Where do you stand on the Junior Doctors' strikes ?

the_twin

Let's see if the efficiency savings materialise. Generic drugs have been prescribed for many years, so that saving is not going to be made again. Various initiatives to keep patients out of hospital have failed to generate the planned savings. A large scheme to care for the elderly in Cambrigeshire recently collapsed after a few months as it was not financially viable. At the moment there is some very creative accounting going on to try to get the headline NHS deficit down for the past year. That can't go on for ever either.

Chalky

@the_twin, I'm not a party political person and tend to damn most politicians much the same, but please remind me what wonders Tony and Gordon did for the NHS?

the_twin

They invested in it, with the aim of spending being in line with our European neighbours. As a result waiting times fell drastically, along with mortality from cancer and heart disease. Patient satisfaction reached an all time high. The ban on smoking in public places will have a major public health impact. Other initiatives, such as around national NHS IT, were less successful. http://www.kingsfund.org.uk/sites/files/kf/High-Performing-NHS-progress-review-1997-2010-Ruth-Thorlby-Jo-Maybin-Kings-Fund-April-2010.pdf

Fretwired

the_twin said:

They invested in it, with the aim of spending being in line with our European neighbours. As a result waiting times fell drastically, along with mortality from cancer and heart disease. Patient satisfaction reached an all time high. The ban on smoking in public places will have a major public health impact. Other initiatives, such as around national NHS IT, were less successful. http://www.kingsfund.org.uk/sites/files/kf/High-Performing-NHS-progress-review-1997-2010-Ruth-Thorlby-Jo-Maybin-Kings-Fund-April-2010.pdf

You're having a laugh - are you a left-wing PR man? Labour put more money into the NHS .. the GP's decided to grab a chunk - the result their pay went up and their hours went down and they didn't have to work weekends - forced more people into A&E. The senior consultants did likewise with the result that 90% of the money was eaten up in wages and the rest went on the failed IT system. To this day Blair says he feels the scars of dealing with NHS unions.

And New Labour freed NHS Trusts from government control which gave us the Mid Staffs crisis - Andy Burnham refused to have a public enquiry and now dares to spout forth on NHS failures. He failed when he was in charge. Labour may have spent more money but they added layers of bureaucracy, pointless targets and debt. Gordon Brown and PFI.

And who can forget Tony Blair on BBC's special PM's Question Time getting attacked by Labour voters who couldn't get GP appointments. He didn't realise there was a problem caused by his new contract.

And here's Hewitt getting kicked by a junior doctor - some things don't change.

ToneControl

If I were a medic, I would not go on strike for this

Drew_TNBD

ToneControl said:

If I were a medic, I would not go on strike for this

Medics can't go on strike. The scout, the heavy, and the engineer all get every 3rd Friday off, and the Pyro gets a 2 hour lunch break on account of his excessively hot fire-torch.

the_twin

I'm not a left wing PR man. I was asked what good Blair did for the NHS and I gave some examples. If I'd been asked about misjudgements, I could have talked about allowing GPs to drop responsibility for providing the out of hours service in exchange for a £6000 drop in their income. Strangely enough most GPs took this opportunity. There is still out of hours primary care of course, it is just the responsibility of commissioning groups to organise this rather than individual GP practices. The days when Dr Finlay would personally pop round to attend to you on a Sunday evening probably never existed, even in the 1960s.

Fretwired

the_twin said:

I'm not a left wing PR man. I was asked what good Blair did for the NHS and I gave some examples. If I'd been asked about misjudgements, I could have talked about allowing GPs to drop responsibility for providing the out of hours service in exchange for a £6000 drop in their income. Strangely enough most GPs took this opportunity. There is still out of hours primary care of course, it is just the responsibility of commissioning groups to organise this rather than individual GP practices. The days when Dr Finlay would personally pop round to attend to you on a Sunday evening probably never existed, even in the 1960s.

They did .. our local GP made house calls until around 1970.

And in my area Labour and the NHS is a toxic subject. Our health services were 'reconfigured' which meant four local hospitals were closed and two upgraded (this is a county). We were supposed to have a smaller hospital with A&E .. to cut to the chase Labour closed our hospital completely and invested the money in one 15 miles away. It made no sense as the one that got all the money couldn't be expanded, but it was in a Labour area. The result our local NHS Trust saved money but we don't have enough hospital beds nor maternity cover, and A&E is overstretched. NHS services cut by Labour .. who'd have thought it.

Labour and the Tories .. two sides of the same coin.

chrispy108

Is that Hertfordshire?

