# NHS rant alert



## Tashyboy (Jan 31, 2016)

Sat at home and chillin out with Missis T when I have come across a story on the BBC website.
In essence Sherwood Forest trust is in talks with a trust in Nottingham and Derby to take over the trust. It is in special maeasures and is bleeding money. It has to pay 3 million quid a month as PFI which will cost the trust 2.3 BILLION QUID til the deal expires in 2043. 
Who the flippin Eck signed this deal?
It is said that government money will have to be used  said       ( Mark Spencer MP aka fat useless waste of space knobber pal of miners&#128544 . Others have said it needs to be copper bottomed. what's that mean ?
The very thing that narks me about this is that the people who agree to this new deal will be the same vultures who agreed to a trust in the first place.
Missis T works for this trust and loves her job ( who wouldn't holding men's peckers all day), but despises the politics that are killing "the soul" of the NHS. She ( and her pals) flogs there guts out for this Trust and feel that me, you and Joe public are being shafted when it comes to how our hospitals are being run by the people that claim to know best, (politicians). 
This hospital has had more Chief execs over the last five years, positions invented, and is still in a massive financial mess. Why are these people not accountable.
Am off coz me bp is rising, and that's not good for my PD and I don't fancy going to Sherwood Forest hospitals for treatment.
Rant ( not quite ) over.


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## pokerjoke (Jan 31, 2016)

Tashyboy said:



			Sat at home and chillin out with Missis T when I have come across a story on the BBC website.
In essence Sherwood Forest trust is in talks with a trust in Nottingham and Derby to take over the trust. It is in special maeasures and is bleeding money. It has to pay 3 million quid a month as PFI which will cost the trust 2.3 BILLION QUID til the deal expires in 2043. 
Who the flippin Eck signed this deal?
It is said that government money will have to be used  said       ( Mark Spencer MP aka fat useless waste of space knobber pal of miners&#55357;&#56864 . Others have said it needs to be copper bottomed. what's that mean ?
The very thing that narks me about this is that the people who agree to this new deal will be the same vultures who agreed to a trust in the first place.
Missis T works for this trust and loves her job ( who wouldn't holding men's peckers all day), but despises the politics that are killing "the soul" of the NHS. She ( and her pals) flogs there guts out for this Trust and feel that me, you and Joe public are being shafted when it comes to how our hospitals are being run by the people that claim to know best, (politicians). 
This hospital has had more Chief execs over the last five years, positions invented, and is still in a massive financial mess. Why are these people not accountable.
Am off coz me bp is rising, and that's not good for my PD and I don't fancy going to Sherwood Forest hospitals for treatment.
Rant ( not quite ) over.
		
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You may well be right about what you say but not being from that area I couldn't comment.

However I have noticed and congratulations are in order you have officially become the biggest moaner on the forum.


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## Hobbit (Jan 31, 2016)

Think you're losing sight of the fact that it is in special measures, and failing, because of a high mortality rate. People are dying, and you want to argue politics?!?

There's a possibility of it being run by successful Trusts with far lower DEATH rates, and you're quibbling?


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## Blue in Munich (Jan 31, 2016)

Hobbit said:



			Think you're losing sight of the fact that it is in special measures, and failing, because of a high mortality rate. People are dying, and you want to argue politics?!?

There's a possibility of it being run by successful Trusts with far lower DEATH rates, and you're quibbling?
		
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And IF that high mortality rate is because they cannot afford equipment or staff because they are paying Â£3 million a month in interestâ€¦â€¦â€¦â€¦â€¦.?


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## Hobbit (Jan 31, 2016)

Blue in Munich said:



			And IF that high mortality rate is because they cannot afford equipment or staff because they are paying Â£3 million a month in interestâ€¦â€¦â€¦â€¦â€¦.?
		
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Then thank God a successful, well managed Trust will take over. Queen's Med in Nott is one of the best run Trusts in the UK and, if anything, the opportunity to have them run SFT should be welcomed.

Equipment replacement is covered by the original PFI agreement - it's one of the reasons PFI's are daylight robbery. 

Many Trusts have similar, and greater, levels of debt yet are not in special measures. Linking one with debt is a red herring.


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## Tashyboy (Jan 31, 2016)

Hobbit said:



			Think you're losing sight of the fact that it is in special measures, and failing, because of a high mortality rate. People are dying, and you want to argue politics?!?

There's a possibility of it being run by successful Trusts with far lower DEATH rates, and you're quibbling?
		
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Its been in special measures for the last couple of years but for people that have been using it well forever. It has been drowning since the day it became a trust. 
Blue has hit one of the nails on the head.
Missis T was telling me that one of her patients rang the local rag ( Chad ) and wanted a story saying what fantastic treatment she had received from the trust. The patient was told " No thanks" that won't sell papers.

