Last Nights BBC Programme The Hospital

[fallen-archie]

If you did not see it then I recommend you do so on the Iplayer. It was an interesting insight into the comings and goings at Paddington St Mary's Hospital, a real fly on the wall documentary that throws some light on to te problems faced by our NHS. It mirrors my own experience within the system which is truly heading towards breaking point. Despite this, staff continue to do their best while consultants turn up for operations that cannot take place due to a lack of intensive care beds, To see so many highly paid and highly skilled Consultants sitting around awaiting a bedspace is soul destroying. The amount of money spent on the NHS needs to be rechannelled into the areas of greatest need and we as the general public need to stop abusing the system simply because it is free. I am proud of our NHS but without change will it last into the 22nd century?

[cee-dee]

I didn't watch that prog and although I knew it was on, I chose not to watch it.

There are several points which need consideration before anyone (like the media hypers!) starts criticising things.

The first is that there are many, many more people in the country using/needing attention from the NHS and from that it doesn't take a genius to work out that more of everything is therefore needed.

As you and I well know, many more people are surviving trauma compared to years ago which adds to even more need.

All that has to be paid for by someone. That someone is Joe Public. Without contributions, there's no money to pay for it all. "The Government" has no money, the money all comes from Joe Public.

Now, quite apart from the above, there's all the non-productive people all leeching off the system. In this area, the Health Board Management Structure comprises 66 people plus another 9 "Independent Members". What on earth are they all doing? How many hours do THEY "work"? How much do they all cost the NHS?

On top of all that, there's an aging population of doctors nearing retirement being replaced by younger (often more agitating and militant)  people. Many GPs seem to be resigning from a local practice and then "returning" as locums and getting paid at enhanced rates, all creaming more off the system. A year or so back the highest paid locum in this area got in excess of £140,000 for the year. Elsewhere, I seem to remember the highest paid locum in the country creaming off over £400,000 for the year. Looking at that and comparing it to what those poor nurses get (who're back-and-to, up-and-down ALL day!) it makes you want to........... well, it does anyway.

What's the answer? I don't know. If anyone says it all needs looking in to, what will happen? More non-productive people will see that as a fine way to cream more money off the system conducting some sort of "inquiry".....

[fallen-archie]

Firstly CD it really is worth a watch, I did not see anything that I haven't witnessed at first hand. Yes the media may try and hype things up but it does clearly show the kind of problems faced daily.
I feel that something needs to be done to make it better for all, however I do not have any immediate answers .
Perhaps someone else on here does?

[cee-dee]

Having witnessed it all first hand over a total of 18 days, it annoys me that I can't do anything about it and media hype doesn't help.

All those criticising seem to want is to throw ever more money in to the situation when really, a lot of the money available today is being wasted on those with their hand in the till.

[jd.linklater]

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@cee-dee wrote:

Having witnessed it all first hand over a total of 18 days, it annoys me that I can't do anything about it and media hype doesn't help.

All those criticising seem to want is to throw ever more money in to the situation when really, a lot of the money available today is being wasted on those with their hand in the till.

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Precisely. The last I read close to 50% of people employed in the NHS have no medical qualifications, we might start by whittling their numbers down. A classic case of too many chiefs and not enough indians.

[suzieseaside]

Never mind the next century, I reckon the system will collapse within a decade.

Jeremy Hunt has been planning to close A&E departments across the country.  Where I live the nearest hospital (20 miles away) is planned for closure of A&E and maternity, leaving the closest 30 miles away and at least an hour's journey assuming no traffic jams.  There have been numerous local petitions to sign, online and in the street, and I hope it will make a difference but who knows

People are dying on trolleys in hospital corridors waiting for treatment.  More funds are needed but also better management of funds.  I read last year that huge redundancies were being paid out to some senior employees who were then re-employed by the NHS.

I didn't see the documentary but will look for it. Perhaps it was the one initiated by 38 degrees and funded by their members?

https://home.38degrees.org.uk/2016/11/25/the-results-are-in-2/

There are plenty of petitions to sign e.g. this one which I received today and signed

https://speakout.38degrees.org.uk/campaigns/1805?utm_source=email&utm_medium=blast&utm_campaign=11_1...

How our politicians can plan to close so many hospital departments is beyond me, when clearly the NHS has been in crisis for a while now.  There must be a way to manage the NHS better.  I think people might be prepared to pay a bit more tax providing it went to the NHS and nothing else, but who would trust our Government?

And yes, as mentioned in another thread, irresponsible drunks who fill ambulances and A&E departments every weekend should be charged for treatment.

[fallen-archie]

Or possibly Too many Chiefs and not enough Beds!

