Discussion
Murph7355 said:
I don't think I know enough detail about him or his predecessors to materially comment.
I wonder how much of the negative view is down to him being at the helm at the worst point to date in NHS history? And from what I read I do wonder how much of the junior doctor fiasco (which I suspect plays a huge part in the negativity) was at his door.
I was never a particular fan of hers years ago, but I do wish people would listen to Anne Widdecombe on the NHS.
My sister's a nurse, along with a reasonable number of close friends and acquaintances. Middle management pissing about seems to be a key theme in their woes. That and the general public - all rights and no responsibilities whatsoever.
I witnessed that first hand when my mum was in for a serious op. Family of the woman in the next berth making a proper pain in the arse of themselves, ignoring the rules, being utterly rude to staff and disturbing everyone else around them in a serious ward. I wouldn't do that job for a million quid a year...at least not without the clout to kick d
heads into touch.
Hunt has been the worst in my career of 20 years, by far. The jd fiasco was squarely down to his desire for a vanity project of a 7 day nhs (without any additional resources) and guess what, the jds were absolutely correct. Patient harm has increased as a result of these changes. I wonder how much of the negative view is down to him being at the helm at the worst point to date in NHS history? And from what I read I do wonder how much of the junior doctor fiasco (which I suspect plays a huge part in the negativity) was at his door.
I was never a particular fan of hers years ago, but I do wish people would listen to Anne Widdecombe on the NHS.
My sister's a nurse, along with a reasonable number of close friends and acquaintances. Middle management pissing about seems to be a key theme in their woes. That and the general public - all rights and no responsibilities whatsoever.
I witnessed that first hand when my mum was in for a serious op. Family of the woman in the next berth making a proper pain in the arse of themselves, ignoring the rules, being utterly rude to staff and disturbing everyone else around them in a serious ward. I wouldn't do that job for a million quid a year...at least not without the clout to kick d
heads into touch.968 said:
Hunt has been the worst in my career of 20 years, by far. The jd fiasco was squarely down to his desire for a vanity project of a 7 day nhs (without any additional resources) and guess what, the jds were absolutely correct. Patient harm has increased as a result of these changes.
It's a close run thing with Andrew Lansley though with his pointless health and social care bill968 said:
Given the lack of resources available (and I don't care how much government spin JagLover likes to regurgitate, the expenditure has not increased at the same rate and effectively is a cut as it is no way keeping up with demand) .
But it has been increasing in real terms and significantly so.It has also remained constant as a share of GDP. Now this may not be enough due to both an ageing population and increased patient numbers due to population growth, but it doesn't change the fact we are allocating the same resources as a share of the economy now as we were in 2010.
So we have a number of different options, or some combination of them
a) increase spending as a share of GDP which will require higher taxes or lower spending elsewhere.
b) find a way of increasing GDP (can be done with better policy choices but is not simply a matter of waving a magic wand)
c) ensure those entering the country are paying sufficiently high taxes that they are covering their "share" of NHS spending
d) eliminate so called "health tourism"
e) reduce what the NHS does
Pretending there are infinite resources that could be allocated to the NHS if it weren't for those "heartless Tories" doesn't help anyone.
Edited by JagLover on Wednesday 13th December 08:30
JagLover said:
But it has been increasing in real terms and significantly so.
It has also remained constant as a share of GDP. Now this may not be enough due to both an ageing population and increased patient numbers due to population growth, but it doesn't change the fact we are allocating the same resources as a share of the economy now as we were in 2010.
So we have a number of different options, or some combination of the two .
a) increase spending as a share of GDP which will require higher taxes or lower spending elsewhere.
b) find a way of increasing GDP (can be done with better policy choices but is not simply a matter of waving a magic wand)
c) ensure those entering the country are paying sufficiently high taxes that they are covering their "share" of NHS spending
d) eliminate so called "health tourism"
e) reduce what the NHS does
Pretending there are infinite resources that could be allocated to the NHS if it weren't for those "heartless Tories" doesn't help anyone.