Biggest moaner on the forum, cheers poker&#128077;&#128513;, I am chuffed I have got to retirement with all my fingers (pit joke ), but Missis T finishes in 17 months and will be leaving a job she loves and is not to chuffed at how her career is finishing to the detriment of others. &#128543;


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## Foxholer (Jan 31, 2016)

To me, this seems fairly typical of what is happening to many 'failing' hospitals!

Government (both Tory and Labour and there were even a few by the Coalition, but certainly fewer and with altered characteristics) imposed PFI on many projects for dodgy accounting motives. Then they have offloaded the ongoing costs to the Trusts (in the case of NHS). Where these have been too much to handle - on top of the 'normal' costs involved - then patient care, staff morale and necessary capital expenditure suffers. Oh, and top management use their flexibility to move - and do so!

It's still amazing how good the NHS can be in certain areas, even in facilities that are virtual nissen huts!

Here's an interesting analysis - not sure on the bias  - about the cost of PFI!

http://www.nhsforsale.info/privatisation-list/surgery/the-great-pfi-swindle.html

However, I agree with the fundamental tenet of PFI! The public sector *is* poor at managing large projects compared to the private sector. Unfortunately, it seems to be particularly bad at managing PFI contracts!!


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## Tashyboy (Jan 31, 2016)

Hobbit said:



			Think you're losing sight of the fact that it is in special measures, and failing, because of a high mortality rate. People are dying, and you want to argue politics?!?

There's a possibility of it being run by successful Trusts with far lower DEATH rates, and you're quibbling?
		
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Hobbit there is nothing you have said that I disagree with, apart from the politics view, ( bit about that in a min). 
I have actually said to Missis T, that even though your department ( urology ) is classed as excellent. The feel good factor in the hospital is rock bottom. I have told her, you may well be surprised that a successful trust may come in and appreciate what you/ your department actually do. So she may be in a win win situation. however uncertainty is a "bad man.
This is the bit about the politics that I do not understand. I have/had a mortgage and five years later I can get a better deal at another bank so I change banks. Sherwood Forest NHS trust cannot change banks and is stuck with massive debt. why?. Who allowed that to be signed? 

BUT.
It is now accepted that government cash will have to be used to allow the trust to be bought out. eh why? Why not use that government cash to get out of a financial deal that is strangling the Sherwood trust during past, present and future times.
When I worked at the pit, UK coal declared itself bankrupt. Then started up the day after owing nothing to no one. Even had my pants down on my pension. If  there Bank is unwilling to play ball, why can they not declare themselves bankrupt, then start up the following day as another company.

seeing as I am now the official no 1 moaner on here &#128513;&#128513;. The same could be said for the five " academy schools" in the north Notts area that have been classed as failing its pupils. Are academy's and trusts failing the people they were set up to serve? If so why? And who's to blame?


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## Tashyboy (Jan 31, 2016)

Foxholer said:



			To me, this seems fairly typical of what is happening to many 'failing' hospitals!

Government (both Tory and Labour and there were even a few by the Coalition, but certainly fewer and with altered characteristics) imposed PFI on many projects for dodgy accounting motives. Then they have offloaded the ongoing costs to the Trusts (in the case of NHS). Where these have been too much to handle - on top of the 'normal' costs involved - then patient care, staff morale and necessary capital expenditure suffers. Oh, and top management use their flexibility to move - and do so!

It's still amazing how good the NHS can be in certain areas, even in facilities that are virtual nissen huts!

Here's an interesting analysis - not sure on the bias  - about the cost of PFI!

http://www.nhsforsale.info/privatisation-list/surgery/the-great-pfi-swindle.html

However, I agree with the fundamental tenet of PFI! The public sector *is* poor at managing large projects compared to the private sector. Unfortunately, it seems to be particularly bad at managing PFI contracts!!
		
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Ow he's answered some of my questions, cheers foxy&#128077;


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## Hobbit (Jan 31, 2016)

The (usual) PFI terms are horrendous, and getting out from under them would be even more crippling. Imagine what it would cost to re-equip a full hospital 3 times during a 30 year lease. This is often one of the terms of a PFI. Imagine the cost of non-clinical services like catering/portering/estates mgt and repairs, and then there's the rent.

A typical theatre block, like that at SFT, would cost pushing Â£750k just for the anaesthetic machines. An ITU bed, with vent and pumps... Maybe Â£60k.

Can't see a PFI company walking away from that, nor the NHS being able to buy them out.


