The NHS Debate (Merged threads)

[Saintslass]

Well it sounds like your dad had a bad time. But the fact remains that when this government came to power in 2010 satisfaction with the NHS was at an all time high, and waiting times on trolleys or otherwise were at an all time low.  The reverse is now generally the case.

I'm sure I saw a report on the BBC's website recently, around the time the junior doctors were trying to avoid giving up their extra working hours, that said that satisfaction with the NHS is still very high. 

 

My Dad did have a very bad time and he had it in 2007 when apparently all was rosy in the NHS.  Except of course it wasn't. 

[Robin Evans]

Again, I can only give the opinion of a clinician.

Post community care act was a bloody awful time in my field. A major screw up by the major govt. Ill planned introductions of trusts and the balls up that had become nurse education were tragic.

I'm no Blair fan... but steadily nurse ed improved no end. Services in LD improved similarly as Joe Mansell et al reported on the services and the then govt adopted his findings into subsequent legislation...

There were down sides but the balance sheet remained positive.

The morale now is shot. Integrated teams are being shot to bits savaged by the cuts.

Cinical delivery is being compromised by reducing capacity and increased defensive administration. This is observed at conferences across the country.

Being a clinician is no longer enjoyable though I'm not yet in s position to retire.

I have friends who have been teachers, policemen, friends who are social workers and nurses.

Asked if they would recommend their job to a young adult starting out, nurses on balance still would.... The rest are all an emphatic no.

I suppose nursing can still attract where teaching and social work struggles

[Robin Evans]

The nurses getting sent down today deserve every minute of their lost freedom. The third can consider herself very fortunate.

Abhorrent behaviour.... why do the bloody job.....

Absolutely appalled by this case....

Sh it like this just keeps repeating all too oft

[Saintslass]

The nurses getting sent down today deserve every minute of their lost freedom. The third can consider herself very fortunate.

Abhorrent behaviour.... why do the bloody job.....

Absolutely appalled by this case....

Sh it like this just keeps repeating all too oft

There are bad apples everywhere.  There is likely to appear to be more of them in a massive organisation like the NHS.  Proportionately though the numbers - at least of proven bad apples - are tiny really aren't they?

[Robin Evans]

Yes its a very tiny minority.

What I really can't get my head round is why?

I retrained as a nurse in my 30s. I did so cos I had ideals, an urge to make a difference and a real desire to care for some of the most vulnerable people in our society. I'm still driven by those same desires.

Why do the job if you dont believe in such philosophy? What are you doing in the care domain if you are malificent or neglectful.

I really don't get these people.... is there something we miss when we screen student nurses? I'm lost on this one. Such a dreadful case and a bad reflection on nursing that we have trained, developed and employed rs holes like these....

[Saintslass]

Yes its a very tiny minority.

What I really can't get my head round is why?

I retrained as a nurse in my 30s. I did so cos I had ideals, an urge to make a difference and a real desire to care for some of the most vulnerable people in our society. I'm still driven by those same desires.

Why do the job if you dont believe in such philosophy? What are you doing in the care domain if you are malificent or neglectful.

I really don't get these people.... is there something we miss when we screen student nurses? I'm lost on this one. Such a dreadful case and a bad reflection on nursing that we have trained, developed and employed rs holes like these....

I'm a qualified teacher.  I have asked the same questions when cases of paedophilia or other warped behaviour have arisen in the teaching profession but again if you look at the number of teachers practising in the country the numbers of bad apples are tiny in that profession also.

 

No system is foolproof and there will always be those who use the professions as either a cover or a motivator for nefarious deeds.  We can only do our best, be vigilant and spill the beans if we see something happening that shouldn't be.  After all that, the perps get the punishment they deserve under law. 

[ckn]

[Trojan]

Apparently the NHS is at the moment so over loaded that we are being urged to take our problems to the local pharmacy.  So if you break your leg. nip down to Boots to get it fixed.  TBH I don't recall this ever happening before.

http://www.independent.co.uk/news/uk/politics/nhs-ae-crisis-hospitals-struggle-to-keep-up-with-festive-demand-9954833.html

[Griff9of13]

Apparently the NHS is at the moment so over loaded that we are being urged to take our problems to the local pharmacy. So if you break your leg. nip down to Boots to get it fixed. TBH I don't recall this ever happening before.

http://www.independent.co.uk/news/uk/politics/nhs-ae-crisis-hospitals-struggle-to-keep-up-with-festive-demand-9954833.html

That's from Friday 2 January 2015.

