[Politics] NHS today

[AmexRuislip]

Morning Mike, sorry to hear of yr experiences, sounds absolutely third world.
I hope you get seen soon and all us resolved.
I know it's just words (me), but it seems different experiences in different areas, the SE has and is always underwhelmed.

 

[Herr Tubthumper]

Is the German system half private half public?

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

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

 

[CheeseRolls]

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.

Poor bleeder!

The seventh person managed to get a cannula in my arm the last time I was in Worthing hospital for a CT scan. The worst one was the one that was almost in and it was only when my arm started to puff up in the scanner that this became apparent. Bring on the machines!

 

[drew]

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.

Have you any stats to back that up? The Kings Fund did a review and found there are fewer management posts in the NHS than the private sector!

https://www.kingsfund.org.uk/projects/health-and-social-care-bill/mythbusters/nhs-managers

Trouble is it's a myth perpetuated by some elements of the press.

 

[Bry Nylon]

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.

This post isn't aimed at any poster on here - more just a general observation - but it really doesn't matter how much money you chuck at the NHS, it will never be enough as too many people don't take personable responsibility for their health then expect the NHS to bail them out when it all goes pear shaped. (In many cases, quite literally).

Its easy to bash the NHS but walk down any highstreet and look at what they are having to deal with, ffs. Latest figures for the UK are that 28% of all adults are obese and a further 36% are overweight. Worse than that, >25% of kids are obese by the time they reach the final year of primary school. This manifests itself in a myriad of health issues that suck up NHS resources, but rather than address their own behaviour, there seems to be an unspoken attitude of, "I'll indulge in a really unhealthy lifestyle and then expect the NHS to be available to fix the damage I've done." I don't believe any national health service could cope with such an unhealthy general population.

Could the NHS perform better in many instances? Probably? But do we all need to take a bit more personal responsibility for our health? Most certainly.

 

[maltaseagull]

Have you any stats to back that up? The Kings Fund did a review and found there are fewer management posts in the NHS than the private sector!

https://www.kingsfund.org.uk/projects/health-and-social-care-bill/mythbusters/nhs-managers

Trouble is it's a myth perpetuated by some elements of the press.

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?

 

[Harry Wilson's tackle]

Awful, just awful, I actually do sympathize with you.

That said, I would refuse to sign a self discharge form as they cannot exactly hold you prisoner now can they? By all means blame the current Tory government for many of the issues in the NHS, but also maybe the whole culture within the organisation needs looking at? Middle managers, departmental bosses and their like have maybe become consumed by a "avoid responsibility at all costs' mindset. I wish you a speedy recovery.

Thank you for your good wishes. I appreciate that.

The woman and her colleague honestly told me I could not leave unless I signed the waiver. I suspect the can't do it, but late at night, feeling poorly and a buzzer away from the cheery security guys, I found I couldn't argue. I did make a fuss but capitulated.

Now I'm trying to work out what to do next. We are arranging a GP appointment where I will ask for a CT appointment. My worry is they will tell me to rock up at Ashford and go through the same rigmarole.

I have found that a codeine reduces the spasms (and I slept through the night) but the issue is still here. I will ask the GP to give me some more. Horrible drug but if it lets me sleep....

I'm lucky, my missus is very organized. If it transpires I have to run the same gauntlet she will decant the nipper to a friends so she can pick me up. I'm not sure what some poor sod with no support is supposed to do. My guess is they are staying at home and not using the NHS.

 

[Harry Wilson's tackle]

Jeez Harry,
that’s bloody awful.

If i were nearer you and not covid positive i would collect you and take you.
any of us on NSC near Harry and could help him?

That's really kind. After the unexpected situation yesterday we can plan a bit of child shuffling if my missus needs to be on standby, assuming I can get another appointment..

 

[LamieRobertson]

Not going to comment on the reasons/solutions as this thread will very quickly go the same way as as any other that can be politicised but hope you’re ok and whatever it is gets sorted asap @HWT.