I lived in Hatfield and then Watford, it scared me how long it would take to get to Stevenage at rush hour in an emergency, and I had friends in Hemel who had similar worries with Watford General (which is easily 10 minutes from the motorway with no traffic, three times that in normal rush hour traffic).

the_twin

We can look forward to a lot of reconfiguration over the next few years. Take a look at what is happening in Manchester. That's not to say that all change is bad. Much is badly needed, but there does need to be sufficient capacity to deal with the level of demand, which is frequently not the case.

Fretwired

chrispy108 said:

Is that Hertfordshire?

I lived in Hatfield and then Watford, it scared me how long it would take to get to Stevenage at rush hour in an emergency, and I had friends in Hemel who had similar worries with Watford General (which is easily 10 minutes from the motorway with no traffic, three times that in normal rush hour traffic).

Yep. The Tories built a new 'hospital' but in reality it's more of a super clinic - no A&E, maternity, surgery etc but I guess it takes some pressure of the main hospitals.

the_twin

chrispy108;1058497" said:

Is that Hertfordshire?

I lived in Hatfield and then Watford, it scared me how long it would take to get to Stevenage at rush hour in an emergency, and I had friends in Hemel who had similar worries with Watford General (which is easily 10 minutes from the motorway with no traffic, three times that in normal rush hour traffic).

You are nearly always better off being taken a little further to somewhere with the expertise and facilities to treat your life threatening condition rather than somewhere that has neither but is a few miles closer. The results of changes to trauma, stroke and heart attack care bear this out.

Fretwired

the_twin said:

chrispy108;1058497" said:

Is that Hertfordshire?

I lived in Hatfield and then Watford, it scared me how long it would take to get to Stevenage at rush hour in an emergency, and I had friends in Hemel who had similar worries with Watford General (which is easily 10 minutes from the motorway with no traffic, three times that in normal rush hour traffic).

You are nearly always better off being taken a little further to somewhere with the expertise and facilities to treat your life threatening condition rather than somewhere that has neither but is a few miles closer. The results of changes to trauma, stroke and heart attack care bear this out.

I agree and the fact my dad's still alive is testament to this, but closing 'basic' services like maternity and A&E was a mistake IMHO. Hertfordshire has a serious lack of maternity units and capacity.

chrispy108

the_twin said:

You are nearly always better off being taken a little further to somewhere with the expertise and facilities to treat your life threatening condition rather than somewhere that has neither but is a few miles closer. The results of changes to trauma, stroke and heart attack care bear this out.

Yes, but it's not just about "life threatening conditions" is it?

You complained about the Tories shutting hospitals a few pages ago, now you're defending Labour shutting hospitals!

Are you Heidi Alexander?

the_twin

There is a difference between changing services so that, for example, the care of life threatening conditions is improved and starving the NHS of funds so that the overall capacity and standard is reduced. The problem is that any change tends to be automatically be seen as a cut with the inevitable intervention from the local MP. It would be helpful to have a more considered view to change. And what is A&E for if not emergency conditions, which require the right supporting services from the rest of the hospital? Otherwise it's just a minor injuries unit or glorified out of hours GP service.

Sambostar

I had a moment of enlightening last night it pretty much describes how the NHS and even private healthcare operates.

In any animal society, the old go off and die and don't get a look in for the competition, the young are looked after as they are precious and the ones in between of mating age, basically have better chances of survival if they are popular.  The dejected ones roam around on their own avoiding contact or join the society at the bottom of the pecking order and get or seek little attention.  Obviously the ones at the top of the bunch, with the most money will always get the most attention.  Although in human society, due to inheritances and swindling ways, they are not always the most popular or the best.

But basically, we think we're above it and human and all, but the truth is that of you are over 75 the NHS writes you off and you can't get any life extending medicines other than palliative care.  The youngest get the lions shares of care and are pushed to the front of the queue.  People in families get the second most amount of care as they have kids to look after and network.  Single middle aged plus men probably get the least as they seek it out less and the richest obviously pay their way extra for their own care.

So it's all sorted itself out really, just as the animal kingdom does and we think we are above that.

And I'II probably die in the back of an ambulance sad and lonely because the NHS know I have no next of kin and don't want me to fie in hospital less I bring their league tables down.

Ace.

the_twin

That's not the case. The most money is spent on 80 and 90 year olds.

Sambostar

Oh. But only because there are so many of them., I hear the moan that the GP's is full up of people and it wasn't 30 years ago...yeah because nobody was old 30 bloody years ago.

ToneControl

from my experience of watching my parents get ill, and my kids being born, and getting some serious illnesses, I can say that maternity gets more cash, and kids get fixed really fast

the_twin

The per capita spend is much higher for those aged 80 or 90 than any other age group, reflecting the burden of ill health.