Dispatches - NHS in Crisis
Discussion
Vasco said:
Isn't the problem just the sheer size of the NHS operation.
By coincidence, yesterday I had to go to a major local hospital A+E for various tests. About 100+ patients were waiting for apx 3 hours (better than usual apparently), despite the fact that the staff were clearly working their socks off.
I then had to go to another section where 6-8 staff were generally milling around their Reception area. They were certainly readily available to meet any urgent demand but an average of, say, 6 staff doing very little got a bit tiresome after another 3 hours.
The whole organisation needs a massive overhaul and reorganisation - which simply won't happen.
It's just so ridiculously vast. Where would you start?
Well the private sector have already picked off the most profitable areas so of course with the failure of the tories to match spending to both demand and inflation no wonder it’s on its arse.By coincidence, yesterday I had to go to a major local hospital A+E for various tests. About 100+ patients were waiting for apx 3 hours (better than usual apparently), despite the fact that the staff were clearly working their socks off.
I then had to go to another section where 6-8 staff were generally milling around their Reception area. They were certainly readily available to meet any urgent demand but an average of, say, 6 staff doing very little got a bit tiresome after another 3 hours.
The whole organisation needs a massive overhaul and reorganisation - which simply won't happen.
It's just so ridiculously vast. Where would you start?
leef44 said:
Vasco said:
Isn't the problem just the sheer size of the NHS operation.
By coincidence, yesterday I had to go to a major local hospital A+E for various tests. About 100+ patients were waiting for apx 3 hours (better than usual apparently), despite the fact that the staff were clearly working their socks off.
I then had to go to another section where 6-8 staff were generally milling around their Reception area. They were certainly readily available to meet any urgent demand but an average of, say, 6 staff doing very little got a bit tiresome after another 3 hours.
The whole organisation needs a massive overhaul and reorganisation - which simply won't happen.
It's just so ridiculously vast. Where would you start?
And it is growing. Every time someone comes across another gap in society where an illness/sickness/condition has not been catered for then it hits tabloid headlines. Politicians want to score points by being the one who allocated billions implementing another division/department.By coincidence, yesterday I had to go to a major local hospital A+E for various tests. About 100+ patients were waiting for apx 3 hours (better than usual apparently), despite the fact that the staff were clearly working their socks off.
I then had to go to another section where 6-8 staff were generally milling around their Reception area. They were certainly readily available to meet any urgent demand but an average of, say, 6 staff doing very little got a bit tiresome after another 3 hours.
The whole organisation needs a massive overhaul and reorganisation - which simply won't happen.
It's just so ridiculously vast. Where would you start?
At the same time, there are no additional staff and this is to be absorbed into the current overstretched workload.
Hang on a minute, didn't I say billions are allocated? Yes, where does that money go because it is not in additional staffing.
It's so oversized and creaking so inefficiently while being economically unsustainable.
The budgets for each department are say 50 WTE’s on various bands.
To run that service at demand you need x number of staff. When the staff are unavailable (sickness, maternity, job vacancies) then there’s a requirement to employ agency staff.
For example the cost of 1 consultant from Agency is the same as 3 WTE consultants.
You can see how quickly the money goes.
Someone said about the paracetamol problem too. Why can you buy them for 3p each from the supermarket but the NHS pay X ?
There are also lots of discussions about reducing staff costs by changing job bandings. However I’ve never heard folk saying that the Senior management banding should be reduced. It’s always Band 4 and below.
740EVTORQUES said:
There’s also a real sense of managers measuring what they can measure not what they should measure.
Example surgeons were told that finished cases early was inefficient as that was not using all the theatre time while colleagues that were slower were using the resources efficiently.
There are lots of Alice in Wonderland style examples of poor management and perverse incentives.
Not sure what your role is but serious question, Would you move to the private sector ?Example surgeons were told that finished cases early was inefficient as that was not using all the theatre time while colleagues that were slower were using the resources efficiently.
There are lots of Alice in Wonderland style examples of poor management and perverse incentives.
Downward said:
740EVTORQUES said:
There’s also a real sense of managers measuring what they can measure not what they should measure.
Example surgeons were told that finished cases early was inefficient as that was not using all the theatre time while colleagues that were slower were using the resources efficiently.
