What state is the NHS in? How can we improve it

ToneControl

spark240 said:

I had cause to go to Walsall manor hospital a few years ago at around 12.00 midnight, I went in the wrong entrance and had to walk all the way through to get to the right ward. It was like a ghost town, no staff, no patients, and I thought all this ££££££ of equipment and resources not being used?....  there no future in that.

well, at midnight...   unlikely to be much outpatient work. I was operated on  at midnight when my appendix ruptured though.

But yes,  factories work shifts, why have  loads of kit unused? Is it cheaper to pay people extra to work  in the evenings?
My Mom died in the Manor, it was a pretty crap building when she was first ill, but they have spent a lot - PFI I assume, it's pretty  modern now.

Axe_meister

It's not just the NHS that is badly managed. I'd say the entire social system is.
We deal with our Local Education authority SEN department on almost a daily basis. The level of incompetence when it comes to admin is beyond pale.
loss of documents, left hand not knowing what the right is doing, out right lies when trying to defend their incompetence.

Go private (health and education) everything in regards to your case is fully documented/tracked. You phone up and they know who you are from your phone number and you are directed to the right person straight away.
I'd hate to be somebody with below average Education/intelligence and try to navigate the system.

ToneControl

Axe_meister said:

Go private (health and education) everything in regards to your case is fully documented/tracked. You phone up and they know who you are from your phone number and you are directed to the right person straight away.

I'd hate to be somebody with below average Education/intelligence and try to navigate the system.

I agree that you usually get better health care going privately, but not always I have found!
You do always get consultants - so can be confident of fast diagnoses,  but it's not always joined up with the NHS. For example, one private hospital I use is  adjacent to  the NHS one, the (NHS) consultants  can access your medical records  (past tests, etc) in their consulting rooms. At many private hospitals, they can't.

Anyway, you make a good point, that I have  thought about in more general terms;  people with chronic illnesses are  more likely to come to harm generally if they have below average intelligence: how can  someone with an IQ of 80 manage diabetes,  coeliac disease, haemophilia, etc?

the_twin

Private health care is wonderful, unless you become seriously ill, in which case you will very rapidly become an NHS patient. 

mgaw

bottom line for me is we the GB public need to look after our own health WAY better than most do now.

its all very well people banging about the "issues" facing the NHS, if everyone got their fingers out and ate well exercised etc, the demand would drop dramatically followed rapidly by an easing of the ridiculous pressure and costs of providing health care, to what can fairly be described as a lazy, unhealthy, indulged and entitled population. (not everyone but there is an awful lot of people who fall into this category.

ToneControl

mgaw said:

bottom line for me is we the GB public need to look after our own health WAY better than most do now.

its all very well people banging about the "issues" facing the NHS, if everyone got their fingers out and ate well exercised etc, the demand would drop dramatically followed rapidly by an easing of the ridiculous pressure and costs of providing health care, to what can fairly be described as a lazy, unhealthy, indulged and entitled population. (not everyone but there is an awful lot of people who fall into this category.

no, I've seen too many (even ultra) healthy people fall ill or die, you can't just  say that - everyone dies, everyone gets ill, even the macho guys who never see their GP. The most costly illnesses are not self-inflicted

the_twin

No it wouldn't. We would still get old and frail. And no amount of good food and exercise is going to stop the onset of dementia. 

ToneControl

the_twin said:

Private health care is wonderful, unless you become seriously ill, in which case you will very rapidly become an NHS patient. 

in the UK , yes
But with private, at least you can get a fast diagnosis, and the first treatments expedited

It goes against my principles tbh, but less so when faced with the dilemma "do I leave my Mrs and kids with no income, and maybe no me, just to prove I don't agree with upgrading to private?" 

I've had 2 medical conditions completely dimissed by the NHS, yet  picked up  immediately in private care
To be fair, I've had one life-changing condition  guessed by a GP, years after  a private consultant  failed to  understand it

ToneControl

the_twin said:

No it wouldn't. We would still get old and frail. And no amount of good food and exercise is going to stop the onset of dementia. 

