[Misc] The NHS

[Superphil]

Terrible question. Should be neither in the private sector or a In the political system. Should be completely sacrosanct, financed by government but run for the entire public, not just those that a political party wants to run it for.

 

[Durlston]

I finished with appointments down at the RSCH as I felt it was for all for their benefit. They wouldn't subsidise my travel (costing me close to £20 each time). I'd rather they spent time on somebody that is seriously ill. I've completely changed my diet and no loss of blood this year through nosebleeds, vomiting blood or even shaving by changing blades that cost a wee bit more). If I have to live with anaemia naturally that's fine. I also have to be careful with my epilepsy but following advice is a lot more economical than travelling a 30-mile round trip and getting severely stressed beforehand with ocasionally pointless tests.

 

[Half Time Pies]

If there are two poorly run hospitals in B&H then a third and maybe a fourth would be built, because a new well run hospital is needed and will be successful. When it is successful the other two poorly run hospitals which nobody uses anymore go bust and become flats. Circle of life.

If our current hospital building record in this country seems slow and inflexible, I'd suggest that might be because they are publicly managed operations, business tends to be a lot more efficient and flexible than government.

Btw, according to the Argus there are 10 hospitals in Brighton & Hove.
http://www.theargus.co.uk/li/hospitals.in.Brighton and Hove/

This is absolutely pie in the sky! Look at how long it took for us to get the planning for the Amex through, any significant development in Brighton is extremely difficult regardless of if you are a business or publicly owned. The monopolies and mergers even had to step in to prevent my local gym (virgin active) being sold to David Lloyd due as it it would stifle competition as there would be two David Lloyds in the town and little competition due to the fact that it is extremely costly and difficult to locate a suitable site in Brighton to open a health and leisure centre, let alone a acute hospital.

In many ways I am a free market advocate but it has its limitations, in a free market, goods and services are allocated through transactions based on mutual consent. No one is forced to buy from a particular supplier. In a free market, no transactions occur if a price cannot be agreed.

In Health Care when someone needs a service its its in a completely different way to when someone might be considering purchasing a mobile phone for example. When I become seriously unwell and get rushed in to hospital I am in no position to shop for the best provider. Whatever happens next will not be a market transaction.

If I am unhappy with the service I receive I can't wait 5-10 years for another acute hospital to crop up to offer an alternative to the failing provider in my area. I need to be treated now, I don't have a choice.

In healthcare often the poorest parts of society have the most need yet a free market would allocate the best health care resources to the most affluent parts of the country. We would end up with heath care inequality with poor choice and provision in less affluent and less populated areas and unless you think it is OK for poor people to suffer then this would be totally unacceptable.

In terms of the 10 hospitals on the list, I was actually talking acute hospitals, on the list 2 are private, 3 are on the same site and effectively the same hospital and the others are small community outpatient hospitals.

 

[Hampster Gull]

The NHS has not stood still in that time!

I love the NHS, it is close to my heart for a few reasons, but it is wobbling under the strain of politicians dabbling and an ageing population. Getting back to it’s routes by focusing on those who can’t pay seems appropriate

 

[drew]

Add social care to the NHS.
Have a 24 hour doctors surgery at every Hospital Why, there is the A and E and everyone should have out of hours service which should be their first port of call.
Ruthless baring down on waste...ie drug prices wouldn't disagree about waste but not sure about drug prices. Comes down to market rates.
Increase NIC s Not necessary. NIC doesn't fund the NHS. It used to but now the money just goes into the central taxation pot. Do away with NIC and adjust Income Tax.
Remove the triple lock. Why penalise the pensioners. As far as I'm aware pensions go up by average wage increases, inflation rate or a minimum of 2.5%. As the pension is only £122 per week, a 2.7% increase based on current inflation is a mere £3.29 per week!!!! If you want to cut back on pensions, means test them so the wealthy pensioners who are on very nice final salary schemes don't get the state pension
Allow more general nursing be done by the nurses.
........

What exactly is your understanding of general nursing and why do you think this isn't being done by nurses?

 

[drew]

Just a question, did the NHS ever work, if so why can't we go back to that system.

I have my feeling gs on why it has failed of late, but dont want to voice them.

It does work it's just some with a political agenda want to paint a picture that it isn't working. It's under extreme stress but it is working and compares favourably with other country's systems.

