J Hunt and S Hawking - how do we know...
Discussion
Derek Smith said:
If posters wish to be taken seriously then they really need to stick to the facts and not make nonsensical generalisations.
Derek Smith said:
I think you will find that the original purpose of the NHS was to make health care available free at the point of service. No mention was made of limiting it to broken legs. It removed health care from the remit of councils and ensured national control. Before the war there was a plethora of different businesses providing health care to those who could pay, meaning that illnesses in one area which were treated would kill you in others. Hospitals to an extent depended on the largess of doctors to provide basic care. Certainly a considerable number of experienced doctors would work for a pittance, although many followed the dollar.
The idea that it was set up for A&E and TB is nonsensical. For instance, TB already had its own treatment centres, although again, varying over the country. Many of these were set up at the turn of the century, albeit for reasons of isolation as much as treatment. The NHS therefore had little to do with TB other than to take over these centres. In some areas this was a slow process.
New treatments and better general health care reduced the number of those afflicted and a general rise in the standard of living helped as well. In poorer areas of London immediately post war, there were many families with one or more members suffering from TB.
There was never, ever, any limitations placed on delivery. If you had a serious ailment, nurses did not check a list to see if your particular problem was on it. The emergency side of it hardly changed and there was a fairly efficient form of A&E before the war. Whilst payment was required, it was rarely enforced. Many people were unemployed and had no money.
The death rate for births was over 1% before the war. Much of this was down to amateur midwives, women in the community who were called on to help. They were not allowed to charge unless qualified. If something went badly wrong then hospital was an option, but normally too late. This was the reality for the poor.
Infant mortality was one of the main targets of the NHS and how rapid the drop was showed how effective the NHS was.
Other countries manage to provide effective and efficient health care. If we can’t keep up then rather than the cop out option of fanciful cuts across the board, we should look to these other countries to discover what they do differently
They have a very different approach to that of the NHS, that's for sure!The idea that it was set up for A&E and TB is nonsensical. For instance, TB already had its own treatment centres, although again, varying over the country. Many of these were set up at the turn of the century, albeit for reasons of isolation as much as treatment. The NHS therefore had little to do with TB other than to take over these centres. In some areas this was a slow process.
New treatments and better general health care reduced the number of those afflicted and a general rise in the standard of living helped as well. In poorer areas of London immediately post war, there were many families with one or more members suffering from TB.
There was never, ever, any limitations placed on delivery. If you had a serious ailment, nurses did not check a list to see if your particular problem was on it. The emergency side of it hardly changed and there was a fairly efficient form of A&E before the war. Whilst payment was required, it was rarely enforced. Many people were unemployed and had no money.
The death rate for births was over 1% before the war. Much of this was down to amateur midwives, women in the community who were called on to help. They were not allowed to charge unless qualified. If something went badly wrong then hospital was an option, but normally too late. This was the reality for the poor.
Infant mortality was one of the main targets of the NHS and how rapid the drop was showed how effective the NHS was.
Other countries manage to provide effective and efficient health care. If we can’t keep up then rather than the cop out option of fanciful cuts across the board, we should look to these other countries to discover what they do differently
Derek Smith said:
It would appear that in the majority of these, national health care is supported by all parties.
And yet none of them have a health service that resembles our NHS.Derek Smith said:
I wonder if that’s a better idea than removing treatment from those seriously ill.
Who has proposed removing treatment from the seriously ill?Derek Smith said:
I don’t know the answer to the funding of the NHS. To that extent I’m just like those posters on here who come up with fanciful ideas of stopping treatment of people unlike them.
More misleading nonsense - who suggested that?Derek Smith said:
However, I do know what would be a massive step in the right direction: take control away from politicians who regard it as an opportunity to push their mantra.
Whilst the NHS had a lot to do with the overall health of the nation, more or less full employment and a significant rise in the standard of living had a much greater effect.
The history of health care in the UK in the 20th century cannot be described by a simple soundbite. There have been books written on the subject that did not cover every aspect. Glib phrases such as the NHS being set up to cure broken legs and illnesses already being treated should indicate how much credence one should place on posts.
Neither should one place much credence on posts which take 12 paragraphs where 4 sentences would provide the same amount of useful information.Whilst the NHS had a lot to do with the overall health of the nation, more or less full employment and a significant rise in the standard of living had a much greater effect.
