NHS Fiasco

[CirclipParticipant @circlip]

Have stopped trying to ring in to arrange a telephone consultation, despite the cost of petrol it's cheaper to drive to the surgery and arrange it over the counter than wait on the phone.

Before the masses scream about the waste of money on PPI and contracts issued to 'Mates' due to the pandemic, they should be looking back to the decades of internal fraud. Perhaps an opertune time to repeat the series of TV programmes that highlighted the NHS internal investigation department.

NO government is prepared to grasp the nettle and give it a d*mn good shaking, the bush would intertwine and protect itself. Wonder if we would then need to spend more on unemployment ??

Regards Ian

[Clive IndiaParticipant @cliveindia]

For me, and I do stress for me, the problem starts at the GPs and their problem started with the 2006 contract negitiated by Andy Burnhanm and Patricia Hodge. This gave a substantial payrise and took away GP cover for out-of-office-hours. This allowed for GPs to go part time and why not work a 4 day week for £80k+ instead of 5 days for £100k+.
Now the GPs are nearly inaccessible fat-cats and we have nonsense like 111. A&E is full because there is nowhere else to go.
So, to fix it, I think we either have to fix GPs or sack them and restart. A place next to A&E which deals with the less urgent stuff and the worried-well which is cloggin up A&E would be my preference.
I find myself agreeing with most of what SOD says so verbally, except I really don't believe it's my fault.
I really think we will not get far in improving things until someone defines the boundaries of the NHS. There is plenty going on at the perphery which should be outside the responsibility of NHS – we all know what they are but are too woke to say it. If we can get back to the core, essential stuff then there is hope IMHO. Telephone appointments are a short term way of easing things – if you can get one (3 hours over 3 days to get to talk for 5 mins last week).

[SillyOldDufferModerator @sillyoldduffer]

Posted by Circlip on 12/12/2022 10:57:13:…

NO government is prepared to grasp the nettle and give it a d*mn good shaking, the bush would intertwine and protect itself. Wonder if we would then need to spend more on unemployment ??

Regards Ian

Sorry to say the idea that things can be fixed with a d*mn good shaking seems stupid to me. It means the NHS should be fixed by a team of Baby Batterers!

In my experience carefully targetted surgical strikes are far more effective than ignorant angry lashing out. Lashing out makes me feel better, but the answer is almost always wrong, causing even more trouble in the long run.

The PPI scandal is an example: in order to get quick results, politicians overrode the usual government procurement rules. 'Obviously' a bunch of time-wasting bureaucrats were getting in the way. Sadly, this opened the door to a host of fraudulent and incompetent suppliers and about £9Bn of taxpayers money was wasted. Then it was decided to not pursue the wrongdoers, which many voters still find hard to understand.

Dave

[SamsarandaParticipant @samsaranda]

I posted earlier on this thread about if my cat needed treatment from our vet as to the stark difference if the NHS was involved. Unfortunately I had to take my cat to the vet this morning, vet took blood samples and the results were available this afternoon, there was an anomaly with his liver results, he is booked in for 8.30 tomorrow morning for an anaesthetic and ultrasound of his liver; how can the NHS ever become that responsive, there is a very long way for the NHS to go. Hoping that the results of my cats ultrasound are good news but a sense of foreboding tells me that it won’t be, still if he needs surgery I know he will have it as soon as is practicable, probably no longer than a couple of days. Dave W

[Frances IoMParticipant @francesiom58905]

“and about ?9Bn of taxpayers money was wasted. Then it was decided to not pursue the wrongdoers, which many voters still find hard to understand” probably because it was shipped out of reach including it seems barrowloads washed via the IoM.

[Clive IndiaParticipant @cliveindia]

Posted by Circlip on 12/12/2022 10:57:13:

Have stopped trying to ring in to arrange a telephone consultation, despite the cost of petrol it's cheaper to drive to the surgery and arrange it over the counter than wait on the phone.

Before the masses scream about the waste of money on PPI and contracts issued to 'Mates' due to the pandemic, they should be looking back to the decades of internal fraud. Perhaps an opertune time to repeat the series of TV programmes that highlighted the NHS internal investigation department.

NO government is prepared to grasp the nettle and give it a d*mn good shaking, the bush would intertwine and protect itself. Wonder if we would then need to spend more on unemployment ?? Regards Ian

Yes, drive to the surgery if you can – you'll get what you nearly want, quicker.
There has to be clear water between the NHS and the government. I know NHS managers are rediculously well paid, and have the opportunity of blaming the government when they mess up, with few defined deliverables to be measured against.
I know the NHS management were totally responsible for the PPE crisis – they didn't have the bank of PPE they were supposed to have had for emergencies. Guilty.
I also know the "bunch of time-wasting bureaucrats" SOD talks about, I think meaning the opposite, in NHS procurement actually are as described, and certainly have plenty of procedures – we may have just got the stuff by now.
NHS management were not banging on anybody's door to put it right – they were just able to pass the buck and the government were daft enough to take it, instead of kicking their rump hard and remembering at bonus time.
Like I say – I know.

