Funding the NHS

[jonjh1964]

In my wife’s Day Surgery about a third of all operations are cancelled on the day, mainly because of ‘no shows’ or patients that turn having eaten/not stopped taking their meds/not taken their pre-meds. One day a week is children’s teeth extractions - usually 1/2 dozen plus - too many sweets/sugary drinks too little brushing.

Who cares - it’s free isn’t it?

[Peter (Monty)]

Pretty decent summaries

[XTR2Turbo]

I believe in the NHS and want it to prosper but genuine question what do people mean by privatisation and what is the issue?

If it is free at point of access and more efficient do we really care how it is delivered?

You could already argue that the NHS is massively dependent on private companies for almost all the equipment it buys anyway.  Why should it be any different for managing and organising.

I am not being controversial I just don't understand the opposition.

David

[DonPeffers]

Seems we've been here before looking at Independent article from 09 January 2017

"NHS doctors are being forced to choose who lives and who dies as a shortage of intensive care beds means terminally ill patients are being refused life-saving surgery."

http://www.independent.co.uk/life-style/health-and-families/health-news/nhs-crisis-intensive-care-bed-shortages-jeremy-hunt-doctors-choose-who-live-die-operation-procedure-a7517051.html

Many excellent points raised by Jeff although NHS IT systems have a bad history regarding cost and cancellations.

I looked up Government online petitions regarding the NHS and the responses were tiny.

We will all have to fight harder if we are to keep our beloved NHS.

[Peter (Monty)]

Agreed @DonPeffers

Unfortunately any petition that isn't aligned with government policy just get a "thanks for your input" response, they are a waste of time and divert people's energy away from the actual problem. The only way to fight is at the ballot box and for people to vote for a party which actually wants a universal healthcare system to succeed.

Canada, Scandinavia and others all have outstanding universal healthcare systems, we don't have to reinvent the wheel, we should just be copying what they do

[jeff oakley]

David raises some important issues and it is one of those people do not really get. At Emerson Green near Bristol there is a unit which is 100% for NHS patients but is owned and run by Care UK.

I was there for my man bits fondling and was listening to people speaking saying how wonderful the unit is. Prompt service, clean and efficient and how the NHS is wonderful.

I explained that this was actually a private hospital, employing none NHS staff working for the NHS, the attitude changed. It was wrong that a private company could make a profit out of health care, in their minds, as they were so programmed that only a wholly owned and state run NHS could be right, that even though this worked well, only got paid the same as an NHS unit for all treatments.

The savings are made in pensions, admin and being able to do elective surgeries without having to constantly change due to emergencies. To me there is nothing wrong with that so long as they only get the same money and have to swallow any costs that happen afterwards, like infections etc.

Ideologically many feel it is plain wrong, but as David says does anyone really care if they get the healthcare their NI has paid for without additional costs.  

The real savings are in the back office  functions but those wanting to change things for the better are up against those who do not want to lose their role or their staff to work harder.

One example, my wife looks after a number of CSU operations, in one they took over there was 10 staff who were moaning about the workload, how they needed more staff and overtime etc. In another unit there was 3 people doing the same work, with no issue but changing that took almost three years.

Private companies have looked at taking over, but due to TUPE rules they end up with staff who are part of the problem and are not that keen on taking on contracts where there is no money to be saved in a relatively short time frame.

The public need to understand that change is needed as it cannot go on. The cry is the tories want to privatise everything in the NHS, ignoring that Labour privatised more, they cannot possibly do that but they can use the private sector responsibly to achieve the same ends, but that politically is a bomb no one wants to pick up and we will still be having discussions in another 10 years.

Also Jonjh made a good point, when people see something is free they do abuse it. He is right about operations, my Daughter is studying to be and anaesthetic Dr, she has had a few who turn up having been told nil by mouth, having cannulas inserted to confess to having had a cup of tea. The waste of money should be charged to them without a doubt as until we do they will continue wasting NHS resource. 

[XTR2Turbo]

5 minutes ago, jeff oakley said:

Also Jonjh made a good point, when people see something is free they do abuse it. He is right about operations, my Daughter is studying to be and anaesthetic Dr, she has had a few who turn up having been told nil by mouth, having cannulas inserted to confess to having had a cup of tea. The waste of money should be charged to them without a doubt as until we do they will continue wasting NHS resource. 

I would have no issue with a £50 or £100 fee for using the NHS each time same as for a prescription if it cut out a lot of the abuse. 

[jeff oakley]

8 minutes ago, XTR2Turbo said:

I would have no issue with a £50 or £100 fee for using the NHS each time same as for a prescription if it cut out a lot of the abuse. 

I would. We already pay and health care in the UK should not be based on ability to pay. Pensioners for example might not go to a GP when ill and some poor but hard working good people should not have to chose, between food or healthcare.