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## Hacker Khan (Jan 31, 2016)

Tashyboy said:



			Sat at home and chillin out with Missis T when I have come across a story on the BBC website.
In essence Sherwood Forest trust is in talks with a trust in Nottingham and Derby to take over the trust. It is in special maeasures and is bleeding money. It has to pay 3 million quid a month as PFI which will cost the trust 2.3 BILLION QUID til the deal expires in 2043. 
Who the flippin Eck signed this deal?
It is said that government money will have to be used  said       ( Mark Spencer MP aka fat useless waste of space knobber pal of miners&#128544 . Others have said it needs to be copper bottomed. what's that mean ?
The very thing that narks me about this is that the people who agree to this new deal will be the same vultures who agreed to a trust in the first place.
Missis T works for this trust and loves her job ( who wouldn't holding men's peckers all day), but despises the politics that are killing "the soul" of the NHS. She ( and her pals) flogs there guts out for this Trust and feel that me, you and Joe public are being shafted when it comes to how our hospitals are being run by the people that claim to know best, (politicians). 
This hospital has had more Chief execs over the last five years, positions invented, and is still in a massive financial mess. Why are these people not accountable.
Am off coz me bp is rising, and that's not good for my PD and* I don't fancy going to Sherwood Forest hospitals for treatment.*
Rant ( not quite ) over.
		
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How about if Sherwood Forest golf club took over the hospitals?  Would you go then?


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## Tashyboy (Jan 31, 2016)

Hacker Khan said:



			How about if Sherwood Forest golf club took over the hospitals?  Would you go then?
		
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hacker I bet they could do a better job. :whoo:


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## SocketRocket (Jan 31, 2016)

Tashyboy said:



			hacker I bet they could do a better job. :whoo:
		
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Cant say i would be looking forward to a Greenskeeper checking my prostate!


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## ScienceBoy (Feb 1, 2016)

Tashyboy golf does not stand for Good OutLet for Frustration...


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## Spartacus (Feb 1, 2016)

Problem with the NHS is the number of patients it now treats. 

There's always been the death/birth balance so the numbers shouldn't have changed much there, although more of the 'Kyle' generation spew out more kids for more handouts so there's a small increase.

It's the fatties and foreigners that drain it. I'm so fat because all it eat is cakes and crisps but help me because my body is failing. Add to that the number of foreign people, who don't contribute, who want help as their mud hut hospitals are a gazillion years behind as they're still fighting amongst each other over religion than moving forward and building for the future.


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## Ethan (Feb 1, 2016)

Tashyboy said:



			Sat at home and chillin out with Missis T when I have come across a story on the BBC website.
In essence Sherwood Forest trust is in talks with a trust in Nottingham and Derby to take over the trust. It is in special maeasures and is bleeding money. It has to pay 3 million quid a month as PFI which will cost the trust 2.3 BILLION QUID til the deal expires in 2043. 
Who the flippin Eck signed this deal?
It is said that government money will have to be used  said       ( Mark Spencer MP aka fat useless waste of space knobber pal of miners&#128544 . Others have said it needs to be copper bottomed. what's that mean ?
The very thing that narks me about this is that the people who agree to this new deal will be the same vultures who agreed to a trust in the first place.
Missis T works for this trust and loves her job ( who wouldn't holding men's peckers all day), but despises the politics that are killing "the soul" of the NHS. She ( and her pals) flogs there guts out for this Trust and feel that me, you and Joe public are being shafted when it comes to how our hospitals are being run by the people that claim to know best, (politicians). 
This hospital has had more Chief execs over the last five years, positions invented, and is still in a massive financial mess. Why are these people not accountable.
Am off coz me bp is rising, and that's not good for my PD and I don't fancy going to Sherwood Forest hospitals for treatment.
Rant ( not quite ) over.
		
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PFI is the scandal the public knows little about. Private companies build hospitals, and rent them to the NHS at extortionate rates, with crippling maintenance contracts for 30 years, then can kick the NHS out and walk away. The deals were negotiated between skilled private sector negotiators and numpties at the DH. Guess who got the better deal? Many of the contracts were sold on at he profits after completion, such was the obvious profit contained within. 

PFI was a way for politicians to deliver shiny new hospitals, and off balance sheet (not part of the public debt). If there ever was a selling off the family silver, and throwing in most of the family's gold too, it is PFI. 

The ultimate irony occurred when HMRC sold off their buildings on a leaseback basis to a company which then turned out to be offshore.


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## Kellfire (Feb 1, 2016)

Spartacus said:



			It's the fatties and foreigners that drain it. I'm so fat because all it eat is cakes and crisps but help me because my body is failing. Add to that the number of foreign people, who don't contribute, who want help as their mud hut hospitals are a gazillion years behind as they're still fighting amongst each other over religion than moving forward and building for the future.
		
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Wow.


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## Tashyboy (Feb 1, 2016)

ScienceBoy said:



			Tashyboy golf does not stand for Good OutLet for Frustration...
		
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It don't but am going to use that one tomorrow on the course &#128513;


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## Tashyboy (Feb 1, 2016)

Ethan said:



			PFI is the scandal the public knows little about. Private companies build hospitals, and rent them to the NHS at extortionate rates, with crippling maintenance contracts for 30 years, then can kick the NHS out and walk away. The deals were negotiated between skilled private sector negotiators and numpties at the DH. Guess who got the better deal? Many of the contracts were sold on at he profits after completion, such was the obvious profit contained within. 