[A SmithParticipant @asmith78105]

Easy to retrospectively pick apart decisions made during an unprecedented crisis. The media were screaming for something to be done to resolve the PPE shortage, the Civil Service were operating at a glacial rate and the usual professional critics were poised to find fault.

[Anonymous]

Might be worth comparing the NHS experience to other public health services around the world. Certainly, all the complaints here would apply just as much in my neck of the woods (Ontario) and, I suspect, other jurisdictions.

I don't think these services scale well to ever increasing patient volumes. There is a sweet spot somewhere (that we passed decades ago) and it's been downhill from there.

[SillyOldDufferModerator @sillyoldduffer]

Have to disagree with both Clive and A Smith. Their analysis is flawed, for example it was the Civil Service who actually delivered PPE, not the go-faster short-cut rule breaking that wasted £9Bn. Unlike A Smith I don't think the government were panicked into foolish decisions by the media and 'professional critics', whoever they might be. Be even worse if the government had reacted to pressures of that sort – weak and foolish.

One other example. I'm startled by Clive's certainty that the NHS were supposed to have enough PPE in stock to handle the crisis. What, warehouses full of millions of the right sort of masks ready for an emergency that had never happened on that scale before? When it's known masks aren't effective against other viral infections? It seems an unlikely precaution, and no one else in the world had enough masks either.

I dislike the defence that what went wrong was all someone else's fault. A big boy did it and ran away! In my book, the government are fully in charge and have been so for over a decade. Governments are responsible for what they do and fail to do. Not good in my opinion to deny failure, even if you are a committed loyalist! It's because when things go wrong, the causes have to be addressed, not swept under the carpet to save face. And politically motivated flag waving is a rotten way of solving technical problems.

In case anyone thinks I'm anti-conservative, it's just that they happen to be running the UK at the moment. Actually I'm against underperforming governments of all persuasions. I concentrate on competence and delivery whilst ignoring propaganda and spin. Democracy breaks unless politicians are held to account by the electorate. For me there are no sacred cows.

Dave

[Tony Pratt 1Participant @tonypratt1]

Unfortuanateley Dave the NHS is seen as a sacred cow, no one party dare sort it out if that is actually possible! Whoever is in power can do 'no right' according to the opposition, the only way forward is to have a cross party committee to try to achieve a consensus on improving the NHS, at the moment it is going downhill fast for many many reasons.

Tony

[Tony Pratt 1Participant @tonypratt1]

Double post

Edited By Tony Pratt 1 on 15/12/2022 18:52:30

[Nigel Graham 2Participant @nigelgraham2]

I have long held a niggling suspicion that the NHS and other public services are in a pickle because successive governments of all flavours love to tinker, experiment, invent "initiatives" and play Cliche Bingo with them; rather than acting on advice from anyone – in those services or indeed within Parliament and the Civil Service – who actually understands the work.

The do have Parliamentary Select Committees that exist to inform and advise the policy-makers, but do the latter take that advice or is it lost in partisanship and balance-sheet games?

Unfortunately, unlike that other victim of the initiatives-brigade, education; the NHS is the victim of its own success. By cruel irony, it is helping "us" make more and more of us, all living longer but not necessarily in much better health because we survive the once-killer illnesses to allow the nastier, crueller ones at us.

To be fair though the NHS does recognise this, hence its various health advice, screening and vaccination schemes; while the 111 service is well-meant but might be worse than useless for the patients of an individual surgery that does not operate it efficiently.

'

The quality does seem to vary considerably around the country, if this discussion is a clue to that.

I have had both knees replaced (in Dorset County Hospital, and before The Pestilence), assorted other bits sorted, various injections, blood-tests, screenings and the like; and always had very good care delivered very efficiently.

I have also had to use the 111 service, perfectly satisfactorily despite the usual torture-by-music common to all call-centres. Once when still in a lot of pain and difficulty moving after falling very heavily on a concrete yard the previous day. The upshot was an ambulance half an hour later, to take me for a hip X-ray.That showed nothing broken, but I still needed physiotherapy help and time for what was probably something torn, to heal.

