Discussion
Mothersruin said:
Why do the staff in English NHS places scream about disaster but they're almost completely silent about the Welsh NHS.
Could there be a political agenda?
No, because in Wales the staff complain about the NHS there. It happens that most of us live in England so comment on NHS England. Could there be a political agenda?
The only political agenda is driven by the politicians who like to use the NHS as a political football to try and win votes. This is why depoliticising the NHS is the way forward and making the SoS a non-party affiliated position or better still a cross party select group that holds the CEO of the NHS accountable. This would enable mid/long term planning and enable the actual priorities to be tackled rather than the absurd, unevidence based fads of the SoS of the day.
The Dangerous Elk said:
More tinfoil and reading needed, try absorbing the words "last working in the NHS", you lot do like AVOIDING the questions don't you.
Am I surprised, not really, am I surprised the NHS never changes, not really (one reason I left it behind as an employer).
Are you going to propose any changes that do not have the mythical money anus s
tting cash over your wondrous solutions ?
Suggestion for you:
Public sector organisations such as the NHS are severely under-reporting absence.
(Data collected by normal absence recording tools in the NHS).
According to the CBI/Pfizer survey, the cost per absent employee in the NHS is, on average, 46% more than in the private sector.
If you were able to read you might've noticed that I have proposed a radical solution to the NHS problems.Am I surprised, not really, am I surprised the NHS never changes, not really (one reason I left it behind as an employer).
Are you going to propose any changes that do not have the mythical money anus s
tting cash over your wondrous solutions ?Suggestion for you:
Public sector organisations such as the NHS are severely under-reporting absence.
(Data collected by normal absence recording tools in the NHS).
According to the CBI/Pfizer survey, the cost per absent employee in the NHS is, on average, 46% more than in the private sector.
Edited by The Dangerous Elk on Thursday 11th January 09:07
I'm glad we've established you're pretending you were once a dentist.
Am I somehow responsible for the NHS under-reporting absence?
1. A snide little comment, again I will let that pass without reply
2. I never claimed anything, you assumed, misread, accused, invented and insulted. I take it the accusations of made up posts, qualifications etc have checked out then, I expect no apology from you however.
3. No, you are not wholly responsible. You are (by constantly avoiding ANY criticism) a big part of the resistance to improving it however, at least that is how it comes across here.
It is sadly a wholly typical attitude within the NHS and in my experience draws scorn from those that have left. (Not a criticism of the "care" of staff" I note)
Most of my present colleagues are ex NHS (what Uk healthcare professionals are not) and to a Woman and a Man, they see the reasons for the failures and particularly the present "crisis". They mostly accept the political barriers have not been beneficial but also know very well the problems that are constantly enhanced by the "system", the self-interest of senior staff, the waste and the dreadfully archaic management methods & skills to name a few.
Most of us work in one way or other on a pan-European basis and often frequent non-Uk hospitals, we see the fundamental differences between the systems plus the resulting "value" of their healthcare by the European public for their systems. As noted by another poster DNA rates are unpunished and "just accepted" along with their multiplying costs, unacceptable absence rates and its vast under-reporting is simply just one other of many.
Senior management is diabolical, it constantly covers itself by playing the "disaster card" and perpetually under-plans for predictable loads year after year. The absence rates are just one small example of the appalling way the health service is run on a day to day basis and I used that in an attempt to get at least one solution from you.
If patients are suffering today under the present short-term "winter crisis" situation, it is Management and Senior Staff who are to blame and it is they who should carry the can with some being sanctioned legally for their failings and patient suffering.
Long term, things need to change and that will only happen without the constant cries of no-change/more money from within.
I feel I have made all the points I wish and this conversation is up against barriers between us that are insurmountable, as such I will leave it here.
Thank you for the conversation even if we are at polar positions.
2. I never claimed anything, you assumed, misread, accused, invented and insulted. I take it the accusations of made up posts, qualifications etc have checked out then, I expect no apology from you however.
3. No, you are not wholly responsible. You are (by constantly avoiding ANY criticism) a big part of the resistance to improving it however, at least that is how it comes across here.