PFI was a way for politicians to deliver shiny new hospitals, and off balance sheet (not part of the public debt). If there ever was a selling off the family silver, and throwing in most of the family's gold too, it is PFI. 

The ultimate irony occurred when HMRC sold off their buildings on a leaseback basis to a company which then turned out to be offshore.
		
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Ethan, Why are trusts not able to renegotiate financial deals ? like I have mentioned my company walked away from its financial rssposibilities and started up again the following day under another name. Why can't trusts do the same and remove the financial burden.


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## Ethan (Feb 1, 2016)

Spartacus said:



			It's the fatties and foreigners that drain it. I'm so fat because all it eat is cakes and crisps but help me because my body is failing. Add to that the number of foreign people, who don't contribute, who want help as their mud hut hospitals are a gazillion years behind as they're still fighting amongst each other over religion than moving forward and building for the future.
		
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Fatties, for sure.

Foreigners are not a major issue for the NHS. 

Most foreigners in this country do not come from mud huts and only an offensive trolling bigot would argue as much.


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## Bunkermagnet (Feb 1, 2016)

Lets be honest, every part of the NHS could and should be looked at regarding it's financial accountability. I know plenty of nurses who would rather be an agency nurse than be "on the books". They get paid more for less days worked. Whatever the rights or wrongs of the  permanent staff pay levels, there are still plenty milking it for their own gains.


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## Kellfire (Feb 1, 2016)

I see it every day in my job (determining inpatient/day case patient cost) how much tighter the NHS is getting with its funding and (more precisely, in my case) how Trusts are determined to secure as much funding as they can for the patients that they see from the NHS. There are levels of scrutiny behind patient flow and treatment (planning, at the time and after the event) that wasn't evident even five years ago. 

The NHS is in new levels of accountability.


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## Foxholer (Feb 1, 2016)

Kellfire said:



			I see it every day in my job (determining inpatient/day case patient cost) how much tighter the NHS is getting with its funding and (more precisely, in my case) how Trusts are determined to secure as much funding as they can for the patients that they see from the NHS. There are levels of scrutiny behind patient flow and treatment (planning, at the time and after the event) that wasn't evident even five years ago. 

The NHS is in new levels of accountability.
		
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Is that actually 'accountability' - as in being accountable/responsible - or simply 'requesting cost justification/affordability/funding allocation' - as in 'charge-ability!'? Both laudable, but very different, exercises!


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## Kellfire (Feb 1, 2016)

Foxholer said:



			Is that actually 'accountability' - as in being accountable/responsible - or simply 'requesting cost justification/affordability/funding allocation' - as in 'charge-ability!'? Both laudable, but very different, exercises!
		
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Actual accountability -  clinicians are much more involved in the allocation of funding to their work, making themselves more available to discuss the recording of their work for example. My Trust is also implementing new processes constantly to stream line areas of the hospital (A&E being under extremely high scrutiny for their admittance times), all staff being asked to give a simple idea for cost saving at their annual performance review, posts that are vacated undergo much tighter scrutiny (my department have had to justify two posts recently to the board that were up for filling).

Compared to what I saw when I first joined the NHS, times are changing rapidly.


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## Hobbit (Feb 1, 2016)

There are some fantastic, commercially aware managers within the NHS, and they are a blessing to deal with. They drive a proper hard bargain and 'win' much for the organisation but, equally, understand that the 'win' has to be for both sides. 

And then there are the dinosaurs from a time long, long ago who should be put out to grass.


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## Tashyboy (Feb 1, 2016)

Hobbit said:



			There are some fantastic, commercially aware managers within the NHS, and they are a blessing to deal with. They drive a proper hard bargain and 'win' much for the organisation but, equally, understand that the 'win' has to be for both sides. 

And then there are the dinosaurs from a time long, long ago who should be put out to grass.
		
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Hobbit the bit I don't understand is, X number of years ago when Sherwood Forest hospitals decided to become a trust. Someone signed for the "financial package" of the deal. If it was the chief exec at that time. Surely signing a multi billion deal was not his forte. So how was this/these allowed to happen. Money being made by trusts is going out of the hospital into banks.


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## Ethan (Feb 1, 2016)

The internal market introduced by the Tories around 1990 set the NHS on the road to ruin. Ostensibly it was intended to introduce innovation using market techniques, but a national (or even local) health service does not operate like a proper market. Instead, what happened was that a lot more transaction costs were introduced and activity switched to that which could be measured at the expense of other less measurable things which mattered. Then people start to game the system. Set a 4 hour A&E waiting time (from check in to disposal) and what happens is that ambulances are not allowed to park when things are busy, so drive around the car park. Seriously. 

