2 Friends left NHS

[Otta]

Mick Mac Wrote:

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> So, doctors and nurses paid for by the British

> taxpayer, to look after an increasing number of

> immigrant patients?

The "British taxpayer" includes immigrants. And there will be a hell of a lot more non tax paying Brits than immigrants using the NHS.

[JoeLeg]

????

I have no

> idea

> > what the solution might be.

>

>

> Theoretically loads:

>

> New Treatments that are more cost effective

> Technology that delivers services/treatments more

> effectively - from profound changes in say laser

> surgery technique to simple appointment/reminders

> setting delivered better but basically technology

> can reduce cost in myriad ways

> Better management all round to improve

> efficiency

> Better procurement practice

> Better non=-medical 'practice' eg, I read that

> the recent change to giving people with fluey type

> symptons anti-biotic perscriptions but framing

> this as "This is in case you don't feel better in

> 2 days then get the subscription' has had a

> material impact on subscription costs

> Further Devolving of some 'medical' powers and

> applications down the chain (see Jabs via

> qualified Nurses as an eg of standard practice now

> - used to just be doctors)

> Self- monitoring via technology/apps - is already

> but could be massive in reducing GP pressure

> and/or 'preventetive' practice

>

> These are just off the top of my head in 5 mins

I welcome the sound of all of those, and some of them sound like innovative ways of reducing stress in the system. I am however sceptical of management and procurement improving!

[nxjen]

???? Wrote:

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> nxjen Wrote:

> --------------------------------------------------

> -----

> > "The increase in the use of NHS services is far

> > more to do with a population that lives longer

> and

> > people who cannot/will not access more

> appropriate

> > services, than any increase in immigration."

> >

> > What I haven't seen discussed anywhere is that

> > ever evolving medical research is continuously

> > making new discoveries in terms of treatment

> and

> > drugs which increases costs to the NHS to treat

> > previously untreatable conditions. I have no

> idea

> > what the solution might be.

>

>

> Theoretically loads:

>

Whilst I agree with your suggestions for cost savings, what I'm trying to say is that as more and more fantastic medical treatments and equipment become available, these will make a potentially unlimited call upon NHS funds. Much medical research is undertaken for commercial reasons. Even with the best political will in the world, the NHS budget is finite and already certain treatments and drugs are only available privately. I fear this will give further amunition to those that are promoting private medical insurance for all.

[titch juicy]

Jeremy Wrote:

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> Quite - funding is the main issue.

>

> I'm not going to pretend that abusers and

> timewasters don't exist (from all walks of life)

> but it ain't the only issue...

It's not so much the funding, but what's done with the funding.

This is anecdotal from two NHS docs (one a renal specialist, one an anesthetist (sp?)) that I was on a walking weekend with a few weeks ago. The amount of bureaucracy within the NHS is costing millions and the external contracts (maintenance, office equipment, security etc) are an horrendous waste of money.

For example, a window on a ward needs fixing. Only one company can do it, and that company charges way more than ten other companies. Same with a new printer.

The funding the NHS is getting is being badly wasted.

So, perhaps a bit of an overhaul is required with some serious streamlining in areas other than essential services and staff.

I know very little about the realities, but this is what the doctors reckoned.

[Jeremy]

titch juicy Wrote:

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> So, perhaps a bit of an overhaul is required with

> some serious streamlining in areas other than

> essential services and staff.

From what I've heard, an NHS streamlining exercise would probably involve hordes of keen-but-clueless McKinsey grads, being charged out at >?1K a day...

[rendelharris]

titch juicy Wrote:

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> It's not so much the funding, but what's done with

> the funding.

>

> This is anecdotal from two NHS docs (one a renal

> specialist, one an anesthetist (sp?)) that I was

> on a walking weekend with a few weeks ago. The

> amount of bureaucracy within the NHS is costing

> millions and the external contracts (maintenance,

> office equipment, security etc) are an horrendous

> waste of money.

>

> For example, a window on a ward needs fixing. Only

> one company can do it, and that company charges

> way more than ten other companies. Same with a

> new printer.

Sounds the same as in teaching, at least ten years ago - need a new packet of board markers, put in a request to the head of department who in turn puts in a request to the bursar who orders them from the only approved supplier at a higher price than the stationer's round the corner - most of the time one would go and buy them out of one's own pocket to save the hassle, but obviously that's not quite so practical for an MRI scanner.

