The NHS?

[cee-dee]

How about we have a thread to put a cat amongst the pigeons?

The news headlines are full of criticisms about chaos in the A & E and about ambulance waiting times but have a think about what the cause of the problems really are?

The long and the short of it is that there are insufficient hospitals and (faithful, overworked) staff at the sharp end all coupled with an ever increasing population.

Now straight away critics will blame "The Government", however, it's not just happened in the last 10 years or so so you can forget jumping on the political bandwagon.

Leaving aside the shortages for a moment, have a look at how things are getting exploited by those "higher up" in the NHS.

At GP level, at one time doctors were happy to become a GP and some experienced doctors needed an incentive to become a Locum. They were expected to be able to cope and fit in with any eventuality so were paid accordingly. That was fine until the wider population of GPs thought that was such a great idea, getting more money for the same job so now hoards of them are packing in the GP job and becoming a Locum. Lack of GPs and the difficulty getting "an appointment" leads to people heading for A & E? The highest paid locum was reported to be coining in over £400k a year so why would anyone want to be a GP if they could make lots of extra money by doing that? Faced with the same situation, I suppose you'd do the same? The system is all wrong?

Now the "Health Boards". The one for this area has 75 people listed on the "Health Board Management Structure". What the heck are they doing? Isn't money being creamed off by relatively non-productive people?

Going back to the Ambulance/A & E waiting times, it's nothing new or just a Winter thing. A bit of history:-

After 10pm on 24th August 2015 (a Monday) I was to be transferried from a hospital here to another and on entering an ambulance I commented on the smell of diesel fumes. The Ambulance staff said they had been waiting outside A & E with a patient on board for five hours! They have to keep the engine running to power all the equipment. I couldn't count the ones waiting so I dunno how many were there.

Not long after that, on the 14th of September (a Monday) again late at night I was taken to the local hospital and had to wait before admission to A & E in the ambulance for over two hours.

So, those two experiences were not in the Winter or at a weekend or during a spell of "infections" at the hospital, it was just the sheer volume of patients requiring treatment and a shortage of beds and staff.

Now, what to do? There's no quick fix is there? Hospitals take time to build and equip not to mention lots of money but then there's the staff needed. Where are they coming from? You can't mass produce doctors or nurses. They tried that with teachers in the '60s by lowering standards and look what happened there?

So, what're we going to do? Any practical suggestions?

[theelench]

Fallen-archie has mentioned the legal vultures hovering around A&E.  That by itself leads to a lot of the interminable waiting around and also a huge waste of money.

On one of my rare visits to A&E I had what started out as a winter URTI and was treating myself at home with over the counter remedies.  Got up in the night with a very sore throat to take some more and realised I couldn't swallow it, so drove myself to A&E.

I was there for hours, mostly waiting for test results to come back, they did tests for everything it might conceivably be and even things it was almost impossible that it could be.  I was then transfered to another hospital with an ENT dept., for several days of observation.  Only when I got there and had been seen by an ENT consultant did treatment begin.  He re-opened my throat with something tubular with handles like scissors and prescribed a course of anti-biotics.

I can't critisise the staff or my treatment in any way but what in essence was simply a pretty bad throat infection must have cost the NHS thousands.  I took up a bed space for hours in A&E, most of the tests weren't really necessary, an emergency ambulance took me to a second hospital where I took up the time of a consultant who was then compelled to put me in another bed as the staff watched the anti-biotics cure me.

I'm sure the medical staff were 99.9% certain what was wrong with me about an hour after I was first seen in A&E.  A junior doctor could have treated me but with these vultures hovering every box must be ticked, every avenue explored and common sense completely ignored. 

[1956glyn]

On  a lighter note...next mood swing in 6 minutes?

You are very lucky....mine are every 3 !!

For those that may not know.....i am female and just use hubbys account to answer on the Boards.

[1956glyn]

Deleted as my replies are posting twice for some unknown reason

[right-then-petal]

i knew that your holding the camara

[margaret*e]

That is a good point, Creeky, also valid at the other end of life, babies, some born with severe defects that would have died quickly years ago can now survive, even very premature babies.

[fallen-archie]

Indeed Creeky has really put the spanner in the works with that one!
I know where he is coming from and to some extent I agree however having recently been saved myself I am eternally grateful to those who came to my aid and kept me alive, I have worked since I was a lad and was only 18 months away from retirement which I want to enjoy, I would also like to see my grandchildren when they are born so being in sound mind and still able to do the Telegraph crossword and with my faculties in place I am eternally grateful to be here and thank the NHS for all they did to prevent me shuffling of the mortal coil prematurely. If however I were institutionalised and unable to look after myself I am certain I would see things differently. We all need to acknowledge when we become a burden on society before it is too late to do so.

[dark_castle1]

That is easily explained shirl ! women always want the last word  

[Anonymous]

Lets count our blessings for the moment, we still have "free" healthcare. That is more than they have in many other countries.

In Holland people have to contribute towards their healthcare and you can be insured in different bands. Problem is that you never know when you might get an illness that is not covered in your band. Then you have to find the rest of your money somewhere else. Not easy when you are a pensioner or on benefits. So people start to go to the doctor less and self medicate or do without. They don't have much choice sometimes.

