Waste in the NHS
Discussion
technodup said:
nd there we have it, someone else's fault.
People on here rattle on about tip run cars all the time. It's the same principle. Low value, low concern. Except in the NHS it's not low value, it's 'free' and consequently many people don't give a f
k.
All I'm suggesting is a bit of education might improve users behaviour and ultimately save a few quid.
There we have what? Someone, who seems to know what they are talking about, explained to you that, unsurprisingly, you are focusing on the wrong things. Big costs are elsewhere. Not that I think that NHS is a sinking ship, but what you are doing is trying to pump water out of supertanker with a hand pump. People on here rattle on about tip run cars all the time. It's the same principle. Low value, low concern. Except in the NHS it's not low value, it's 'free' and consequently many people don't give a f
k.All I'm suggesting is a bit of education might improve users behaviour and ultimately save a few quid.
I've used the NHS a few times recently. I was impressed by the treatment I received. The reports of everything falling apart and bodies in the corridor turned out not to be apparent. I was seen, treated and a long term problem was resolved as much as it every can be.
The idea that it is broken is wrong. I know a couple of people who work in the NHS on medical and they say that a problem is too many managers. Managers say that they are merely responding to the demands from the government. Having worked in the police, I see a similar system to there where the government's idea to make things more efficient is to increase demand.
The American system is not suitable for this country. Just look at comparable costs: if we can't afford the NHS, we can't afford one that costs many times more.
Any problem is solvable but not by politicians nor the likes of Dacre.
My solution is simple, straightforward, guaranteed to work and will cost little: force all MPs and their families to use the NHS and be banned from taking out medical insurance. The damn thing would improve overnight and, I would guess, the first thing they would do is stop interfering.
The idea that it is broken is wrong. I know a couple of people who work in the NHS on medical and they say that a problem is too many managers. Managers say that they are merely responding to the demands from the government. Having worked in the police, I see a similar system to there where the government's idea to make things more efficient is to increase demand.
The American system is not suitable for this country. Just look at comparable costs: if we can't afford the NHS, we can't afford one that costs many times more.
Any problem is solvable but not by politicians nor the likes of Dacre.
My solution is simple, straightforward, guaranteed to work and will cost little: force all MPs and their families to use the NHS and be banned from taking out medical insurance. The damn thing would improve overnight and, I would guess, the first thing they would do is stop interfering.
Pesty said:
rscott said:
Sadly the reason it's a brand new crutch is that many trusts don't collect and re use crutches when the patient no longer needs them.
It's worse than that. Even if you take the crutch, frame back they skip it. It's policy.
sidicks said:
Those that can easily afford to pay for such things tend to be those that are paying (or have paid) more than their fair share of tax to fund the NHS in the first place.
I've seen you mention this sort of thing on a few threads and I think it's a pretty selfish attitude to have to be honest.It's the same mindset that leads multi-millionaires to claim winter fuel payments. Do you think that's right too?
gasman712 said:
MellowshipSlinky said:
Was thinking about this today actually - fell off my ladder this morning and after spending all day in the resus unit of my local A&E, with what I can only describe as top, top care from everyone - in between the doses of Ketamine (how much is that?) it was going through my head as to how much my treatment was costing.
Strangely though, it was as I was about to leave when they presented me with a brand new crutch - I could easily afford to pay for such items, (I know others can't...) so it got me thinking how many of 'me' are given stuff by the NHS who could actually give a contribution for items such as this.
Ketamine costs pennies. Literally.Strangely though, it was as I was about to leave when they presented me with a brand new crutch - I could easily afford to pay for such items, (I know others can't...) so it got me thinking how many of 'me' are given stuff by the NHS who could actually give a contribution for items such as this.
Although if it ends up going the way of many other anaesthetic drugs then the manufacturers will be shutting production facilities and there'll be a sudden reduction in supply due to production closure and it won't be available except at added cost
sawman said:
Pesty said:
rscott said:
Sadly the reason it's a brand new crutch is that many trusts don't collect and re use crutches when the patient no longer needs them.
It's worse than that. Even if you take the crutch, frame back they skip it. It's policy.
ks, unsurprisingly. In my trust patients are instructed to return them after use.Murph7355 said:
968 said:
Yes he’s talking bks, unsurprisingly. In my trust patients are instructed to return them after use.
Every trust should be made to do this. User pays a deposit, brings it back, gets their deposit back. ks, unsurprisingly. In my trust patients are instructed to return them after use.I was rushed in by abwilans, in my work clothes, with no wallet or money whatsoever.
Admittedly my wife came later...
grumbledoak said:
You are missing the point others are making: no-one with the power to change the NHS wants to save any money. That is not what they are there for. It is not what the NHS is there for. That's why it cannot be "fixed"; to their mind it isn't "broken".