The results of this massive disaggregation has been hugely costly. Every NHS Trust has a separate committee to evaluate new medicines., But medicines work the same in one part of the country as another. This is all massive duplication. Same for loads of other stuff, which bleeds money, and enforced PFI deals costs a fortune. 

But the long game was privatisation, at least in part, so work continued to put in place systems to measure stuff for billing and productivity measures, and to make the workforce more flexible by changing work practices and reducing pension and salary bills. Legislative steps have been taken to allow parts of the NHS to be tendered to any wiling provider, with no preference allowable to NHS services, removing ultimate responsibility for the NHS from the Sec of State for Health and making much of the correspondence relating to the contractual deals inaccessible to FOI requests. 

It is probably too far gone now to fix. I would favour removal of the internal market entirely and going back to an old style top down command and control system.


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## Hobbit (Feb 1, 2016)

Tashyboy said:



			Hobbit the bit I don't understand is, X number of years ago when Sherwood Forest hospitals decided to become a trust. Someone signed for the "financial package" of the deal. If it was the chief exec at that time. Surely signing a multi billion deal was not his forte. So how was this/these allowed to happen. Money being made by trusts is going out of the hospital into banks.
		
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Turning it into a Trust wasn't the worst thing. PFI + all the other outsourced (read money syphoning) dept etc is what is killing it. 

You've hit one of the nails on the head, i.e. money going out of the NHS at disproportionate levels. Depts/organisations being set up to, basically, syphon money off. NHS Supply Chain; its a misnomer. Its majority owned by DHL. They skim a bit of every deal from the Trust and a bit from the supplier....

Aaaaaarrggghhh! And breathe in, 2,3,4 and relax.


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## Ethan (Feb 1, 2016)

Hobbit said:



			Turning it into a Trust wasn't the worst thing. PFI + all the other outsourced (read money syphoning) dept etc is what is killing it. 

You've hit one of the nails on the head, i.e. money going out of the NHS at disproportionate levels. Depts/organisations being set up to, basically, syphon money off. NHS Supply Chain; its a misnomer. Its majority owned by DHL. They skim a bit of every deal from the Trust and a bit from the supplier....

Aaaaaarrggghhh! And breathe in, 2,3,4 and relax.
		
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This is the issue. Spending on the NHS rose under several GOvts, but spending on actual healthcare fell while spending on other rubbish within the NHS rose sharply. Some of this was obscured by failure to reclassify clinical personnel switched to managerial roles.


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## Foxholer (Feb 1, 2016)

Kellfire said:



			Actual accountability -  clinicians are much more involved in the allocation of funding to their work, making themselves more available to discuss the recording of their work for example. My Trust is also implementing new processes constantly to stream line areas of the hospital (A&E being under extremely high scrutiny for their admittance times), all staff being asked to give a simple idea for cost saving at their annual performance review, posts that are vacated undergo much tighter scrutiny (my department have had to justify two posts recently to the board that were up for filling).

Compared to what I saw when I first joined the NHS, times are changing rapidly.
		
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Still seems more like Accounting than Accountability to me!

To perhaps labour my point, what processes (and possible sanctions) have you specified for when something goes wrong? Or have you merely analysed/assigned costs to the specific procedures involved - perhaps including some sort of average/contingency for cases where things can go wrong?


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## Kellfire (Feb 1, 2016)

Foxholer said:



			Still seems more like Accounting than Accountability to me!

To perhaps labour my point, what processes (and possible sanctions) have you specified for when something goes wrong? Or have you merely analysed/assigned costs to the specific procedures involved - perhaps including some sort of average/contingency for cases where things can go wrong?
		
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My department assign pre-determined cost codes for both diagnoses and procedures, based on WHO and NHS/HSCIC guidance - we don't have discretion to alter things on the fly. We do record any complications (aka things going "wrong") and longevity of stay changes the finances considerably. The costs behind the codes are reviewed every year, along with the rules behind them so it's a constantly changing process as medical advancements are made and the NHS analyses the information we send them each year.

Sanctions etc are handled by a separate team. We are kept away from that side of things so that we are not influenced in how to record the information in a way to maximise money or to obscure clinical error.


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## Ethan (Feb 1, 2016)

Kellfire said:



			Actual accountability -  clinicians are much more involved in the allocation of funding to their work, making themselves more available to discuss the recording of their work for example. My Trust is also implementing new processes constantly to stream line areas of the hospital (A&E being under extremely high scrutiny for their admittance times), all staff being asked to give a simple idea for cost saving at their annual performance review, posts that are vacated undergo much tighter scrutiny (my department have had to justify two posts recently to the board that were up for filling).

Compared to what I saw when I first joined the NHS, *times are changing rapidly*.
		
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Indeed, for the worse. 