It is sadly a wholly typical attitude within the NHS and in my experience draws scorn from those that have left. (Not a criticism of the "care" of staff" I note)
Most of my present colleagues are ex NHS (what Uk healthcare professionals are not) and to a Woman and a Man, they see the reasons for the failures and particularly the present "crisis". They mostly accept the political barriers have not been beneficial but also know very well the problems that are constantly enhanced by the "system", the self-interest of senior staff, the waste and the dreadfully archaic management methods & skills to name a few.
Most of us work in one way or other on a pan-European basis and often frequent non-Uk hospitals, we see the fundamental differences between the systems plus the resulting "value" of their healthcare by the European public for their systems. As noted by another poster DNA rates are unpunished and "just accepted" along with their multiplying costs, unacceptable absence rates and its vast under-reporting is simply just one other of many.
Senior management is diabolical, it constantly covers itself by playing the "disaster card" and perpetually under-plans for predictable loads year after year. The absence rates are just one small example of the appalling way the health service is run on a day to day basis and I used that in an attempt to get at least one solution from you.
If patients are suffering today under the present short-term "winter crisis" situation, it is Management and Senior Staff who are to blame and it is they who should carry the can with some being sanctioned legally for their failings and patient suffering.
Long term, things need to change and that will only happen without the constant cries of no-change/more money from within.
I feel I have made all the points I wish and this conversation is up against barriers between us that are insurmountable, as such I will leave it here.
Thank you for the conversation even if we are at polar positions.
Edited by The Dangerous Elk on Thursday 11th January 23:21
The Dangerous Elk said:
If patients are suffering today under the present short-term "winter crisis" situation, it is Management and Senior Staff who are to blame and it is they who should carry the can with some being sanctioned legally for their failings and patient suffering.
Spot on. In my experience, senior managers within the NHS are teflon coated - nothing sticks, and there is almost zero proper governance.What tends to happen is that the higher levels of management promote internally using staff who have no previous management experience to fill the lower level management posts, for example ward management. This effectively gives them more control because lower level managers don't have the experience or confidence to challenge decisions and policies. They dare not bring in experienced managers from 'outside' who will challenge some of the methods. At one hospital I know, staff nurses are promoted to ward management positions and they have zero knowledge of how to do the job effectively - They're nurses not managers. This is almost certainly the case elsewhere.
The increase in 'CYA' (cover your arse) tactics from senior management also means that the burden of paperwork that gets pushed down the chain of command right to ward level is unmanageable.
Until somebody steps in and sorts out some of these trusts from the top down, and has to guts to be totally ruthless, nothing is going to change. it's a cosy life for far too many overpaid and under skilled people in the NHS, and in time it will kill it.
As per the above two posts. Unfortunately I think we are probably past the point where the situation can be recovered.
The behemoth that is the NHS is effectively too big to be managed under the current structure and political direction.
Ironically it needs to have a bigger remit - to include Social Care as the interface between the two services is actually creating problems, costs and inefficiencies.
If there was a separate tax element that everyone paid (not necessarily an addition to current total) and was obvious on your payslip or tax return then 'we' might actually seem some change. Politicians, medical professionals and the public might arrive at a consensus on what 'we' are willing to pay.
When 'we' see the cost in our payslip each month then 'we' might not place such undue pressure on A&E etc.
Medical professionals might learn to work within the money that 'we' are willing to spend on the service.
The behemoth that is the NHS is effectively too big to be managed under the current structure and political direction.
Ironically it needs to have a bigger remit - to include Social Care as the interface between the two services is actually creating problems, costs and inefficiencies.
If there was a separate tax element that everyone paid (not necessarily an addition to current total) and was obvious on your payslip or tax return then 'we' might actually seem some change. Politicians, medical professionals and the public might arrive at a consensus on what 'we' are willing to pay.
When 'we' see the cost in our payslip each month then 'we' might not place such undue pressure on A&E etc.
Medical professionals might learn to work within the money that 'we' are willing to spend on the service.
langtounlad said:
As per the above two posts. Unfortunately I think we are probably past the point where the situation can be recovered.
The behemoth that is the NHS is effectively too big to be managed under the current structure and political direction.
Ironically it needs to have a bigger remit - to include Social Care as the interface between the two services is actually creating problems, costs and inefficiencies.