However, there is this: Only use A&E in emergency this Christmas, public told

It's staggering that they have to make these announcements, the clue is right there in the name; ACCIDENT and/or EMERGENCY! Anything else you should go elsewhere.

[Just Browny]

Apparently the NHS is at the moment so over loaded that we are being urged to take our problems to the local pharmacy. So if you break your leg. nip down to Boots to get it fixed. TBH I don't recall this ever happening before.

http://www.independent.co.uk/news/uk/politics/nhs-ae-crisis-hospitals-struggle-to-keep-up-with-festive-demand-9954833.html

If you need to go to A&E, go. If you don't, don't.

Bit of a non-story, but then you'd be surprised how many folk see fit to rock up in their local A&E when there's not much wrong with them.

[tonyXIII]

If you need to go to A&E, go. If you don't, don't.

Bit of a non-story, but then you'd be surprised how many folk see fit to rock up in their local A&E when there's not much wrong with them.

This is true, but there is nowhere else to go for relatively minor injuries. For example, if I were to cut myself while carving the turkey (I won't, because I get my wife to carve it!), I would clean the wound, apply some antiseptic, bandage it and then I would like a nurse or doctor to assess it in case it needs a stitch or two. It's not life-threatening, but where do I go?

Which prompts my real question. What, realistically, should we expect from the NHS? It is not realistic to expect it to provide massively expensive treatment for everyone (anyone?). There are limits and we need to understand and accept that. At 62, I wouldn't expect the NHS to fund £100,000 worth of treatment. I would hope for the appropriate pain relief and some sympathetic care. Beyond that is unrealistic. If I were 32 and had a wife and 2 children, the sums would be different and £100,000 would seem a perfectly reasonable sum for the NHS to accept. It's not a pleasant thought, but it needs thinking.

[ckn]

This is true, but there is nowhere else to go for relatively minor injuries. For example, if I were to cut myself while carving the turkey (I won't, because I get my wife to carve it!), I would clean the wound, apply some antiseptic, bandage it and then I would like a nurse or doctor to assess it in case it needs a stitch or two. It's not life-threatening, but where do I go?

Which prompts my real question. What, realistically, should we expect from the NHS? It is not realistic to expect it to provide massively expensive treatment for everyone (anyone?). There are limits and we need to understand and accept that. At 62, I wouldn't expect the NHS to fund £100,000 worth of treatment. I would hope for the appropriate pain relief and some sympathetic care. Beyond that is unrealistic. If I were 32 and had a wife and 2 children, the sums would be different and £100,000 would seem a perfectly reasonable sum for the NHS to accept. It's not a pleasant thought, but it needs thinking.

Dial 111, ask them what resources are best suited.  In your specific example, they'd probably send you to an out-of-hours GP-run site, if one exists in your area or even send a night-duty GP round if it's concerning enough.  If you really were worried though they have live waiting time statistics for all A&Es in your area where you could go get an emergency triage, they'd even call ahead and let them know you were coming so that your place in the queue was already secured.

 

On the wider issue though, my projects team is currently working with four hospital trusts putting in GP-led triage units in A&E where you only get into A&E proper if you're a genuine A&E case, those with minor injuries get transferred to nursing care, those with illnesses that can be done by GPs are done by them.  The core of it though is getting the data sharing bit right, if you're one of those people who believed the Daily Mail and opted-out of the NHS data sharing for summary care records then you're a gold-standard idiot who gets what they deserve if you go to A&E and you suffer poorer care because the doctors can't get your medical records.  For those (over 99% in my area) who haven't opted out then we're putting the enhanced, full care record into many A&E departments and even into hospital wards meaning your record can almost go anywhere with you in the NHS.  We're getting there but it's not helped with some local-level idiots and narcissists running Trusts and CCGs who get sucked into flattery by sales cretins who convince them to go away from the core systems towards more inferior, incompatible systems that mean that we can only link in the basic summary care record.

 

In our area, we've even taken it a step further by linking in with all the safeguarding bodies in some areas.  For example, if you go to ANY hospital in Essex and you have a previous domestic violence incident, child protection worry or any other risk linked to you then the triage administrator/nurse will have that flash up in their face.  In the past, busy nurses and doctors have just treated the incident, the linked safeguarding data allows them to deal with the larger picture.

