The NHS Debate (Merged threads)

[JohnM]

Nope, not with you. Can you be more specific?

[gingerjon]

According to the Times, one of the problems holding back the 7 Day NHS plan is that there are to many lady doctors...

 

The logic seems to be that women are more likely to work flexibly, the seven day NHS uber-plan requires flexible working, therefore the growing presence of women in key roles is an issue.

[longboard]

I listened to the first few minutes of his interview on Today this morning whilst getting dressed, in about three minutes he managed to mention North Staffs twice in an interview that was about NHS funding. He really is a ######.

 

A bounder?

[clwydianrange]

Jeremy Hunt!

Rhyming slang?

[Robin Evans]

[JohnM]

Rhyming slang?

 

 What rhymes with Jeremy?

[Bearman]

What rhymes with Jeremy?

Enemy?

[Saintslass]

According to the Times, one of the problems holding back the 7 Day NHS plan is that there are to many lady doctors...

So it would appear, if the report is accurate.  Apparently women doctors work an average of 25 hours a week.

[ckn]

So it would appear, if the report is accurate.  Apparently women doctors work an average of 25 hours a week.

On the other side, considerably more women doctors stay in the NHS at consultant grade compared to a higher number of male doctors who do the bare minimum to keep their NHS badge while concentrating on more lucrative private medicine.

 

There are more female doctors in the junior doctor grades now than at any time on record.  In some core specialties women outnumber men considerably.  That number will most likely mean a higher availability in the consultant grades plus also more of a tolerance, that the rest of society already accepts, for female doctors to take maternity leave and/or work flexible hours.

[Trojan]

Rhyming slang?

Can't be they're useful.

[ckn]

Just to put things in context, here's a summary of state funded health spending per capita in US dollars for the G7 countries.

 

Canada: $3131.80

France: $2632.70

Germany: $3829.90

Italy: $2406.00

Japan: $3149.80

United States: $4197.50

United Kingdom: $2802.20

 

(Source: OECD)

 

So, fifth out of the seven on that list,  If you just look in the EU then we're 14th out of 28.  Yet in every key health indicator we're either number 1 or number 2 (although we haven't released 2015 indicators yet to OECD).  We slip in the scoring quite significantly on issues such as mental health and child mortality since 2010 but we're still punching above our weight in terms of funding per capita.

 

Next time you hear someone talk about the NHS being inefficient, or costing too much, or any rises in funding being unaffordable, these are the figures for you.  The US state healthcare system, where you get thrown in the skip to die if you haven't the private insurance unless you're seriously lucky, costs them 50% more per capita than our system.  It's not that our system is unaffordable, going by those statistics it clearly isn't, but it's more down to our politicians not being willing to fund it and the blanket media coverage telling us how expensive and unaffordable it is.  In terms of sheer efficiency, the NHS is approximately 40-50% more efficient towards clinical outcomes, i.e. your health, with the money given than our competitor countries, yet all parties at the last election promised to cut the NHS by at least £30bn of "efficiency savings" while giving £8bn of extra funding (Labour excluded they only wanted to give £2bn) meaning a net "efficiency" cut of £24-£28bn.  Next time you hear a politician talking about the NHS needing efficiency cuts then just roll out these figures and ask them to explain themselves.

[Griff9of13]

48-hour junior doctors' strike off (for now)

[ckn]

On the other side, considerably more women doctors stay in the NHS at consultant grade compared to a higher number of male doctors who do the bare minimum to keep their NHS badge while concentrating on more lucrative private medicine.

There are more female doctors in the junior doctor grades now than at any time on record. In some core specialties women outnumber men considerably. That number will most likely mean a higher availability in the consultant grades plus also more of a tolerance, that the rest of society already accepts, for female doctors to take maternity leave and/or work flexible hours.

Quoting myself here but there's a point to it. I'm at a private hospital tonight taking my wife to her consultant appointment. 15 consultant rooms, all 15 consultants are male.

[Wolford6]

Over Christmas and New Year, I was admitted to hospital, released and then had to attend several more times for tests and reviews. I was attended by two male junior doctors, three female junior doctors and one senior male doctor.

 

The two male junior doctors didn't want to listen to my description of my symptoms; they were too keen to make their own diagnosis. The other four were far more sympathetic and, ultimately, productive.