this is the trouble,  and the media tells people to eat well and exercise, and they will live forever
my mate ran 5k or 10k twice a week  from his teens, he loves exercise, always at the gym,
had a better body at 40 than I did at 22, but still got heart valve disease and spent  months off work
luckily, he is mostly now back to normal

my ex died from a fat globule  causing a stroke during an operation 3 days after breaking her leg, there are millions of stories like this,  
there's too much  media  coverage trying to push  blame onto victims.  I don't know  anyone ill who  brought it on (other than smoking, which was ignored or  recommended when they started)

the healthier we get, the more we live longer, to get  old age  conditions, the NHS must be  funded to cope
we see some vigorous people in their 70s, 80s,  they are not virtuous, they are lucky-  I know many who cannot do the same things in their 30s due to bad luck with  undeserved random illnesses

mgaw

ToneControl said:

mgaw said:

bottom line for me is we the GB public need to look after our own health WAY better than most do now.

its all very well people banging about the "issues" facing the NHS, if everyone got their fingers out and ate well exercised etc, the demand would drop dramatically followed rapidly by an easing of the ridiculous pressure and costs of providing health care, to what can fairly be described as a lazy, unhealthy, indulged and entitled population. (not everyone but there is an awful lot of people who fall into this category.

no, I've seen too many (even ultra) healthy people fall ill or die, you can't just  say that - everyone dies, everyone gets ill, even the macho guys who never see their GP. The most costly illnesses are not self-inflicted

I can say that millions have preventable illness Diabetes 2 for example..it all adds up to a huge burden...obesity being the prime example, in most cases completely avoidable....there is too much pussy footing around on this issue, there are exemptions to all rules but logic dictates, a healthy populade is better than an unhealthy populace

ToneControl

mgaw said:

ToneControl said:

mgaw said:

bottom line for me is we the GB public need to look after our own health WAY better than most do now.

its all very well people banging about the "issues" facing the NHS, if everyone got their fingers out and ate well exercised etc, the demand would drop dramatically followed rapidly by an easing of the ridiculous pressure and costs of providing health care, to what can fairly be described as a lazy, unhealthy, indulged and entitled population. (not everyone but there is an awful lot of people who fall into this category.

no, I've seen too many (even ultra) healthy people fall ill or die, you can't just  say that - everyone dies, everyone gets ill, even the macho guys who never see their GP. The most costly illnesses are not self-inflicted

I can say that millions have preventable illness Diabetes 2 for example..it all adds up to a huge burden...obesity being the prime example, in most cases completely avoidable....there is too much pussy footing around on this issue, there are exemptions to all rules but logic dictates, a healthy populade is better than an unhealthy populace

I agree, but I am saying  that I am not convinced that the per-person average lifetime cost to the NHS would change much  - we'd just live longer and  have  strokes, heart disease and  cancers eventually.

I see that  health promotion is a good thing, but I suspect that would add more to quality of life and GDP rather  than reduce  NHS costs per person. btw, that  idea of denying treatment to the obese last week was  immoral 

mgaw

its not the best approach, you are wrong though to think that the lifetime cost to the NHS of a healthy person who is fit, active and eats well isnt lower than the inactive obese smoker heavy drinker etc....sure they may not live as long but there are a lot of visits to DR and hos[itals and dont ignore social care costs, mobility etc.

The bottom has to be that if this country wants to protect the NHS it has to assist it by assuming responsibility for its own health, its a strange state of affairs we have so much given yet it is abused

Snap

the_twin said:

No it wouldn't. We would still get old and frail. And no amount of good food and exercise is going to stop the onset of dementia. 

actually it would help.

one of the largest problems the NHS is facing is the massive increase in long term conditions - thing slike hypertension, cardivascular disease, diabetes and obesity. All these are hugely affected by lifestyle and are largely caused by living an unhealthy lifestyle. Not that you don't get all these problems in people who look after themselves no; but you get all these problems at a younger age if you live badly. That means that instead of someone having diabetes for say 10 years, and then dying, they have it for 40 years and cost the NHS much much more.

Because we are generally so unhealthy as a population now (booze and diet and lack of exercise) we need the NHS more, and more often. That overloads the system.

If you are fat and young you will likely get high blood pressure, diabetes, heart failure, high cholesterol, atrial fibrillation, arthritis and cancer way before someone who is young and fit. Multiply that up by millions of people, you can quickly see the escalation in cost and burden.

Course that's not the whole problem, but its one that we could all address if we really were bothered.

mgaw

/\ this,  exactly my point....it is nonsensical to argue to the contrary the NHS is being royally abused by the public most take it for granted so much that they dont even realise what they are doing to it.

Lodious

My dad died yesterday after 10 days in hospital following a heart attack. It was pretty horrible to watch the NHS in action. All the staff were great in isolation, but the methods they communicate with and structures they have to work within make success very unlikely. The IT infrastructure is just laughable, my kids have more advanced tools for doing primary school homework.