 

[Eeyore]

Is it time to get rid, bring in a firm that can run our health system? Or should we stick with politicians that use it like a political football whilst people die? We could make it private with systems in hand to make it a proper health institution, or we could leave it as a political football to kick around. I would personal;ly like to see it dismantled from politicians, because, at the end of the day it just seems to get worse and worse and worse. We still pay our NHS but put it in the hands of business, people we can trust to give us a service. Am I wishing too much or is business a bit too scary to hand our health to? I know it's a bastion of socialism, but are we now taking on too much?

Successive governments have been doing this for years.

 

[cunning fergus]

I am no more a bigot than you are, what is important is that you and I care enough to have a view which sadly is not the case with so many that in the end apathy maybe it's death

Well, that is yet to be proved, the point I am making is that Brexit if it is managed properly will mean that any Govt seeking to privatise the NHS will do so in full transparency in the HOP.

Trade deals done by the EU, are in contrast negotiated in the shadows, by the unelected Commission. It was in this environment that the U.K. would have had TTIP imposed on us, which is exactly why the establishment love the EU, i.e. less transparency and less accountability.

Equally, I am no Tory lover, but this b@llocks about only Labour being able to save the NHS is, well b@llocks. They are th3 political party that went bat sh!t crazy for PFI, loading liabilities of billions on the taxpayer for years to come. Of course if you were not a bigot you would appreciate this.........

 

[RexCathedra]

By all means, privatize. You only need to look across the pond to the US' resounding success in this area.
We pay 2-3 times more per capita for no demonstrable improvement in outcomes.
Only the market can do magic like that.

You got suckered into following the US on post-secondary education, why not do it all over again?

 

[Half Time Pies]

Add social care to the NHS.
Have a 24 hour doctors surgery at every Hospital
Ruthless baring down on waste...ie drug prices
Increase NIC s
Remove the triple lock.
Allow more general nursing be done by the nurses.
........

I agree that the NHS and social care budgets should be linked, I own a home care company and we see this ridiculous revolving door situation where patients are discharged in to the community without adequate care in place and then as a result end up back in hospital again. If adequate funds were spent in the community on providing people with the care that they needed then this would help prevent hospital admission and massively reduce the pressure on the NHS.

I think in terms of the doctors surgery at the hospital we definitely need a new approach to where and when health facilities are accessible. Getting an appointment at my doctors surgery is an absolute nightmare and I can understand why some people would use an out of hours doctor at the hospital or A&E as an alternative. We definitely need more walk in clinics in places that are easily accessible and open longer but I am not sure that the right place is in hospitals as they are often a nightmare, parking is difficult and expensive. We need to see them in train stations, supermarkets, high streets and places like that and open at times when people can get to them before and after work. I think a lot of people end up presenting at hospital with issues that could have been resolved by their local GP but have been left to get much worse.

We also now have access to things like online doctors and if the NHS provided this kind of service they could do an initial triage using technology like this to ensure that patients are directed through the system appropriately.

Finally I think we need a new approach to prescribing, there is a doctors surgery in Herstmonceux which has the lowest prescriptions rates in the county due to the fact that the doctors do social prescribing, they will look at a persons overall health, fitness and wellbeing and work with the community to ensure that patients are supported to improve their overall health.

 

[portslade seagull]

Apologies, as we were talking about the NHS I assumed Nomad was on about clinical consultants. In the case you refer to I'm assuming he was on a contract rather than direct employee. As with any contractors, you have to pay the going rate.

The problem with the RSCH is that it is running at a deficit, as probably most trusts are, therefore any savings, unfortunately, go into reducing that deficit rather than increasing staff numbers!

Yes he was. Lived with us over that period. Drove us nuts. Ex army Sergeant Major so the names he was calling the management wasn't nice.

 

[drew]

Well, that is yet to be proved, the point I am making is that Brexit if it is managed properly will mean that any Govt seeking to privatise the NHS will do so in full transparency in the HOP.

Trade deals done by the EU, are in contrast negotiated in the shadows, by the unelected Commission. It was in this environment that the U.K. would have had TTIP imposed on us, which is exactly why the establishment love the EU, i.e. less transparency and less accountability.

Equally, I am no Tory lover, but this b@llocks about only Labour being able to save the NHS is, well b@llocks. They are th3 political party that went bat sh!t crazy for PFI, loading liabilities of billions on the taxpayer for years to come. Of course if you were not a bigot you would appreciate this.........