(That fall was by tripping violently over a small step, and basically diving head-first across the yard, but luckily landing on my hip and shoulder, not my head. Had I fallen forwards and somewhat diagonally, I would have dived head-first into my steam-wagon chassis. Less far to fall but possibly causing serious head and face injuries from the many sticky-uppy, angly bits of metal, tools and so forth…)

'

There is a very strange, looming headache for health services anywhere. It seems a lot of people are turning to all sort of quack-doctors, medical scare-stories, conspiracy-fantasies, and Home Hypochondriac Helps on t'Net; sources of no genuine medical value. So when the victims of these finally seek real help, it may have to be much more complicated treatment for diseases now well-advanced; a burden to both themselves and to the service.

See for example, Radio Times for next Tuesday (2oth): BBC R4, 12.04; The New Gurus – this episode sub-titled The Urine Man from its example of one such quack, who drinks his own for reasons presumably the programme will clarify. At dinner-time.

+++++

The ringers on here may find the preceding programme, starting at 11:30, more edifying. In the 3-part Laura Barton's Music Notes that morning's episode will be about bell-ringing.

[A SmithParticipant @asmith78105]

Oh well, live and lean. Apparently, it is easy to make the correct decisions during an unprecedented crisis.

[Ady1Participant @ady1]

If I was going to fix things I would start with the BMA and dump the lot of them

Cuba has 9 doctors per 1000 people

UK has 2.5 doctors per 1000 people

The BMA is the core of the problem and they have created a crippling shortage of medical professionals

A new setup, the UKMA, for people who want to be doctors and help society

and leave the BMA to fester in a corner as bait for the politicals and moneygrabbers

Edited By Ady1 on 17/12/2022 10:55:58

[Nigel McBurney 1Participant @nigelmcburney1]

Unfortuneatly the uk has drifted into a situation where an awful lot of the population do not want to work,and a fewer number have no intention have working,it can be virtually impossible to sack anyone and very little disipline,Last weekends Telegraph had an article on the benefits system and showed how much money people on benefits can get it was obscene in my mind compared to the pitance OAP s receive, it eeds a big stick to get the unemployed working. Recent experience with the NHS is dismal,to relieve my wife from extreme pain we have spent an awful lot of cash(enough to buy 10 reasonable Bridgeports) to have private treatment though private treatment is not as good as it was,as they expand due to demand some of the poor staff from the NHS have got into their system. Visit any NHS establishment and there are various staff wandering around carrying bits of paper so that they appear to be doing something and so many are over weight in a system which tries to encourage the public to loose wight to improve their health,I do agree with the comments of why do nurses have to have degrees,why should someone who wants to be a nurse be barred because they simply cannot afford to get a degree,and the ones who do get degrees dont want to do the dirty end of the job , As for 111 they are a waste of time, quicker to go to A&E, my wife was in some pain following an op and one weekend all she wanted to know was could she safely take double the dose of tablets,after ages on the phone all she asked could a doctor advise her via the phone ,simple one might think,oh no the 111 operator insisted that and ambulance be sent with two crew,they examined her and then phoned a doctor and got the answer that it was ok to double the dose,the ambulance crew did their job, but as we are out the sticks,that simple answer cost a round trip of 25 miles for that ambulance and crew ,absolute waste of NHS funds, I often think that when I see government ministers and NHS chiefs on the tv the come over in their manner and speech as not up to the job,being in command of a vast incompetent empire with no risk of loosing their job unless they go to a party in no 10.

[Martin KyteParticipant @martinkyte99762]

Nurses have degrees for two reasons in my view. Firstly when a significant uplift to salary was required some decades ago it was agreed to provided there was a corresponding increase in productivity though upskilling. Secondly, the senior nurses now do many of the jobs that were previously done by doctors, which effectively releases the higher paid Doctors to do the things only they are qualified to do. The lower end ( no pun intended) work is done by ward assistants who feed, clean and generally care for the patient’s non medical needs.

This all seems quite reasonable to me.
regards Martin

Edited By Martin Kyte on 17/12/2022 12:13:54

[Jim GuthrieParticipant @jimguthrie82658]

Posted by A Smith on 17/12/2022 10:20:30:

Oh well, live and lean. Apparently, it is easy to make the correct decisions during an unprecedented crisis.

Various health authorities had been predicting another pandemic for several years and I think I remember from discussions at the start of the pandemic that the UK government had carried out an exercise in 2016 to assess the UK's readiness to deal with such a pandemic. This had highlighted problems like shortage of PPE. So our government had a lot of current information of what was required if a pandemic happened. The pandemic could only have been termed unprecedented because the government chose to ignore warnings.

Jim.

