The NHS is disputing Red Cross' claims of a humanitarian crisis across hospitals in England.
Should they be getting involved in the politics? Does the government need to be spending more on the NHS?
I really don't think that the total funding amount is the issue. It's the gross incompetence of the management, the wanton wastage and dire organisation that is the problem.
There are obvious examples of criminal waste going on. I remember a couple years ago there was a small outcry about the computer hardware contract that was across a number of hospitals. Thousands of computers plus industrial printers, scanners and much more. Anyone with any competence would strike a deal that involved a bulk buying discount. Instead the contract it turned out cost more than if they had walked into PC world and bought the stuff over the counter. And they weren't even getting the latest models.
Get vaguely competent people in the right positions and you will get savings without really trying.
I have huge respect for the medical staff in the NHS but the admin and middle management is chaos.
There have been cases of businessmen going into hospitals and reorganising the management and admin (not touching the medical side) and suddenly huge savings were made.
Agree in part that management could be better but in recent years the admin staff have been decimated. Saving on salaries certainly but piling immense pressure onto their colleagues who in my experience finally have to give it up and leave. It has also meant that clinical staff have to do a lot of the jobs previously done by others thus leaving them free to concentrate on the patients.
In my job I and my colleagues spent far to much time tracking down notes and sorting appointments. Completely necessary to the wellbeing of the patient but hardly good use of highly trained clinical staffs time.
The NHS is an absolute mess. I'm convinced that most of it will be in private hands in 20 years. A lot of it is already.
You don't know what you've got till its gone springs to mind. Still there are profits to be made and that's all that really matters.
One of the Government techniques in the public sector when cutting budgets is knowing that the cuts lead to job loses and as you say more workload on the staff remaining. The system is failing but they know that the remaining staff do what they can to keep things going, including unpaid hours, no breaks and working days off, and a lot of managers are not prepared to speak out concerned with their own jobs and CV make out things are manageable. So on paper it looks like things are ok and the cut backs have had no negative effects. The government/managers then say oh well you obviously easily managed with the last cuts which must mean you can cut things further.........rinse and repeat.
From an outsiders point of view, it seems to me the NHS spends far to much on medication that is not necessary - particularly to those that get it for free. It seems a lot of the time it's an easy option to dish out scripts, rather than deal with the underlining issues.
The sheer amount of services that are now available that weren't even considered when the NHS was conceived is phenomenal. We need to have a serious debate about what we want from the NHS. Is it there to provide treatment for those that are sick, or does it need to provide a full social service covering all areas of health?
If the former, then we need to remove services that are 'nice to have' or make people pay for them.
If the latter, then we need to fund it properly from taxation.
Finally the political nonsense being spouted by the Red Cross is a disgrace. They should be focussing their time and commitment to where it is really needed.
As a matter of interest. Which services do you think should not be provided. Not a snarky comment.
I was hoping nobody asked that specific questions as whatever I say some people will find controversial.
Removing an existing service provided by the NHS is going to upset various groups of people, many of whom feel that they have a 'right' to be supported by the NHS and in the end the tax payer. But we need to be mature enough to have that debate.
As an example, there has been a lot published recently about fertility treatment. What can be done now is amazing and brings a fulfillment and joy to many, many people. However, should it be something that the NHS provides or something that should be paid for by the recipients?
Sensible and mature discussions could be held over various contentious services. The problem is, more and more services are being provided year on year - some truly miraculous and life saving, others that may just improve quality of life.
None of us live for ever. Should taxpayers be expected to pay £1m a year to extend a bed bound 100 year olds life by a further 2 years?
It's difficult I know. And when it's a member of your own family, then it is even worse. But we need to do something. Because it sure isn't working now.
