[Misc] UK healthcare/NHS funding

[Audax]

Pretty much what my daughter says. Crap management, crap infrastructure/technology, crap admin....and now too much demand...all leading to way too much stress on frontline staff in turn leading to loads of sick leave and resignations, creating a vicious circle. Interestingly she's moved off the wards into a senior research nurse role recently on a stage 1 clinical trial within a very small team - no stress, own office, flexible hours, loads of available training etc etc etc. NHS are managing the project but I think the drug company is funding it..............

My Mrs has also moved from a frontline role in community nursing to a research role. She did it nearly 10 years ago, and nothing's changed that would see her move back the other way. Even in research, though, the NHS is struggling to hire and retain enough staff.

Unfortunately the NHS is way too fragmented. We all talk about it as if it's a national institution. The problem is, it isn't: it's broken up into smaller Trusts, each run locally, and the way the local Trust system interacts with data protection laws etc introduces a whole host of unnecessary blockages in being able to give the patient easy choices to make.

As an example: I live in Uckfield. From where I am, if I need a blood test and my GP doesn't have an early enough appointment available, then I have to go to Eastbourne. Why? Because my GP works directly with Eastbourne and they have direct access to the results. I *could*, in theory, go to Pembury, Haywards Heath, or Brighton (relatively similar travel times, each with its own advantages): but for all of those options the GP has to wait for the results to be sent to them through longer routes that makes them non-viable for urgent blood tests.

That's just silly: it shouldn't matter where the bloods are taken and processed. The results should be reported into a system that my GP has direct access to regardless of which Trust the lab actually belongs too. Or better yet: do away with the Trusts, run the NHS from a centralised national institution. Make use of economies of scale introduced by doing so to reduce the number of administrative staff and use the funds freed up to improve the packages for doctors and nurses so that more people make the choice to enter those professions.

Let's face it - there's clear evidence that the Trusts system is failing, with some Trusts chronically underfunded and constantly on the brink of collapse

 

[Harry Wilson's tackle]

It is impossible to sell the NHS. The NHS is a principle that all patients can have the necessary treatment free at point of sale. That is not something which can be sold.

There is a school of thought, which certainly wasn't shared by Gordon Brown, that no-one should be allowed to make a profit out of healthcare. And obviously people who have that viewpoint won't agree with the idea of outsourcing tratment, using private hospitals, the GP system, and so on. But that isn't the same as selling off the NHS, because the NHS is a principle, not an operating system.

Yes, quite. I meant identifying components of the healthcare operating system that could be flogged off to private operators, rather than flogging the principle. The consequence would be hat the NHS would shrink in terms of capability, and the middle classes would engage even more with what they engage with already - private healthcare. Apologies for not making myself clear.

If the tories can pull off this trick while making it appear to be a way of making things better for a sufficient number of voters, they may try it, but my guess is they will need to let the present systen get hugely shitter, to the point where it looks dead on the vine, before making a move. After all, they still haven't had the guts to flog off the BBC yet, even though some of them are itching to do so, and it could be done relatively painlessly (compared with the upheaval of defenestrating the NHS).

 

[beorhthelm]

Technical/legal fair share, yes.

Subjective/'moral' fair share, arguably not.

do you believe that a company or person should pay more than the legally required amount, simply because you want them to pay more? not very equitable.

 

[The Clamp]

https://www.theguardian.com/world/2...id-patients-a-day-during-pandemic-says-report

 

[dazzer6666]

My Mrs has also moved from a frontline role in community nursing to a research role. She did it nearly 10 years ago, and nothing's changed that would see her move back the other way. Even in research, though, the NHS is struggling to hire and retain enough staff.

Unfortunately the NHS is way too fragmented. We all talk about it as if it's a national institution. The problem is, it isn't: it's broken up into smaller Trusts, each run locally, and the way the local Trust system interacts with data protection laws etc introduces a whole host of unnecessary blockages in being able to give the patient easy choices to make.

As an example: I live in Uckfield. From where I am, if I need a blood test and my GP doesn't have an early enough appointment available, then I have to go to Eastbourne. Why? Because my GP works directly with Eastbourne and they have direct access to the results. I *could*, in theory, go to Pembury, Haywards Heath, or Brighton (relatively similar travel times, each with its own advantages): but for all of those options the GP has to wait for the results to be sent to them through longer routes that makes them non-viable for urgent blood tests.

That's just silly: it shouldn't matter where the bloods are taken and processed. My GP should get the results should be reported into a system that my GP has direct access to regardless of which Trust the lab actually belongs too. Or better yet: do away with the Trusts, run the NHS from a centralised national institution. Make use of economies of scale introduced by doing so to reduce the number of administrative staff and use the funds freed up to improve the packages for doctors and nurses so that more people make the choice to enter those professions.

Let's face it - there's clear evidence that the Trusts system is failing, with some Trusts chronically underfunded and constantly on the brink of collapse

All sounds familiar.....when no 1 was on the wards, she told me if a patient was transferred to the nearest 'big' hospital (Western General in Edinburgh in her case typically) for specialist treatment her place couldn't deal with, records needed to be faxed over. In 2021............of course meaning an already stressed out and overworked nurse would have to spend ages doing it.

