Discussion
200Plus Club said:
Well explained thanks.
Today's paper news suggesting a new hidden agenda of privately managed "regional" health care management companies to take over from the local commissioning teams..
I think you mean the ACOs - Accountable Care Organisations. This is worth a read:Today's paper news suggesting a new hidden agenda of privately managed "regional" health care management companies to take over from the local commissioning teams..
https://www.england.nhs.uk/wp-content/uploads/2017...
The Surveyor said:
Let me have another go at explaining why I think as a business, the NHS is rotten.
....
For me (and whilst I'm sure you won't agree) the principle of one NHS division calculating then charging another NHS entity for services which are all funded from the same pot is a ridiculous waste of money.
All you're doing there is criticising the English purchaser/provider split or "internal market" model which has its advantages and disadvantages. Wales (for example) doesn't have that system. There, the organisation which gets the funding provides all the care (hospitals/community/GP services/Mental Health, although not emergency ambulance and there's a notionally separate commissioning body for very specialised care). ....
For me (and whilst I'm sure you won't agree) the principle of one NHS division calculating then charging another NHS entity for services which are all funded from the same pot is a ridiculous waste of money.
But Wales has all of the problems of the rest of the NHS, longer waiting lists, minus a slack handful of vast open-plan offices full of contract managers and commissioning teams.
The enduring problems remain:
(1) Rising demand for NHS services, people living longer but with more things wrong with them, cutting the cake ever thinner to give everyone a piece.
(2) Successive governments' inability to look beyond short-term political aims relating to workforce and infrastructure. Leading to staffing shortages, huge agency/bills, mounting deficits, riskier care, poor staff retention etc etc. Crisis in Primary Care, people going to A&E when they can't get an appt to see their GP.
(3) Underfunded social care, (massive problem not discussed enough) particularly for older people. Leads to more people (preventably) coming in through the hospital front door, not enough care packages to get medically fit people discharged out the back door.
(4) System where urgent care (people suddenly needing help) and planned care (scheduled operations etc) competes for the same resource (i.e. beds and staff). Urgent care trumps planned care, so ops are cancelled and waiting lists get longer.
(5) Resistance to change. The solutions are to be found in system change. New ways of running the NHS, and the answers are already there. It potentially means lots of things but particularly shifting resource which is heavily shoved towards hospitals when it could be in community services keeping people well (and crucially more independent) in their homes. Close a hospital?... -Cue protest marches by people who are ironically suffering at the hands of a system they are fighting to preserve, politicians blocking change for their own vote-winning gain and a paralysed system where it should be allowed to be more agile like successful companies.
There's your problems, (there are many, many more). But it's not one problem, it's never one problem. It's never simple and neither are the answers in health care. You can summarise it as inefficiency -and it kind of is, but in a tabloid world, that points a simple finger at pantomime baddie NHS managers, when the reality is that the power to change the NHS is actually in the hands of those who don't want to know. Governments, the self-interested and the masses who don't understand, -but have a vote.
captainzep said:
All you're doing there is criticising the English purchaser/provider split or "internal market" model which has its advantages and disadvantages. Wales (for example) doesn't have that system. There, the organisation which gets the funding provides all the care (hospitals/community/GP services/Mental Health, although not emergency ambulance and there's a notionally separate commissioning body for very specialised care).
But Wales has all of the problems of the rest of the NHS, longer waiting lists, minus a slack handful of vast open-plan offices full of contract managers and commissioning teams.
The enduring problems remain:
(1) Rising demand for NHS services, people living longer but with more things wrong with them, cutting the cake ever thinner to give everyone a piece.
(2) Successive governments' inability to look beyond short-term political aims relating to workforce and infrastructure. Leading to staffing shortages, huge agency/bills, mounting deficits, riskier care, poor staff retention etc etc. Crisis in Primary Care, people going to A&E when they can't get an appt to see their GP.
(3) Underfunded social care, (massive problem not discussed enough) particularly for older people. Leads to more people (preventably) coming in through the hospital front door, not enough care packages to get medically fit people discharged out the back door.