The history of health care in the UK in the 20th century cannot be described by a simple soundbite. There have been books written on the subject that did not cover every aspect. Glib phrases such as the NHS being set up to cure broken legs and illnesses already being treated should indicate how much credence one should place on posts.
Murph7355 said:
I suspect we are all in violent agreement that depoliticising the NHS is required. Sidicks included.
I suspect we also all agree that charging for some services is needed. ie "free for all at point of service" is outmoded and a millstone.
I'm far from convinced these two items alone are enough, but as you note, they'd be a start. However getting/keeping the momentum going is, I would think, going to need some services to be stopped altogether. And other structural changes (including remuneration structures).
It would also have to be decided what the budget is. That cannot be set by the "CEO" alone. It must be set against other government funding.
What services would you consider should be charged for?I suspect we also all agree that charging for some services is needed. ie "free for all at point of service" is outmoded and a millstone.
I'm far from convinced these two items alone are enough, but as you note, they'd be a start. However getting/keeping the momentum going is, I would think, going to need some services to be stopped altogether. And other structural changes (including remuneration structures).
It would also have to be decided what the budget is. That cannot be set by the "CEO" alone. It must be set against other government funding.
This charge you mention, how would it be apportioned? For instance, what about the disabled who find it difficult to get and retain employment? They would have little uncommitted income. This smacks of targeting the sick and the poor so would you suggest that these are exempted?
We already pay certain health care costs at the point of delivery. Only last month I paid over £50. There is also the charge for prescriptions. Should someone who is on chemo pay for all the pills they must take over a long period or should they have to work out whether it might be all worth it?
There is already rationing in the NHS. I pay for regular medical treatment. I could get it under the NHS but instead of it being weekly, as required, it would be limited to monthly so pointless.
There is, unfortunately, no simple solution.
Derek Smith said:
What services would you consider should be charged for?
This charge you mention, how would it be apportioned? For instance, what about the disabled who find it difficult to get and retain employment? They would have little uncommitted income. This smacks of targeting the sick and the poor so would you suggest that these are exempted?
Why don't you ask 968, he posed the same solution.This charge you mention, how would it be apportioned? For instance, what about the disabled who find it difficult to get and retain employment? They would have little uncommitted income. This smacks of targeting the sick and the poor so would you suggest that these are exempted?
Derek Smith said:
We already pay certain health care costs at the point of delivery. Only last month I paid over £50. There is also the charge for prescriptions. Should someone who is on chemo pay for all the pills they must take over a long period or should they have to work out whether it might be all worth it?
There is already rationing in the NHS. I pay for regular medical treatment. I could get it under the NHS but instead of it being weekly, as required, it would be limited to monthly so pointless.
There is, unfortunately, no simple solution.
Exactly, so extending this would not be unreasonable.There is already rationing in the NHS. I pay for regular medical treatment. I could get it under the NHS but instead of it being weekly, as required, it would be limited to monthly so pointless.
There is, unfortunately, no simple solution.
sidicks said:
Derek Smith said:
If posters wish to be taken seriously then they really need to stick to the facts and not make nonsensical generalisations.
Derek Smith said:
Other countries manage to provide effective and efficient health care. If we can’t keep up then rather than the cop out option of fanciful cuts across the board, we should look to these other countries to discover what they do differently
They have a very different approach to that of the NHS, that's for sure!Derek Smith said:
It would appear that in the majority of these, national health care is supported by all parties.
And yet none of them have a health service that resembles our NHS.Derek Smith said:
I wonder if that’s a better idea than removing treatment from those seriously ill.
Who has proposed removing treatment from the seriously ill?Derek Smith said:
I don’t know the answer to the funding of the NHS. To that extent I’m just like those posters on here who come up with fanciful ideas of stopping treatment of people unlike them.
More misleading nonsense - who suggested that?Derek Smith said:
To take the rest of your points in turn, I’m shocked to see that you think sticking to facts is laughable. Actually, I’m not. Again, no argument, just an emoji.
You suggest that other countries have different set ups to their health services. A prize for stating the obvious. You do realise that this was implicit in my post, don’t you. Or rather, you don’t. Again, it adds nothing to the argument.
You ask who suggested removing treatment from the seriously ill. Tthe suggestion I was responding to suggested that the NHS should return to basics and respond to broken legs and TB.
You suggest that someone who takes time to support his point of view should be ignored. Yes, well that comes as no surprise.