If there was a separate tax element that everyone paid (not necessarily an addition to current total) and was obvious on your payslip or tax return then 'we' might actually seem some change. Politicians, medical professionals and the public might arrive at a consensus on what 'we' are willing to pay.
When 'we' see the cost in our payslip each month then 'we' might not place such undue pressure on A&E etc.
Medical professionals might learn to work within the money that 'we' are willing to spend on the service.
Is there any other system, anywhere in the world, that you'd like to see replicated here?The behemoth that is the NHS is effectively too big to be managed under the current structure and political direction.
Ironically it needs to have a bigger remit - to include Social Care as the interface between the two services is actually creating problems, costs and inefficiencies.
If there was a separate tax element that everyone paid (not necessarily an addition to current total) and was obvious on your payslip or tax return then 'we' might actually seem some change. Politicians, medical professionals and the public might arrive at a consensus on what 'we' are willing to pay.
When 'we' see the cost in our payslip each month then 'we' might not place such undue pressure on A&E etc.
Medical professionals might learn to work within the money that 'we' are willing to spend on the service.
langtounlad said:
The behemoth that is the NHS is effectively too big to be managed under the current structure and political direction.
I dunno about "too big". The main problem is the short-termism of parliamentary cycles.langtounlad said:
Ironically it needs to have a bigger remit - to include Social Care as the interface between the two services is actually creating problems, costs and inefficiencies.
Agreed.langtounlad said:
If there was a separate tax element that everyone paid (not necessarily an addition to current total) and was obvious on your payslip or tax return then 'we' might actually seem some change. Politicians, medical professionals and the public might arrive at a consensus on what 'we' are willing to pay.
When 'we' see the cost in our payslip each month then 'we' might not place such undue pressure on A&E etc.
Or will it have the unintended consequence of a segment of society looking at their payslip and deciding "We're getting our money's worth"?When 'we' see the cost in our payslip each month then 'we' might not place such undue pressure on A&E etc.
langtounlad said:
Medical professionals might learn to work within the money that 'we' are willing to spend on the service.
On the whole, I'd have thought that "medical professionals" were separate from those setting and holding budgets. The medical professionals - by which I'm thinking of the actual "do-ers", the front-line clinical staff - are doing the best they can with what they're given.Edited by TooMany2cvs on Saturday 13th January 09:00
All the posters in this thread are clearly thinking about the issues in the NHS, whichever viewpoint they take. Unfortunately, people who spend much effort mulling over these problems are very much in the minority. The vast majority of the population just expect it to be there and to be free. They have no regard for how they live their life, use services and what impact that has.
I have numerous people every week who fail to attend appointments, when questioned why they didnt turn up or cancel ahead of time just shrug. They dont care that there is a cost to a failed appointment.
Someone did cancel an appointment 5 minutes before it was due, explaining that he couldnt attend, as he had been out on the lash the night before and his girlfriend was so drunk he was in an ambulance with her heading to the already overburdened a&e dept.
Maybe if people had a better understanding of how much it all costs they may show more responsibility in their usage of services, and look after themselves better to avoid the need in the first place
I have numerous people every week who fail to attend appointments, when questioned why they didnt turn up or cancel ahead of time just shrug. They dont care that there is a cost to a failed appointment.
Someone did cancel an appointment 5 minutes before it was due, explaining that he couldnt attend, as he had been out on the lash the night before and his girlfriend was so drunk he was in an ambulance with her heading to the already overburdened a&e dept.
Maybe if people had a better understanding of how much it all costs they may show more responsibility in their usage of services, and look after themselves better to avoid the need in the first place
Edited by sawman on Saturday 13th January 20:45
sawman said:
All the posters in this thread are clearly thinking about the issues in the NHS, whichever viewpoint they take. Unfortunately, people who spend much effort mulling over these problems are very much in the minority. The vast majority of the population just expect it to be there and to be free. They have no regard for how they live their life, use services and what impact that has.
I have numerous people every week who fail to attend appointments, when questioned why they didnt turn up or cancel ahead of time just shrug. They dont care that there is a cost to a failed appointment.
