Nurses: The NHS is at breaking point
Discussion
loafer123 said:
jjlynn27 said:
loafer123 said:
Murph7355 said:
Which it can't be right now (still have a deficit, still have a massive national debt).
So 9-5ers needs to take time out to fit in unless GPs can be persuaded. Ultimately funding it (or their employers funding) their appointment (TOIL, holiday, sick pay etc).
Just to repeat the point I made above, this is about funding which has been provided to GPs to open more flexibly, but where they are not doing so.So 9-5ers needs to take time out to fit in unless GPs can be persuaded. Ultimately funding it (or their employers funding) their appointment (TOIL, holiday, sick pay etc).
How the hell are they assessing demand for appointments that are not yet offered in any meaningful way? And how are they being assessed as to whether they are meeting this theoretical demand once they adjust?
Are many of these "my bloody GP shuts his doors at 1500, lazy b
d" anecdotes actually GPs responding to "demand"? 
Presumably the GPs are working the hours they are paid to do. And presumably they aren't sat on their arses during those hours wantonly not seeing people. Ergo, what good will it do opening over a wider time range without more doctors? Other than potentially to appease those who are so ill they are still able to go to work 9-5/are unwilling to make an appointment in those hours...?
I think the NHS is fq'd btw, but despite acknowledging that some in its employ will need cattle prodding I genuinely believe the majority will be doing the best they can.
Also FWIW I do not think the state of the NHS is this current govt's fault. It's society's fault for living longer and expecting more and more of what started life as a basic service (because it could be no more in 1948). It's a typically warm and fuzzy socialist ideal that was never really affordable, and most definitely is not now in the way it is being used.
Mark Benson said:
I don't disagree with the theory, but in practice it would never get off the ground or if it did and you were really determined, the charge would only apply to those without 'special' status or a vocal advocacy group.
The minute you announce your universal payment policy the publicity and noise from those (or more likely their advocates in charities and NGOs) claiming they merit exemption would be deafening.
You then have 2 choices; allow exemptions which opens the door to just about every group except the working middle class, middle income income (Tory voting) demographic becoming exempt, or sticking to your guns and facing an onslaught of vitriol and negative reporting which will paint you as the 'Nasty Party' all over again such that even Corbyn would stand a chance in 2020.
Agreed. Except even the middle class, middle income voters would be in uproar too (witness child benefit).The minute you announce your universal payment policy the publicity and noise from those (or more likely their advocates in charities and NGOs) claiming they merit exemption would be deafening.
You then have 2 choices; allow exemptions which opens the door to just about every group except the working middle class, middle income income (Tory voting) demographic becoming exempt, or sticking to your guns and facing an onslaught of vitriol and negative reporting which will paint you as the 'Nasty Party' all over again such that even Corbyn would stand a chance in 2020.
This is why services like the NHS are screwed. It's simply a matter of time. And why a poster elsewhere is right when he notes it's the inadequacies of the electorate being blamed on the govt (to a large extent).
del mar said:
Could you set it up that you pay £X for your first visit and then related subsequent visits are either free are charged at a reduced amount ?
That would address some of the issues of the long term ill / disabled etc, but might deter the time wasters.
My wife went to A & E for migraine vertigo, a £10 / 20 charge wouldn't have stopped her going she was in some distress. Whilst waiting in the queue a large man without a shirt and an overly glamorous woman with soft Irish accident pushed to the front of the queue - she had broken a nail and it really hurt. Would she have gone it if it cost her £20, maybe / maybe not.
Whilst everybody complains the parking charge does not appear to have stopped anybody going.
You could feasibly implement it so that subsequent, justified (by the medic, not the patient) visits don't incur a levy. In my mind the objective isn't to fund the NHS through the back door. It's to weed out those putting unnecessary strain on the system.That would address some of the issues of the long term ill / disabled etc, but might deter the time wasters.
My wife went to A & E for migraine vertigo, a £10 / 20 charge wouldn't have stopped her going she was in some distress. Whilst waiting in the queue a large man without a shirt and an overly glamorous woman with soft Irish accident pushed to the front of the queue - she had broken a nail and it really hurt. Would she have gone it if it cost her £20, maybe / maybe not.
Whilst everybody complains the parking charge does not appear to have stopped anybody going.
Murph7355 said:
You could feasibly implement it so that subsequent, justified (by the medic, not the patient) visits don't incur a levy. In my mind the objective isn't to fund the NHS through the back door. It's to weed out those putting unnecessary strain on the system.
Unfortunately that woul lead to GPs and their secretaries being inundated with complaints from people who aren't happy that their previous visit was regarded as non-essential and so they now have to make a payment etc...sidicks said:
Unfortunately that woul lead to GPs and their secretaries being inundated with complaints from people who aren't happy that their previous visit was regarded as non-essential and so they now have to make a payment etc...