You criticise and complain but put forward no alternatives. You produce no arguments, just gainsay what others have posted. You quote and do not respond to the points raised.
sidicks said:
Derek Smith said:
...Other countries manage to provide effective and efficient health care. If we can’t keep up then rather than the cop out option of fanciful cuts across the board, we should look to these other countries to discover what they do differently
They have a very different approach to that of the NHS, that's for sure!What do which countries do that the NHS doesn't, and how would the NHS improve by adopting those ways of working?
Derek Smith said:
Re: your last paragraph, I think you are hoisted there, old chum.
It is unfortunate that the world is becoming Twitter based. None of your posts on this thread have produced anything other than criticisms of the posts of others. I could put your suggestions in a post of zero words.
Demonstrably not true - I can only assume you jumped in to target me, having not read much of the rest of the thread. Or at least not understood it.It is unfortunate that the world is becoming Twitter based. None of your posts on this thread have produced anything other than criticisms of the posts of others. I could put your suggestions in a post of zero words.
Derek Smith said:
To take the rest of your points in turn, I’m shocked to see that you think sticking to facts is laughable. Actually, I’m not. Again, no argument, just an emoji.
You must have missed the facts that I quoted that were repeatedly denied by 968 (who seem to be siding with - purely a convenient oversight from your perspective, I'm sure.Derek Smith said:
You suggest that other countries have different set ups to their health services. A prize for stating the obvious. You do realise that this was implicit in my post, don’t you. Or rather, you don’t. Again, it adds nothing to the argument.
You do realise that the approach used by other countries is fundamentally different to how the NHS works - many would argue the exact opposite of what people support with the current NHS..? Or maybe not.Derek Smith said:
You ask who suggested removing treatment from the seriously ill. Tthe suggestion I was responding to suggested that the NHS should return to basics and respond to broken legs and TB.
You suggest that someone who takes time to support his point of view should be ignored. Yes, well that comes as no surprise.
No, I really said no such thing!You suggest that someone who takes time to support his point of view should be ignored. Yes, well that comes as no surprise.
Derek Smith said:
You criticise and complain but put forward no alternatives. You produce no arguments, just gainsay what others have posted. You quote and do not respond to the points raised.
As above if you can't understand what I've written then that's your limitation, not mine. Others have understood the point being made. Some agree with it.3 more posts from Sidicks where he criticises the minutiae of others and fails to contribute anything.
Name something you would do.
An example of something I would take out of NHS provision. http://www.bbc.co.uk/news/health-40410459
Name something you would do.
An example of something I would take out of NHS provision. http://www.bbc.co.uk/news/health-40410459
Derek, you and several others display remarkable resilience in dealing with sickdick, I keep away from most of his rantings as I think he deliberately sets out to create dissent. Something I think he enjoys, or maybe he gets paid for his posts. That might at least explain the never ending hamster wheel of disagreements he manufactures. Whatever it is, one thing I'm sure of, he could start a fight in *Mount Saint Bernard Abbey.
- Home of a silent monastic order
Dixy said:
An example of something I would take out of NHS provision. http://www.bbc.co.uk/news/health-40410459
The article said:
NHS England said it did not carry out the operation for cosmetic reasons, only for clinical conditions.
For the past few years clinical commissioning groups have been able to refer only patients who are experiencing physical pain or emotional distress. [/quote[
For the past few years clinical commissioning groups have been able to refer only patients who are experiencing physical pain or emotional distress. [/quote[
Dixy said:
3 more posts from Sidicks where he criticises the minutiae of others and fails to contribute anything.
Name something you would do.
An example of something I would take out of NHS provision. http://www.bbc.co.uk/news/health-40410459
Do you now agree with me - not everything the NHS does is essential and money can be saved by not doing those things in the future.Name something you would do.
An example of something I would take out of NHS provision. http://www.bbc.co.uk/news/health-40410459
Great, thanks.
TooMany2cvs said:
In what way?
[/quore]
Which other (comparable) countries have a health system that is free in the same way our is?
[/quore]
Which other (comparable) countries have a health system that is free in the same way our is?
TooMany2cvs said:
What do which countries do that the NHS doesn't, and how would the NHS improve by adopting those ways of working?
Ask Derek, it was his idea. And apparently I'm not allowed to comment on other people's ideas (however flawed they are).sidicks said:
TooMany2cvs said:
In what way?