Some of the stuff you mention, A&E 4 hour wait, for example, is a complete and utter waste of time and diverts and distorts practice and resources, not to mention is gamed by every Trust. So long as people are triaged properly, people who have no need to be there can wait all day for all I care. Might encourage them not to come back for something trivial. 

I can think of one great cost saving idea - get rid of Trust structures and process entirely and return to regional and local health authorities.


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## SocketRocket (Feb 1, 2016)

So in short it's all the Conservatives fault then?


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## Ethan (Feb 1, 2016)

SocketRocket said:



			So in short it's all the Conservatives fault then?
		
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Well, the Tories started the internal market, Blair continued the job, but the present lot have accelerated further and probably through the point of no return. It is mostly the Tories fault.


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## HomerJSimpson (Feb 1, 2016)

Find it hard recruiting an ever increasing raft of middle management (band 6-8) that seem to be providing little real term results. No idea what some of these fancy titles are designed to deliver but galling when we are struggling to get HCA's, nurses and midwives in to fill an increasing number of positions, thus becoming ever more reliant on agency spend and therefore more cost


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## SocketRocket (Feb 1, 2016)

Ethan said:



			Well, the Tories started the internal market, Blair continued the job, but the present lot have accelerated further and probably through the point of no return. It is mostly the Tories fault.
		
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In your opinion of course!


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## Foxholer (Feb 1, 2016)

Kellfire said:



			My department assign pre-determined cost codes for both diagnoses and procedures, based on WHO and NHS/HSCIC guidance - we don't have discretion to alter things on the fly. We do record any complications (aka things going "wrong") and longevity of stay changes the finances considerably. The costs behind the codes are reviewed every year, along with the rules behind them so it's a constantly changing process as medical advancements are made and the NHS analyses the information we send them each year.

Sanctions etc are handled by a separate team. We are kept away from that side of things so that we are not influenced in how to record the information in a way to maximise money or to obscure clinical error.
		
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I'm now absolutely certain that what you are talking about is Accounting, NOT Accountability!


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## Kellfire (Feb 1, 2016)

I'm in the "accounting" side of things. I'm not personally involved in the accountability side.


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## Tashyboy (Feb 1, 2016)

Kellfire said:



			I'm in the "accounting" side of things. I'm not personally involved in the accountability side.
		
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Give over kellfire, that old cheggar. &#128513;


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## Ethan (Feb 2, 2016)

SocketRocket said:



			In your opinion of course!
		
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Have you an opinion? Care to share?

Tell me what I said that you think is incorrect and why.


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## Kellfire (Feb 2, 2016)

Tashyboy said:



			Give over kellfire, that old cheggar. &#55357;&#56833;
		
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Well, I am. I'm nowhere near senior enough to hold anyone accountable except some limited amount over the people in the team I lead, but from my relatively low position I see people being held much more accountable than previously. Not saying it's ideal yet but it's improving.


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## Tashyboy (Feb 2, 2016)

Kellfire said:



			Well, I am. I'm nowhere near senior enough to hold anyone accountable except some limited amount over the people in the team I lead, but from my relatively low position I see people being held much more accountable than previously. Not saying it's ideal yet but it's improving.
		
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Kellfire, am joking honest, but to pick up on what you say re accountability. Missis T and colleagues have the view that when it comes to accountability. Drs , nurses, care assistants etc know and accept they have IT. But there is a level within the NHS that does not know what it means and are not held accountable for there
 " mistakes".


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## Ethan (Feb 2, 2016)

But this talking about financial accountability, demanding that they code every procedure and interaction, cost everything, and lots of paperwork. It is a nonsense and a complete waste of time and money. Doctors want clinical accountability and responsibility, but management don't want that. The idea that these changes are to improve patient care is risible, and demonstrably false. 

Back in the day, if I saw a patient at a medical outpatients, and found they had a specialist problem, say a neurological issue, I could call round to the neuro clinic running at the same time, get someone to see the patient and they would walk round there and then. Now, doctors have to write a letter to the GP, ask the GP to make a new referral, punter goes home, goes to see GP, gets a new appointment 6 weeks later and goes back to the hospital. All in the name of financial accountability.

Likewise, if a GP send a latter to a named Consultant for a referral, the letter is intercepted by a referral team, who check the details against their clipboard, and if they find something missing, they bounce the referral. The Consultant never even sees it. But it helps manage the waiting list because it does not count as a valid referral. 

Every Trust has a formulary committee (or similar). Every time a new medicine is approved, each Trust then reviews the clinical data and makes a decision on how it will be used in that Trust. Now, whether it is a good medicine or a bad medicine, it works pretty much the same in patients in Northampton as Newcastle, yet a range of different decisions emerge. This is a colossal waste of time and money. 