The TTIP negotiations were to allow governments to still make decisions about how they run their services so you are just scaremongering. The NHS was to all intents and purposes protected. It would only be at risk if the government of the day wanted to allow US firms in. As it turned out, Trump was unlikely to sign anyway, especially has he chucked out the similar negotiations with the Pacific countries.

As for the commission, of course they are unelected, just as our civil service isn't elected. Do you honestly think David Davies is the only one involved in negotiations over Brexit. It will be the same when we have to negotiate trade deals around the world. Experts in negotiations will do the donkey work with final agreement ratified by elected representatives (well at least elected on our side of the fence).

By the way, I agree with your comments re Labour and the PFIs. They should have just borrowed the money themselves and built the things. However, I don't think the NHS is safe in the hands of the Tories, at least not as the NHS we know today.

 

[drew]

We also now have access to things like online doctors and if the NHS provided this kind of service they could do an initial triage using technology like this to ensure that patients are directed through the system appropriately.

We had this, it was called NHS direct. You could go online and list your symptoms and also ring. The current government closed it down and replaced it with 111 telephone service

 

[Half Time Pies]

We had this, it was called NHS direct. You could go online and list your symptoms and also ring. The current government closed it down and replaced it with 111 telephone service

What I am talking about is different, its a face to face interaction on a Skype type platform with a qualified doctor where they can even prescribe for simple ailments and arrange for the medication to be ready for you at your local pharmacy, the one I have been using is called push-doctor https://www.pushdoctor.co.uk

 

[Doonhamer7]

This is a great discussion - with good diverse points of view. There are some big picture items missing: 1) the nhs should be retitled the national sick service - most of us don’t engage with it until we’re sick. What we really need is early health intervention to prevent sickness - think diabities / dementia which are just going to cost more. If we stop them occurring then it saves money. 2) some form of privatisation would save money - savings would be considerably greater than profit made - we definitely do not want the US model. 3) remember - the private companies make money for their shareholders. The majority of these shareholders are pension funds - so these are our pensions we are talking about. 4) The drug companies also have to spend lots on R&D, I read once that more drugs fail in r&d than get to market, and without decent returns we already see the big pharmaceutical companies doing nothing on new antibiotics - this could be a big killer. 5) Out sourced contracting margins (profits) are very small especially when you start to fully understand all the risks you take. Carillion’s downfall was on big construction contracts going south not its FM/outsourced work 6) PFI is not the cheapest way to build anything as the companies have to borrow from the banks / asset funds, they can never give money cheaper than govts can borrow at but most important it gets debt off the govt books. Both political parties are responsible for using PFI. 7) in my time I have worked with a variety of govt departments ( incl MoD, London Underground) or recently privatised ones (BT, southern water, electrical ones) and they were so inefficient in how they did things - in my chats with executive/senior mgt it was initially very culturally difficult to make real change. So based on this the NHS could easily save 20% of it’s budget if run as some form of GOCO. 8) in my experience Govt procurement / management is poor - not commercially astute - thinks cheapest means best value - a private company understands when to pay more to ensure better service.

In summary the NHS has to change big time or it will drag us all down - it’s too big to fail ( just like banks but bigger) and just throwing money at it won’t help.

 

[cunning fergus]

The TTIP negotiations were to allow governments to still make decisions about how they run their services so you are just scaremongering. The NHS was to all intents and purposes protected. It would only be at risk if the government of the day wanted to allow US firms in. As it turned out, Trump was unlikely to sign anyway, especially has he chucked out the similar negotiations with the Pacific countries.

As for the commission, of course they are unelected, just as our civil service isn't elected. Do you honestly think David Davies is the only one involved in negotiations over Brexit. It will be the same when we have to negotiate trade deals around the world. Experts in negotiations will do the donkey work with final agreement ratified by elected representatives (well at least elected on our side of the fence).

By the way, I agree with your comments re Labour and the PFIs. They should have just borrowed the money themselves and built the things. However, I don't think the NHS is safe in the hands of the Tories, at least not as the NHS we know today.

Neither you or can say with any certainty what the outcome of TTIP would have been, however opposition to it was widespread in EU member states and rightly so.

https://stop-ttip.org/what-is-the-problem-ttip-ceta/

This is not “scaremongering” but recognising that the EU in matters such as trade negotiations do so in private and far from the scrutiny of the HOP and media. You know I am right on this point, so let’s not do any knock-about.

