or there.


The NHS is badly run. Gerry Robinson came up against a brick wall when called in for a televised series to help a hospital trust. Senior management couldn’t manage incredibly stubborn alt confident senior consultants/surgeons who were not prepared to change, or interrupt their afternoons at private hospitals. Mrs.W is an NHS frontline practicioner - she describes illogical inefficiencies and systems, stubborn individuals unprepared to change to help patients.

In summary, follow the German financial model, but also look at widespread rejigging of the chaos.

 

[maltaseagull]

A series of separate quasi independent organizations within the large whole can be measured, values and....eventually sold. Every time there is a problem in a trust it seeds the idea that it would be better for everyone if they were run 'properly' in the private sector.

It has certainly been the case in the past that elements in the conservative party stated a wish to sell off the NHS, and creating expensive failing trusts is the perfect way to facilitate such change.

That said, this would require a degree of planning that seems far too complicated for Johnson. Gove, however....

Despite feeling poorly, you continue to post lucid comments. I now realise why there weren't loads of your videos on the Albums2022

Best wishes and I hope you feel better soon

 

[Herr Tubthumper]

Are they all employed by the State / a single employer?

Google lists world's largest employer as the US Dept. of defence at 2.91 million people....

No, they wil not all be employed by the state.

 

[Herr Tubthumper]

Are they all employed by the State / a single employer?

Google lists world's largest employer as the US Dept. of defence at 2.91 million people....

As an aside as you mention US defence, the US has the largest healthcare spend per capita in the world.....by a big margin. And look how ****ed up their system is.Maybe it's to tend to all those gun shot wounds?

 

[Harry Wilson's tackle]

Despite feeling poorly, you continue to post lucid comments. I now realise why there weren't loads of your videos on the Albums2022

Best wishes and I hope you feel better soon

Thanks. Appreciated

 

[beorhthelm]

This sounds absolutely horrendous - I Hope you get sorted - the system is broken.

Why is the NHS in such a mess? it cannot simply be lack of people or cash - it's the WORLDS 8th largest employer (1.7 million people) and employs far more people than French/German Health providers....where it is going wrong?

Answers on a postcard please.

not equivilent, as noted already. NHS is just one large monolithic employer, held up as the only source of healthcare. elsewhere they break down primary healthcare from the start and recognise there a wider set of services.

Germany employs 5.7m health care workers….almost 3 times as many as the UK.

https://www.bundesgesundheitsminist...629_BMG_Das_deutsche_Gesundheitssystem_EN.pdf

which counts that wider healthcare industry.

 

[Lyndhurst 14]

As a Brit working in the States I, and many other Brits I know, would always extol the virtues of the NHS over the US Healthcare system. A lot of Americans were impressed that Brits would pay into a system that they may have to use a lot or, if they are fortunate, hardly ever and that would take care of them from cradle to grave. They view this as socialized medicine and it is not for them. They seem to prefer their system which strikes me as crazy. Yes, if you are adequately covered by insurance it's a very good system but if not it's a grim outlook. Lose your job and you lose your medical cover. Obamacare has helped somewhat but the inadequacies are still glaring.

That is why it is so sad to see what is now happening to the NHS. As posters have said it's nothing to do with the front line staff, they are brilliant, compassionate people. It seems to be the underfunding by governments and mismanagement at the NHS Trusts who have ever increasing numbers of consultants and managers . Reminds me of one of the Yes Minister episodes where they had a hospital full of doctors, surgeons, nurses and machines that go ping but no actual patients. It does seem sometimes as if the current government is deliberately underfunding the NHS so those that can afford it will opt out and pay for their treatment, privatisation by stealth.

When the NHS inoculated millions of people against Covid they did an amazing job; efficient, well organized with individuals given exactly the information they needed - no red tape or bureaucracy. Why is it so difficult to transfer that organizational nous into the rest of the system ?

 

[beorhthelm]

The NHS is badly run. Gerry Robinson came up against a brick wall when called in for a televised series to help a hospital trust. Senior management couldn’t manage incredibly stubborn alt confident senior consultants/surgeons who were not prepared to change, or interrupt their afternoons at private hospitals. Mrs.W is an NHS frontline practicioner - she describes illogical inefficiencies and systems, stubborn individuals unprepared to change to help patients.

they closed consultant led maternity services in Eastbourne General because consultants didnt like working there. apparently most lived in the Sussex/Kent borders so Hastings was better for them.

 

[usernamed]

Nothing of use to add here that hasn’t already been discussed, but wishing you the best for a speedy recovery Harry.

 

[Durlston]

Mike, sorry to hear of your frustration at the hospital and the ineptitude of some of the staff. You are not alone mate. I hope things get better for you. I haven't read all of the thread because I've hardly been on NSC in the last couple of months.

I've been tearing my hair out in the last two months re: my father, who suffered a stroke. I'd like to personally thank everyone that posted their best wishes on here. He got (fairly) good treatment afterwards in the hospital and was allowed home after four weeks. To say looking after him has been a challenge would be the biggest understatement of the century. Only two nurses have visited him at home and they were both box-ticking check-ups - nurses that had just qualified it seemed. Then, a month ago he suffered another stroke - but this time nowhere near as bad. Kept in for a couple of days before he was discharged. Mentally, he has fallen apart. The frustration of not being able to speak clearly and shortness of breath with severe fatigue has created depression which he has never suffered from before in his life.