The A&E 4 hour wait limit causes convulsions in hospital management. It is based on the interval between arrival in the dept and disposal (admission, discharge etc). So if the wait time starts to approach 4 hours and there is a risk of "breach", squads of managers descend and start to harass staff to move patients through. They also instruct ambulances with non urgent cases not to arrive, so they wait in the car park. They generally don't bring extra staff or muck in themselves. 

Most of these targets get gamed and distort proper clinical priorities, although they make keep the books tidy.


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## SocketRocket (Feb 2, 2016)

Ethan said:



			Have you an opinion? Care to share?

Tell me what I said that you think is incorrect and why.
		
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I never suggested you were wrong, I only suggested it was your opinion.   Others may have different opinions and they will also believe them to be right.

I dont hold any particular opinion as I believe the issues are very complex and subjective.   I can see that there has been rather a lot of Government input into the way the NHS operates and that has been the case as long as it has been in existence, but as they are the purse holders of Public funds so I guess they will want and expect some input on our behalf.  I guess we have a choice during elections on who we prefer to hold that purse.

I would like to think that all Governments have the best interest of the NHS at heart and are being advised by a great army of civil servants, I doubt if many Ministers have the where-with-all to understand the complexity of the organisation.  Maybe we have the wrong people in the Civil Service?

I doubt very much if the NHS will ever exist without financial problems, whatever is poured into the hole it will still be a black one with an insatiable appetite for the green dollar.    We would like to believe that this very large investment will be  used to the best effect and value is wrung out of every buck.  Somehow I cant see that ever happening.

I like to look at issues from different angles and have a detached view that is not blinkered by sentiment.   Some Health Services in other countries seem to be working well and don't seem to produce the emotion and strife we experience.  Germany and Australia for example seem to produce the product and to a high standard but they seem to use a mixture of State and Private insurance to fund and service it.   I am not an expert on the subject by any means but I think we should be more open in looking into such schemes rather that considering them the work of the Devil.

I would also agree with current suggestions that an ageing population is putting an amount of stress on the NHS and would also say that the increased user base is also doing the same.   We don't seem to have increased services to take account of these factors, even though we have known they are happening.

Will there ever be enough money available to make it work?    I don't think so!

As I suggested I am not an expert but thats the way I see it at the moment.


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## Tashyboy (Feb 26, 2016)

Missis T has just got in from work and is having a nice little rant. been sat in an office most of the afternoon with consultants etc listening to managers talk about "the vision for the future". 
Anyway they have been told that they can no longer have "open " appointments. reason being that when patients are referred again for the same problem, there GP has to pay again. Missis T and others said if you think we will discharge patients who have ongoing cancer and other long term conditions you can get stuffed. After much discussion managers agreed there " may" be special circumstances where open appointments may be used.
Heres the best one. Said manager then said that "Anyone who is serving or has served in HM forces that needs an appointment, they are in the same category as cancer patients, and will be seen within 2 weeks". Now Missis T and said consultants were livid and asked how long this has been the case and why were they not told from day one.
So ladies and gents, if you know of any serving or served members of our forces please let them know. If anyone has anything to add to this, please add.
Have a good weekend Tash.


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## Deleted member 16999 (Feb 26, 2016)

Tashyboy said:



			Missis T has just got in from work and is having a nice little rant. been sat in an office most of the afternoon with consultants etc listening to managers talk about "the vision for the future". 
Anyway they have been told that they can no longer have "open " appointments. reason being that when patients are referred again for the same problem, there GP has to pay again. Missis T and others said if you think we will discharge patients who have ongoing cancer and other long term conditions you can get stuffed. After much discussion managers agreed there " may" be special circumstances where open appointments may be used.
Heres the best one. Said manager then said that "Anyone who is serving or has served in HM forces that needs an appointment, they are in the same category as cancer patients, and will be seen within 2 weeks". Now Missis T and said consultants were livid and asked how long this has been the case and why were they not told from day one.
So ladies and gents, if you know of any serving or served members of our forces please let them know. If anyone has anything to add to this, please add.
Have a good weekend Tash.
		
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Been in a while mate, it's part of the Governments "Armed Forces Covenant" some hospitals/areas are aware, some less so.
We are meant to make our GP's mention it when being referred and then the hospitals are meant to react.
It somehow seems wrong to me and my missus, why are we anymore medically important than someone else who needs treatment.


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## Tashyboy (Feb 26, 2016)

pauldj42 said:



			Been in a while mate, it's part of the Governments "Armed Forces Covenant" some hospitals/areas are aware, some less so.
We are meant to make our GP's mention it when being referred and then the hospitals are meant to react.
It somehow seems wrong to me and my missus, why are we anymore medically important than someone else who needs treatment.
		
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I think your first sentance is what Missis T and Co were unhappy about not being informed about when it first came out.
having said that, I know where you are coming from to an extent. However talking to one of my lads pals who comes out of the army soon (medically discharged).
He has seen some bad things (as has probably most) and I would like to think he would or should be in front of me in the queue.
Got a pal in the TA REME's, sergeant now. Served in the first Gulf war, anyway he has had some serious medical problems and I don't know if A, serving TA soldiers qualify, B if he is aware.