(4) System where urgent care (people suddenly needing help) and planned care (scheduled operations etc) competes for the same resource (i.e. beds and staff). Urgent care trumps planned care, so ops are cancelled and waiting lists get longer.
(5) Resistance to change. The solutions are to be found in system change. New ways of running the NHS, and the answers are already there. It potentially means lots of things but particularly shifting resource which is heavily shoved towards hospitals when it could be in community services keeping people well (and crucially more independent) in their homes. Close a hospital?... -Cue protest marches by people who are ironically suffering at the hands of a system they are fighting to preserve, politicians blocking change for their own vote-winning gain and a paralysed system where it should be allowed to be more agile like successful companies.
There's your problems, (there are many, many more). But it's not one problem, it's never one problem. It's never simple and neither are the answers in health care. You can summarise it as inefficiency -and it kind of is, but in a tabloid world, that points a simple finger at pantomime baddie NHS managers, when the reality is that the power to change the NHS is actually in the hands of those who don't want to know. Governments, the self-interested and the masses who don't understand, -but have a vote.
Spot on, pretty muchBut Wales has all of the problems of the rest of the NHS, longer waiting lists, minus a slack handful of vast open-plan offices full of contract managers and commissioning teams.
The enduring problems remain:
(1) Rising demand for NHS services, people living longer but with more things wrong with them, cutting the cake ever thinner to give everyone a piece.
(2) Successive governments' inability to look beyond short-term political aims relating to workforce and infrastructure. Leading to staffing shortages, huge agency/bills, mounting deficits, riskier care, poor staff retention etc etc. Crisis in Primary Care, people going to A&E when they can't get an appt to see their GP.
(3) Underfunded social care, (massive problem not discussed enough) particularly for older people. Leads to more people (preventably) coming in through the hospital front door, not enough care packages to get medically fit people discharged out the back door.
(4) System where urgent care (people suddenly needing help) and planned care (scheduled operations etc) competes for the same resource (i.e. beds and staff). Urgent care trumps planned care, so ops are cancelled and waiting lists get longer.
(5) Resistance to change. The solutions are to be found in system change. New ways of running the NHS, and the answers are already there. It potentially means lots of things but particularly shifting resource which is heavily shoved towards hospitals when it could be in community services keeping people well (and crucially more independent) in their homes. Close a hospital?... -Cue protest marches by people who are ironically suffering at the hands of a system they are fighting to preserve, politicians blocking change for their own vote-winning gain and a paralysed system where it should be allowed to be more agile like successful companies.
There's your problems, (there are many, many more). But it's not one problem, it's never one problem. It's never simple and neither are the answers in health care. You can summarise it as inefficiency -and it kind of is, but in a tabloid world, that points a simple finger at pantomime baddie NHS managers, when the reality is that the power to change the NHS is actually in the hands of those who don't want to know. Governments, the self-interested and the masses who don't understand, -but have a vote.
BlackLabel said:
Here we go. 
I knew the floodgates were opened when taxes were increased for adult social care.
I could support this as long as they simultaneously significantly improve procedures to ensure eligibility for treatment.
We cannot have massive funding increases, while at the same time have the NHS continuing to have many within it trying to run a IHS.
An NHS card with biometric data seems the best way to me.
We cannot have massive funding increases, while at the same time have the NHS continuing to have many within it trying to run a IHS.
An NHS card with biometric data seems the best way to me.
Oh and from reading the Guardian article they talk about the pressures from an ageing population but nothing of the pressures from a rising population.
Between 2014 and 2016 the numbers registered with GP practices rose by over 1 million.
There are also 2.3 million more people registered with GPs than the official population estimate.
https://commonslibrary.parliament.uk/social-policy...
Between 2014 and 2016 the numbers registered with GP practices rose by over 1 million.
There are also 2.3 million more people registered with GPs than the official population estimate.
https://commonslibrary.parliament.uk/social-policy...