I don't think that's what 968 is saying generally.It has also remained constant as a share of GDP. Now this may not be enough due to both an ageing population and increased patient numbers due to population growth, but it doesn't change the fact we are allocating the same resources as a share of the economy now as we were in 2010.
So we have a number of different options, or some combination of the two .
a) increase spending as a share of GDP which will require higher taxes or lower spending elsewhere.
b) find a way of increasing GDP (can be done with better policy choices but is not simply a matter of waving a magic wand)
c) ensure those entering the country are paying sufficiently high taxes that they are covering their "share" of NHS spending
d) eliminate so called "health tourism"
e) reduce what the NHS does
Pretending there are infinite resources that could be allocated to the NHS if it weren't for those "heartless Tories" doesn't help anyone.
And with numerical acumen like the bit in bold you should be working on NHS budgets
JagLover said:
But it has been increasing in real terms and significantly so.
It has also remained constant as a share of GDP. Now this may not be enough due to both an ageing population and increased patient numbers due to population growth, but it doesn't change the fact we are allocating the same resources as a share of the economy now as we were in 2010.
So we have a number of different options, or some combination of the two .
a) increase spending as a share of GDP which will require higher taxes or lower spending elsewhere.
b) find a way of increasing GDP (can be done with better policy choices but is not simply a matter of waving a magic wand)
c) ensure those entering the country are paying sufficiently high taxes that they are covering their "share" of NHS spending
d) eliminate so called "health tourism"
e) reduce what the NHS does
Pretending there are infinite resources that could be allocated to the NHS if it weren't for those "heartless Tories" doesn't help anyone.
I don't think that's what 968 is saying generally.It has also remained constant as a share of GDP. Now this may not be enough due to both an ageing population and increased patient numbers due to population growth, but it doesn't change the fact we are allocating the same resources as a share of the economy now as we were in 2010.
So we have a number of different options, or some combination of the two .
a) increase spending as a share of GDP which will require higher taxes or lower spending elsewhere.
b) find a way of increasing GDP (can be done with better policy choices but is not simply a matter of waving a magic wand)
c) ensure those entering the country are paying sufficiently high taxes that they are covering their "share" of NHS spending
d) eliminate so called "health tourism"
e) reduce what the NHS does
Pretending there are infinite resources that could be allocated to the NHS if it weren't for those "heartless Tories" doesn't help anyone.
And with numerical acumen like the bit in bold you should be working on NHS budgets
Crackie said:
200Plus Club said:
Just remember one thing. The govt forced all trusts to compete against each other for many years. All went pretty much their own way. Separate supplier systems, seperateteams of managers, different software. It cost billions. It will cost the same again to unravel. Most trusts do not liaise or communicate with others outside their very local area or if not part of the same group. All broadly have the same management job roles and a lot of people in theory "could" be made redundant by cooperation. It won't happen quickly , you are talking 20yrs min before the regional group working takes any major effect.
Set it off in one direction and stop the govt interfering again in 5 yrs time is all it needs really. Competition and NHS trust status is what started a lot of duplication and waste.
The duplication of roles and lack of inter trust communication might take 20 years to improve; better start straight away then. It would not be expensive to set up a small team to carry out a cost benchmarking exercise between trusts. This benchmarking would look at cost to equivalent services or procure of equivalent materials. Set it off in one direction and stop the govt interfering again in 5 yrs time is all it needs really. Competition and NHS trust status is what started a lot of duplication and waste.
This data may already be available under freedom of information............if it isn't then it should be imho. Lets get it out in the open and scrutinised. If things are being done well everywhere than the critics will have to back off...........if there are improvements to be made then lets start ASAP.
Also Trusts are now having to standardise on products. This is a slow process though but is underway.
https://www.supplychain.nhs.uk/savings/nationally-...