 

Mind you, none of them told me I had pneumonia. My own doctor told me that after I had more or less recovered.

[gingerjon]

Quoting myself here but there's a point to it. I'm at a private hospital tonight taking my wife to her consultant appointment. 15 consultant rooms, all 15 consultants are male.

 

The area I'm tangentially connected with is one of the few areas that still has more men than women at trainee level, although that is shifting.  Certainly it now stands out for that reason.  There are many more men at consultant level - and with private practice to go with it - in part because it takes a hell of a long time to reach that level.

 

On a personal note, I see very little difference in how men and women behave *in* their job -- but there is a clear difference in what those workplaces are like.

[Saintslass]

The US state healthcare system, where you get thrown in the skip to die if you haven't the private insurance unless you're seriously lucky, costs them 50% more per capita than our system.

Not quite true - I mean about being thrown on to a skip to die unless you're lucky.  There is a public health system in the USA.  Nobody is left to die in a skip in the USA.  There are public hospitals everywhere to which those who cannot afford insurance go for treatment.

 

 

It's not that our system is unaffordable, going by those statistics it clearly isn't, but it's more down to our politicians not being willing to fund it and the blanket media coverage telling us how expensive and unaffordable it is.  In terms of sheer efficiency, the NHS is approximately 40-50% more efficient towards clinical outcomes, i.e. your health, with the money given than our competitor countries, yet all parties at the last election promised to cut the NHS by at least £30bn of "efficiency savings" while giving £8bn of extra funding (Labour excluded they only wanted to give £2bn) meaning a net "efficiency" cut of £24-£28bn.  Next time you hear a politician talking about the NHS needing efficiency cuts then just roll out these figures and ask them to explain themselves.

You conveniently fail to question the management of Trusts and hospitals in your assessment.

 

My local hospital, St Helens Hospital, lost its A&E department under Labour.  A town of 180,000 people now doesn't have its own A&E department; we have to use Whiston Hospital which is in a neighbouring town.  Anyway, St Helens Hospital was rebuilt in the dying days of the Labour government using some of that money which now forms the deficit.  It has short term stay patients following specific operations and also has lots of outpatient facilities.  It has just scored outstanding in the NHS version of Ofsted.  It is the third best hospital of its kind in the country.  In fact St Helens & Knowsley Health Trust has just scored a Good with outstanding features as a result of its recent 'Ofsted', which took place in autumn of last year.  All the while though there have been efficiency savings for St Helens & Knowsley Health Trust to achieve I'm sure and yet they have managed it.  So I'm afraid all this leftwing propaganda about how the NHS is underfunded and its alleged lack of funds is the reason for the situation it finds itself in just doesn't cut it with me.  I am more convinced than ever that management also comes into it.

[ckn]

Not quite true - I mean about being thrown on to a skip to die unless you're lucky.  There is a public health system in the USA.  Nobody is left to die in a skip in the USA.  There are public hospitals everywhere to which those who cannot afford insurance go for treatment.

 

You conveniently fail to question the management of Trusts and hospitals in your assessment.

 

My local hospital, St Helens Hospital, lost its A&E department under Labour.  A town of 180,000 people now doesn't have its own A&E department; we have to use Whiston Hospital which is in a neighbouring town.  Anyway, St Helens Hospital was rebuilt in the dying days of the Labour government using some of that money which now forms the deficit.  It has short term stay patients following specific operations and also has lots of outpatient facilities.  It has just scored outstanding in the NHS version of Ofsted.  It is the third best hospital of its kind in the country.  In fact St Helens & Knowsley Health Trust has just scored a Good with outstanding features as a result of its recent 'Ofsted', which took place in autumn of last year.  All the while though there have been efficiency savings for St Helens & Knowsley Health Trust to achieve I'm sure and yet they have managed it.  So I'm afraid all this leftwing propaganda about how the NHS is underfunded and its alleged lack of funds is the reason for the situation it finds itself in just doesn't cut it with me.  I am more convinced than ever that management also comes into it.

Point 1: The number one official cause listed for personal bankruptcy in the US is healthcare costs, it's number one by a very, very long way.  You will get basic free emergency care in the US in many, not all, places, i.e. you are in an accident or are in emergency need but you'd best avoid certain hospitals.  Acute care, i.e. urgent care that's not an immediate emergency such as cancer, heart surgery and so on is invariably patchy, very few states cover it in full for the poorest in society and those will often look to recoup the cost from you by any means.  Here's what would happen if Breaking Bad were set in the UK.