I infest King's a lot and I'm continually surprised at things which have obviously cost a fortune and aren't needed. The check-in terminals are a case in point: 60% of people just ignore them and go straight to the receptionists (who are lovely and obviously see it as part of their job) to check in, 25% of people try to use them then give up and go to the receptionist, about 15% of people actually check in with them.

As for ?2K 70" TV sets in waiting rooms tuned to Bargain Hunt which nobody's watching, why?

I'm continually bewildered by the costs quoted for the NHS, for example that a ten minute GP appointment costs ?45, not including any prescription, which bumps it up on average to near ?100. Now assuming a GP sees around thirty patients a day that's ?1350 a day, GPs take about ?350 of that, still seems to leave an awful lot over for admin staff and buildings etc.

The frontline staff in the NHS, both medical and admin, are brilliant and have literally saved my life at least four times, but there must be some ways of cutting costs without affecting frontline staff.

[steveo]

Yes, all of that Rendel

[Otta]

People only ever talk about frontline staff (who I agree we need, and ideally more of). But often forget the medical secretaries behind the scenes. Without these people, clinics simply don't happen. Letters don't get sent, appointments don't get booked. They are being put upon with ever increasing workloads, and a lot feel they are at breaking point.

I totally agree, there are savings to be made, but staffing budgets need to not only be protected, but ideally increased. And that needs to include non medical staff, because they can be just as important to the running of a hospital.

[rendelharris]

Absolutely - by frontline staff I meant to imply all working on the actual practice of medicine and/or patient management.

[JohnL]

Otta Wrote:

-------------------------------------------------------

> People only ever talk about frontline staff (who I

> agree we need, and ideally more of). But often

> forget the medical secretaries behind the scenes.

> Without these people, clinics simply don't happen.

> Letters don't get sent, appointments don't get

> booked. They are being put upon with ever

> increasing workloads, and a lot feel they are at

> breaking point.

>

> I totally agree, there are savings to be made, but

> staffing budgets need to not only be protected,

> but ideally increased. And that needs to include

> non medical staff, because they can be just as

> important to the running of a hospital.

Aren't a lot of the non frontline staff outsourced now and,

the first thing outsourcers do is cut staff.

The NHS I worked for between 1992 and 1998 has totally changed

- beyond the purchaser/provider split that happened in that

period.

Could they be actually spending too much on change and need some

stability ?.

[Otta]

I am not sure. I think most secretaries at Guys & Tommy's are NHS staff.

[miga]

stringvest Wrote:

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> Chld a citizen and needs looking after so social services

BS - child not a citizen by default. I know - I'm not, so my child's not.

[DaveR]

The evidence does not suggest that the key (long-term) weakness of the NHS is funding, but structure. But for as long as it is political suicide to suggest that alternative systems may actually be better (as in France, Germany, Belgium and the Netherlands, for example) nothing will change, and 'the government' will be blamed.

Even the 'Socialist Health Association' agrees:

https://www.sochealth.co.uk/2015/01/18/international-comparisons-say-nhs/

as does (perhaps less surprisingly) the Adam Smith Institute:

https://www.adamsmith.org/blog/healthcare/comparing-apples-to-apples-nhs-still-ranks-below-average

[????]

and, as an aside, it's partly that unwillingness to address changes and get it reformed and working in general which often leads the bigoted to blame immigrants for the problems of the NHS - it needs reform, not an open ended cheque book, or it will break....ironically groown up Labour MPS (so none of the current leadership) really do know this but it's their 'dog whistle' Vs the Tories

[steveo]

The Tories must think they'll landslide the next election so now is the hour to put on the helmets and reform away.

If not they should.

[uncleglen]

Stringvest said

'..Pregnant person from somewhere in the world appears, gives birth and then will not leave, as nowhere to go. Child a citizen and needs looking after so social services involved. One took up a bed for over 3 weeks refusing "temporary accommodation....."

So a child born in the UK is a citizen? Anchor babies....

[JoeLeg]

It's only automatic if one of your parents is a British citizen, either born here or naturalised.

If both parents are not British citizens then it gets much more complicated. And is certainly not guaranteed.

[ianr]

> It's [acquisition of British citizenship by birth in the UK] only automatic if one of your parents is a British citizen

Having a parent (mother or married father) deemed settled/without time limit on stay is also sufficient.