Someone did cancel an appointment 5 minutes before it was due, explaining that he couldnt attend, as he had been out on the lash the night before and his girlfriend was so drunk he was in an ambulance with her heading to the already overburdened a&e dept.
Maybe if people had a better understanding of how much it all costs they may be more responsibility attached to their usage
I'd be in favour of something like a fine for missed appointments or something like three strikes and you're off the books.I have numerous people every week who fail to attend appointments, when questioned why they didnt turn up or cancel ahead of time just shrug. They dont care that there is a cost to a failed appointment.
Someone did cancel an appointment 5 minutes before it was due, explaining that he couldnt attend, as he had been out on the lash the night before and his girlfriend was so drunk he was in an ambulance with her heading to the already overburdened a&e dept.
Maybe if people had a better understanding of how much it all costs they may be more responsibility attached to their usage
On the rare occasion I visit my local GP's surgery, they have a poster up with the daily and weekly number of appointments missed, and the numbers seem huge to me.
TooMany2cvs said:
On the whole, I'd have thought that "medical professionals" were separate from those setting and holding budgets. The medical professionals - by which I'm thinking of the actual "do-ers", the front-line clinical staff - are doing the best they can with what they're given.
However, the question is whether medical professionals have a responsibility to assist in managing budgets.For example, should the cost of a medical treatment form part of the judgement as to whether a treatment is appropriate for a particular patient? This is a highly contentious issue even among doctors.
During my training I worked with a GP who tried to get this point across to me:
"You have 2 patients, both need hypertension treatment. You have 2 treatment options - one costing £10 per month; one costing £100 per month, but offering a lower rate of side effects, such as dizziness, or blackouts. Patient A is an HGV driver with a young family. Patient B is quite old, generally frail and in a residential home as they are chairbound without help. Your budget will not stretch to £200 a month. Who should get which prescription?"
His point was that, if you prescribed medication to patient A, and he had a blackout - then the consequences would be catastrophic. Loss of licence, loss of job, potentially loss of home for the whole family, and subsequent health impact of the stress and poverty caused by this. Even though B would be at higher risk of side effects, the consequence of those side effects, in the larger picture, would be limited; even the risk of fall would be limited as they rarely stand or walk without assistance.
The alternative view is that the £10 per month treatment is inappropriate for both, and therefore the only medically acceptable option is to prescribe the £100 per month medication to both, and that the budget needs to be increased to support it.
A more recent example, is the use of new technologies. For example, we treat a lot of arterial aneurysms, and the preferred option is to fill the aneurysm with implants so that it gets blocked up. The established technique has been to fill it with small implants consisting of coiled wire springs. These cost around £500 each, and take about 20 minutes each to install. If an aneurysm takes 6 coils, then you need to plan for a 2-3 hour procedure (so around £1500 in theatre/staff time) and about £3000 in implants.
There is a new technology available, which is a self-expanding wire mesh. This is a single shot procedure. The single implant expands to fill the aneurysm in one go. Procedure time 30-45 minutes. The disadvantage is the cost of the implant: about £9000. The procedure is much quicker, but the treatment is twice the cost.
Trials show that the two treatment options are identical in terms of side effects, recovery time, and reliability. However, the doctors LOVE the new flow-disruption technology, because it is so quick to use; they can do 3-4 cases in one half-day, instead of 1.
So, in this case, is it justifiable to use the more expensive technology routinely? Is it justifiable if there is a significant waiting list, given that this new technology can increase throughput? Is it justifiable to use this technology to build experience with it, in anticipation that costs will fall if more implant suppliers are able to develop similar technology?
Should management be getting involved? Right now, management's opinion is that "this is a medical decision; price cannot come into it". Is that a justifiable opinion?
WatchfulEye said:
However, the question is whether medical professionals have a responsibility to assist in managing budgets.
For example, should the cost of a medical treatment form part of the judgement as to whether a treatment is appropriate for a particular patient? This is a highly contentious issue even among doctors.
During my training I worked with a GP who tried to get this point across to me:
"You have 2 patients, both need hypertension treatment. You have 2 treatment options - one costing £10 per month; one costing £100 per month, but offering a lower rate of side effects, such as dizziness, or blackouts. Patient A is an HGV driver with a young family. Patient B is quite old, generally frail and in a residential home as they are chairbound without help. Your budget will not stretch to £200 a month. Who should get which prescription?"
