Anyone want a sensible debate on....

[Norman Verona]

Having seen the French system from within and now experienced the UK system (NHS) I think it's time to face facts.

As the doctors and consultants are not part of the NHS but contract into it isn't it time we abandoned any attempt to run an integrated system which is costing us all a lot of money, is just not working and which is run by highly paid, non medical, administrators.

I was in hospital yesterday having a heart scan (ultra sound). I got talking to the nurse. She agreed with all I said about the shambles we call an NHS. Her colleagues and her have volunteered to work Saturdays at no extra pay to attempt to bring down the waiting time. I have been booked in since the end of April and got a call on Thursday asking if I could come in on Saturday.

She has been in the NHS doing her job for 22 years. In the early days she reported to the cardiac consultant and they had monthly meetings to discuss improvements to the department and see if they needed any more equipment. Their finance request went to the hospital finance manager (one person) who would quickly say yes or no or in x months.

Now, she says it takes 6 months notice to get all the people who decide on capital expenditure together. Not one is medical and they decide on what equipment can be bought. She pointed to a large machine on a trolley. It had been purchased for the department. It wasn't needed but no one asked them. However, another qualified nurse and another ultra sound machine which was needed to bring down the waiting time wasn't available.

To put things in perspective when it was deemed I needed this scan in France I was referred to the cardiac department of the local hospital and see WITHIN 2 HOURS of being in my doctors surgery. Why? because it was seen as life threatening if I had too much water around my heart - I did and was admitted immediately.

I asked why this doesn't happen in the UK. The answer is simple. My doctor can request the scan as urgent or non-urgent. Urgent will cost his budget more money.

Come on lads - up the revolution.

[Matt Seabrook]

We used to have a health service to be proud of Norm. Not just a heath service but a welfare state that would look after the most needy in our society. My better half works in this sector and they are having budget cuts of 40% to this sector. Now when you hear of cycle paths having millions spent on them to get them back up to scratch and Cornwall council having 12 million spent on there offices to have them redecorated it makes me more than a little angry.

[Norman Verona]

The welfare state was indeed a major step forward.

However, hasn't it become a cash cow for managers and consultants?

The moment we make decision making based on money rather than on medical need we have lost the purpose.

Still, why I should I care, I'm back to a place where the elected government fully understand their role and reason for being there is to look after the people.

[Paul Hurdsfield - Joint Manchester AO]

Not just the NHS, but nowadays there are far too many people on committee's talking about how they are going to do things, than people actually doing what needs to be done  

[Doug Dastardly]

One of my employee's wives is a nurse and apparently some nurses refuse to do overtime then turn up through an agency to do the same work for more money!

Another friend is a HR manager for the NHS and says its a shambles, a lot of management have iron clad contracts so cannot be paid off nomatter how incompetent they are. Or if their job gets cut they have to be offered another job at the same money, even if it's less hours and at a lower level. Obviously eventually this leads to some overpaid underworked staff.

There are indeed many good workers too who probably don't get the support they deserve.

[SootySport]

I think the NHS is great, the couple of times I have used a hospital, I can say our our local was brilliant.

The biggest problem these days is the overall cost and the demands by the general public using and expecting ever increasing expensive treatments and drugs.  Coupled together with longer living humans it is not surprising the costs of delivering the NHS is spiralling out of control.

You have to remember at the inception of the NHS the UK was a world industrial power and funding a free health service was not a problem. Forward 60 years and now the UK is not what it was on the world rich list and the GB pound cannot afford an unlimited public service.

How a free NHS can be funded in the future I have no simple answer, cutting a bit of bureucresy and cost cutting is not going to suddenly give us all the treatment we are expecting for the long term future, a more radical and dare I say private contract system of supplying the NHS with it's bread and butter needs everyday is the the only way to go, as long as the at the end off it,  the UK public receive treatment for free. Some treatments may well have to disappear like free treatment to overseas visitors to name one, there are plenty of other non essential services that we should be expected to pay for ourselves.

We can all nitpick on certain aspects of NHS money wasting but there is a wider picture to be resolved in the future and save the NHS.

[Man On The Clapham Omnibus]

A couple of members of my family are either currently NHS employees or have been. The management headcount is a scandal; the tv series 'Cardiac Arrest' a few years back was, I'm told, uncannily accurate. But there is vast waste in clinical departments too: surgical kits costing hundreds or even thousands being opened for one £1 piece of kit and the rest being scrapped because they're no longer sterile, for example. If the parts that are wanted were ordered separately as well as in kits thousands could be saved in one area alone. As with so many serious problems there's no easy answer. Failure to keep appointments is an area that especially irks me. An expensive consultant, or even more expensive GP can be twiddling their thumbs because some ignoramus cannot have the common courtesy to cancel an appointment. The only saving grace is that the money stays in the UK mainly, unlike some other government expenditure: IT, defence, etc., which is often foreign sourced.

[Blatman]

Interesting to see a confirmed socialist arguing for the French system which in any other debate would considered as a massively right wing policy of if you can't pay, you can't play...