My grandmother who had had 14 children, was so poor that she had a prolapse she carried between her legs in an old sheet, as they could not afford the operation to fix her. The day the NHS was formed there was a queue of women like her at the Dr's, she got her operation very quickly, hence my support for the NHS. However I can see change is needed as what it does now it was never designed to do.

I would have no issue with a £50 or £100 fine for missing an appointment or more for causing an operation to be cancelled.

[Peter (Monty)]

Using the power of private companies is fine as long as the public service still has control. I live in south London and Southern Rail basically held commuters hostage for 18 months with 80% of trains cancelled some days. The issue was the long (10-year?) contract meaning zero pressure on Southern and no ability for people to use alternative services. Free market only works if there's competition.

If we can work out how to get private companies to compete to provide better and better healthcare - while still being available to all - I'm all for it.

[DonPeffers]

http://www.bbc.co.uk/news/uk-england-nottinghamshire-42656165     

Alice Johnson was in town with her two-year-old daughter when she started bleeding heavily

Suffering a miscarriage said she took a tram to hospital after being told she faced a five-hour wait for an ambulance.

Alice Johnson said she called 999 after she started bleeding heavily in Nottingham city centre.

She lost nearly five pints of blood before having a miscarriage at Queen's Medical Centre (QMC).

East Midlands Ambulance Service (EMAS) apologised that it could not provide the level of service she had wanted.

Ms Johnson, from Clifton, said she had a small bleed while shopping with her two-year-old daughter, and called 999 when it became heavy.

She said she received a call back from a nurse, who told her to make her own way to hospital and, as she could not move, she was helped by her mother-in-law onto the tram.

She said her boots filled with so much blood it spilled onto the tram.

"It was a horrifying experience that nobody should have to go through," she said.

 

137,107 have signed the following petition and I have just done so at    https://speakout.38degrees.org.uk/campaigns/nhs-winter-crisis-2018

It might not do any good but if you want to join me please do so.

I was somewhat alarmed that last nights ITV news had no NHS crisis coverage and C4 seemed the same. Have the powers that be put a notice out to media to stop alarmist reporting? Meanwhile PM has announced 25 year plans for trees and plastic--great!!

 

[andy665]

2 hours ago, DonPeffers said:

http://www.bbc.co.uk/news/uk-england-nottinghamshire-42656165     

Alice Johnson was in town with her two-year-old daughter when she started bleeding heavily

Suffering a miscarriage said she took a tram to hospital after being told she faced a five-hour wait for an ambulance.

Alice Johnson said she called 999 after she started bleeding heavily in Nottingham city centre.

She lost nearly five pints of blood before having a miscarriage at Queen's Medical Centre (QMC).

East Midlands Ambulance Service (EMAS) apologised that it could not provide the level of service she had wanted.

Ms Johnson, from Clifton, said she had a small bleed while shopping with her two-year-old daughter, and called 999 when it became heavy.

She said she received a call back from a nurse, who told her to make her own way to hospital and, as she could not move, she was helped by her mother-in-law onto the tram.

She said her boots filled with so much blood it spilled onto the tram.

"It was a horrifying experience that nobody should have to go through," she said.

 

137,107 have signed the following petition and I have just done so at    https://speakout.38degrees.org.uk/campaigns/nhs-winter-crisis-2018

It might not do any good but if you want to join me please do so.

I was somewhat alarmed that last nights ITV news had no NHS crisis coverage and C4 seemed the same. Have the powers that be put a notice out to media to stop alarmist reporting? Meanwhile PM has announced 25 year plans for trees and plastic--great!!

 

Whilst the above is absolutely terrible and should never be allowed to happen its far from clear that the problem was caused by lack of funding - more likely to be poor expenditure of funding, poor management, poor training etc etc

In this day and age the answer to every problem appears to be the same - throw more money at it 

A far more in-depth look at why the NHS is struggling would be far wiser before we resort to simply spending more - perhaps more money is required but lets sort out how effectively the current 145 BILLION per year is spent first

[Blatman]

On 1/13/2018 at 13:00, DonPeffers said:

Have the powers that be put a notice out to media to stop alarmist reporting?

If they had, the media would report that as well because it would be a very juicy scandal indeed. 

I love these sorts of conspiracy theories because even a quick glance suggests this type of cover up is impossible. There are just too many moving parts for this to be able to happen. The trouble is conspiracy theorists are big on noise, short on evidence in 100% of cases. They work on the premise that the appearance of impropriety does the damage and it is very difficult for the accused to prove a negative because the answer, whilst truthful, is what anyone would say and sounds weak. 

Anyone want to discuss the moon landings?  

[DonPeffers]

After an 8 day gap of seemingly no NHS news in the media there has, in the last 2 days, been news appearing including https://www.theguardian.com/society/2018/jan/25/hospitals-still-in-grip-of-winter-crisis-nhs-england-figures-show   

Dr Nick Scriven, president of the Society for Acute Medicine (SAM), said the figures undermined Theresa May’s insistence at prime minister’s questions on Wednesday that the NHS in England was the best prepared for winter it has ever been.