I have had my share of bad experiences with the NHS, really I have,  but I also saw how lucky I was that it was for free and my loved ones are still with me and I with them.

It doesn't mean that I don't think it needs a good overhaul though and some doctors need a good kicking...

[astrologica]

So have I Busty....anyone with a heart would have sympathy. Even folks who are anti-immigration have hearts...and sympathy.

[**bustysinclaire**]

I am not anti or pro astro xxx. I just have sympathy. Thankfully every country's problems will be solved soon so no matter who lives where, everyone will have the same as everyone else, the rich blessings that a perfect system on a perfect planet can provide, completely united. That us certainly something to look forward to IMHO. Xxx

I didn't really comment that you hadn't got sympathy either astro. I know from many of your posts you are dismayed at the terribly unfair problems and calamities that our planet and its occupants have to endure. Xxx

[1956glyn]

I am wondering how long have these legal vultures been hovering around A & E ?   I would certainly have something to say to them !

To be fair the last time (touch wood) we had to visit an A & E was over 5 years ago.   One parent was in Warwick Hospital  (30 miles away) for 6 months and my mother was in our local hospital both at the same time.  

I never saw any of these Vultures and between hubby and i we were visiting both hospitals almost on a daily basis.

Is this a fairly new thing?

[fallen-archie]

Not really, it’s been going on for some time, several years, even if there is no one there if you check the notice boards they often put their contact details on there. Equally there are tv ads from solicitors who specialise in medical claims, Personally I don’t see the difference between what they do and those who try and get you to claim when abroad for having an upset tummy.

[vamo48]

There is no easy answer to the NHS's problems, but I do think there are too many managers and too much waste.   I read recently that our local hospital was asking a consultant for ideas on what to change.  I thought "good idea, ask a senior doctor's opinion", - but no, they didn't mean that sort of consultant.  They are paying some outsider a fortune to tell them how to save money.  So, it doesn't look as if the answer is to throw money at the problem, and it also doesn't look as if common sense is becoming common any time soon.  

A&E should be used for accidents and emergencies (there's a novel idea), obvious time-wasters should be turned away, prisons should have their own resident doctors, and there should be more walk-in GP surgeries to deal with minor injuries.  

Finally, on the subject of immigration - take away all the doctors and nurses of foregin origin, and then see how the NHS copes.

[jd.linklater]

---

@vamo48 wrote:

There is no easy answer to the NHS's problems, but I do think there are too many managers and too much waste.   I read recently that our local hospital was asking a consultant for ideas on what to change.  I thought "good idea, ask a senior doctor's opinion", - but no, they didn't mean that sort of consultant.  They are paying some outsider a fortune to tell them how to save money.  So, it doesn't look as if the answer is to throw money at the problem, and it also doesn't look as if common sense is becoming common any time soon.  

A&E should be used for accidents and emergencies (there's a novel idea), obvious time-wasters should be turned away, prisons should have their own resident doctors, and there should be more walk-in GP surgeries to deal with minor injuries.  

Finally, on the subject of immigration - take away all the doctors and nurses of foregin origin, and then see how the NHS copes.

---

Now you're talking, latest figures from GOV.UK say that 48% of people employed by the NHS have no medical qualifications, what the hell are they all doing?

[fallen-archie]

I suppose if you take into account those who look after admin, laundry, porters, caterers, car park attendants, cleaners, security, electricians and maintenance personnel + the inevitable managers and accountants they will no doubt feature quite heavily in the figures,

[vamo48]

That is true, also the assistants in many departments are properly trained to do their jobs but are not qualified nurses.

Of more concern is the waste - here are a few examples.  Lighting and heating left on in rooms not in use.  Perfectly good waiting room seating from one department thrown out and replaced.  Paying for agency nurses, and paying to recruit nurses from abroad, rather than taking on experienced qualified nurses wishing to return part time after bring up their families.  

[theelench]

And who are these consultants?  All too often senior administrators between jobs.  There's a well established network amonst these people, they flit from one part of "public service" admin. to another collecting golden hand-shakes / good-byes and re-settlement allowances every time they move.  Working for consultancy companies in between to tide themselves over.

There's always plenty of things to review or study because their friends decide that these things need "outside" expertise to be made more efficient, and while the consultation is going on it can be pointed to as a way of deflecting any criticism of how poorly the in-post admin is doing its job.

A friend worked in Brighton for a "service" run jointly by the Council and the Health Care Trust providing short-term care for patients discharged from hospital.  The purpose being to stop bed blocking by getting patients out of hospital quicker.

The head of this service came directly from running the local marina, he created a labyrinth of senior management and immediately set up two reviews on how to run it in the most cost effective way.  (Because he didn't have a clue)  Meanwhile the under staffed front line spent hours every day doing nothing because of poor management, basically because managers spent more time in meetings with each other than doing anything else. 

The cost per hour of this "service" was more than twice that of equivalent private services.  The whole annual budget was spent in just over six months and the service was ended.  The Head of Service departed for another well paid job in Bristol.

This whole caste of dead-wood administrators need cutting out of the system, they infest Local Authorities, Housing Associations and Health Care and are often only there because they wouldn't survive without their supporting network in a really competitive environment.