It feels like I've become almost his full-time carer with little help from the NHS. My sister has a young family so doesn't have as much time as me. I don't mind the burden - it's not my dad's fault whatsoever. My mother has been a rock throughout all of this. She's allowed me a chance to let off steam when life has ground me down. I need to work (part-time at mo) to pay for bills and the rising cost of living. I just pray that there's some sort of light appearing in a long, dark tunnel. I feel absolutely shattered.

 

[Neville's Breakfast]

I know your story and I feel the same about the NHS in general. And don't get me wrong, most of the people I dealt with yesterday were excellent. But there was a lack of organization and, I fear, knowhow. And yes, the NHS is conceptually brilliant - which I suppose is my point - it seems to have been allowed to become deeply suboptimal, and the extent may be patchy around the UK. I apprecaite that many tories love the NHS and it is no loger seen as 'that socialist monster'. However I am not sure that there are not a few ghosts in the political machine who don't mind the neglect and have a ready solution - go private.

During Covid I had a hernia op. They were short staffed. Doing the bloods was a bit of a sweat, with an ambulance driver and a 19 year old medical student eventually getting a vein at the fourth attempt. That's fine.

Yesterday the hospital was visibly quiet. When I was taken to have my bloods done it was by someone who was doing nothing but taking bloods. When he first collected me he said 'where are the IV lines?'. I said 'nobody has put any in yet!'. I was sent away for half an hour.

I was called back. He tried to spike me when I still had my coat on. He didn't ask me to pump my fist and when I offered he said it wasn't needed. He couldn't get into one vein. He then thought he had the one in my hand, shoved the needle in further and I though 'he gone through it, do I say something?'. He then proceeded to pump a mix of my blood and air into the subcutaneous space. After giving up he said he'd get 'the machine'. That's when I went into maybe 3 hours of sitting around till I asked and found that he had no access to 'the machine' as it was being used elsewhere, and had initiated no action (like asking someone competant to spike me) so I was in limbo. I complained to some other staff and a nurse offered to do it and 2 minutes later she had put the lines in. It was the most absurd spiking experience I have had and I have been spiked dozens of times. That's not pressure due to emergencies. At the time there were none. And I was in among the acute medical need lot - one step down from car crash, heart attack or stroke victims (albeit there was a woman in there with acute heart failure who should have gone direct to the cardiology unit). Organizational chaos.

The bottom like is it matters not whether he NHS is generally brilliant (which it is on many levels), or whatabout how well you were treated, what happened yesterday was completely unacceptable. Every patient I spoke to told me this was their worst ever NHS experience. The glaring and simple issue that could be fixed is transparency. They don't tell us anything. Expectations are not managed. And they lie about how long you've been waiting (in a particularly nasty way - accusing patients of being wrong when they question the nonsense) - and yet not on purpose - the system predicates this. There is no need for that. Indeed at no time yesterday did anyone ask me how I was, and whether I needed any pain relief, even though I was doubled up in agony repeatedly. And it isn't if nobody was around - there were on average 10 staff buzzing around at all times. When people went to the front desk with a question they got daggers. I did. That simply isn't acceptable.

I think you make some good points and there may indeed be an element of postcode lottery. The NHS on Merseyside is exceptional, partly I think because of the teaching hospitals here (eg my hospital) and centers of excellence in neurology at Liverpool Walton and the cancer hospital at Clatterbridge. I get a taxi to work and several drivers have told me about the southerners they have picked up who have come up here for several days for the cancer care. If I still lived down south I might have died because of a misdiagnosis after my stroke. That was at the height of Covid when resources really were stretched. That was put right by consultants from Liverpool Walton and my hospital, working collaboratively.
Your story about the bloods makes me shiver. I always book in with the same nurse at my GP surgery as she is very efficient and never misses !
I think the point about ‘he who shouts loudest’ has always happened for non acute cases. I remember when my MIL died and older family members were afraid to question anything. She only got increased painkillers when we stepped in and asked.
The debate that needs to be had is what do we want from our NHS ? It was set up for one thing and it’s reach has extended so much because of medical advances. Someone earlier in the thread talked about modern expectations and that is also a factor. Higher taxation is the only way to go if we want everything and that is nothing to do with socialism.
I hope you are all sorted and feeling better now.

 

[Kinky Gerbil]

I find it quite difficult to explain succintly but Wikipedia does a good job.

https://en.wikipedia.org/wiki/Healthcare_in_Germany

It actually seems a sensible approach

 

[Ooh it’s a corner]

Gosh H - sounds horrendous. I hope it proves a one-off for you and you pick up swiftly.

Agree with Herr T and several others. Would happily be taxed more to improve quality of the NHS. It has been magnificent on many fronts and we need it to be forevermore so that good healthcare is there for EVERYONE not just the privileged.

Health and shelter are the two most important needs. It would be ideal if we had a government who recognised that and started caring for other people instead of themselves. Christ I hope they get slaughtered in both by-elections next week.

Wake up those who STILL want to believe BJ and the Cretins - a Labour government or Lab/Lib and friends etc is likely to have a far stronger commitment to health and social care than the present mob - we need some kind of radical change to move forward with the NHS and so much else

 

[Herr Tubthumper]

It actually seems a sensible approach

Above all it works, and works very well. as an adendum to my earlier post the missus had to book a post-surgery consultation. She rang yesterday at 4:05....office was closed so she left a message. They called her at 6pm last night, and twice this morning. She has an appointment for 9am on Monday. This was just for very minor and elective op. A friend had a hernia done and dusted within 5 weeks from onset.

What I like most about the system is that my care, in old age, will be paid for b the state. No selling of house, no dipping into my savings...all paid for by the state. The 14% I often refer to is, in part, a savings plan for my old age.