My Dad has been ill with lots of things wrong with him for the last two years so I have had a lot of dealings with the health service, and more to the point, Bexley social services. He has a catheter - if it gets infected he needs to see a nurse to have it replaced. Getting the district nurse out is pot luck, usually it means a 999 call and a relatively non-urgent ambulance. If he goes in on a Monday or Tuesday they usually let him out again the same day. If it is a Thursday or Friday it is guaranteed they will keep him in over the weekend, because there is no one to restart the care package. A simple admin function, probably cut years ago, means he is sat in a bed in hospital for up to 3-4 days more than needed. And that bed could be used by someone who needs it more. Multiply that across the country and you can see why there's a problem (only one reason I know). Social care has been cut and cut again, especially for adults, as it is a cinderella service that unless you have contact with it, no one will care. I've been trying for nearly a year to get the council to assess my dad to go into a nursing home. I've finally got them to meet him next week. Suspect that will be the next struggle, as they'll find a way of saying no because they don't want to pay for it. There needs to be a joined up service of care and health. But care is fragmented and I really feel sorry for the poor carers who come round on minimum wage every day to clean my dad. If they get stuck in traffic they don't get paid, and the pressure is on them all the time not to spend the full time allocated.
I don't think the Red Cross is wrong to say this. I read that 3 people died last week in Worcester hospital after being kept on trolleys as there were no beds. Probably because they were full of old people who couldn't go anywhere else.
I can see a couple of PhD theses coming based around examining the questions:
'We would not have the NHS today without the prior existence of the British Empire and the continued existence of the Commonweath of Nations.'
Followed by:
'The British Empire extracted vast wealth from many countries that were previously wealthy countries, there are many instances of gross misrule and some instances of massacre. It is difficult to assess whether any positives, such as general rule of law, democratic government where this did not previously exist, and infrastructure development and health service development in the former colonial countries outweigh the negatives. This paper seeks to examine the dichotomy between British empire as creator and British Empire as destroyer.'
I can see a couple of PhD theses coming based around examining the questions:
'We would not have the NHS today without the prior existence of the British Empire and the continued existence of the Commonweath of Nations.'
Followed by:
'The British Empire extracted vast wealth from many countries that were previously wealthy countries, there are many instances of gross misrule and some instances of massacre. It is difficult to assess whether any positives, such as general rule of law, democratic government where this did not previously exist, and infrastructure development and health service development in the former colonial countries outweigh the negatives. This paper seeks to examine the dichotomy between British empire as creator and British Empire as destroyer.'
Funnily enough I read a book called Ghosts of Empire that tackles some of the latter, arguing that the individualism and haphazard decision-making in much of the British Empire led to choas after the empire retreated. The author looks at Sudan, Kashmir, Nigeria, Iraq and Burma, all of which I think can be argued are a bit of a mess. It's an interesting book, well-written and I think skewers a lot of the neo-imperialism promoted by Niall Ferguson.
It's author is Kwasi Kwarteng - anti-imperialist radical Old Etonian Conservative MP for Spelthorne.
Seems to me that it's a similar story for a lot of things in this country. It needs a proper long term plan and politicians are not interested in the long term. Simpler to focus on the short term and throw money at things.
It's long overdue that we reduced the overseas aid budget and spent some of it on the NHS and other care services.
£12.2 billion pounds per annum is a staggering sum and if only £0.5M was diverted away from foreign causes such as Ethiopian pop groups (it now has), it would make a massive difference.
I'm all for foreign aid, but not in such massive sums, when our own services are in dire straits.
Agreed, one thing is for sure, every penny that goes to someone from abroad in NHS services should come out of our foreign aid budget. It might mean that there is less Spice Girl groups in Ethiopia, and for that I can only apologise for being a cold hearted bastard, but sometimes, and this is a cliche, charity begins at home.
If, as the sixth largest economy in the world, you cannot figure out how to provide proper care to your own citizens, it is ridiculous to blame people in foreign countries who desperately need help (some of which is the result of the empire). This is not a Labour or Toy thing, this is a human decency thing.
