Unpopular opinion - NHS is useless

The biggest pressure is the additional cost of agency staff who earn more.
There’s a reason why no Private hospitals offer A&E and Trauma centres because it’s not profitable.
If the NHS solely provided Cataracts operations and other profitable procedures it wouldn’t have any funding issues.

Look at the likes of Spa medical. See Specsavers and the like to offering hearing aids until the CCG’s reduced the funding which meant they couldn’t cover the costs. Where do these patients now go for this care, Yes the NHS who have to cover the costs themselves.

Back in 2015 an agency nurse was costing us c£2K p/w and things have got a good deal tighter since then, I know. The numbers spun up very very quickly.

Is it though? My wife has been left for 6 months, and she still has access to the NHS training website via her old NHS email address. The training website she has access to is from an external provider so there is a cost involved and she could be doing all manner of courses on it.

Well if it was correctly funded they wouldn't be i
a) in consultation to remove 3 triple therapy cystic fibrosis drugs because they are suddenly now not cost effective despite that price remaining static since they were approved
b) NHS Trusts already forecasting mult million pound deficits before Xmas
c) the imposition of "block" fixed figure contracts between providers and commissioners with using 20/21 as a baseline for negotiation
d) ICS with almost £1b less across the country compared to 22/23
e) removal of specialised services such as routine cancer from specialised commissioning to local ICS who as above have less money.

I could go on but not everything is some people make out or read in the papers

Yes my general thoughts are very much along the lines of HOW the budget is spent not that the budget is insufficient.

Some of the waste is astonishing and the internal resistance to change is equally astonishing.

I fear the days of a single service for all are numbered but not due to underfunding. Sad times

From a single page ago:



We are an ageing population of fatties and we've been underfunding for years. Gen Xers will probably be the first to be hit. Hopefully gen Z will be able to reap something of an upswing .

It is an easy little tag line to throw out but think of one "efficiency" saving that will save me £2m on my drug budget for 24/25. This is just one trust.

We already have regional procurement frameworks, discounts/rebate schemes with manufacturers, VAT efficient dispensing methods, utilising generics and biosimilars to their maximum, outsourcing aseptic manufacturing for dose banded chemo.....

I don't think it is a case of spending better but one person may say "don't spend on xyz" and someone else may disagree. Who is right or wrong?

Basically due to an increasing, ageing population who live longer there is the inevitable increase in resources which generally are more labour intensive. Elderly care is a massive burden which stretches far outside of the acute care sphere. If only this utter shambles of a government would fix adult social care it would lead to massive increase in capacity within the acute care. You wouldn't have little Doris sat in a hospital bed for 2 months without requiring medical care while she waited for a care package. That would free up a space for someone sat with an ambulance crew at MIU or A&E waiting to be handed over which means the ambulance service are not sat with unmet demand. I know this might sound fanciful but the impact of improved adult social care would be far reaching within health but nobody seems to give a st in positions with influence.

I know the usual sack the management line and replace with nurses is trotted out but some large NHS Trusts are spending £1b+ each year. Who runs that when the management are replaced with a nurse? The adage of matrons running hospitals is long gone. Employ managers to manage and nurses to nurse

Yeah and you still have a colossal amount of waste. When a mate's firm took over provision on an NHS service they took a hard look at expenditure and found immediately that staff were only one item in a packet of assorted consumables then throwing the rest away (they other items weren't ever needed).

Blair's government threw a lot of money at the Service and realised after a few years that they were getting diminishing bang for the taxpaper buck.

Using a consumable as an example of what may appear to be waste.

Spiriva inhaler. Once a patient is started they need continuation packs. However the continuation packs are more expensive than the starter pack which includes the device and capsules. So a patient will receive a new device every month as this is cheaper but it may look like waste but in actual fact it is cheaper to the NHS.

Staffing levels in clinical posts (i.e. nurses) is the biggest challenge to the NHS. There are not enough nurses to fill all the posts. So staff are working overtime or they are using bank staff. The other option is not having the extra staff and wards then become below safe working levels. This is a direct consequence of central government via DH taking money from Health Education England to fund an "NHS budget increase". This money whilst appearing to come from the magic money tree was simply just removing the funding to train healthcare professionals such as nurses and paramedics who now have to self fund instead. So the £5b or whatever figure they quoted was simply moving the money from one NHS piggy bank to another and a long term staffing strategy was ruined. Since this bunch of shysters were elected in 2010 they done so much harm to pubic services through a combination of utter incompetence which is expected with the people they had in place and also things like the Health and Social Care Act which has been a disaster. So much so they are in the process of repealing lots of it. The NHS is not awash with money, otherwise every single department in every hospital in the country would not be having to develop cost improvement strategies (cuts) for next year and the year after. Funding is being cut by stealth across the board but people lap up the PR from the bunch of chancers in Downing Street