The NHS

[BlackVanDyke]

P-Jay said:

I've spent a lot of time under the care of the NHS in the last couple of years, and had a couple of goes at Private Care.

Firstly my first-hand experience of the NHS is so far removed from the nonsense you read about in the press (and on PH sadly) sometimes it's not even funny anymore.

It's not as efficient as it could be, but that's not always a bad thing - a private company would probably consider having a brigade of doctors, registrars and consultants on hand as waste - but if you turn up in the back of a ambulance all smashed to bits you're pretty glad of a half dozen specialists checking you out and there's no point discussing when you'd like your procedure over a coffee when you're bleeding to death, you want seeing to proto by a organisation that's got the size, manpower and depth of experience to fix you.

I've never waited to see a physio, consultant, doctor, home care nurse they were always available just when I needed.

There's waste, but they're not dropping tonnes of cash on swanky looking waiting rooms or advertising which is a whole lot more wasteful IMHO.

This. And likewise wrt to experiences.

At 26 with a life-limiting progressive condition I am thoroughly uninsurable, and I depend on a huge number of different sectors of the NHS to keep me as well and functional as I can be even while bits of my body stop working. That includes two very low-incidence specialisms - things where there are just a handful of consultants in the entire country who have the relevant knowledge and experience. Obviously this means that the few hospitals where this handful of medics work, are tertiary referral centres who get patients sent right across the country to be under their care.

I haven't seen anything in the published plans for the (destruction of the) NHS which even acknowledges that this model of care exists, let alone that provides for the needs of the (maybe?) few tens of thousands of us who need it.

[turbobloke]

P-Jay said:

There's waste, but they're not dropping tonnes of cash on swanky looking waiting rooms or advertising which is a whole lot more wasteful IMHO.

OK and first-hand experiences are what count for all of us so as long as all of them are as good as this and BlackVanDyke's experience, we're all going to get excellent and hopefully efficient service.

The other side of the coin is that it does still have to be paid for and in terms of waste, the right wing think tank Reform published a report in 2007 (iirc) detailing £25bn of waste annually in the NHS. If reality is anywhere near that level, then NHS efficiency needs attention extremely urgently.

It may be less than £25bn in the reality of 2012 - but by how much? That's a colossal amount of waste even when compared to the enormous NHS budget.

[Murph7355]

turbobloke said:

....
The other side of the coin is that it does still have to be paid for...

Spot on.

And even when the waste is done away with, there may (will) still be situations where a scheme of treatment cannot be provided. This will be tragic in most circumstances by their very nature, but it cannot be avoided. There is no infinite fund - quite the opposite at the moment.

[P-Jay]

turbobloke said:

P-Jay said:

There's waste, but they're not dropping tonnes of cash on swanky looking waiting rooms or advertising which is a whole lot more wasteful IMHO.

OK and first-hand experiences are what count for all of us so as long as all of them are as good as this and BlackVanDyke's experience, we're all going to get excellent and hopefully efficient service.

The other side of the coin is that it does still have to be paid for and in terms of waste, the right wing think tank Reform published a report in 2007 (iirc) detailing £25bn of waste annually in the NHS. If reality is anywhere near that level, then NHS efficiency needs attention extremely urgently.

It may be less than £25bn in the reality of 2012 - but by how much? That's a colossal amount of waste even when compared to the enormous NHS budget.

Firstly, I rarely trust these reports on waste and spending, they’re usually heavily biased to suit whoever is paying for it.

There is waste in terms of say a Hospital sending 1000 IV's to landfill because they can't store them whilst another Hospital down the road orders 1000 new ones it desperately needs (I made that up BTW), which is almost unforgiveable but you fear is a unhappy inevitability of having such a massive organisation that's been growing organically for decades at the whim of it's political masters - can you imagine a Private Company with a turnover of £125bn a year and 1.7 million employees being run under those conditions, it wouldn't last 5 years.


Then there is waste in terms of say the Children’s Intensive Care Ward in the University Hospital of Wales in Cardiff. (AKA The Heath) it's got 6 beds, but they're rarely more than half full, and it's not unheard of for it to have no occupied beds at all. The staff who work there are pretty specialist and do get farmed out around the hospital when they're quiet but depending you on your point of view, and whether your report is funded by the left or right of the house, or by a private medical company it's ether a huge waste of money.... or an indispensible resource that quite rightly should never be at full capacity leaving us without a safety net. This is why trying to grade the efficiency of the NHS like some large PLC will never work.

I’m all for a bit more Private Sector thinking in the NHS, I don’t feel it uses it’s huge buying power to get the best deal, in fact in the case of things like Gaviscon Plus it seemed to be getting the piss taken out of it, but it should never be allowed to be privatised – there’s no money to be made in expensive contingencies.

[turbobloke]

One of the points I was making is that there's plenty of room in £25bn for some over-estimation - there would still be an unacceptable level of waste, and probably still is.