Downward said:
Crackie said:
200Plus Club said:
Just remember one thing. The govt forced all trusts to compete against each other for many years. All went pretty much their own way. Separate supplier systems, seperateteams of managers, different software. It cost billions. It will cost the same again to unravel. Most trusts do not liaise or communicate with others outside their very local area or if not part of the same group. All broadly have the same management job roles and a lot of people in theory "could" be made redundant by cooperation. It won't happen quickly , you are talking 20yrs min before the regional group working takes any major effect.
Set it off in one direction and stop the govt interfering again in 5 yrs time is all it needs really. Competition and NHS trust status is what started a lot of duplication and waste.
The duplication of roles and lack of inter trust communication might take 20 years to improve; better start straight away then. It would not be expensive to set up a small team to carry out a cost benchmarking exercise between trusts. This benchmarking would look at cost to equivalent services or procure of equivalent materials. Set it off in one direction and stop the govt interfering again in 5 yrs time is all it needs really. Competition and NHS trust status is what started a lot of duplication and waste.
This data may already be available under freedom of information............if it isn't then it should be imho. Lets get it out in the open and scrutinised. If things are being done well everywhere than the critics will have to back off...........if there are improvements to be made then lets start ASAP.
Also Trusts are now having to standardise on products. This is a slow process though but is underway.
https://www.supplychain.nhs.uk/savings/nationally-...
It is the same with CSU service, many CCG have not accepted a change in working and now are actively taking it back in house where it will cost more but they have their own team not shared.
It does need a cross party team who are allowed a 10 year window to make changes that will deliver savings in certain areas, but there will always be a growing demand for cash as wages rise and population grows and complexity grows. The NHS needs to evolve what each government does is try to revolutionise it by sound bite and blame of each other.
There is some good work being done, bringing social care and medical together to work on reducing bed blocking for example but it is so slow. Also some of the people who are managers (none medical) are trying to cut beds and staff costs as that is the easiest way to make savings but at the expense of the medical staff and the patients,
Du1point8 said:
how about take a 10% of the current increase the NHS is demanding and get those IT folks in and start working out the BS and Crap and see if this cant rebuilt into one big infrastructure that has nodes off it which act as the regions and then the data sharing can start.
An NHS IT project....what could possibly go wrong! 
98elise said:
Du1point8 said:
how about take a 10% of the current increase the NHS is demanding and get those IT folks in and start working out the BS and Crap and see if this cant rebuilt into one big infrastructure that has nodes off it which act as the regions and then the data sharing can start.
An NHS IT project....what could possibly go wrong! spaximus said:
98elise said:
Du1point8 said:
how about take a 10% of the current increase the NHS is demanding and get those IT folks in and start working out the BS and Crap and see if this cant rebuilt into one big infrastructure that has nodes off it which act as the regions and then the data sharing can start.
An NHS IT project....what could possibly go wrong! That's only the start of the interference that the NHS staff would do, they didnt know their ass from their elbow, but were adament that they knew more than the consultants brought it and would ignore any of the warnings given to them.
Du1point8 said:
spaximus said:
98elise said:
Du1point8 said:
how about take a 10% of the current increase the NHS is demanding and get those IT folks in and start working out the BS and Crap and see if this cant rebuilt into one big infrastructure that has nodes off it which act as the regions and then the data sharing can start.
An NHS IT project....what could possibly go wrong! That's only the start of the interference that the NHS staff would do, they didnt know their ass from their elbow, but were adament that they knew more than the consultants brought it and would ignore any of the warnings given to them.
Then follows the investigation as to who is to blame and we find we have still spent millions but no one is actually to blame.
Yes I am sure there was political interference but the end result is we did not get what we paid for and various NHS departments are not all on the same IT systems and still no one got blamed and money still got spent.
Unless things change any big IT project will be destined for the same problems.