 

Point 2: How can you have Trust management who were reporting huge surpluses on a few years ago, getting outstanding reports on all inspections and having outstanding clinical outcomes become disastrously bad in the space of a few years when it's the same people?  The only thing is that they've had every penny ripped away from them in surplus then asked for efficiencies year after year after year when there just aren't any left.  I know one Trust that went from very healthy to having to postpone recruiting vacant nursing spots because NHS England cut their funding.

 

Some Trusts are keeping their books balanced by stopping non-life threatening treatments.  More and more Trusts by the month are stopping prescribing hearing aids, even for people who have lost virtually all hearing.  Then you get those who are going up and up the list cutting into things that are not immediately life threatening but are long term such as diabetes clinics.  Eventually there will be choices that have to be made over emergency care treatments.

 

We consistently get some of the best treatment in the world at a price well below any of our peers in the world for the same quality.  Our efficiency against money spent is not a point of debate, it's incontrovertable, we are by far and away the indisputably most efficient state healthcare organisation in the world.  If you look at our rankings for health outcomes against the amount we pay for it then I just can't see why you'd be so insistent that we have to make more efficiency savings, we're already indisputably giving the best value for money and every efficiency from now is just cutting muscle because there's no fat left.

[Saintslass]

Point 1: The number one official cause listed for personal bankruptcy in the US is healthcare costs, it's number one by a very, very long way.  You will get basic free emergency care in the US in many, not all, places, i.e. you are in an accident or are in emergency need but you'd best avoid certain hospitals.  Acute care, i.e. urgent care that's not an immediate emergency such as cancer, heart surgery and so on is invariably patchy, very few states cover it in full and those will often look to recoup the cost from you by any means.  Here's what would happen if Breaking Bad were set in the UK.

 

I have never watched Breaking Bad so your link would mean little to me and therefore I will let you know ahead of time that I haven't read it!  But I do know a bit about the US public healthcare system as I spent a lot of time in the US over a two year period.  I believe your original comment was hyperbole.

 

 

Point 2: How can you have Trust management who were reporting huge surpluses on a few years ago, getting outstanding reports on all inspections and having outstanding clinical outcomes become disastrously bad in the space of a few years when it's the same people?  The only thing is that they've had every penny ripped away from them in surplus then asked for efficiencies year after year after year when there just aren't any left.  I know one Trust that went from very healthy to having to postpone recruiting vacant nursing spots because NHS England cut their funding.

Assuming such Trusts exist there could be many reasons.  I haven't seen any announcements that St Helens & Knowsley NHS Trust has changed its management recently and yet they have gone from an average Trust to one of the best in the country (according to the Care Quality Commission).  Salford NHS Trust which is based in a tough area of the country is one of only two Trusts to score Outstanding in the new 'ofsteds'.  That Trust has been highlighted many times on the news for its excellent practice and there are no reports of it failing financially.

 

Here is an interesting article from the Daily Telegraph today providing insight into what the CQC found in its first full scale monitoring of the system (and it has taken a Tory government to actually introduce such monitoring!): http://www.telegraph.co.uk/news/nhs/11931401/Three-in-four-NHS-hospitals-are-failing-says-watchdog.html 

 

Management can become stale, can become too secure or too big for its boots and those can be reasons why previously successful management teams begin to fail.  Likewise they may achieve under certain conditions but when conditions change they do not have the ability or dynamic or creativity or whatever to adapt to those changes. 

 

 

We consistently get some of the best treatment in the world at a price well below any of our peers in the world for the same quality.  Our efficiency against money spent is not a point of debate, it's incontrovertable, we are by far and away the indisputably most efficient state healthcare organisation in the world.  If you look at our rankings for health outcomes against the amount we pay for it then I just can't see why you'd be so insistent that we have to make more efficiency savings, we're already indisputably giving the best value for money and every efficiency from now is just cutting muscle because there's no fat left.

I think all organisations, but particularly publicly funded ones, should behave responsibly at all times both in how they approach those they are paid to serve and in how they approach the money given to them to provide that service.  Simply throwing money at the NHS isn't sustainable and nor is it responsible as there will be waste just as there is in every public sector organisation (sometimes quite shocking waste).  I don't see any contradiction in wanting to have a responsibly managed public sector organisation while also wanting to see patient care put first.  The two are not mutually exclusive. 