[goldenwonders]

The problem with the NHS is that its broken, money will not solve this problem. The whole system needs taking apart and rebuilding from scratch! I have many issues that I could raise here which would raise eyebrows, one of which happened only today to my 17 year old daughter.

I personally think the problem is not the hospitals - it's the GP's before you even arrive at an hospital.

The main reason the A+E's are in chaos and over used is because people cannot get to see their GP's - so where do they go if they know they are possibly seriously ill?? They do the only thing left open to them - they go to A+E.

GP's received an enormous payrise courtesy of Bliar - made them so wealthy they did not need to work full time. I tried to make an appointment to see my GP on Monday, and I always have to go through the Spanish Inquisition to get an appointment with the receptionists (I'm not going with a trivial complaint I have Prostate Cancer) - then told he was on Holiday until next week. So earliest appointment was Tuesday next week.

As my wife pointed out - why on earth would he go on holiday at what is said to be the most difficult time of the year?? He is young, well paid and could easily afford to go in the Summer when his services are in less demand. If he were a teacher he would not be allowed to go on holiday in term time - surely a similar system should operate for GP's.

[upthecreekyetagain]

There may well be a number of areas where costs can be cut in the NHS  but it doesn't follow from that, that there isn't a money shortage within the NHS.

We spend less per capita on our health service than many other western countries yet are still, (at least I am), proud of our National Health Service - this being the case they must be getting far more right than they are wrong.

Having been admitted into hospital on three occasions recently via A&E I have seen the pressure the staff have been under both in A&E and on the wards and operating theatres and have also seen how some people react when it is politely suggested that they should go to their GP or local NHS drop in centre.

It is not management that are responsible for there being insufficient beds, nurses, doctors, equipment and so on - I've seen first hand beds tied up by patients who no longer need to be in hospital but have nowhere suitable to be discharged to, yet still take up nursing and ancilliary staff time - reducing management won't solve this problem, (could well make it worse), money is the only solution.

It all really boils down to where we get the money from, savings on current services, reducing the services offered or more tax income.  The one that takes the most time and potentially has the lowest returns is cost cutting, tax is the only one offering immediate returns.

[cee-dee]

It's true that some problems in A & E are caused by people who go there either after getting "fobbed off" at their GP, it being a weekend or by just jumping the gun and going straight there.

The GP situation is getting way out of hand and it's difficult to know what to believe as to GP remuneration when there's conflicting information. However, GPs don't seem to be badly paid? It seems to me that people want the money but don't want the work?:-

http://www.telegraph.co.uk/news/uknews/11856441/Average-GP-pay-dips-below-100000-for-first-time-in-a...

https://www.prospects.ac.uk/job-profiles/general-practice-doctor

[astrologica]

I watched the programme last night and it was a real eye-opener. I wouldn't not want to be any of those people who have to make those life or death decisions. The whole NHS system is broken..from top to bottom. I don't think throwing more money at the problem will solve anything. As Suzie said, there are far too many people taking  redundancy with huge payoffs, and then going back to work doing the same job. Also, the cost of agency doctors and nurses is astronomical. My sister works for the NHS, assessing patients who are ready to go home. Every working day she is chasing her tail, because the care is not there for just-discharged patients. The home care people are treated like the lowest of the low, and paid peanuts. They should be treated as professionals and paid accordingly. 

Drunks and drug addicts should be left to their own devices....money is wasted on them. Breast implants should not be paid for by the NHS unless they are a necessity after a mastectomy. IVF should not be paid for by the NHS...having a child is a blessing...not a right.

And I do think that we all have a responsibility to look after our own health as far as we can. People who drink too much, eat too much, smoke too much or take drugs should go to the back of the queue...the risks of all these are well known these days. Yes...we all have a right to treatment, but we also have a responsibility to ourselves. 

Health tourists from abroad should not be treated until they have paid up front, or are insured. Nigerian women who fly in to have their babies on the NHS should be sent home...minus baby, until they have paid.

As with every other aspect of life in this country, we have become far to liberal and soft, and the whole world takes advantage.

Also.. we have a very serious crisis in Mental Health care. The number of cases of young people with mental disorders, hearing voices etc is soaring....I do wonder if this is the beginning of the Cannabis time bomb going off. Another result of our soft liberal attitude to drugs in this country.

[upthecreekyetagain]

If we want to live in a democratic capitalist society then we have to subscribe to the idea of supply and demand in both the goods and labour market.

40% of our GPS weren't born in the U.K., (nearly 30% of all doctors), and we don't have the young doctors coming through the system who want to become GPs.  As the age demographic of GPs rises the need for new GPs will only increase.