 

I'll give one example of how this system works in practice, one of my senior managers went to Leeds for a wedding a few weeks ago.  He forgot his critical medication, silly man, and only noticed late at night on the first night there.  The medication is on the controlled list meaning it's damnably hard to get if you've "forgotten" it.  He called 111, was put through to a nurse practitioner who had access to his full care record back in our patch, she then called a controlled late-hours pharmacy and authorised him to get enough extra medication to get him through the trip.  That then went on his record so that his GP wouldn't authorise a repeat issue for that extra prescribed medication time.  Easy.  And all done within the NHS because in some ways it still is one organisation with core links.

 

On your second paragraph, you should get identical levels of care whether you're 2, 22 or 102.  We can afford it as a nation, we simply choose not to do so.  We pretend the NHS is precious to us but then we accept our politicians paying under half of what the US does per capita for state funded healthcare.  We accept the outright lie that the NHS is inefficient and wasteful when it provides a near universal healthcare system, albeit slowly fracturing and some areas already dead in the water, at roughly 400-600% of the efficiency of US state-funded institutions.  That's why we can provide the healthcare we do at half the cost per-person of the US.  Fund the NHS properly and your question becomes almost irrelevant.  If we can find the money to give multi-billion pound tax cuts to large businesses every year for the last six years, we can fund the NHS properly.

[Trojan]

This is true, but there is nowhere else to go for relatively minor injuries. For example, if I were to cut myself while carving the turkey (I won't, because I get my wife to carve it!), I would clean the wound, apply some antiseptic, bandage it and then I would like a nurse or doctor to assess it in case it needs a stitch or two. It's not life-threatening, but where do I go?

Which prompts my real question. What, realistically, should we expect from the NHS? It is not realistic to expect it to provide massively expensive treatment for everyone (anyone?). There are limits and we need to understand and accept that. At 62, I wouldn't expect the NHS to fund £100,000 worth of treatment. I would hope for the appropriate pain relief and some sympathetic care. Beyond that is unrealistic. If I were 32 and had a wife and 2 children, the sums would be different and £100,000 would seem a perfectly reasonable sum for the NHS to accept. It's not a pleasant thought, but it needs thinking.

I think even at 62 if you needed £100,000 worth of treatment from the NHS you'd get it.  My granddaughter, born in 2013 received (at a conservative estimate) £1M worth of treatment shortly after her birth.  She would have died otherwise.  It's not the big ticket items, it's the day to day, cut finger, broken arm, regular appointments to check up on a particular condition that are suffering.  The is one of the richest countries in the world.  We are happy it would seem to spend £100bn on a nuclear bomb that we can't use without US permission.  We are happy to bomb Syria with bombs that cost the equivalent of a nurse's yearly salary per go. We're providing Cameron with his own personal plane at a cost they are not prepared to divulge, we throw millions at the ludicrous royal family.  But we are cheeseparing in the NHS.  This government require "efficiency savings," cuts to you and me, whilst pretending to protect the NHS.  Anyone with eyes to see knows they are privatising it bit by bit.  But they deny this.  They are a disgrace, and Labour are as bad for not denouncing the whole travesty instead of tiptoeing around it.

[ckn]

I We are happy to bomb Syria with bombs that cost the equivalent of a nurse's yearly salary per go.

Each of the typical bombs dropped costs £110,000.  A typical mission costs over £500,000.  That's around 12 fully costed nurses' salaries for a year per single plane mission.

[Phil]

Each of the typical bombs dropped costs £110,000. A typical mission costs over £500,000. That's around 12 fully costed nurses' salaries for a year per single plane mission.

Can one of the right wingers on this board either defend or refute this statement?

[ckn]

Can one of the right wingers on this board either defend or refute this statement?

A slightly more accurate version from that left wing bastion, Sky News.  I was shooting from the hip with my figures but am happy to concede the accuracy of the figures to Sky News.

[Ramite]

Half a million is about right assuming the aircraft dropped all its bombs\ missiles every sortie which probably doesn't happen every time. A paveway is about 20k , a Brimstone is about 110k and a storm shadow which I doubt will be used much is about 800k. Total cost for the whole operation in Syria is guess work but I'd plump for 30\40 million.

Edit ckn beat me to it.

[Padge]

 

Cameron is looking into the idea of an Easter Single to prop the NHS.

[Alfie Taylor]

Can one of the right wingers on this board either defend or refute this statement?

The nurses are then getting sacked after a year, correct?

To get this lovely money do we have to weigh in the bombs and planes at a pawnbrokers?

What of the armed forces personnel who we no longer need? Wait, they can be the nurses for a year!

We've currently got a bloke in space paid for by you and me, there's probably a few nurses who could go through years of training then get a job for a year if we weren't so frivolous with lunatic ideas like that.