His point was that, if you prescribed medication to patient A, and he had a blackout - then the consequences would be catastrophic. Loss of licence, loss of job, potentially loss of home for the whole family, and subsequent health impact of the stress and poverty caused by this. Even though B would be at higher risk of side effects, the consequence of those side effects, in the larger picture, would be limited; even the risk of fall would be limited as they rarely stand or walk without assistance.
The alternative view is that the £10 per month treatment is inappropriate for both, and therefore the only medically acceptable option is to prescribe the £100 per month medication to both, and that the budget needs to be increased to support it.
A more recent example, is the use of new technologies. For example, we treat a lot of arterial aneurysms, and the preferred option is to fill the aneurysm with implants so that it gets blocked up. The established technique has been to fill it with small implants consisting of coiled wire springs. These cost around £500 each, and take about 20 minutes each to install. If an aneurysm takes 6 coils, then you need to plan for a 2-3 hour procedure (so around £1500 in theatre/staff time) and about £3000 in implants.
There is a new technology available, which is a self-expanding wire mesh. This is a single shot procedure. The single implant expands to fill the aneurysm in one go. Procedure time 30-45 minutes. The disadvantage is the cost of the implant: about £9000. The procedure is much quicker, but the treatment is twice the cost.
Trials show that the two treatment options are identical in terms of side effects, recovery time, and reliability. However, the doctors LOVE the new flow-disruption technology, because it is so quick to use; they can do 3-4 cases in one half-day, instead of 1.
So, in this case, is it justifiable to use the more expensive technology routinely? Is it justifiable if there is a significant waiting list, given that this new technology can increase throughput? Is it justifiable to use this technology to build experience with it, in anticipation that costs will fall if more implant suppliers are able to develop similar technology?
Should management be getting involved? Right now, management's opinion is that "this is a medical decision; price cannot come into it". Is that a justifiable opinion?
Clearly not. There is a limited budget.For example, should the cost of a medical treatment form part of the judgement as to whether a treatment is appropriate for a particular patient? This is a highly contentious issue even among doctors.
During my training I worked with a GP who tried to get this point across to me:
"You have 2 patients, both need hypertension treatment. You have 2 treatment options - one costing £10 per month; one costing £100 per month, but offering a lower rate of side effects, such as dizziness, or blackouts. Patient A is an HGV driver with a young family. Patient B is quite old, generally frail and in a residential home as they are chairbound without help. Your budget will not stretch to £200 a month. Who should get which prescription?"
His point was that, if you prescribed medication to patient A, and he had a blackout - then the consequences would be catastrophic. Loss of licence, loss of job, potentially loss of home for the whole family, and subsequent health impact of the stress and poverty caused by this. Even though B would be at higher risk of side effects, the consequence of those side effects, in the larger picture, would be limited; even the risk of fall would be limited as they rarely stand or walk without assistance.
The alternative view is that the £10 per month treatment is inappropriate for both, and therefore the only medically acceptable option is to prescribe the £100 per month medication to both, and that the budget needs to be increased to support it.
A more recent example, is the use of new technologies. For example, we treat a lot of arterial aneurysms, and the preferred option is to fill the aneurysm with implants so that it gets blocked up. The established technique has been to fill it with small implants consisting of coiled wire springs. These cost around £500 each, and take about 20 minutes each to install. If an aneurysm takes 6 coils, then you need to plan for a 2-3 hour procedure (so around £1500 in theatre/staff time) and about £3000 in implants.
There is a new technology available, which is a self-expanding wire mesh. This is a single shot procedure. The single implant expands to fill the aneurysm in one go. Procedure time 30-45 minutes. The disadvantage is the cost of the implant: about £9000. The procedure is much quicker, but the treatment is twice the cost.
Trials show that the two treatment options are identical in terms of side effects, recovery time, and reliability. However, the doctors LOVE the new flow-disruption technology, because it is so quick to use; they can do 3-4 cases in one half-day, instead of 1.