 

[Comrade Sam]

Clean out the Virgin Islands with a big sack, fill it with untaxed loot and buy us all a hospital and a house!

 

[Audax]

All sounds familiar.....when no 1 was on the wards, she told me if a patient was transferred to the nearest 'big' hospital (Western General in Edinburgh in her case typically) for specialist treatment her place couldn't deal with, records needed to be faxed over. In 2021............of course meaning an already stressed out and overworked nurse would have to spend ages doing it.

My father-in-law (may he rest in peace) had a similar thing happen. He was transferred initially from a home, to Uckfield hospital, and then onward to Eastbourne as Uckfield couldn't handle his case. That involved 2x transfers of documents, and along the way one of those transfers didn't go as well as it should have - which ultimately meant his care at Eastbourne wasn't optimal. That was within the last 10 years, and when we reviewed his case we had to go to each Trust/institution involved separately to get all of the documents.

 

[beorhthelm]

All sounds familiar.....when no 1 was on the wards, she told me if a patient was transferred to the nearest 'big' hospital (Western General in Edinburgh in her case typically) for specialist treatment her place couldn't deal with, records needed to be faxed over. In 2021............of course meaning an already stressed out and overworked nurse would have to spend ages doing it.

few months ago everyone wet the bed over centralised GP records, they'd do the same when centralised hospital record come up. so its faxes for the foreseeable.

 

[drew]

I do find it bizarre that there are some people bemoaning the amount of managers/admin staff there are supposedly in the NHS and in the next breath are adovocating private health insurance which is surely adding another layer of admin!

 

[drew]

few months ago everyone wet the bed over centralised GP records, they'd do the same when centralised hospital record come up. so its faxes for the foreseeable.

Was it that there were centralised records or was the furore about the fact they may be made accessible to third parties?

 

[beorhthelm]

Was it that there were centralised records or was the furore about the fact they may be made accessible to third parties?

its was both, the objection to centralisation being that it would make 3rd party access easier.

3rd parties already access the data through the GPs, not so well covered in the furore.

 

[pb21]

do you believe that a company or person should pay more than the legally required amount, simply because you want them to pay more? not very equitable.

It's not about what I want, it's about what is fair and how you might define fair.

 

[Badger]

Would I pay more? Yes.

Would I subscribe to an insurance system? Yes.

When I lived in Canada as a foreigner (student) I was required to pay for health insurance. As a student the cost was trivial (about ten dollars a year if I recall correctly, at a time when I was paid around ten thousand dollars a year). Everyone can afford that. I am not sure how they dealt with rough sleepers but there was some sort of safety net.

The health system there was fantastic. After 3 years I did my meniscus and got it fixed with keyhole surgery. One of my colleagues did the anaesthesia. I hope it is still as brilliant there as it was (calling @stoneham park).

I can confirm the healthcare system in Canada is still great. It's by no means perfect but it's a million times better than it is over the border.

If you're a resident, you qualify for free healthcare. In Ontario it's called OHIP (Ontario Health Insurance Plan). You even get a photo card with your OHIP number which you use whenever you have any medical appointment. It doesn't cover everything; ambulances aren't included, bizarely; but any kind of emergency treatment is taken care of without charge. Even for things which aren't covered there are safety nets in place and people don't get given a huge bill like in the US.

A significant number of employers offer an extended health insurance plan. This is slightly different to private medical insurance in the UK. It offers extra coverage for things not included in OHIP. For example, I use it for all my dentist appointments which has been very useful as I've had my wisdom teeth removed over the last couple of years.

I've barely heard a bad word about the healthcare system here. It works well and I don't think we pay much more tax than the UK (if at all).

 

[Wrong-Direction]

Its being run into the ground so eventually we all accept total privatisation

Sent from my SM-A600FN using Tapatalk

 

[ken tiler]

My Mrs has also moved from a frontline role in community nursing to a research role. She did it nearly 10 years ago, and nothing's changed that would see her move back the other way. Even in research, though, the NHS is struggling to hire and retain enough staff.

Unfortunately the NHS is way too fragmented. We all talk about it as if it's a national institution. The problem is, it isn't: it's broken up into smaller Trusts, each run locally, and the way the local Trust system interacts with data protection laws etc introduces a whole host of unnecessary blockages in being able to give the patient easy choices to make.

As an example: I live in Uckfield. From where I am, if I need a blood test and my GP doesn't have an early enough appointment available, then I have to go to Eastbourne. Why? Because my GP works directly with Eastbourne and they have direct access to the results. I *could*, in theory, go to Pembury, Haywards Heath, or Brighton (relatively similar travel times, each with its own advantages): but for all of those options the GP has to wait for the results to be sent to them through longer routes that makes them non-viable for urgent blood tests.

That's just silly: it shouldn't matter where the bloods are taken and processed. The results should be reported into a system that my GP has direct access to regardless of which Trust the lab actually belongs too. Or better yet: do away with the Trusts, run the NHS from a centralised national institution. Make use of economies of scale introduced by doing so to reduce the number of administrative staff and use the funds freed up to improve the packages for doctors and nurses so that more people make the choice to enter those professions.