[ckn]

I give up. There are none so blind as those who will not see. I won't be replying to your posts any more on this thread.

[Saintslass]

Looks like things are getting down to the nitty gritty in the junior doctors' dispute: http://www.theguardian.com/society/2016/jan/19/saturday-working-is-major-sticking-point-in-junior-doctors-dispute

[Saintslass]

I give up. There are none so blind as those who will not see. I won't be replying to your posts any more on this thread.

My guess is you didn't read the Telegraph link?

 

I can't agree with your stance.  We simply don't agree.  I don't see why that is the case of me not seeing.  It is simply a case of us not agreeing.

[Trojan]

Not quite true - I mean about being thrown on to a skip to die unless you're lucky.  There is a public health system in the USA.  Nobody is left to die in a skip in the USA.  There are public hospitals everywhere to which those who cannot afford insurance go for treatment.

 

You conveniently fail to question the management of Trusts and hospitals in your assessment.

 

My local hospital, St Helens Hospital, lost its A&E department under Labour.  A town of 180,000 people now doesn't have its own A&E department; we have to use Whiston Hospital which is in a neighbouring town.  Anyway, St Helens Hospital was rebuilt in the dying days of the Labour government using some of that money which now forms the deficit.  It has short term stay patients following specific operations and also has lots of outpatient facilities.  It has just scored outstanding in the NHS version of Ofsted.  It is the third best hospital of its kind in the country.  In fact St Helens & Knowsley Health Trust has just scored a Good with outstanding features as a result of its recent 'Ofsted', which took place in autumn of last year.  All the while though there have been efficiency savings for St Helens & Knowsley Health Trust to achieve I'm sure and yet they have managed it.  So I'm afraid all this leftwing propaganda about how the NHS is underfunded and its alleged lack of funds is the reason for the situation it finds itself in just doesn't cut it with me.  I am more convinced than ever that management also comes into it.

A & E at Huddersfield Royal Infirmary is to close.  People in Huddersfield and the Colne Valley will  either have to go to Halifax, Barnsley or Oldham. (which is not just another district, it's another county) this is under the wonderful Lansley NHS. 

[gingerjon]

 

Assuming such Trusts exist there could be many reasons.  I haven't seen any announcements that St Helens & Knowsley NHS Trust has changed its management recently and yet they have gone from an average Trust to one of the best in the country (according to the Care Quality Commission).

 

The trust overall rated 'good', far from being one of the best in the country.  The report was published yesterday.  A&E in particular was a concern.  It was also noted that they have a heavy reliance on bank and agency staff.

 

Still, one hospital did well on one measure.  Everything is fine.  Must be, the media picked up on that aspect and put the rest at the end.

[Saintslass]

The trust overall rated 'good', far from being one of the best in the country.  The report was published yesterday.  A&E in particular was a concern.  It was also noted that they have a heavy reliance on bank and agency staff.

 

Still, one hospital did well on one measure.  Everything is fine.  Must be, the media picked up on that aspect and put the rest at the end.

St Helens & Knowsley Trust tweeted about being 'one of the best in the country', quoting the Commission so that is where I took that from.  St Helens Hospital also quoted the CQC in calling it (the hospital) the third best in the country of its type.  I think I rather believe the quotes than your post, if that's no problem to you!  (And the Trust was rated Good with Outstanding Features, which is better than Good)

 

I think the fact that St Helens Hospital did so well and that the Trust did so well shows that government funding is not the sole problem that those on the left would like everyone to claim that it is. 

[Trojan]

St Helens & Knowsley Trust tweeted about being 'one of the best in the country', quoting the Commission so that is where I took that from.  St Helens Hospital also quoted the CQC in calling it (the hospital) the third best in the country of its type.  I think I rather believe the quotes than your post, if that's no problem to you!  (And the Trust was rated Good with Outstanding Features, which is better than Good)

 

I think the fact that St Helens Hospital did so well and that the Trust did so well shows that government funding is not the sole problem that those on the left would like everyone to claim that it is. 

Grow up.  They've cut £20bn from NHS in "efficiency" savings and haven't increased spending by the amount required to keep up with health inflation.  The Tories have been a disaster for the NHS. No change there then.