So, in this case, is it justifiable to use the more expensive technology routinely? Is it justifiable if there is a significant waiting list, given that this new technology can increase throughput? Is it justifiable to use this technology to build experience with it, in anticipation that costs will fall if more implant suppliers are able to develop similar technology?
Should management be getting involved? Right now, management's opinion is that "this is a medical decision; price cannot come into it". Is that a justifiable opinion?
WatchfulEye said:
However, the question is whether medical professionals have a responsibility to assist in managing budgets.
For example, should the cost of a medical treatment form part of the judgement as to whether a treatment is appropriate for a particular patient? This is a highly contentious issue even among doctors.
During my training I worked with a GP who tried to get this point across to me:
"You have 2 patients, both need hypertension treatment. You have 2 treatment options - one costing £10 per month; one costing £100 per month, but offering a lower rate of side effects, such as dizziness, or blackouts. Patient A is an HGV driver with a young family. Patient B is quite old, generally frail and in a residential home as they are chairbound without help. Your budget will not stretch to £200 a month. Who should get which prescription?"
His point was that, if you prescribed medication to patient A, and he had a blackout - then the consequences would be catastrophic. Loss of licence, loss of job, potentially loss of home for the whole family, and subsequent health impact of the stress and poverty caused by this. Even though B would be at higher risk of side effects, the consequence of those side effects, in the larger picture, would be limited; even the risk of fall would be limited as they rarely stand or walk without assistance.
The alternative view is that the £10 per month treatment is inappropriate for both, and therefore the only medically acceptable option is to prescribe the £100 per month medication to both, and that the budget needs to be increased to support it.
A more recent example, is the use of new technologies. For example, we treat a lot of arterial aneurysms, and the preferred option is to fill the aneurysm with implants so that it gets blocked up. The established technique has been to fill it with small implants consisting of coiled wire springs. These cost around £500 each, and take about 20 minutes each to install. If an aneurysm takes 6 coils, then you need to plan for a 2-3 hour procedure (so around £1500 in theatre/staff time) and about £3000 in implants.
There is a new technology available, which is a self-expanding wire mesh. This is a single shot procedure. The single implant expands to fill the aneurysm in one go. Procedure time 30-45 minutes. The disadvantage is the cost of the implant: about £9000. The procedure is much quicker, but the treatment is twice the cost.
Trials show that the two treatment options are identical in terms of side effects, recovery time, and reliability. However, the doctors LOVE the new flow-disruption technology, because it is so quick to use; they can do 3-4 cases in one half-day, instead of 1.
So, in this case, is it justifiable to use the more expensive technology routinely? Is it justifiable if there is a significant waiting list, given that this new technology can increase throughput? Is it justifiable to use this technology to build experience with it, in anticipation that costs will fall if more implant suppliers are able to develop similar technology?
Should management be getting involved? Right now, management's opinion is that "this is a medical decision; price cannot come into it". Is that a justifiable opinion?
Good post. As a medical, medical doc I will have to say that in your first example obv the £100 treatment is much, much more cost effective even for the old lady. Because at the end of the day we are trying to prevent an admission. Even one admission will negate all the cost benefits of the £10 vs £100. Which is why warfarin, even though it is much, much cheaper than the DOACs, are slowly being phased out.For example, should the cost of a medical treatment form part of the judgement as to whether a treatment is appropriate for a particular patient? This is a highly contentious issue even among doctors.
During my training I worked with a GP who tried to get this point across to me:
"You have 2 patients, both need hypertension treatment. You have 2 treatment options - one costing £10 per month; one costing £100 per month, but offering a lower rate of side effects, such as dizziness, or blackouts. Patient A is an HGV driver with a young family. Patient B is quite old, generally frail and in a residential home as they are chairbound without help. Your budget will not stretch to £200 a month. Who should get which prescription?"
His point was that, if you prescribed medication to patient A, and he had a blackout - then the consequences would be catastrophic. Loss of licence, loss of job, potentially loss of home for the whole family, and subsequent health impact of the stress and poverty caused by this. Even though B would be at higher risk of side effects, the consequence of those side effects, in the larger picture, would be limited; even the risk of fall would be limited as they rarely stand or walk without assistance.
The alternative view is that the £10 per month treatment is inappropriate for both, and therefore the only medically acceptable option is to prescribe the £100 per month medication to both, and that the budget needs to be increased to support it.