Seconded

Get well soon Harold

 

[Thunder Bolt]

That's not necessarily the case. There are many minor injury clinics in Brighton, Crawley, Horsham and I think Uckfield but people tend to go to their nearest A&E.

The Victoria in Lewes is a minor injury unit and open 8-8 every day,

https://www.sussexcommunity.nhs.uk/...-centre-utc-at-lewes-victoria-hospital/109005

 

[Thunder Bolt]

Thank you for your good wishes. I appreciate that.

The woman and her colleague honestly told me I could not leave unless I signed the waiver. I suspect the can't do it, but late at night, feeling poorly and a buzzer away from the cheery security guys, I found I couldn't argue. I did make a fuss but capitulated.

Now I'm trying to work out what to do next. We are arranging a GP appointment where I will ask for a CT appointment. My worry is they will tell me to rock up at Ashford and go through the same rigmarole.

I have found that a codeine reduces the spasms (and I slept through the night) but the issue is still here. I will ask the GP to give me some more. Horrible drug but if it lets me sleep....

I'm lucky, my missus is very organized. If it transpires I have to run the same gauntlet she will decant the nipper to a friends so she can pick me up. I'm not sure what some poor sod with no support is supposed to do. My guess is they are staying at home and not using the NHS.

If you need to attend as an emergency, don't call an ambulance, get a taxi. Ambulances are in queues hours long because patients in A&E can't be moved into beds, because beds are full. Very ill patients have to stay in the ambulances with paramedics attending them. The average wait for an ambulance is 7-14 hours.

 

[Harry Wilson's tackle]

Harry on behalf of the NHS I am extremely sorry for everything that you and your fellow patients have been through. I could probably explain why and justify each of your points but in the end it will not change the situation. I work in the East of England where I could tell you many similar stories. If you read the online BBC News today you will find another such example in Gloucestershire. What you describe happens everyday, and only becomes raw when we ourselves or one of our own experience it first hand.
If everyone gave 10% of their wages to an all inclusive NHS It still
Would not be enough, because we are very good at making I’ll people live longer. It would of course improve waiting times and service delivery and would have possibly changed your experience today.
I understand there is a bill going through Parliament that is trying to insure that all service providers in the NHS are in fact employees and not private establishments. This may mean that it stays nationalised but it would stop companies making a profit instead of the money staying in the system even if that may increase its inefficiency. I could give you so many examples in my area which you would find unbelievable in current day situations by why make you feel worse than you already do.
The NHS is a very special service. The vast majority of its employees have you at heart as they are also in need of its service’s. It just needs reinventing for today’s expectations and that will never happen as long as it is run by a government that puts profit over people.
So once again I apologise to you and everyone else who has been through the same situation or knows someone who has, we really are trying to do our best in extremely difficult circumstances.

Not your fault mate!

I work in a big London teaching hospital. I understand the money issue, but what I have seen is a massive growth of 'management' which comprises massive collection of data and box ticking for no useful purpose. The medics I know (probably around 50, consultants and senior trainees) are supremely pragmatic and if given nothing more than a sharp knife and a bible to work with would just crack on and do their best.

My impression, after many years (I started my post doc at St Thomas' Hospital in 1986), is an increasingly beurocratic system where there is a written protocol for everything (from repairing an aneurism to wiping your arse), where ordering materials is complicated and absurdly expensive, where innovation is driven by administrators to make life easier for them (and create work for them) and where, frankly, we have crossed an event horizon where more administrators are needed to deal with the expansion of administration and oversight. Not their fault by the way - it's part of the system.

We have suffered since the late 80s with the introduction of market forces and tendering. But this means we are not fleet of foot and eyewatering wast happens. The financial set up is from fairy land, with a complete disconnect between change and need.

A trivial example (this is college stuff rather than NHS but the same things occur), every year the forms we complete for annual appraisal are changed. We employ peole full time to manage the apparaisal experience. Not one thing has come of my appraisal in 30 odd years. And worse, we are required to record all our activity hours (teaching and research). I teach on around 50 courses. My 'return' is in 3 sections each with around 20 columns. That 3,000 bits of data. Until this year my data were rolled over for me to update. This year - guess what - the college (and hospital - medics have to do this too) bleached our data.