I was there during the last NHS IT disaster - my particular bit was wildly successful (nothing to do with me, it was successful for pretty much everyone), but the rest of it was a shocker. I can’t give details, but it was very amusing reading pretty much all of the IT press at the time and wondering why my recollection of the meetings was totally different.
Three things were fundamentally flawed with the programme from a technical point of view.
Firstly, they tried to implement secondary care systems without sorting primary care, and thus a common patient identifier. It seems bloody obvious that you roll out primary care first, get all the GPs using a common system and the use the data coming from that to feed secondary care. Last time I looked (about 5 years ago) this was starting to happen organically....
Secondly, most of the software didn’t exist. The analogy I’d use is trying to fly across the Atlantic when your plane consisted of a load of sheet metal and the drawings for some engines. Only the engines actually fitted on the space shuttle. You could fool some of the people for a while by loading it all into a lorry and driving to the coast (look, status is green, we’ve left the airport), but anyone with half a clue could see that the lorry was going to sink. There was an option to build a boat, but everyone ignored that.
Finally, they didn’t sort the trust structure and data ownership. Right up front they needed to say “This is the NHS, you give us your data, we can use it, if you don’t like it, sod off elsewhere”. But no, they didn’t do that, so there were all sort of special interest groups literally costing billions implementing crazy rules.
Health tourism - the doctors hate the idea of anything other than an international service, which will treat any punter who arrives. My GP mate suggests that about 15% of her workload is people with absolutely no right to treatment - to be fair, she’s not that far from Heathrow which probably makes it worse. The usual story is bloke poles up with his mum who “is visiting the U.K. for a long holiday”. Mum doesn’t speak English, may or may not be related to the bloke. Mum has a cough, can she have something for it? Mum actually has lung cancer, knows perfectly well she has lung cancer, is not surprised at the diagnosis, and is very greatful for stloads of treatment, after which she vanishes. Bloke suggests that mum has died/vanished so of course can’t pay.
Three things were fundamentally flawed with the programme from a technical point of view.
Firstly, they tried to implement secondary care systems without sorting primary care, and thus a common patient identifier. It seems bloody obvious that you roll out primary care first, get all the GPs using a common system and the use the data coming from that to feed secondary care. Last time I looked (about 5 years ago) this was starting to happen organically....
Secondly, most of the software didn’t exist. The analogy I’d use is trying to fly across the Atlantic when your plane consisted of a load of sheet metal and the drawings for some engines. Only the engines actually fitted on the space shuttle. You could fool some of the people for a while by loading it all into a lorry and driving to the coast (look, status is green, we’ve left the airport), but anyone with half a clue could see that the lorry was going to sink. There was an option to build a boat, but everyone ignored that.
Finally, they didn’t sort the trust structure and data ownership. Right up front they needed to say “This is the NHS, you give us your data, we can use it, if you don’t like it, sod off elsewhere”. But no, they didn’t do that, so there were all sort of special interest groups literally costing billions implementing crazy rules.
Health tourism - the doctors hate the idea of anything other than an international service, which will treat any punter who arrives. My GP mate suggests that about 15% of her workload is people with absolutely no right to treatment - to be fair, she’s not that far from Heathrow which probably makes it worse. The usual story is bloke poles up with his mum who “is visiting the U.K. for a long holiday”. Mum doesn’t speak English, may or may not be related to the bloke. Mum has a cough, can she have something for it? Mum actually has lung cancer, knows perfectly well she has lung cancer, is not surprised at the diagnosis, and is very greatful for s
tloads of treatment, after which she vanishes. Bloke suggests that mum has died/vanished so of course can’t pay. Another winter, another NHS crisis.
"A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
"A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
BlackLabel said:
Another winter, another NHS crisis.
"A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
I wonder if the people who are so ready to reach for "third world" comparisons have ever been to the third world?"A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
TooMany2cvs said:
BlackLabel said:
Another winter, another NHS crisis.