There are lots of Alice in Wonderland style examples of poor management and perverse incentives.
Not sure what your role is but serious question, Would you move to the private sector ?Example surgeons were told that finished cases early was inefficient as that was not using all the theatre time while colleagues that were slower were using the resources efficiently.
There are lots of Alice in Wonderland style examples of poor management and perverse incentives.
S600BSB said:
Downward said:
740EVTORQUES said:
There’s also a real sense of managers measuring what they can measure not what they should measure.
Example surgeons were told that finished cases early was inefficient as that was not using all the theatre time while colleagues that were slower were using the resources efficiently.
There are lots of Alice in Wonderland style examples of poor management and perverse incentives.
Not sure what your role is but serious question, Would you move to the private sector ?Example surgeons were told that finished cases early was inefficient as that was not using all the theatre time while colleagues that were slower were using the resources efficiently.
There are lots of Alice in Wonderland style examples of poor management and perverse incentives.
Downward said:
S600BSB said:
Downward said:
740EVTORQUES said:
There’s also a real sense of managers measuring what they can measure not what they should measure.
Example surgeons were told that finished cases early was inefficient as that was not using all the theatre time while colleagues that were slower were using the resources efficiently.
There are lots of Alice in Wonderland style examples of poor management and perverse incentives.
Not sure what your role is but serious question, Would you move to the private sector ?Example surgeons were told that finished cases early was inefficient as that was not using all the theatre time while colleagues that were slower were using the resources efficiently.
There are lots of Alice in Wonderland style examples of poor management and perverse incentives.
I only operate one day a week now. I used to (and would like to) operate three days per week.
That’s the point I’m making
My daughter is seeing a few specialists at the moment, luckily I have BUPA health care through work and I added my children.
One specialist she needed to see, the appointment was arranged in a week and she got the results the same day.
A friend of hers needs to see the same type of specialist on the NHS, her appointment is currently booked for November.
I have started seeing a private dentist now, it's just so much less hassle.
My daughter is in for a big shock if she ever needs to see the NHS again.
One specialist she needed to see, the appointment was arranged in a week and she got the results the same day.
A friend of hers needs to see the same type of specialist on the NHS, her appointment is currently booked for November.
I have started seeing a private dentist now, it's just so much less hassle.
My daughter is in for a big shock if she ever needs to see the NHS again.
chrisgtx said:
Labour are in charge of the hospitals in Wales and it’s no better.
That's true, but I'm not sure how it could be different. Wales can only pay what Westminster gives them, they have limited or no tax raising powers and the 7 NHS trusts in Wales are self-governing. How the NHS does with the next government will depend on what they're prepared to pay, and how they find that money. Increased taxation rates or a stronger economy, I doubt they can borrow much more, for very long.
I would ban the use of agency staff from hospitals. From her experience, lots of nurses are leaving the NHS, then signing up to agencies, only to be given shifts back on the wards or in critical care at inflated rates. They're all at it.
If the use is banned, where else can the agency staff go? Back to the NHS at their old rates is where, which means increased numbers of nurses.
If the use is banned, where else can the agency staff go? Back to the NHS at their old rates is where, which means increased numbers of nurses.
Fastchas said:
I would ban the use of agency staff from hospitals. From her experience, lots of nurses are leaving the NHS, then signing up to agencies, only to be given shifts back on the wards or in critical care at inflated rates. They're all at it.
If the use is banned, where else can the agency staff go? Back to the NHS at their old rates is where, which means increased numbers of nurses.
So when you ban them who will staff them to safe working levels in the imaginary point between ban and potential re-employment by NHS?If the use is banned, where else can the agency staff go? Back to the NHS at their old rates is where, which means increased numbers of nurses.
What happens if they don't come back?
The obvious thing would be to use in-house bank staff or use bank staff from other NHS Trusts to cover it? I know of staff who work in the private sector but also employed on a zero hours contract by local NHS trust to top up earnings. But then if you cant cover shifts by bank staff whereabouts do you go if no agencies exist
Too many people is the problem.
Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
kestral said:
Too many people is the problem.
Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
Can a UK resident move easily to Oz, NZ, USA and Canada ?Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
epom said:
It comes down to accountability, the days of there being any are long gone. Our crew are currently building a hospital that is expected to cost €2.4billion once finished. Yes Billion.