Accordingly IF Brexit is managed properly, going forward there will be much greater scrutiny on trade negations and this will make it much more difficult for any political party to “privatise” the NHS. This is a good thing.

As above, you know the European Commission is not the civil service so let’s not argue that, it would be embarrassing. I’m glad you mentioned David Davies though because he has been elected, whereas Michael Barnier who he is negotiating with is what exactly? Yep, an unelected official employed by the European Commission. This is too easy, you must be losing your touch.

Sometimes having exchanges like this with people like you remind me of when I could post on the Brexit thread........they were happy days, so thanks for the nostalgia.

Re Tories I broadly agree, but Labour are not the Labour of old, and they are so pro EU and therefore pro corporations they turned their back on nationalisation, I have no faith that like with PFI they will sell out the NHS just like they didn’t utter a peep when the Mail was sold off.

 

[DavidinSouthampton]

Is it time to get rid, bring in a firm that can run our health system? Or should we stick with politicians that use it like a political football whilst people die? We could make it private with systems in hand to make it a proper health institution, or we could leave it as a political football to kick around. I would personal;ly like to see it dismantled from politicians, because, at the end of the day it just seems to get worse and worse and worse. We still pay our NHS but put it in the hands of business, people we can trust to give us a service. Am I wishing too much or is business a bit too scary to hand our health to? I know it's a bastion of socialism, but are we now taking on too much?

What are Carillon doing these days?

The best way to avoid it becoming a political football is for someone to be put in charge who is far-sighted enough to try and seek a political consensus over it. And that won't happen in a million years in the current poisonous political climate.

 

[drew]

What I am talking about is different, its a face to face interaction on a Skype type platform with a qualified doctor where they can even prescribe for simple ailments and arrange for the medication to be ready for you at your local pharmacy, the one I have been using is called push-doctor https://www.pushdoctor.co.uk

Fair enough. Had a quick look and would agree that is something that out of hours service could provide. Nothing wrong with using modern technology. Who knows, even local GPs could use during surgery hours anyway.

 

[BadFish]

Why not vote in some politicians that don't use it as a political football. Maybe some politicians that fund it and run it properly?

Sent from my SM-A520F using Tapatalk

 

[drew]

Neither you or can say with any certainty what the outcome of TTIP would have been, however opposition to it was widespread in EU member states and rightly so.

https://stop-ttip.org/what-is-the-problem-ttip-ceta/

This is not “scaremongering” but recognising that the EU in matters such as trade negotiations do so in private and far from the scrutiny of the HOP and media. You know I am right on this point, so let’s not do any knock-about.

Accordingly IF Brexit is managed properly, going forward there will be much greater scrutiny on trade negations and this will make it much more difficult for any political party to “privatise” the NHS. This is a good thing.

As above, you know the European Commission is not the civil service so let’s not argue that, it would be embarrassing. I’m glad you mentioned David Davies though because he has been elected, whereas Michael Barnier who he is negotiating with is what exactly? Yep, an unelected official employed by the European Commission. This is too easy, you must be losing your touch.

Sometimes having exchanges like this with people like you remind me of when I could post on the Brexit thread........they were happy days, so thanks for the nostalgia.

Re Tories I broadly agree, but Labour are not the Labour of old, and they are so pro EU and therefore pro corporations they turned their back on nationalisation, I have no faith that like with PFI they will sell out the NHS just like they didn’t utter a peep when the Mail was sold off.

Really!!!

Regarding TTIP, your post was trying to suggest it was a foregone conclusion that the NHS would go when the deal went through which was far from the truth!

Any trade deal is signed off by the member states, not the commission. The commissioners are not elected but they are nominated by each member state, but then you already know that. The point I was making about the commission and the civil service were that they are the organisations that will be doing all the spade work for the negotiations. Both sides will then get their respective bosses to sign off on any agreement, the government on our side and the remaining 27 governments on the other side, but I guess you also know that.

You bang on about EU negotiations are far from the scrutiny of the HOP. Really. http://trade.ec.europa.eu/doclib/docs/2006/december/tradoc_118238.pdf

Hopefully you can provide a link to the progress of any negotiations our government are currently engaged in?

Still, let's not sabotage this thread so you can post Brexit crap which it seems you can't do on the official thread!!!!