First of all, I would completely disagree with the idea that empire has been a negative influence on these countries. I would argue, as an example, that India would be far, far worse today were it not for the Empire's influence, and don't get me wrong a lot of that was to exploit their natural resources, but no one would deny the Romans did a lot, and I am sure a few hundred years from now once all the self hating people have died away the British Empire will be viewed in a similar way.
And I am not blaming foreign countries at all. My personal opinion is that money that is wasted is money that is wasted. We waste a LOT of money. Claims of £350 million a week are ridiculous when it comes to the EU, but we waste a lot of money that we needn't waste. A lot of money isn't going to blankets for Syrian migrants, or food for the starving, it is going to ridiculous vanity projects... Spending money for the sake of spending money (as we are commited to in our foreign aid budget as it is locked in at a percentage) is ridiculous.
As is always the case with the NHS, your opinion will be based entirely on your political leanings.
My personal opinion is that you could quadruple the amount of money the NHS gets and it would still be demanding more. That is not *just* a criticism of how much they love pissing money up the wall but also a comment about the drug companies/equipment manufacturers who will base their prices on what they know the NHS can afford.
It's the NHS though, so mustn't grumble... Labour good, Tories bad etc... Such an asinine argument.
I've worked in the NHS under both labour and conservatives. Both equally bad.
There are some fundamental issues regarding funding that are just not widely understood.
The NHS of today is about as high tech as you can get and it gets more high tech year on year. It's a fact of life that leading edge medical equipment is expensive and whereas 20 years ago it could adequately perform for a good number of years these days it's more or less obsolete buy the time it's bought and installed. Patients demand the best and why shouldn't they. The level of training required to use the new generations of equipment is enormous. Bright young things are just not interested in doing the highly educated stress filled, target driven under paid jobs the NHS has to offer.
Again. I could go on forever.
My point exactly, but instead, any time a Conservative so much as stands for election, they want to privatise the NHS and throw everyones gran out onto the pavement to die, whilst lighting their cigars with crisp £50 notes they have stolen off some poor pensioner somewhere. Like I said it is ridiculous and the arguments about the NHS are much, much more complex than that, especially with regards to things like NHS inflation which you mention. Medical inflation runs at a much higher rate than general inflation, for obvious reasons such as tech and innovation which costs money.
If you increase the value of the NHS budget year on year by the consumer prices index, in real terms for the NHS, it is getting poorer.
We'll have to agree to disagree on the empire, I would imagine that making people second class citizens in their own land, slavery and indentured servitude are probably seen as negative impacts "on these countries". But hey, we built some railways so it's all good.
Slavery? I suppose the British Empire only existed pre 1833?
Only on Charltonlife can you open a thread on the Red Cross claiming there's a humanitarian crisis in the NHS, skip straight to the most recent post and see its moved on to the British Empire and Slavery.
My Dad has been ill with lots of things wrong with him for the last two years so I have had a lot of dealings with the health service, and more to the point, Bexley social services. He has a catheter - if it gets infected he needs to see a nurse to have it replaced. Getting the district nurse out is pot luck, usually it means a 999 call and a relatively non-urgent ambulance. If he goes in on a Monday or Tuesday they usually let him out again the same day. If it is a Thursday it is guaranteed they will keep him in over the weekend, because there is no one to restart the care package. A simple admin function, probably cut years ago, means he is sat in a bed in hospital for up to 3-4 days more than needed. And that bed could be used by someone who needs it more. Multiply that across the country and you can see why there's a problem (only one reason I know). Social care has been cut and cut again, especially for adults, as it is a cinderella service that unless you have contact with it, no one will care. I've been trying for nearly a year to get the council to assess my dad to go into a nursing home. I've finally got them to meet him next week. Suspect that will be the next struggle, as they'll find a way of saying no because they don't want to pay for it. There needs to be a joined up service of care and health. But care is fragmented and I really feel sorry for the poor carers who come round on minimum wage every day to clean my dad. If they get stuck in traffic they don't get paid, and the pressure is on them all the time not to spend the full time allocated.