This won't be improved by restricting when they can go on holidays, capping their wages and forcing them to work unsocial hours.  If we want to attract young doctors into becoming GPs then pay and conditions for them patently have to improve.  Their pay and conditions may seem excellent to most of us but that's irrelevant, if we can't attract enough people into the job then they're simply not good enough.

[fallen-archie]

Of Course supply and demand comes into the equation as does pay and working conditions. The role of all hospital staff regardless of rank is to help sick people and to be free to do that, Right now that is impossible due to the overbearing nature of the hierarchy and Government policy regardless of political hue. Look at the number of British Doctors and Nurses who choose to go abroad to work, sometimes permanently and sometimes working in the voluntary sector, they do so for experience and because they are passionate about their chosen vocation. When I have been into Hospital which has been far too often of late, I found staff working under extreme pressure and subjected to horrendous abuse, Where has respect gone? Why is everyone so rude and what can we do about it. Shifts are long and arduous enough without all the abuse staff are forced to endure. Government need to address this and the fact that the resources given are insufficient given the population demographics we have today.. I also agree that our GP Surgeries need to be far more flexible in order to take pressure off A&E departments, You cannot get an urgent apointment at your GP unless you are at deaths door in which case they call an ambuance and despatch you off to A&E.  I have never known it as bad as this yet we managed during the war! 

[evoman3957]

I'm actually amazed that people are surprised that this problem exists and is getting worse.  From a point of view of simple mathematics, it is self explanatory.  If you have three groups of people, A,B & C.......A being those too young to work ( or in full time education )......B being those who are working ( in full time employment ) and C being those who no longer work ( retired ) or can't work.  Group B therefore ( on the whole ) provide the revenue to look after the other two groups ( A & C ).  For arguments sake, if each group contained 1 Million people and 500,000 in group A moved to group B ( became employed and were replaced by another 500,000 entering group A for the first time ).......500,000 in group B moved to group C ( retired etc. ) and 500,000 in group C Died; then some sort of balance may be achievable. However ( not to put too finer point on it ) the 500,000 in group C aren't dying, in fact they are living considerably longer and in an ever increasing state of ill health or neediness........whether that be from needing knee or hip replacement operations, to cancers; predominantly associated with old age. So the only demography that is significantly changing, is that of group C.  Now, although medical science's achievements in increasing longevity is to be commended......it does come at a cost and that cost is because the group concerned, require the most care.  With the next phase in the healthcare for that group being sadly lacking ( almost neglected for years ).....ie. care homes, nursing homes, home help, etc. etc. it is being left up to hospitals to cover the problem; hence beds being taken up in hospitals, by older people who are fit enough to be discharged from a hospital environment, but can't be, because their future care can't / isn't being addressed. This is only going to get worse and unless the fifth richest economy in the world, can acquire enough brain cells; to work out how to chanel some of that wealth, to where it is most needed.............we may as well just accept that this is the beginning of the end.  As far as the programme was concerned, it was good; but I get my information first hand ( missing out the middle man ) from my Son......who is a Hospital A & E Doctor.

[joe_bloggs*]

"In 2011 the NHS was lauded as the best health service in the developed world in a study by the Commonwealth Fund in terms of cost, efficiency and patient satisfaction. Six years later, after a programme of unprecedented cuts which has seen the service wilfully starved of funds, the NHS is now in the worst crisis in its history and is rapidly approaching breaking point"

http://www.huffingtonpost.co.uk/dr-mona-kamal/nhs-crisis-jeremy-hunt_b_14127276.html?

As Noam Chomsky said: '' That's the standard technique of privatisation: defund, make sure things don't work, people get angry, you hand it over to private capital. '

[fallen-archie]

I disagree with the huffenpuffpost article because it advocates backing a people's group comprising of an affiliation by individual supporters, unions nationally and locally, anti-cuts campaigns, and other student, pensioner, unemployed, disabled people’s, women’s, Black people’s, youth and LGBT campaigning organisations. **bleep** is that about, every time a discussion requiring collective support from people across the political spectrum along comes another left wing lobby driven by the disabled, LGBT, Black organisations etc etc. Same old same old left wing clap trap full of caring and sharing ideas designed at spending other people's money. All that will do is get folks backs up and do little to promote our health service.

[joe_bloggs*]

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@fallen-archie wrote:
I disagree with the huffenpuffpost article because it advocates backing a people's group comprising of an affiliation by individual supporters, unions nationally and locally, anti-cuts campaigns, and other student, pensioner, unemployed, disabled people’s, women’s, Black people’s, youth and LGBT campaigning organisations. **bleep** is that about, every time a discussion requiring collective support from people across the political spectrum along comes another left wing lobby driven by the disabled, LGBT, Black organisations etc etc. Same old same old left wing clap trap full of caring and sharing ideas designed at spending other people's money. All that will do is get folks backs up and do little to promote our health service.