Some of the patients were ungrateful scumbags. When offered free tea and rice pudding once guy shouted ' I want biscuits'. The porter explained he didn't have any. They guy just shouted back 'I want biscuits!' . I later saw him smoking in the entrance to the hospital, which given he was in a cardio ward, seems unwise.

It's a really sad situation. I don't ever think it will get better as any attempt to reform is met with 'Hands off our NHS', and the system seems completely broken at the moment.

On a slightly trivial note, I would punish by execution the use of any inkjet printed sheets of A4 blue tacked to walls / doors. If signage is needed, get a sign made and fixed properly so the wall/door can be cleaned properly. Does my head in that it's allowed.

ESBlonde

@Lodious my deepest sympathies for your loss. 

ThePrettyDamned

@tonecontrol if seeing a private doctor gets a diagnosis quicker (although they may be an NHS doctor anyway), would that still be the case if everyone had to go private? Genuine question. Unless they're prepared to build a lot more infrastructure, I don't think they would. 

Put simply, could private cope? If yes, it is only because some people who need it cannot afford it. Because if they could, they'd still be in the queue right there with everyone else. 

LoFi

ThePrettyDamned said:

@tonecontrol if seeing a private doctor gets a diagnosis quicker (although they may be an NHS doctor anyway), would that still be the case if everyone had to go private? Genuine question. Unless they're prepared to build a lot more infrastructure, I don't think they would. 

Put simply, could private cope? If yes, it is only because some people who need it cannot afford it. Because if they could, they'd still be in the queue right there with everyone else. 

I don't think anyone's suggesting that the existing private infrastructure could cope with the demands currently placed on the NHS, nor do I think that anyone's suggesting demolishing all NHS buildings and sacking all the staff. If your question is "Would waiting times (or whatever) automatically improve if all existing doctors (both private and NHS) and patients were to become private?" then the answer is no - without additional changes, it's just a matter of where the funding comes from.

However, if you knew that your appointment was going to cost you a hundred quid, and you'd only be able to claim it back from your insurance if you showed up, you'd be more likely to show up, and this on its own would reduce waiting times. This (or imposing a fine for missed appointments) is one of a thousand things that could be done to incrementally improve the NHS, and seems perfectly reasonable to me, but can't be done because it'd be viewed as creeping privatisation (despite the fact that NHS dentists already do it).

ToneControl

ThePrettyDamned said:

@tonecontrol if seeing a private doctor gets a diagnosis quicker (although they may be an NHS doctor anyway), would that still be the case if everyone had to go private? Genuine question. Unless they're prepared to build a lot more infrastructure, I don't think they would. 

Put simply, could private cope? If yes, it is only because some people who need it cannot afford it. Because if they could, they'd still be in the queue right there with everyone else. 

personally  I would prefer to abolish private medicine, so as to  compel the richest & most powerful to  ensure the NHS was improved as much as possible, anyway,  all but one of the private doctors I have seen are NHS consultants. They do it  after their  compulsory NHS shifts

Mostly they have had their own MRI, X-Ray,   and USS, not sure where pathology  is done.
However, when I've been using the private hospital that is linked by corridors into my local NHS general  hospital,  I've had all the scans done in the NHS  facilities -  where  I've  still seen the consultant  radiographer/physician, but in the NHS  facility, so I assume the NHS gets paid for the use of it.  Trouble is,  you  can then  get  bumped into waiting if someone urgent comes in, which  - although perfectly fair, slightly  negates one part of the attraction of  private health care for someone self employed.

I think your question may not be a useful  way to think of it really -  everyone won't go private, but  I guess if people had the cash, they'd all pay to use NHS  rooms and kit.    That would be  like  publicly  owned facilities,  hired by a private service
You could see that  you could have public services  provided by a private sector firm, using public sector kit, Maybe the tories are planning that?  

ToneControl

mgaw said:

its not the best approach, you are wrong though to think that the lifetime cost to the NHS of a healthy person who is fit, active and eats well isnt lower than the inactive obese smoker heavy drinker etc....sure they may not live as long but there are a lot of visits to DR and hos[itals and dont ignore social care costs, mobility etc.

The bottom has to be that if this country wants to protect the NHS it has to assist it by assuming responsibility for its own health, its a strange state of affairs we have so much given yet it is abused

it sounds like common sense, but I've seen enough counter-intuitive statistics on various topics to be suspicious:
do you have any reports or stats to back up this view?