Hurdles everywhere.I'd set up an AI driven phone system that would be the only recourse for dealing with such complaints. I would charge the government relatively little for administering it. I'd probably employ the people who did the quoting systems for Direct Line, or possibly the sales systems at one of my local Volvo dealers, to develop it.
Anyone getting through that would need some sort of treatment afterwards and so would get it for free anyway
In fact thinking about it, maybe just put the bookings for appointments on such a system.
Murph7355 said:
And therein you have the immediate get out of jail free card.
How the hell are they assessing demand for appointments that are not yet offered in any meaningful way? And how are they being assessed as to whether they are meeting this theoretical demand once they adjust?
Are many of these "my bloody GP shuts his doors at 1500, lazy bd" anecdotes actually GPs responding to "demand"?
Presumably the GPs are working the hours they are paid to do. And presumably they aren't sat on their arses during those hours wantonly not seeing people. Ergo, what good will it do opening over a wider time range without more doctors? Other than potentially to appease those who are so ill they are still able to go to work 9-5/are unwilling to make an appointment in those hours...?
I think the NHS is fq'd btw, but despite acknowledging that some in its employ will need cattle prodding I genuinely believe the majority will be doing the best they can.
Also FWIW I do not think the state of the NHS is this current govt's fault. It's society's fault for living longer and expecting more and more of what started life as a basic service (because it could be no more in 1948). It's a typically warm and fuzzy socialist ideal that was never really affordable, and most definitely is not now in the way it is being used.
On the subject of weekend demand; How the hell are they assessing demand for appointments that are not yet offered in any meaningful way? And how are they being assessed as to whether they are meeting this theoretical demand once they adjust?
Are many of these "my bloody GP shuts his doors at 1500, lazy b
d" anecdotes actually GPs responding to "demand"? Presumably the GPs are working the hours they are paid to do. And presumably they aren't sat on their arses during those hours wantonly not seeing people. Ergo, what good will it do opening over a wider time range without more doctors? Other than potentially to appease those who are so ill they are still able to go to work 9-5/are unwilling to make an appointment in those hours...?
I think the NHS is fq'd btw, but despite acknowledging that some in its employ will need cattle prodding I genuinely believe the majority will be doing the best they can.
Also FWIW I do not think the state of the NHS is this current govt's fault. It's society's fault for living longer and expecting more and more of what started life as a basic service (because it could be no more in 1948). It's a typically warm and fuzzy socialist ideal that was never really affordable, and most definitely is not now in the way it is being used.
There were trials of 7 day service (reduction in service during the week) ;
June '15
"Weekend GP trial scrapped as few patients show up"
[url]http://www.thetimes.co.uk/tto/health/news/article4467897.ece[url]
Nov '15
Sunday GP appointments 'not in demand', research says
http://www.bbc.co.uk/news/health-34732926
May '15
http://www.pulsetoday.co.uk/news/political-news/gp...
The idiocy of drive for elective procedures to be availble 7 days is just going to add additional cost, not just to NHS but to dependant services too. Short termist myopic decision by dimwit. And that's before take into account number of trainees who left because they had enough.
Edited by jjlynn27 on Monday 16th January 16:39
jjlynn27 said:
...
The idiocy of drive for elective procedures to be availble 7 days is just going to add additional cost, not just to NHS but to dependant services too. Short termist myopic decision by dimwit. And that's before take into account number of trainees who left because they had enough.
...
Another "objective" that I don't see the rationale for. (The stats around mortality were being bandied around IIRC? Or maybe that was about something else).The idiocy of drive for elective procedures to be availble 7 days is just going to add additional cost, not just to NHS but to dependant services too. Short termist myopic decision by dimwit. And that's before take into account number of trainees who left because they had enough.
...
If people really want this sort of flexibility, then pay for it separately.
Same thing goes for "choosing" hospitals and surgeons etc. I'd be all for "Attend Dr Blogs at hospital x on Wednesday 30th at 1400 and you'll be sorted out. Can't make that here's Bupa's number".
Murph7355 said:
Another "objective" that I don't see the rationale for. (The stats around mortality were being bandied around IIRC? Or maybe that was about something else).
If people really want this sort of flexibility, then pay for it separately.
Same thing goes for "choosing" hospitals and surgeons etc. I'd be all for "Attend Dr Blogs at hospital x on Wednesday 30th at 1400 and you'll be sorted out. Can't make that here's Bupa's number".
That stats were from the Keogh report, so badly abused that at the end Keogh himself told Hunt to basically fIf people really want this sort of flexibility, then pay for it separately.