I don't think the Red Cross is wrong to say this. I read that 3 people died last week in Worcester hospital after being kept on trolleys as there were no beds. Probably because they were full of old people who couldn't go anywhere else.
I think this is the first mention of the knock on effect of this and previous government's approach to local government funding. Council's have been absolutely hammered in the last 7 years meaning less and less funding is available to provide social care (and everything else councils provide). There's zero doubt this has lead to people remaining in hospital who do not need to be there but there's no one to arrange and deliver the required care package to allow them to be discharged. Lack of bed space = queues in A&E = ambulances queueing ourside = increased response times for those needing them.
The Public Health functions of the NHS, the stuff that promotes longer term health benefits and is aimed at proactive prevention of factors that eventually result in increased spending on treatment, had funding previously ringfenced by the government. It was then transfered into the responsibility of local government and since then is now subject to the same budget cuts as other council services. I know for a fact PH managers are staggered at the situation they have now found themselves a part of and are struggling to manage the cuts that have been demanded on them.
Voters were told that the Tory party would continue to cut local authority budgets and voted accordingly. To an extent we are getting the situation that we voted for unfortunately.
Which African leader said 'The white man came and persuaded us to kneel down and pray, and when we opened our eyes our land was gone'.
Quite a few of them probably. But who was who said one man one vote once. Human nature is the same the world over, the rich want to remain rich at the expense of the less well off and the poor (or perceived poor) of the world want to be richer than their neighbours. Some of these African countries should be utopian paradises with their natural beauty farm land, climate and mineral wealth but the leaders seam to have carried on where the Europeans left off and taken it to a new level.
And today our health service employs a large number of people from the developing world, away from countries that need them and paid for their training. While we cut back on training budgets and outsource anything and everything. We are in a race to the bottom.
Well, I hope this thread runs and runs like the Brexit one does. In fact, if we had all (not just on CL) expended half as much time and energy debating how to fix the NHS, as we have wasted on the futile exercise of Brexit, we would all be in a much better place.
No, you sub contract different parts of the NHS out to private companies for a certain amount of time. If they offer poor performance over that period, they lose the contract.
No, you sub contract different parts of the NHS out to private companies for a certain amount of time. If they offer poor performance over that period, they lose the contract.
Happening already.
I must admit the model you suggest has worked wonders for the rail service.
Unfortunately the NHS is picking up a 7 year deficit in social care funding as are all of the emergency services - because they are becoming the only port of call in a storm as one by one other underfunded services slam the doors shut whenever they can. This is one of the massive sources of strain in the NHS. Another is that there is NOT room in the system for "efficiency savings" when people are already working more hours than they are paid for. Any savings that could be made will get swallowed up by underpayment to staff.
I know from personal experience that for some the option to work the extra few hours to make sure work gets done stops being an option - either because of the effect on the worker's wellbeing, or else the year on year demands that "this year we have to do what we did last year, but harder and better and with less staff seems an insurmountable hurdle and staff stop caring or leave.
I have already drafted my own resignation letter and it is going in tomorrow. Fuck it. I'm 56 and have lost the will to carry on in a job I am very experienced in and at which I used to be very good.
No, you sub contract different parts of the NHS out to private companies for a certain amount of time. If they offer poor performance over that period, they lose the contract.
Happening already.
I must admit the model you suggest has worked wonders for the rail service.
Well it has worked though hasn't it. I wasn't alive to see public railways but even I know that British Rail was a loathed institution. Railways now are better than they've ever been - frequency of trains is up and the stock (outside of London!) is replaced more frequently. I know this is a weak point in light of Southern Rail, but trains are no longer held to ransom by power hungry unions to the same extent as they were.
The NHS cannot continue become a public sector black hole because of a stupid socialist dream. Keep it free but let privitisation make it more efficient!
No, you sub contract different parts of the NHS out to private companies for a certain amount of time. If they offer poor performance over that period, they lose the contract.