I'm not necessarily talking net savings though. I'm talking about savings which can be utilised elsewhere in the system. And they're forever bemoaning a lack of cash, at every level.And it doesn't necessarily need to be the NHS doing the pushing either. In the last few decades governments of both colours have largely stopped us smoking and drink driving. Why, for example could there not be a standard £60 fine for not showing at an NHS appointment? Like a speeding ticket. They know our name and address.
Charities are forever pushing the 'just £5 a month can save 20 kids from starvation' line. Why can't some government body say 'every missed appointment costs £x and has consequence y'?
As I said in my OP my main point is that people have no clue, so act accordingly. And why wouldn't they, until they're educated about it?
technodup said:
'm not necessarily talking net savings though. I'm talking about savings which can be utilised elsewhere in the system. And they're forever bemoaning a lack of cash, at every level.
And it doesn't necessarily need to be the NHS doing the pushing either. In the last few decades governments of both colours have largely stopped us smoking and drink driving. Why, for example could there not be a standard £60 fine for not showing at an NHS appointment? Like a speeding ticket. They know our name and address.
Charities are forever pushing the 'just £5 a month can save 20 kids from starvation' line. Why can't some government body say 'every missed appointment costs £x and has consequence y'?
As I said in my OP my main point is that people have no clue, so act accordingly. And why wouldn't they, until they're educated about it?
The hospitals/GP surgery already do this but patients don't care. Governments won't enforce anything because they'll lose votes as the government that introduced charges, at least that's what they fear.And it doesn't necessarily need to be the NHS doing the pushing either. In the last few decades governments of both colours have largely stopped us smoking and drink driving. Why, for example could there not be a standard £60 fine for not showing at an NHS appointment? Like a speeding ticket. They know our name and address.
Charities are forever pushing the 'just £5 a month can save 20 kids from starvation' line. Why can't some government body say 'every missed appointment costs £x and has consequence y'?
As I said in my OP my main point is that people have no clue, so act accordingly. And why wouldn't they, until they're educated about it?
BigMon said:
sidicks said:
Those that can easily afford to pay for such things tend to be those that are paying (or have paid) more than their fair share of tax to fund the NHS in the first place.
I've seen you mention this sort of thing on a few threads and I think it's a pretty selfish attitude to have to be honest.It's quite right that those who are better off should pay more to subsidise those that are unable to look after themselves. That doesn't mean that just because someone can afford to pay more, that they should do so. Plenty of high earners pay much more than their legal requirements to help those less fortunate.
BigMon said:
It's the same mindset that leads multi-millionaires to claim winter fuel payments. Do you think that's right too?
It's not really the same. Regardless, I doubt many do so, but it shouldn't be available. Edited by sidicks on Saturday 23 September 20:44
sidicks said:
BigMon said:
sidicks said:
Those that can easily afford to pay for such things tend to be those that are paying (or have paid) more than their fair share of tax to fund the NHS in the first place.
I've seen you mention this sort of thing on a few threads and I think it's a pretty selfish attitude to have to be honest.It's quite right that those who are better off should pay more to subsidise those that are unable to look after themselves. That doesn't mean that just because someone can afford to pay more, that they should do so. Plenty of high earners pay much more than their legal requirements to help those less fortunate.
BigMon said:
It's the same mindset that leads multi-millionaires to claim winter fuel payments. Do you think that's right too?
It's not really the same. Regardless, I doubt many do so, but it shouldn't be available. Edited by sidicks on Saturday 23 September 20:44
I think the NHS is still this nations greatest ever achievement even after years government interference and bad management.
My mother in law has terminal brain cancer. after 6 months or so of treatment there is nothing more that can be done for her treatment wise.
Last weekend after several days of not sleeping and feeling pretty crappy my father in law dialled 101 they sent a paramedic to see if they could do anything to help her , after trying in vain to find her a short term hospice bed so she could get some rest she was taken to a&e and admitted to hospital.
after two days she signed herself out and returned home but now with the district nurse and home help booked to visit her at home.
she now gets
twice daily phone calls from the hospice
twice daily visits from home help
four time weekly visits from the district nurse
on friday due to her finding it impossible to get upstairs to bed the district nurse arranged to have a hospital type bed delivered to their home the same day
today on my way back from a seminar i found two home helps and occupational health nurse all there to help
during my visit i mentioned to the OHN it would be nice to be able to get the MIL into the garden in her wheelchair if only to get her a change of view.
a set of ramps have been ordered for delivery on monday
If my in laws were not of that generation who think that they cannot ask for help from a system they have paid in to all their working lives this would all have been sorted weeks ago.
My mother in law has terminal brain cancer. after 6 months or so of treatment there is nothing more that can be done for her treatment wise.