Anyway I have gone off topic. I feel like a beaten dog, both at work and in my recent NHS experience. Angry rather than sad....

Cheers!

 

[Thunder Bolt]

this is true and a large hurdle. however we've seen Conservatives rise taxes for social care so it is possible if there is a will. the larger hurdle is the doctrine to keep out private health care, despite all evidence across europe of alternative approaches. there is an obsession that this is binary, either 100% public owned or US style 100% insurance based. nothing in between exists in many minds, despite the fact our system has never been 100% public owned. much to admire about the German system starting with the simple business of seeing a specialist instead of a GP.

Taxes might have been raised but there is a graph on this page which shows the spending that actually happened.

https://nhsfunding.info/nhs-crisis-making/

 

[Harry Wilson's tackle]

Now, yesterday I had the exact opposite experience.
Rocked up to Crewe hospital at 9am, got seen, x-rayed, assessed, and arm plastered.
At 10.15 I was on the way home.

Maybe it's a postcode thing?

For sure!

 

[Thunder Bolt]

Not your fault mate!

I work in a big London teaching hospital. I understand the money issue, but what I have seen is a massive growth of 'management' which comprises massive collection of data and box ticking for no useful purpose.

I know exactly what you mean. I have been going to the Orthopaedic centre at Haywards Heath for 18 months now, and recently went into theatre to have a guided steroid injection into the joint between my ankle and my heel. Bear in mind that I have had an xray, MRI scan etc etc, when I arrived for the injection, the nurse had to go through FOUR A4 pages of boxes to tick off, just for a local anaesthetic and a steroid injection.

 

[essbee1]

Really sorry to hear this Harry.

My mum was full of praise for the staff at Sussex County Hospital; a few days back my Dad
accompanied by my Mum went for a short op. Very efficient and kind people according to my mum. Must be a
postcode thing.

 

[Harry Wilson's tackle]

this is true and a large hurdle. however we've seen Conservatives rise taxes for social care so it is possible if there is a will. the larger hurdle is the doctrine to keep out private health care, despite all evidence across europe of alternative approaches. there is an obsession that this is binary, either 100% public owned or US style 100% insurance based. nothing in between exists in many minds, despite the fact our system has never been 100% public owned. much to admire about the German system starting with the simple business of seeing a specialist instead of a GP.

Sorry but your 'facts' are wrong. The NHS is shot through with 'private' and has been since tendering was introduced.

Last night, when I needed a CT scan, I was told that a private company run the CT at night (see my post) and that the hospital has no access to their prioritizing or any idea of waiting times.

In the hospital where I work there is private involvement across the board. And of course the consultants all moonlight at private hospitals.

And of course you can queue jump in an NHS hospital by offering to pay. I was offered this when I last had my knee fixed a couple of years ago, and again when I needed a hernia repair.

I'm not saying it's a good or bad thing (albeit The CT scan issue is clearly very bad), but please get you facts straight.

(Actually.....it is a bad thing).

 

[jakarta]

I know exactly what you mean. I have been going to the Orthopaedic centre at Haywards Heath for 18 months now, and recently went into theatre to have a guided steroid injection into the joint between my ankle and my heel. Bear in mind that I have had an xray, MRI scan etc etc, when I arrived for the injection, the nurse had to go through FOUR A4 pages of boxes to tick off, just for a local anaesthetic and a steroid injection.

Marvellous Scenes, I have a similar procedure before the end of the month (lower back) so thanks for the heads up...

 

[beorhthelm]

Sorry but your 'facts' are wrong. The NHS is shot through with 'private' and has been since tendering was introduced.
...

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.

 

[Harry Wilson's tackle]

Harry, remember emergencies take priority. It is a little unclear how acute your need was. I feel the opposite about the NHS. I am in complete awe about living in a country where my life has been saved several times, the follow up care by several departments has been incredible and I am on free daily medication that keeps me alive.

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.