Happening already.
I must admit the model you suggest has worked wonders for the rail service.
Well it has worked though hasn't it. I wasn't alive to see public railways but even I know that British Rail was a loathed institution. Railways now are better than they've ever been - frequency of trains is up and the stock (outside of London!) is replaced more frequently. I know this is a week point in light of Southern Rail, but trains are no longer held to ransom by power hungry unions to the same extent as they were.
The NHS cannot continue become a public sector black hole because of a stupid socialist dream. Keep it free but let privitisation make it more efficient!
Having travelled to several countries with public railways, I can without a doubt state they piss all over us in terms of value, efficiency and service. If you think we have good rolling stock outside of London, I would point you towards Northern Rail where they are still using trains that have been scrapped for decades by other countries on safety grounds, and where even though services into major cities such as Manchester, Leeds and Liverpool attract similar passenger numbers relative to London, most services only have 2 to 4 carriages every 30 mins, as opposed to 8 to 12 carriages every 10 minutes.
No, you sub contract different parts of the NHS out to private companies for a certain amount of time. If they offer poor performance over that period, they lose the contract.
Happening already.
I must admit the model you suggest has worked wonders for the rail service.
Well it has worked though hasn't it. I wasn't alive to see public railways but even I know that British Rail was a loathed institution. Railways now are better than they've ever been - frequency of trains is up and the stock (outside of London!) is replaced more frequently. I know this is a week point in light of Southern Rail, but trains are no longer held to ransom by power hungry unions to the same extent as they were.
The NHS cannot continue become a public sector black hole because of a stupid socialist dream. Keep it free but let privitisation make it more efficient!
that's exactly what's happening, I wasnt really around to remember the pre-privatised railway, but surely there was never a situation as crazy as the current Southern debacle ?
The railway system in the UK is a disgrace compared to the rest of Europe in terms of value for money and reliability. If anyone is suggesting the NHS follow this model of privatisation the British people deserve much more than this.
Posting without reading but in short the NHS requires a full overhaul - with medical development as rapid as it is, simply unworkable to have a free at point of use health system.
No, you sub contract different parts of the NHS out to private companies for a certain amount of time. If they offer poor performance over that period, they lose the contract.
Happening already.
I must admit the model you suggest has worked wonders for the rail service.
Well it has worked though hasn't it. I wasn't alive to see public railways but even I know that British Rail was a loathed institution. Railways now are better than they've ever been - frequency of trains is up and the stock (outside of London!) is replaced more frequently. I know this is a week point in light of Southern Rail, but trains are no longer held to ransom by power hungry unions to the same extent as they were.
The NHS cannot continue become a public sector black hole because of a stupid socialist dream. Keep it free but let privitisation make it more efficient!
British Rail was a running joke. It was however a running joke because it was underfunded for decades to the point that it couldn't function properly. The solution when it became just too much effort and money for the country to bear in terms of investment was to privatise.
The carrot for investors to take the franchises was a deal that guaranteed them profits far beyond what was good for either the railways or the country.
The result is a mishmash of services and companies each charging more for their inadequate service than in any other country on the planet. As usual the public lines their pockets.
I detest Jeremy Corbyn but on re privatisation of the railways he has it right.
This is exactly the route that is being planned for the NHS. It's being strangled year on year with nonsense ideology of efficiency savings that do not exist. When it gets to the point where the public no longer have faith or really care about it. It will be franchised out to line more people's pockets. I give it twenty years.
Comments
Removing an existing service provided by the NHS is going to upset various groups of people, many of whom feel that they have a 'right' to be supported by the NHS and in the end the tax payer. But we need to be mature enough to have that debate.
As an example, there has been a lot published recently about fertility treatment. What can be done now is amazing and brings a fulfillment and joy to many, many people. However, should it be something that the NHS provides or something that should be paid for by the recipients?
Sensible and mature discussions could be held over various contentious services. The problem is, more and more services are being provided year on year - some truly miraculous and life saving, others that may just improve quality of life.