[SamsarandaParticipant @samsaranda]

Referring to Martins post about the allocation of duties where ward assistants feed the patients it has always intrigued me why the food for patients is served by those whose responsibility it is to clean the ward toilets ! ! ! Dave W

[Martin KyteParticipant @martinkyte99762]

Posted by Samsaranda on 17/12/2022 13:23:37:

Referring to Martins post about the allocation of duties where ward assistants feed the patients it has always intrigued me why the food for patients is served by those whose responsibility it is to clean the ward toilets ! ! ! Dave W

I'm not sure it is, I think cleaners are a separate team.

regards Martin

[Kiwi BlokeParticipant @kiwibloke62605]

Posted by Ady1 on 17/12/2022 10:47:40:

If I was going to fix things I would start with the BMA and dump the lot of them

…

The BMA is the core of the problem and they have created a crippling shortage of medical professionals

How is the BMA, which is effectively the doctors' trade union, and of which membership is voluntary, responsible for the mess? The BMA is not particularly politically effective, and has not held the population or the government to ransom, and it isn't responsible for a shortage of doctors. Indeed, it would like there to be more doctors, and thus a larger membership.

[Mike PooleParticipant @mikepoole82104]

In our house the people who clean also prepare the food and do every other domestic task, you could be picking up dog poop then cooking breakfast. You have to believe that washing with soap and hot water is sufficient to maintain a decent standard of hygiene.

Mike

[Martin KyteParticipant @martinkyte99762]

It is generally held that one of the major reasons for GP s leaving the profession is the changes to lifetime allowance for pensions. If you have reached your limit as a working GP it becomes less attractive to carry on working so many have and are retiring. Another unintended consequence of government action.

But yes the country does need to train more doctors and there just aren’t enough medical schools.

regards Martin

[Kiwi BlokeParticipant @kiwibloke62605]

Posted by Martin Kyte on 17/12/2022 17:20:42:

Posted by Samsaranda on 17/12/2022 13:23:37:

Referring to Martins post about the allocation of duties where ward assistants feed the patients it has always intrigued me why the food for patients is served by those whose responsibility it is to clean the ward toilets ! ! ! Dave W

I'm not sure it is, I think cleaners are a separate team.

regards Martin

The NHS hospital cleaners used to be hospital employees. They knew the job, knew the staff, and knew how to behave in hospitals. Part of Mrs Thatcher's pseudo-business ideological mistake was to 'encourage competition' by hiving off some areas of the NHS to commercial businesses. The idea was that, for instance, a number of commercial cleaning companies would bid for the business of cleaning the local hospital. Any profits made would, naturally, be money 'taken' from the NHS. The NHS already paid cleaners at the low end of their job's pay scale, so how was that ever going to save the NHS money? Well, of course, it resulted in fewer cleaners, many of them who didn't know the job, and less-clean hospitals. In all cases where activity was 'privatised', it had to be financially attractive to the 'private' firms, thus it had to disadvantage both the workers and the NHS. And still, there was an enormous increase in 'managers', getting in the way and drawing fat salaries – and pensions. Their value to the NHS was, of course, not monitored.

Hospital 'Trusts' were invented, supposedly as competing health providers. The insane idea was that these hospitals would compete for business, the 'cheapest' getting the contracts. So patients were expected to travel well beyond their local hospital to get a treatment no longer available locally, because it couldn't be provided 'competitively'? Well, that may work in London, or where there is a high density of hospitals, but what if you lived in Truro, for instance?

Trusts became 'brands' and their management liked to do things like changing the letterhead of the hospital stationery. That was pointless, expensive, and took money away from healthcare delivery. The 'shop floor workers' protested, but bureaucrats generally win.

Does anyone remember the TV series in which Sir John Harvey Jones (hope I've got the name right) was parachuted into various firms, to solve all their problems? He went to the Morgan Car Co., and 'discovered' a living fossil that obviously had no future unless it did all sorts of stupid things that he suggested. He predicted that the company would die within a few years if it carried on as it was. It presumably never occurred to him that he knew nothing of the car industry, nor the preferences of its customers, nor the value of craftsmanship, and was thus unqualified to comment. Like him, politicians' ignorance or competence is no bar to their pronouncements or careers. They seem oblivious to their errors.

[Martin KyteParticipant @martinkyte99762]

Margaret wanted to completely privatise health something her chancellor Ken Clarke was opposed to and the only way he could head her off was to introduce the internal market as a delaying tactic. So whilst I for one would abhor these measures at least it prevented something worse. It took the Second World War to generate the kind of political and social environment to make the creation of the NHS possible let alone the rest of the welfare state, something that happens so rarely. Destroy it and you can never get it back. It’s not perfect but it’s an institution that is solely set on helping individual members of the population irrespective of who you are or what you are worth and that is something worth fighting for.

regards Martin

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