I'm sure the French system has the ability to deal with the population who are unable to work and afford the full price when they turn up to the docs. And we know Norm has said that you pay on the way in and claim back the difference later. If that was proposed by a Tory, he'd be hung by the loony left just for being a capitalist, elitist tory rather than the good sense it seems to be.

Sensible debate on the NHS? Not possible.

As for spending money... council funding cannot simply be re-allocated to the NHS. That's a whole other debate. Council tax, topped up (or not...) by the government is for cycle paths and decorating the council office. It's National Insurance that pays for the NHS. The two are simply not easily interchangable, so the fact that a council is blowing a load of dosh on their paintwork or weeding some cycle paths (which they probably get a european grant for anyway...) has nothing to do with NHS funding, other than it happens to be our money...

[Norman Verona]

Sootie, the major flaw in your argument is that the NHS isn't FREE. The cost is about 30% of the average mans income. The myth that it's free is why we don't complain. We have become brainwashed into thinking we can't complain because it's free.

May I respectfully point out that you shouldn't say the UK health system is "brilliant" until you have experienced another system. Of course, compared to some the UK is good, but compared to many others it would appear to be very expensive for what we get. It is very good for major stuff like heart attacks and strokes and serious injuries. In that case maybe we should call it a "Sickness Service". Health Service implies preventative medicine delivered in good time.

Blatters. Why should the nations health be based on outdated political ideologies. In fact, in France, if you are unemployed or cannot afford to pay for your contribution the doctor has the power to mark you up 100%. Like the UK, chronic illness is 100% paid.  In practice you give your Carte Vitale when making the smaller payments and only pay the balance. Where you pay the whole amount the states portion is credited to your bank immediately. For the larger payments, like a hospital stay, you present your Carte Vitale and pay the balance only.

Most people have private insurance for the balance and the hospital (or whoever) will bill the insurance company direct.

All in all though, for the vast majority of people in France their medical care is far cheaper than paying NI in the UK. Remember that the employers contribution is recovered through the price of the companies sales. One abnormality that has come to my attention is the true cost of drugs. The FULL price of my medication (now don't laugh but I take 12 tablets a day) is far less than paying the prescription charges in the UK. One could say the UK government is cheating it's taxpayers by making a profit on most the drugs administered. Of course I wouldn't say such a thing.

The fact remains. France has the same number of people (60 million) they spend the same sort of money on their health system. Yet they are judged (by the UN health) to have the best in the world. It's by no means perfect, for example you book your next annual or biannual eye test when you have the current examination because if you don't you'll have to wait a few months. No problem once you understand that. In France I rest assured that if I need medical attention and it's deemed urgent I get it straight away. In the UK I waited 3 months for an examination which my French doctor would have had done on the same day.

ed to ad that I'm sure the NI contributions are just chucked in the same pot as all the other taxation. Bit like the ROAD FUND money.

[blitz]

Given my recent history, I have reason to be grateful to NHS medical profeessionals.   However NHS management is quite another story.  Last year I read an article comparing Addenbrooks Hospital Cambridge, with a similar French Hospital. Numbers of Medical staff differed by around three Doctors and slightly more Nurses.   Manager numbers were 50% greater here than there.  This alone is reason to worry about the NHS, never mind the other long list of problems.

[Norman Verona]

Barry, my comments weren't aimed at the doctors or nurses although I have to experiences that my make your hair curl.

It's the governments, of all persuasions, who have tried to run the NHS on political grounds and have introduced a system were the accounts say what can and can't be done and the medical staff have little or no say in how it works.

Without prying I suspect your experience was urgent rather than elective. I waited 3 months for a simple ultra sound on my heart. Had I had a heart attack and taken in by ambulance I would have got it straight away.

Point is, had I had, as suspected, excess water around my heart the heart attack was very probable.

[blitz]

I totally agree.

[Doug Dastardly]

As an interesting sideline....my cousin who is a teacher told me last night that his education trust (or whatever they call themselves) recently had a review which highlighted that they had 350 teaching staff.

And 360 managers / supervisors / admin!

[Norman Verona]

Reminds me of when IBM went "bust". The CEO said that they had 50,000 staff they didn't require.

How do you employ 50,000 people you don't need and not know until you have several billions of dollars losses?

Who do you think is to blame for the (over) 1:1 ratio.

I blame successive governments who have tried to run things from Whitehall. They should have let the professionals run things while the politicians found them the wherewithal to so do.

[Matt Seabrook]

As for spending money... council funding cannot simply be re-allocated to the NHS. That's a whole other debate. Council tax, topped up (or not...) by the government is for cycle paths and decorating the council office. It's National Insurance that pays for the NHS. The two are simply not easily interchangable, so the fact that a council is blowing a load of dosh on their paintwork or weeding some cycle paths (which they probably get a european grant for anyway...) has nothing to do with NHS funding, other than it happens to be our money...

So your saying the money that the NI only goes to heath care. Would you say then that road tax pays for roads and speeding fins go in to road safety? I feel you are being foolish to think that what we are told the money is being used for is actually being used for.