Last weekend after several days of not sleeping and feeling pretty crappy my father in law dialled 101 they sent a paramedic to see if they could do anything to help her , after trying in vain to find her a short term hospice bed so she could get some rest she was taken to a&e and admitted to hospital.
after two days she signed herself out and returned home but now with the district nurse and home help booked to visit her at home.
she now gets
twice daily phone calls from the hospice
twice daily visits from home help
four time weekly visits from the district nurse
on friday due to her finding it impossible to get upstairs to bed the district nurse arranged to have a hospital type bed delivered to their home the same day
today on my way back from a seminar i found two home helps and occupational health nurse all there to help
during my visit i mentioned to the OHN it would be nice to be able to get the MIL into the garden in her wheelchair if only to get her a change of view.
a set of ramps have been ordered for delivery on monday
If my in laws were not of that generation who think that they cannot ask for help from a system they have paid in to all their working lives this would all have been sorted weeks ago.
Pothole said:
I'm a type 2 diabetic, I can afford to pay for my prescriptions. I was pretty much forced to register for exemption by the pharmacy because they could get into trouble if they didn't make me do it. I only order what I need.
They won't get into trouble. It's down to your GP to sign the form gives you the exemption from prescription chargessidicks said:
BigMon said:
sidicks said:
Those that can easily afford to pay for such things tend to be those that are paying (or have paid) more than their fair share of tax to fund the NHS in the first place.
I've seen you mention this sort of thing on a few threads and I think it's a pretty selfish attitude to have to be honest.It's quite right that those who are better off should pay more to subsidise those that are unable to look after themselves. That doesn't mean that just because someone can afford to pay more, that they should do so. Plenty of high earners pay much more than their legal requirements to help those less fortunate.
Edited by sidicks on Saturday 23 September 20:44
But how do you quantify:
sidicks said:
particularly while, there are plenty of people who have basically had the same opportunities but who have chosen not to take them and chosen not to make sacrifices, just sit back and let others subsidise them.
How do you know if someone is just playing the system or is genuinely in need?That is probably the real challenge and christ knows how that's addressed.
I have a daughter who has received a huge amount of medical care since birth (now 2). Some of the things we've seen are ludicrous.
One that sticks in the mind, she had to be transferred to Southampton for an op. At this point she had been in Poole for 5 months since her birth and had a new sats probe fitted that day. The transport team have a different monitor, so had to put on another one. Southampton use a different type again, so thats another sats probe.
Thats approx. £25 each (apparently). So £75 on sats probes (and £50 more for the return to Poole two days later) to be transferred between two hospitals within the same 'transport' area.
Also, there was an article somewhere (possibly wail) that stated the costs different trusts paid for basics such as latex gloves etc and the variances were huge. Why is there not a central purchasing team that get better rates based on huge orders rather than leaving it up to individual trusts to manage? Then the individual trusts can order from the supplier at the best rates.
One that sticks in the mind, she had to be transferred to Southampton for an op. At this point she had been in Poole for 5 months since her birth and had a new sats probe fitted that day. The transport team have a different monitor, so had to put on another one. Southampton use a different type again, so thats another sats probe.
Thats approx. £25 each (apparently). So £75 on sats probes (and £50 more for the return to Poole two days later) to be transferred between two hospitals within the same 'transport' area.
Also, there was an article somewhere (possibly wail) that stated the costs different trusts paid for basics such as latex gloves etc and the variances were huge. Why is there not a central purchasing team that get better rates based on huge orders rather than leaving it up to individual trusts to manage? Then the individual trusts can order from the supplier at the best rates.
Edited by Miocene on Saturday 23 September 23:58
Miocene said:
Also, there was an article somewhere (possibly wail) that stated the costs different trusts paid for basics such as latex gloves etc and the variances were huge. Why is there not a central purchasing team that get better rates based on huge orders rather than leaving it up to individual trusts to manage? Then the individual trusts can order from the supplier at the best rates.
There is. It's called NHS supply chain, although the operation of it is subbed out to DHL.Essentially, NHSSC is the preferred supplier for pretty much anythying. If you want to procure anything, and something in the NHSSC catalogue meets the bill, it is a huge effort to buy it through any other pathway.
The idea is that NHSSC negotiate a national purchasing contract with individual vendors, and then provide a centralised logistics service - so individual trusts, simply send an electronic purchase order to NHSSC for everything they want to buy, so that the accounting is done with a single supplier.
Although, it is not compulsory to buy through NHSSC, it's not uncommon for trusts, particularly those with underresourced procurement departments to insist on purchasing through NHSSC, rather than through an individually negotiated tender process.
I've spent a considerable amount of time in and out of hospital this year, my local being Royal Berks in Reading.
In general I get the feeling they run a pretty tight ship, there is little evidence of day to day operational 'waste' (let's not mention their IT system, that's a different political football).
Every appointment I have I get a reminder text saying 'non-attendance costs the NHS £XXX.XX'... good to see them doing this.
In general I get the feeling they run a pretty tight ship, there is little evidence of day to day operational 'waste' (let's not mention their IT system, that's a different political football).
Every appointment I have I get a reminder text saying 'non-attendance costs the NHS £XXX.XX'... good to see them doing this.
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