None of us live for ever. Should taxpayers be expected to pay £1m a year to extend a bed bound 100 year olds life by a further 2 years?
It's difficult I know. And when it's a member of your own family, then it is even worse. But we need to do something. Because it sure isn't working now.
Social care has been cut and cut again, especially for adults, as it is a cinderella service that unless you have contact with it, no one will care. I've been trying for nearly a year to get the council to assess my dad to go into a nursing home. I've finally got them to meet him next week. Suspect that will be the next struggle, as they'll find a way of saying no because they don't want to pay for it.
There needs to be a joined up service of care and health. But care is fragmented and I really feel sorry for the poor carers who come round on minimum wage every day to clean my dad. If they get stuck in traffic they don't get paid, and the pressure is on them all the time not to spend the full time allocated.
I don't think the Red Cross is wrong to say this. I read that 3 people died last week in Worcester hospital after being kept on trolleys as there were no beds. Probably because they were full of old people who couldn't go anywhere else.
'We would not have the NHS today without the prior existence of the British Empire and the continued existence of the Commonweath of Nations.'
Followed by:
'The British Empire extracted vast wealth from many countries that were previously wealthy countries, there are many instances of gross misrule and some instances of massacre. It is difficult to assess whether any positives, such as general rule of law, democratic government where this did not previously exist, and infrastructure development and health service development in the former colonial countries outweigh the negatives. This paper seeks to examine the dichotomy between British empire as creator and British Empire as destroyer.'
It's author is Kwasi Kwarteng -
anti-imperialist radicalOld Etonian Conservative MP for Spelthorne.The Public Health functions of the NHS, the stuff that promotes longer term health benefits and is aimed at proactive prevention of factors that eventually result in increased spending on treatment, had funding previously ringfenced by the government. It was then transfered into the responsibility of local government and since then is now subject to the same budget cuts as other council services. I know for a fact PH managers are staggered at the situation they have now found themselves a part of and are struggling to manage the cuts that have been demanded on them.
Voters were told that the Tory party would continue to cut local authority budgets and voted accordingly. To an extent we are getting the situation that we voted for unfortunately.
But who was who said one man one vote once.
Human nature is the same the world over, the rich want to remain rich at the expense of the less well off and the poor (or perceived poor) of the world want to be richer than their neighbours.
Some of these African countries should be utopian paradises with their natural beauty farm land, climate and mineral wealth but the leaders seam to have carried on where the Europeans left off and taken it to a new level.
And today our health service employs a large number of people from the developing world, away from countries that need them and paid for their training. While we cut back on training budgets and outsource anything and everything.
We are in a race to the bottom.
*If you book an appointment and don't turn up, you get fined £20
Problem solved
I must admit the model you suggest has worked wonders for the rail service.
I know from personal experience that for some the option to work the extra few hours to make sure work gets done stops being an option - either because of the effect on the worker's wellbeing, or else the year on year demands that "this year we have to do what we did last year, but harder and better and with less staff seems an insurmountable hurdle and staff stop caring or leave.
I have already drafted my own resignation letter and it is going in tomorrow. Fuck it. I'm 56 and have lost the will to carry on in a job I am very experienced in and at which I used to be very good.
The NHS cannot continue become a public sector black hole because of a stupid socialist dream. Keep it free but let privitisation make it more efficient!
The carrot for investors to take the franchises was a deal that guaranteed them profits far beyond what was good for either the railways or the country.
The result is a mishmash of services and companies each charging more for their inadequate service than in any other country on the planet. As usual the public lines their pockets.
I detest Jeremy Corbyn but on re privatisation of the railways he has it right.
This is exactly the route that is being planned for the NHS. It's being strangled year on year with nonsense ideology of efficiency savings that do not exist. When it gets to the point where the public no longer have faith or really care about it. It will be franchised out to line more people's pockets. I give it twenty years.