Let's face it - there's clear evidence that the Trusts system is failing, with some Trusts chronically underfunded and constantly on the brink of collapse

Indeed until the early nineties this was more or less how it was run but the Thatcher government wanted to start on the internal market under Ken Clarke - stupid. In Brighton we had Brighton healthcare I think until it was split firstly into two trusts then now into at least three or more including GP commissioners. This plethora of trusts duplicating many of the services that were more centralised with fat salaries paid to chief executives and directors, management by results creating a climate where front line staff were preoccupied with targets and form filling to the detriment of their clinical work. Having said that, some form of local accountability and even differences in what healthcare was delivered locally beyond the basics could be accomplished by devolving NHS responsibilities to local authorities. This would also have the advantage of integrating Social Services Education and healthcare to the local population and also making local elections far more important.

 

[portslade seagull]

i'd happily pay more tax if it meant better public services

problem is I don't trust this government to use public money properly so really all raising taxes would do is give a few more handouts to Johnson's chums

Agree as do most of my close friends. We would all happily pay more income tax for it to support the frontline workers ie, Nurses, Police, Firemen etc but it would probably get lost in the etha

 

[Harry Wilson's tackle]

I can confirm the healthcare system in Canada is still great. It's by no means perfect but it's a million times better than it is over the border.

If you're a resident, you qualify for free healthcare. In Ontario it's called OHIP (Ontario Health Insurance Plan). You even get a photo card with your OHIP number which you use whenever you have any medical appointment. It doesn't cover everything; ambulances aren't included, bizarely; but any kind of emergency treatment is taken care of without charge. Even for things which aren't covered there are safety nets in place and people don't get given a huge bill like in the US.

A significant number of employers offer an extended health insurance plan. This is slightly different to private medical insurance in the UK. It offers extra coverage for things not included in OHIP. For example, I use it for all my dentist appointments which has been very useful as I've had my wisdom teeth removed over the last couple of years.

I've barely heard a bad word about the healthcare system here. It works well and I don't think we pay much more tax than the UK (if at all).

You lucky sod. Long may it continue. We have a lot to learn in post-empire britland

 

[beorhthelm]

Agree as do most of my close friends. We would all happily pay more income tax for it to support the frontline workers ie, Nurses, Police, Firemen etc but it would probably get lost in the etha

pleased about the NI increase then. its not gone down so well in some quarters despite so many saying they'd be happy to pay more for health.

 

[drew]

I can confirm the healthcare system in Canada is still great. It's by no means perfect but it's a million times better than it is over the border.

If you're a resident, you qualify for free healthcare. In Ontario it's called OHIP (Ontario Health Insurance Plan). You even get a photo card with your OHIP number which you use whenever you have any medical appointment. It doesn't cover everything; ambulances aren't included, bizarely; but any kind of emergency treatment is taken care of without charge. Even for things which aren't covered there are safety nets in place and people don't get given a huge bill like in the US.

A significant number of employers offer an extended health insurance plan. This is slightly different to private medical insurance in the UK. It offers extra coverage for things not included in OHIP. For example, I use it for all my dentist appointments which has been very useful as I've had my wisdom teeth removed over the last couple of years.

I've barely heard a bad word about the healthcare system here. It works well and I don't think we pay much more tax than the UK (if at all).

You say it covers emergency treatment but what about things like replacement hips or knees or chemotherapy etc. You also mention employers do a top up insurance but what about the unemployed, how are they catered for?

 

[PeterOut]

I can confirm the healthcare system in Canada is still great. It's by no means perfect but it's a million times better than it is over the border.

If you're a resident, you qualify for free healthcare. In Ontario it's called OHIP (Ontario Health Insurance Plan). You even get a photo card with your OHIP number which you use whenever you have any medical appointment. It doesn't cover everything; ambulances aren't included, bizarely; but any kind of emergency treatment is taken care of without charge. Even for things which aren't covered there are safety nets in place and people don't get given a huge bill like in the US.

A significant number of employers offer an extended health insurance plan. This is slightly different to private medical insurance in the UK. It offers extra coverage for things not included in OHIP. For example, I use it for all my dentist appointments which has been very useful as I've had my wisdom teeth removed over the last couple of years.

I've barely heard a bad word about the healthcare system here. It works well and I don't think we pay much more tax than the UK (if at all).

It seems that you do pay more in tax than the UK - see https://www.health.org.uk/news-and-comment/charts-and-infographics/taxes-and-health-care-funding-how-does-the-uk-compare
You also spend more, so maybe that links to the greater satisfaction?

This opinion piece gives some perspective on the supposed inefficiencies within the NHS - perhaps it's more to do with the continuous stream of reorganisations that a succession of Health Secretaries impose on the NHS? (Aprox. one new system every 5 years.) https://www.theguardian.com/commentisfree/2021/oct/07/sajid-javid-threat-sack-nhs-chiefs
The latest scheme is being announced just as the latest Bill is going through Parliament, which itself is intended to undo the damage imposed by the previous reorganisation....