Slash overseas aid and what about the billion or so sent to help the refugees in Syria?

I think we're missing a real heartstring pulling trick though, instead of measuring our wasteful spend on trying to blow up evil swine in nurses, let's measure it in kitten rescue. Just how many oh so cute fluffy kittens could we rescue?

[Alfie Taylor]

This government require "efficiency savings," cuts to you and me, whilst pretending to protect the NHS. Anyone with eyes to see knows they are privatising it bit by bit. But they deny this.

Sorry for pointing out your and plenty of others round here stark raving rampant hypocrisy, but this is exactly what YOU voted for.

£20billion of "efficiency savings" is what labour promised, and you hoped we wouldn't notice as you gave the green light to it. We did.

So, just why did you vote to cut £20billion from the NHS? And more importantly why are you and plenty of others whining about the Tories doing exactly what you voted for?

[WearyRhino]

The nurses are then getting sacked after a year, correct?

To get this lovely money do we have to weigh in the bombs and planes at a pawnbrokers?

What of the armed forces personnel who we no longer need? Wait, they can be the nurses for a year!

We've currently got a bloke in space paid for by you and me, there's probably a few nurses who could go through years of training then get a job for a year if we weren't so frivolous with lunatic ideas like that.

Slash overseas aid and what about the billion or so sent to help the refugees in Syria?

I think we're missing a real heartstring pulling trick though, instead of measuring our wasteful spend on trying to blow up evil swine in nurses, let's measure it in kitten rescue. Just how many oh so cute fluffy kittens could we rescue?

 

Perhaps 'people' like YOU should start measuring weapons and armed interventions in terms of dead women, men and children.

[WearyRhino]

Sorry for pointing out your and plenty of others round here stark raving rampant hypocrisy, but this is exactly what YOU voted for.

£20billion of "efficiency savings" is what labour promised, and you hoped we wouldn't notice as you gave the green light to it. We did.

So, just why did you vote to cut £20billion from the NHS? And more importantly why are you and plenty of others whining about the Tories doing exactly what you voted for?

 

It was wrong when Labour "promised" it and it's wrong now. 

[Phil]

The nurses are then getting sacked after a year, correct?

To get this lovely money do we have to weigh in the bombs and planes at a pawnbrokers?

What of the armed forces personnel who we no longer need? Wait, they can be the nurses for a year!

We've currently got a bloke in space paid for by you and me, there's probably a few nurses who could go through years of training then get a job for a year if we weren't so frivolous with lunatic ideas like that.

Slash overseas aid and what about the billion or so sent to help the refugees in Syria?

I think we're missing a real heartstring pulling trick though, instead of measuring our wasteful spend on trying to blow up evil swine in nurses, let's measure it in kitten rescue. Just how many oh so cute fluffy kittens could we rescue?

I'd respond if I could work out just wtf you're on about

[Trojan]

Sorry for pointing out your and plenty of others round here stark raving rampant hypocrisy, but this is exactly what YOU voted for.

£20billion of "efficiency savings" is what labour promised, and you hoped we wouldn't notice as you gave the green light to it. We did.

So, just why did you vote to cut £20billion from the NHS? And more importantly why are you and plenty of others whining about the Tories doing exactly what you voted for?

Don't think so pal. Anyway here's William Keegan.

http://www.theguardian.com/business/2015/dec/27/compassionate-conservatives-george-osborne-austerity-cuts

 

"The background was that, although my old friend Ken Clarke was a successful chancellor who presided over a sustained economic recovery between 1993 and 1997 after the travails and humiliation of Black Wednesday, his success with the budgetary accounts was at the expense of Britain’s public services.

This running down did not begin under the premiership of John Major and Clarke’s chancellorship; the bad work was done by Margaret Thatcher. But it continued under the Major premiership, which was unfortunate, because I, for one, have never doubted Major’s good intentions.

Thus, when the Blair/Brown duumvirate came to power in 1997, there was a lot of work to be done to improve the National Health Service and the state of our schools and transport infrastructure."

[Phil]

Wife had to take her mom to A &E last night as she'd cut her leg.

The good bit, as she's old and a bit frail she was triaged, saw a doctor and given treatment in casualty with 45 minutes.

The bad bits, Mrs D bumped into a friend of ours who is a sister in casualty, she told the wife she had 18 patients in casualty who needed a bed for at least the night but there were no beds free in the entire hospital, plenty of empty wards but no beds. She had to turn casualty into effectively a ward whilst new arrivals were being treat in ambulances.

It's not good enough, it's not nearly good enough.