Which other (comparable) countries have a health system that is free in the same way our is?TooMany2cvs said:
What do which countries do that the NHS doesn't, and how would the NHS improve by adopting those ways of working?
Ask Derek, it was his idea.So - do go on. Feel free to expand on your one-liner...
Actually he gets abusive if you start ridiculing him....and then very emotionally overwrought when his abuse gets ridiculed too.
Quite the psychological study is our Sid.....
But you can send him back to the Finance forum if he's getting too annoying..
Quite the psychological study is our Sid.....
But you can send him back to the Finance forum if he's getting too annoying..
Edited by drainbrain on Wednesday 30th August 17:42
Dixy said:
I do agree with that but not you as you fail to be specific about anything but condemn anyone who holds a differing view.
Condemn? Once again you use an interesting word that fails to be appropriate in the scenario given.I simply pointed out that a high level analysis would suggest the amount that would be raised from your proposal would be relatively small in the scheme of things, would potentially unfairly target those getting ill and hence would do very little to address the NHS being "in crisis".
(Unless you think the crisis is one that can be resolved with hundreds of millions rather than tens of billions?
Derek Smith said:
What services would you consider should be charged for?...
None Derek. None at all. We should keep providing everything to everyone until the money runs out. It won't bother me as governments aplenty have proved they can kick the can down the road far enough that I'll be dead when it comes home to roost properly, and I'll make sure my progeny have the wherewithal to look after their own health as they will need to if we carry on this way
Now, assuming we cannot continue offering everything to everyone, I'll start with IVF and gastric bands. No one gets it.
I could create a list pages long and I guarantee that every self interest group known to man will come out and defend why each should stay as if their lives depended on it
(I give it half a dozen posts before the above two aren't challenged). So do you believe there are no services whatsoever that could/should be cut? Or are you actually in favour of continuing to do nothing but build on the now known false premises of the original deign? As you noted everyone has done since the NHS' inception...
This isn't about "targeting the sick/poor". A crass statement of the sort that often gets used when people want to stick their heads in the sand and to try and kill an argument. This is about targeting a system that is not sustainable such that those very sick/poor people you mention aren't left with nothing at all when it implodes.
Derek Smith said:
If posters wish to be taken seriously then they really need to stick to the facts and not make nonsensical generalisations.
If you read back through the posts you'll see that a poster that I chose not to identify uses your & you're the wrong way round. That's not a generalisation, that's a rather specific point. It makes plenty of sense.Derek Smith said:
I think you will find that the original purpose of the NHS was to make health care available free at the point of service. No mention was made of limiting it to broken legs.
I didn't say that was the case- I said that it was to a more limited remit than its current scope. Please do not attempt to ascribe to me that which I did not say.Derek Smith said:
I don’t know the answer to the funding of the NHS.
Yet you agree that it cannot continue in its current form, much less expand its scope?Derek Smith said:
Murph7355 said:
I suspect we are all in violent agreement that depoliticising the NHS is required. Sidicks included.
I suspect we also all agree that charging for some services is needed. ie "free for all at point of service" is outmoded and a millstone.
I'm far from convinced these two items alone are enough, but as you note, they'd be a start. However getting/keeping the momentum going is, I would think, going to need some services to be stopped altogether. And other structural changes (including remuneration structures).
It would also have to be decided what the budget is. That cannot be set by the "CEO" alone. It must be set against other government funding.
What services would you consider should be charged for?I suspect we also all agree that charging for some services is needed. ie "free for all at point of service" is outmoded and a millstone.
I'm far from convinced these two items alone are enough, but as you note, they'd be a start. However getting/keeping the momentum going is, I would think, going to need some services to be stopped altogether. And other structural changes (including remuneration structures).
It would also have to be decided what the budget is. That cannot be set by the "CEO" alone. It must be set against other government funding.
This charge you mention, how would it be apportioned? For instance, what about the disabled who find it difficult to get and retain employment? They would have little uncommitted income. This smacks of targeting the sick and the poor so would you suggest that these are exempted?
We already pay certain health care costs at the point of delivery. Only last month I paid over £50. There is also the charge for prescriptions. Should someone who is on chemo pay for all the pills they must take over a long period or should they have to work out whether it might be all worth it?
There is already rationing in the NHS. I pay for regular medical treatment. I could get it under the NHS but instead of it being weekly, as required, it would be limited to monthly so pointless.