A more recent example, is the use of new technologies. For example, we treat a lot of arterial aneurysms, and the preferred option is to fill the aneurysm with implants so that it gets blocked up. The established technique has been to fill it with small implants consisting of coiled wire springs. These cost around £500 each, and take about 20 minutes each to install. If an aneurysm takes 6 coils, then you need to plan for a 2-3 hour procedure (so around £1500 in theatre/staff time) and about £3000 in implants.
There is a new technology available, which is a self-expanding wire mesh. This is a single shot procedure. The single implant expands to fill the aneurysm in one go. Procedure time 30-45 minutes. The disadvantage is the cost of the implant: about £9000. The procedure is much quicker, but the treatment is twice the cost.
Trials show that the two treatment options are identical in terms of side effects, recovery time, and reliability. However, the doctors LOVE the new flow-disruption technology, because it is so quick to use; they can do 3-4 cases in one half-day, instead of 1.
So, in this case, is it justifiable to use the more expensive technology routinely? Is it justifiable if there is a significant waiting list, given that this new technology can increase throughput? Is it justifiable to use this technology to build experience with it, in anticipation that costs will fall if more implant suppliers are able to develop similar technology?
Should management be getting involved? Right now, management's opinion is that "this is a medical decision; price cannot come into it". Is that a justifiable opinion?
As for the new surgical treatment - the health service will need to think long term, and see how much it can save in the long run. If the waiting list can be cleared easier with less post-op stay / post-op complications than obviously even if it is more expensive then it will be worth it.
sidicks said:
Clearly not. There is a limited budget.
Lol what a simplistic way of answering what is clearly a complicated health ethics question. Let the professionals trained in the specialty do their job and analyse the cost-benefit, fgs.4567231 said:
Lol what a simplistic way of answering what is clearly a complicated health ethics question. Let the professionals trained in the specialty do their job and analyse the cost-benefit, fgs.
There is a limited budget, no point in pretending otherwise. That doesn't mean that we don't need the professionals to undertake appropriate cost-benefit analysis.FGS!
sidicks said:
There is a limited budget, no point in pretending otherwise. That doesn't mean that we don't need the professionals to undertake appropriate cost-benefit analysis.
FGS!
Which is exactly what the post I quoted said, see belowFGS!
WatchfulEye said:
Should management be getting involved? Right now, management's opinion is that "this is a medical decision; price cannot come into it". Is that a justifiable opinion?
I agree with the phrase "this is a medical decision; price cannot come into it", I don't see what your problem with that is.Obviously (1) we don't go round throwing stuff away and (2) if we (as a profession) thinks it's not worth it, it won't be introduced. So leave it to us and stop saying pointless stuff. - unless you are involved in the procurement in new medical / surgical intervention (I honestly hope not). But I do, routinely too.
4567231 said:
Obviously if we (as a profession) thinks it's not worth it, it won't be introduced. So leave it to us and stop saying pointless stuff.
You asked a question:4567231 said:
Right now, management's opinion is that "this is a medical decision; price cannot come into it". Is that a justifiable opinion?
I provided a response to that question and a justification for my response. HTH.sidicks said:
I provided a response to that question and a justification for my response. HTH.
It wasn't me who asked it. But we are in the profession to provide for the patients, and we leave the finance out of our hands when there is a patient in front of us. Unlike the US, we only do things which are necessary and changes our management - it has been drilled in us since medical school.4567231 said:
It wasn't me who asked it.
Ok.4567231 said:
But we are in the profession to provide for the patients, and we leave the finance out of our hands when there is a patient in front of us. Unlike the US, we only do things which are necessary and changes our management - it has been drilled in us since medical school.
The NHS needs to provide the best care it can for patients, subject to the necessary financial constraints.sidicks said:
The NHS needs to provide the best care it can for patients, subject to the necessary financial constraints.
And what happens when all / most of the hospitals go into the red? Yes... wait for it... nothing (or they get fined, ironically meaning they are further in debt). Our trust fell into the red within 1 month of the new financial year, it is simply inevitable.Gassing Station | News, Politics & Economics | Top of Page | What's New | My Stuff