“Pressures in the system remain high, and it really is offensive and disingenuous to see the prime minister only yesterday remain adamant that the NHS was better prepared than ever this winter,” he said.

From The Institute for Fiscal Studies  https://www.ifs.org.uk/uploads/publications/bns/BN201.pdf  "This measure includes both public and private expenditure on health. UK spending was 9.8% of national income (2015 GDP), 79% of which was accounted for by public spending. 

UK spending was below Japan (11.2%), Germany (11.1%) and France (11.0%)."

Yesterdays BBC news report quotes 9.7% UK,  Germany 11.1% and France 11.3%.

Distressing to see an elderly lady waiting in a corridor on a trolley with severe chest pain on the news the other night.

Hopefully Jeremy Hunt in his new expanded role including Social Care can lessen the bed blocking problem.

[Blatman]

3 hours ago, DonPeffers said:

Theresa May’s insistence at prime minister’s questions on Wednesday that the NHS in England was the best prepared for winter it has ever been.

It can still be the best prepared it has ever been and fail, whether due to sheer weight of numbers or local staffing or management issues or whatever excuse is trotted out. Ask 22 F1 drivers if they are ready and they will all say they are the best they have ever been. Yet 21 of them fail to win every two weeks...

With regards to funding, governments of every colour put up with the same cry of "more money" and they must dance around the answer. From the perspective of those who represent NHS staff, the cry of "more money" is the simplest, easiest thing in the world. NHS funding is no longer a red or blue issue because both sides suffer the same ignominy and we buy in to it without really thinking that deeply about the question or the answer.

3 hours ago, DonPeffers said:

Distressing to see an elderly lady waiting in a corridor on a trolley with severe chest pain on the news the other night.

One too many but... how many people were admitted as acute or emergencies across the NHS on the same night? If we're going to look at numbers then lets look at numbers rather than isolated and potentially sensationalist news story, BBC story or not.

With regards to the spending numbers, I think in France that healthcare is not free at the point of delivery but that those entitled do get a refund of 90% of their up-front costs... I think... Do the values quoted include or exclude the 10% retained as public spending or not?

 

[DonPeffers]

17 hours ago, Blatman said:

It can still be the best prepared it has ever been and fail, whether due to sheer weight of numbers or local staffing or management issues or whatever excuse is trotted out. Ask 22 F1 drivers if they are ready and they will all say they are the best they have ever been. Yet 21 of them fail to win every two weeks...

With regards to funding, governments of every colour put up with the same cry of "more money" and they must dance around the answer. From the perspective of those who represent NHS staff, the cry of "more money" is the simplest, easiest thing in the world. NHS funding is no longer a red or blue issue because both sides suffer the same ignominy and we buy in to it without really thinking that deeply about the question or the answer.

One too many but... how many people were admitted as acute or emergencies across the NHS on the same night? If we're going to look at numbers then lets look at numbers rather than isolated and potentially sensationalist news story, BBC story or not.

With regards to the spending numbers, I think in France that healthcare is not free at the point of delivery but that those entitled do get a refund of 90% of their up-front costs... I think... Do the values quoted include or exclude the 10% retained as public spending or not?

 

See BBC iPlayer 24Jan2018 Daily Politics, Andrew Neil explaining to Robin Walker MP that NHS funding increased by average £5 Bn pa from 1997 to 2010 but since 2010 has been slightly under £2 Bn pa average so funding growing at only 40 % of previous level despite growing population especially elderly and costlier new treatments----see  https://www.bbc.co.uk/iplayer/episode/b09pqsyn/daily-politics-24012018#  view episode 11 to 18 minutes in.

Regarding French healthcare I found for you https://www.frenchentree.com/living-in-france/healthcare/the-cost-of-going-to-the-doctor/  which might help or  please do further Google searches. Interesting stats on https://about-france.com/health-care.htm

If you Google NHS crisis there are plenty of instances of delays and suffering and at 24jan2018 PMQs Corbyn quoted 80 patients either dying or suffering harm while awaiting treatment. This is in the same Daily Politics episode.

Your F1 analogy won't reassure anyone lying injured awaiting an ambulance to be told 'by the way did you know we are the Team McLaren of healthcare? Many talented and committed people, make the most of our budget but don't achieve our goals'.

Independent newspaper today headline  "NHS crisis: Senior Tory MP hits out at Government's 'disingenuous' use of winter statistics---Ministers must show they understand scale of problems facing the NHS, Health Committee chair says"    see http://www.independent.co.uk/news/health/nhs-crisis-latest-government-statistics-winter-disingenuous-tory-mp-sarah-wollaston-criticism-a8155561.html