"A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
I wonder if the people who are so ready to reach for "third world" comparisons have ever been to the third world?"A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
ks.It might be stressed or underfunded, but we don't have a "third world" anything in this country.
I have spent most of the Christmas and New Year in and out of Southmead and yes the terminology is wrong but the situation he describes is real. My 91 year old Father in Law was rushed in on Christmas eve and was admitted as a result, he was lucky to get a bed eventually.
At Southmead at one point there was 37 people on trolley's in A&E with 16 ambulances waiting to unload and get out to bring others back. There was at least a 6 hour wait and here they can send people to out of hours GP services so these weren't all sniffles.
Up in AMU once again there were people who needed admitting as they were ill but there was no where to put them, this was happening all over.
in the paediatric A&E there was also no beds.
The Bristol Royal Infirmary has put an appeal out to stop people coming today as 50 people are waiting to be seen.
If it was your parent, wife or child would you be so flippant as to the situation that is happening. Staff in all the areas were working flat out, eating at their stations whilst filling in paperwork. Third world it is not, third rate or worse it is and unacceptable in any civilised world.
We can bang on about waste and yes there is lots but what I have witnessed, as have others, shames us all and it is not the medics or those trying to keep people alive at fault
At Southmead at one point there was 37 people on trolley's in A&E with 16 ambulances waiting to unload and get out to bring others back. There was at least a 6 hour wait and here they can send people to out of hours GP services so these weren't all sniffles.
Up in AMU once again there were people who needed admitting as they were ill but there was no where to put them, this was happening all over.
in the paediatric A&E there was also no beds.
The Bristol Royal Infirmary has put an appeal out to stop people coming today as 50 people are waiting to be seen.
If it was your parent, wife or child would you be so flippant as to the situation that is happening. Staff in all the areas were working flat out, eating at their stations whilst filling in paperwork. Third world it is not, third rate or worse it is and unacceptable in any civilised world.
We can bang on about waste and yes there is lots but what I have witnessed, as have others, shames us all and it is not the medics or those trying to keep people alive at fault
spaximus said:
I have spent most of the Christmas and New Year in and out of Southmead and yes the terminology is wrong but the situation he describes is real. My 91 year old Father in Law was rushed in on Christmas eve and was admitted as a result, he was lucky to get a bed eventually.
If it was your parent, wife or child would you be so flippant as to the situation that is happening. Staff in all the areas were working flat out, eating at their stations whilst filling in paperwork. Third world it is not, third rate or worse it is and unacceptable in any civilised world.
We can bang on about waste and yes there is lots but what I have witnessed, as have others, shames us all and it is not the medics or those trying to keep people alive at fault
I agree that it shames us all but the suggested remedies are mainly wrong imo and given publicity by tame media (BBC etc) citing 'cutbacks' & 'austerity'.If it was your parent, wife or child would you be so flippant as to the situation that is happening. Staff in all the areas were working flat out, eating at their stations whilst filling in paperwork. Third world it is not, third rate or worse it is and unacceptable in any civilised world.
We can bang on about waste and yes there is lots but what I have witnessed, as have others, shames us all and it is not the medics or those trying to keep people alive at fault
The blame lies with senior NHS director level employees.
This level of demand is easy to predict and is in reality only a small percentage uplift on the average demand. It should be correctly costed within the annual plan.
The appropriate budget to staff accordingly and have sufficient beds available to prevent a bottleneck in A&E at this time of year should be in place.
Failure to plan correctly for a level of demand that happens every year is not the fault of the politicians.
We should be asking why management cannot put in place the appropriate structures to flex the capacity to meet the demand.
There should be a wider debate for things like 'drunk tanks' to help reduce the demand and that should include the politicians as that then involves the public on how the NHS should allocate resources.
But the 'day to day management' of the massive organisation should be professional enough to cope with the seasonality of the operation and sadly it isn't.
That is where the outrage should be directed.
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