There is, unfortunately, no simple solution.
It's a complicated conundrum. The budget is and should not be set by the CEO, but by a cross party committee and the CEO should be accountable to that committee for the budget. The institution of charges has happened already by stealth with the NHS now refusing to fund LPPs or low priority procedures, which previously were carried out with funding. Rationing has occurred for instance with cataract surgery, and our CCG has imposed this very unpopular ration on my patients which penalises the elderly and poor mostly. So it's not a foreign concept. Means tested copayment occurs in Europe, notably France where they have a better system (arguably) than we do. There is greater encouragement for private health insurance and tax breaks accordingly but also insurance companies cannot do the American way and not insure to the same extent.
The starting point is getting rid of the health secretary and the toxic influence of party politics.
With regard to remuneration, much discussed here and as stated previously, we are blamed as the employees by some. However, what is not factored in, is that we are in fact very underpaid for what we do. My job plan is for 12 PAs or programmed activities, which counts for a half day and paid at approximately £140 a half day. That's a laughably small amount for a professional. However, the main issue is that my job actually requires me to do about 16PA equivalent of work, and I'm not paid for any of that additional work, just expected to do it. So if I worked to rule, and all consultants did, the entire service would collapse overnight. The new contract that is forthcoming will be even more punitive, and you'll see many more consultants not taking up posts, becoming long term locums for agencies or leaving the UK.
968 said:
Hi Murph and Derek,
It's a complicated conundrum. The budget is and should not be set by the CEO, but by a cross party committee and the CEO should be accountable to that committee for the budget. The institution of charges has happened already by stealth with the NHS now refusing to fund LPPs or low priority procedures, which previously were carried out with funding. Rationing has occurred for instance with cataract surgery, and our CCG has imposed this very unpopular ration on my patients which penalises the elderly and poor mostly. So it's not a foreign concept. Means tested copayment occurs in Europe, notably France where they have a better system (arguably) than we do. There is greater encouragement for private health insurance and tax breaks accordingly but also insurance companies cannot do the American way and not insure to the same extent.
The starting point is getting rid of the health secretary and the toxic influence of party politics.
With regard to remuneration, much discussed here and as stated previously, we are blamed as the employees by some. However, what is not factored in, is that we are in fact very underpaid for what we do. My job plan is for 12 PAs or programmed activities, which counts for a half day and paid at approximately £140 a half day. That's a laughably small amount for a professional. However, the main issue is that my job actually requires me to do about 16PA equivalent of work, and I'm not paid for any of that additional work, just expected to do it. So if I worked to rule, and all consultants did, the entire service would collapse overnight. The new contract that is forthcoming will be even more punitive, and you'll see many more consultants not taking up posts, becoming long term locums for agencies or leaving the UK.
Is this repeating the nonsense from previously? Unless proved otherwise, no one is blaming the staff for improvements in longevity. HTH.It's a complicated conundrum. The budget is and should not be set by the CEO, but by a cross party committee and the CEO should be accountable to that committee for the budget. The institution of charges has happened already by stealth with the NHS now refusing to fund LPPs or low priority procedures, which previously were carried out with funding. Rationing has occurred for instance with cataract surgery, and our CCG has imposed this very unpopular ration on my patients which penalises the elderly and poor mostly. So it's not a foreign concept. Means tested copayment occurs in Europe, notably France where they have a better system (arguably) than we do. There is greater encouragement for private health insurance and tax breaks accordingly but also insurance companies cannot do the American way and not insure to the same extent.
The starting point is getting rid of the health secretary and the toxic influence of party politics.
With regard to remuneration, much discussed here and as stated previously, we are blamed as the employees by some. However, what is not factored in, is that we are in fact very underpaid for what we do. My job plan is for 12 PAs or programmed activities, which counts for a half day and paid at approximately £140 a half day. That's a laughably small amount for a professional. However, the main issue is that my job actually requires me to do about 16PA equivalent of work, and I'm not paid for any of that additional work, just expected to do it. So if I worked to rule, and all consultants did, the entire service would collapse overnight. The new contract that is forthcoming will be even more punitive, and you'll see many more consultants not taking up posts, becoming long term locums for agencies or leaving the UK.
I guess it's much easier to misdirect, rather than to justify why the employees deserve a benefit now worth 2-3 times its original intended cost?
Edited by sidicks on Wednesday 30th August 21:35
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