Edited by JagLover on Thursday 24th May 09:15
funkyrobot said:
BlackLabel said:
Here we go. I knew the floodgates were opened when taxes were increased for adult social care.
The NHS is akin to a bottomless pit when it comes to money.
This latest "revelation" is yet another simple solution to a complex problem with an unhealthy dose of taboos and elephants in the room being studiously ignored.
The simple solution of rinsing every compliant household for another £2k avoids the need to close up the corporate tax avoidance schemes that governments appear reluctant to tackle, so business as usual.
Wingo
This latest "revelation" is yet another simple solution to a complex problem with an unhealthy dose of taboos and elephants in the room being studiously ignored.
The simple solution of rinsing every compliant household for another £2k avoids the need to close up the corporate tax avoidance schemes that governments appear reluctant to tackle, so business as usual.
Wingo
funkyrobot said:
BlackLabel said:
Here we go. I knew the floodgates were opened when taxes were increased for adult social care.
When the civil service is paying more than 100% over the actual cost for services to be supplied (at least in the area I work in and through no fault of my company) then there is a very serious problem.
Thats just on services. I would hate to think how much over market they are paying for everything else.
If you total all of it up across the services they are wasting tens of billions a year through poor contracts.
Let's actually look at that headline, shall we, before getting all exercised.
21m households (in England) x £2k = £42bn. The current budget for NHS England is £128bn. So that's a 33% increase.
But that's not all at once. Nor is it all new money. The article goes on to talk about a 5% annual increase over the next 5yrs (which will be 28%, thanks to compound %ages), instead of the 3% already promised... And that's all after inflation - so it's not hard to see how that £2k isn't actually THAT much new money.
21m households (in England) x £2k = £42bn. The current budget for NHS England is £128bn. So that's a 33% increase.
But that's not all at once. Nor is it all new money. The article goes on to talk about a 5% annual increase over the next 5yrs (which will be 28%, thanks to compound %ages), instead of the 3% already promised... And that's all after inflation - so it's not hard to see how that £2k isn't actually THAT much new money.
TooMany2cvs said:
Let's actually look at that headline, shall we, before getting all exercised.
21m households (in England) x £2k = £42bn. The current budget for NHS England is £128bn. So that's a 33% increase.
But that's not all at once. Nor is it all new money. The article goes on to talk about a 5% annual increase over the next 5yrs (which will be 28%, thanks to compound %ages), instead of the 3% already promised... And that's all after inflation - so it's not hard to see how that £2k isn't actually THAT much new money.
Is it when your your one of the households that contributes (so your bill will be higher)21m households (in England) x £2k = £42bn. The current budget for NHS England is £128bn. So that's a 33% increase.
But that's not all at once. Nor is it all new money. The article goes on to talk about a 5% annual increase over the next 5yrs (which will be 28%, thanks to compound %ages), instead of the 3% already promised... And that's all after inflation - so it's not hard to see how that £2k isn't actually THAT much new money.
Its especially expensive when you've used the NHS a few time and they have been crap.
Me - long term back pain. My GP give me a pamphlet on back pain with no examination. See our company/private GP and get referred to a physio for proper treatment.
My wife - foot pains. Her GP prescribed pain killers after an x-ray showed no problems. We saw a private podiatrist who says she has one leg slightly longer than the other so needs an insert in one shoe. Problem is now much better.
My daughter - suffers from social anxiety. - 9 months of waiting for an appointment only to be told that we had missed an appointment so would have to go back on the waiting list! We received no correspondence nor can they supply a copy. We get an appointment and it's for group therapy (for someone with social anxiety!!!!). First 3 sessions useless as my daughter won't speak. After 6 sessions the treatment is cut off with no improvement and no way forward.
We're currently looking for a private therapist locally.
I would rather keep my 2k and spend it on actual treatment
zygalski said:
Burwood said:
Looks like May just found the Remoaners 350m a week from the big red bus.
Wrong!Extra government borrowing required.
Good, honest socialist move by May. I applaud her.
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