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If it didn't  advocate backing a people's group would you then agree with it?

[theelench]

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@cee-dee wrote:

All those criticising seem to want is to throw ever more money in to the situation when really, a lot of the money available today is being wasted on those with their hand in the till.

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First I have to say that I didn't see the program because I refuse to support the BBC by paying the licence fee because IMO they are a prime example of what is killing services in this country.  A huge and growing "administration".   Whether it's the NHS, Local Authorities, the Armed Forces, Railways or the BBC there is a vast amount of over administration, sucking far too much out of the budget and its primary aim is to safeguard itself.  So when there are cuts it's the front line that is cut not the non-productive drones.

I heard only last night that the crisis in my local hospital (QEQM Margate) is so bad that GPs are being draughted into A&E.  Yet a neighbour (who works there) tells me that as a priority policy the same hospital has decided that all appliances must be "cord free" if possible.  Health and safety box ticking leading to the scrapping of equipment and buying new to replace it.

A friend in Brighton worked at a Local Authority scheme to reduce bed blocking.  It was so badly run that carers were sitting around with nothing to do because the admin. found it impossible to match carers to patients needing to leave hospital.  The cost of this service per hour of care was over twice as much as similar services provided by the private sector.  It spent its budget in less than six months and closed.   The head of this "service" previously administered a local marina.  He arrived with the usual high salary and relocation package, was totally incompetent, considered his position and swanned off to wreak havoc in another local authority.  With a golden handshake and another relocation package.  

I work for my GP, helping him and his wife in their garden.  We talk as we work and both he and his wife are constantly stressed by the state of his practice.  He regularly works a six day week, often until ten or eleven at night because after seeing the ever growing number of patients he has to catch up on paper-work.  Even though there are twice as many clerical "support" workers than doctors.  The Practice Managers answer to this is to employee a Deputy Practice Manager.  Although he is the head of the health centre he feels that it is out of his control.  The admin. now control the budget and are telling him that he can't employ medical staff, he doesn't have enough money.

If services in this country are to be saved let alone improved the first thing that has to be done is someone from outside the existing structures has to be given a very large axe to hack away the un-necessary form filling and box ticking designed to keep the admin. employed.  This in itself will free much needed money and cut down on the money they waste.  The incompetents who somehow move effortlessly from one job to the next should be put on the dole and effective scaled down management re-introduced.

I could go on and on but I will get a "Ticket Mismatch" soon.

[fallen-archie]

I am pleased to confirm that I do and that the views of Mr Chomsky are also ok in small doses. The trouble is there is no reason in the arguments everything is crystal clear yet it isn't as straight forward as that and anyone with an inch of intelligence knows that!

[goldenwonders]

I think we could all tell stories of what would be good and bad about the NHS - and get opinions of what's right or wrong. But it is the simple things that could save large amounts of money I would like to highlight just two or three...

I've had two wrong prescriptions in the last 6 months - and been told  'don't worry just throw them in the bin' - 'the chemist won't have them back'. Crazy as the blister sealed capsules had been unopened, collected from the pharmacy, removed from the paper bag and taken straight into the surgery (next door) to point out their mistake!

I told one of my clients who has a severe form of arthritis about this - he said it happened to him, he had some EpiPen's delivered direct to his home - they were the incorrect ones, he took them back to his surgery to be told to dispose of them - they cost over £200!!!

My daughter has been a monitored for a heart condition since a baby - at Birmingham Childrens hospital. In the early years she had 6 monthly appointments, then sincethe age of ten, yearly appointments. I would say practically every appointment has been cancelled and the date changed. We have on a couple of occasions then had to change it again because it then conflicted with holiday commitments. This must have cost a fortune in both time and money.

I was telling a neighbour about this - she has regular eye appointments at Wolverhampton Eye Infirmary - apparently she says she has exactly the same thing happen regularly - cancelled and reissued appointments.

I saw recently that hospitals could save a fortune on disabled equipment - crutches, trays and various aids - if only more of us would return them. What a load of carp! When my father in law died five years ago, we tried to return all sorts of things and were told to just dispose of them as they could not have them back due to health and safety issues.

We appear to cater for every foreign language on the planet in the UK - and leaflets and brochures are available to suit! How much does that cost? I have friends in France who are British and they will tell you - if you don't speak the language that's tough in France - they will try and help but they don't waste a fortune catering for non speaking Frenchman.