That sounds like it'll be fantastic with all the high tech equipment you'll be fitting. How many MRI's and such does £2.4billion get you?Vasco said:
kestral said:
Too many people is the problem.
Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
Can a UK resident move easily to Oz, NZ, USA and Canada ?Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
RSTurboPaul said:
Vasco said:
kestral said:
Too many people is the problem.
Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
Can a UK resident move easily to Oz, NZ, USA and Canada ?Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
Is it simple to do ?
chrisgtx said:
Labour are in charge of the hospitals in wales and it’s no better.
13.4 billion debt that NHS trust had was written off by the government on 2020. But in the mean time whilst emergency loans are given, interest paid, and appointments and procedures canceled , until the debt was written off. this goes on all the time and is a government issue.Same thing happens for councils yet everyone thinks it is normal
https://www.gov.uk/government/news/nhs-to-benefit-...
The problem as I see it is that the entire organisation is not fit for purpose and the modern world
It was set up post WW2 when the country was very different, the population was around 40m and life expectancy was around 73 years
We have had incredible advances in medicines and care in the intervening 80 years and we are now keeping people alive and able to live with conditions that would have been quickly fatal in the 40’s. It was never envisioned that treatments (and costs) would expand so dramatically
I really think that it needs to be redrawn and reformed for todays world and yes that probably means that those who can afford to pay should, probably through some form of contribution through insurance or additional tax or even to access services at source ( in Ireland for instance unless you have a medical card you have to pay to see a GP (€50)or attend A&E (€100) unless referred by a GP)
When we look at some of the European models or the Australian model they do seem a better fit for today and have better outcomes
I don’t have an answer, but equally I don’t think just throwing more and more money at it is the answer either
I’ve spent my working life in the public sector and my wife has been in/around the NHS for 37 years and still is, so I’ve an idea about how inefficient it can be and how huge amounts of money can be wasted
It was set up post WW2 when the country was very different, the population was around 40m and life expectancy was around 73 years
We have had incredible advances in medicines and care in the intervening 80 years and we are now keeping people alive and able to live with conditions that would have been quickly fatal in the 40’s. It was never envisioned that treatments (and costs) would expand so dramatically
I really think that it needs to be redrawn and reformed for todays world and yes that probably means that those who can afford to pay should, probably through some form of contribution through insurance or additional tax or even to access services at source ( in Ireland for instance unless you have a medical card you have to pay to see a GP (€50)or attend A&E (€100) unless referred by a GP)
When we look at some of the European models or the Australian model they do seem a better fit for today and have better outcomes
I don’t have an answer, but equally I don’t think just throwing more and more money at it is the answer either
I’ve spent my working life in the public sector and my wife has been in/around the NHS for 37 years and still is, so I’ve an idea about how inefficient it can be and how huge amounts of money can be wasted
Edited by Earthdweller on Wednesday 26th June 09:22
RSTurboPaul said:
Vasco said:
kestral said:
Too many people is the problem.
Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
Can a UK resident move easily to Oz, NZ, USA and Canada ?Many staff leave and go to USA,Aus,NZ or Canada.
Why put up with all this NHS crap.
We then get all the immigrants as nurse and doctors that can hardly speak english.
The whole Country is shot to bits in every respect.
Answer- Get your passport and get out.
and yeah, everyone is saying the NHS is foooked - cant even get the basics right
The irony of having a panel of 5 people, of which only one had anything to do with actual patient care, yet they are all likely to be funded from the health care budget was not lost on me.
Also, can someone tell me why the system has gone to s
t in the last ~10 years. The population of the country has not changed significantly in that time, so in theory at least the physical capacity of the system should be ok, so why is it struggling so much with actual capacity?
It strikes me the problem is not the hospitals, but getting people out of hospital who do not need to be there, but there is nowhere else to put them.
Also, can someone tell me why the system has gone to s
t in the last ~10 years. The population of the country has not changed significantly in that time, so in theory at least the physical capacity of the system should be ok, so why is it struggling so much with actual capacity?It strikes me the problem is not the hospitals, but getting people out of hospital who do not need to be there, but there is nowhere else to put them.
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