Same thing goes for "choosing" hospitals and surgeons etc. I'd be all for "Attend Dr Blogs at hospital x on Wednesday 30th at 1400 and you'll be sorted out. Can't make that here's Bupa's number".
k of. Hunt 'misrepresented' data on 7-day NHS
http://www.bbc.co.uk/news/health-35597243
This doesn't help matters.
http://www.bbc.co.uk/news/uk-england-birmingham-38...
People selling their prescriptions on eBay for profit.
http://www.bbc.co.uk/news/uk-england-birmingham-38...
People selling their prescriptions on eBay for profit.
272BHP said:
This doesn't help matters.
http://www.bbc.co.uk/news/uk-england-birmingham-38...
People selling their prescriptions on eBay for profit.
Lots of Methodone ends up used by people who didn't have a prescription for it!!http://www.bbc.co.uk/news/uk-england-birmingham-38...
People selling their prescriptions on eBay for profit.
Not sure I've seen that on ebay - tends to be a local activity unfortunately
On the subject of charges for GP visits - in Jersey the charge is about £30. GP surgeries are private businesses, and thr social security department contributes £20 (so the full charge would be £50).
It does cut down on the trivial stuff!
Any further treatments or referrals to specialists are free, as are prescriptions (and repeats over the phone too usually).
Weirdly, A&E is free so you do get coughs and colds etc there but they will make you wait a very long time...
The argument for people on low incomes etc is usually given the "thats why we pay out income support" response.
Its the same with GST (like VAT) on food and other essentials, when it was introduced the benefit rates were increased slightly to take account of the slightly higher cost of food.
It does cut down on the trivial stuff!
Any further treatments or referrals to specialists are free, as are prescriptions (and repeats over the phone too usually).
Weirdly, A&E is free so you do get coughs and colds etc there but they will make you wait a very long time...
The argument for people on low incomes etc is usually given the "thats why we pay out income support" response.
Its the same with GST (like VAT) on food and other essentials, when it was introduced the benefit rates were increased slightly to take account of the slightly higher cost of food.
Plymo said:
On the subject of charges for GP visits - in Jersey the charge is about £30. GP surgeries are private businesses, and thr social security department contributes £20 (so the full charge would be £50).
It does cut down on the trivial stuff!
Any further treatments or referrals to specialists are free, as are prescriptions (and repeats over the phone too usually).
Weirdly, A&E is free so you do get coughs and colds etc there but they will make you wait a very long time...
The argument for people on low incomes etc is usually given the "thats why we pay out income support" response.
Its the same with GST (like VAT) on food and other essentials, when it was introduced the benefit rates were increased slightly to take account of the slightly higher cost of food.
Sounds to me like a sensible approach all round. It does cut down on the trivial stuff!
Any further treatments or referrals to specialists are free, as are prescriptions (and repeats over the phone too usually).
Weirdly, A&E is free so you do get coughs and colds etc there but they will make you wait a very long time...
The argument for people on low incomes etc is usually given the "thats why we pay out income support" response.
Its the same with GST (like VAT) on food and other essentials, when it was introduced the benefit rates were increased slightly to take account of the slightly higher cost of food.
sidicks said:
And the evidence for that is...?
The buying up of hospitals by companies like care uk who then rent it back to the nhs and a general feeling. I hope I am wrong but it seems like a systematic attack on the NHS by the media along with those in power allowing failings which will reach a point where the only possible solution is privatisation. Efbe said:
Privitisation is awesome
really not sure why we aren't embracing it more. It gives us free money now with absolutely no problems later down the line.
NHS PFI:
This is the real scandal in the NHS; the vast sums of taxpayers money committed to private businesses with far too few checks and balances and done off balance so it wasn't included in the government spending figures allowing Gordon and Tony to avoid real scrutiny until they were safely out of the way.really not sure why we aren't embracing it more. It gives us free money now with absolutely no problems later down the line.
NHS PFI:
It's clear money needed spending, but they hosed it at the private sector and got such poor VFM in the process.
Cfnteabag said:
sidicks said:
And the evidence for that is...?
The buying up of hospitals by companies like care uk who then rent it back to the nhs and a general feeling. I hope I am wrong but it seems like a systematic attack on the NHS by the media along with those in power allowing failings which will reach a point where the only possible solution is privatisation. https://www.theguardian.com/society/2016/aug/15/cr...
"Department of Health (DH) figures show that the amount of its funding that has gone to “independent sector providers” more than doubled from £4.1bn in 2009-10, Labour’s last year in power, to £8.7bn in 2015-16.
Slow-release privatisation has also seen the percentage of the DH budget finding its way into private hands rising from 4% in 2009-10 to 8% in the last financial year."
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