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## Deleted member 16999 (Feb 26, 2016)

Tashyboy said:



			I think your first sentance is what Missis T and Co were unhappy about not being informed about when it first came out.
having said that, I know where you are coming from to an extent. However talking to one of my lads pals who comes out of the army soon (medically discharged).
He has seen some bad things (as has probably most) and I would like to think he would or should be in front of me in the queue.
Got a pal in the TA REME's, sergeant now. Served in the first Gulf war, anyway he has had some serious medical problems and I don't know if A, serving TA soldiers qualify, B if he is aware.
		
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If he suffered the problems whilst on Duty he'd already be in "the system" already and those looking after him should be aware, Any TA soldier injured on Duty would be covered.
I get the point about service personnel seeing some bad things, but possibly no worse to what some civilians have seen and I don't think they should be less of a priority.
My missus is ex-military, registered disabled and receives a war pension, but she won't use her previous service to queue jump, even though the MOD were found liable for some of her health problems.
The Government announced the Covenant in 2013!


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## Tashyboy (Feb 27, 2016)

Just told Missis T re the 2013 date. Don't suprise her at all.


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## Kellfire (Feb 29, 2016)

Armed forces/ex-armed forces getting preferential treatment is disgusting, in my opinion. All because they picked a certain job?

If there was still conscription then _maybe_ there's an argument for it, but in an era of people actively choosing to serve, no way.


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## Deleted member 16999 (Feb 29, 2016)

Kellfire said:



			Armed forces/ex-armed forces getting preferential treatment is disgusting, in my opinion. All because they picked a certain job?

If there was still conscription then _maybe_ there's an argument for it, but in an era of people actively choosing to serve, no way.
		
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I agree with your point we chose our certain job, but we also didn't ask for the preferential treatment, that was the government, The only service personnel who should get preferential treatment imo are those who were injured in conflict.


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## Tashyboy (Mar 18, 2016)

Seen the best and worst of the NHS over the last couple of days and I am not a happy bunny at all.
As previously mentioned on another NHS thread Missis T has been having a bad back of late, But for last 8 days has been in agony.
Last night we ended up in A and E at 22.20, she sat, walked and stumbled in agony til midnight when she was seen by a nurse. BP through the roof. She showed them the analgesia she had been prescribed which was not helping. She was taken to 
a and e inner sanctum and handed over to another nurse who would prescribe analgesia.
At 01.00 she was offered the same medication which she had in her bag. Missis T was close to tears, said nurse said " well what has the dr said". Through gritted teeth I told her we have not seen one yet. At 01.30, some three hrs later she was given stronger pain killers.
15 mins later she saw a surgical dr and from that point everything has been excellent. But she is still in pain, and at times a lot of it.
But and this is a massive but, Triage in A and E, why treat it in chronological order. Asses yes, but treat no. There are people with cut fingers and sprained ankles being seen before baby's, children and people in agony. Having had several scans today they are still not sure what the problem is. They still think it is still a back problem and rang the hospital trust ( who is taking over kings mill) who has a back specialists. They said "sort out her pain problem before we even contemplate seeing her".
Quite frankly I am bogged off with some of the standard of treatment she has recieved.


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## SocketRocket (Mar 18, 2016)

A relative collapsed this week after some heavy internal bleeding.  He was taken to Hospital and given a blood transfusion and some coagulant medication.  He was then sent home as there was no bed available and has to go back for a colonoscopy in two weeks.  You can imagine how he must be feeling!


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## Big Whacker (Mar 19, 2016)

A and E is for life threatening injuries or serious accidents.

Local GP's are for everything else.

It's no wonder there's a strain.


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## Tashyboy (Mar 19, 2016)

What did not help is that the receptioniat asks everyone if they want to see a dr next door. 
Should that not be the job of a triage nurse?
Patients in here abusing staff in no way helps either.


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## Ethan (Mar 19, 2016)

Triage arose in war, as a way of sifting the walking wounded (who could wait) and the hopelessly wounded (who were too far gone) from those who needed immediate care not to fall into the latter category. It is a widely held view amongst medical circles that triage should be performed by the best trained person available, as it is a very challenging task. 

Triage in EDs serves a slightly different purpose. ED managers are most worried about breaching the 4 hour target, so triage also serves to move people through the sausage machine. It means that complete wasters who have sod all wrong with them still need to get seen, so people that actually have something not too serious but worthy of an ED visit wait longer than they should. It also means that Trusts game the system. When waiting times rise, they do not allow ambulances to check in unless with serious cases, so others drive around the car park, or park offside for a while. Ridiculous. The punters are just as sick, but the managers top the clock starting until they are ready. 

The issue of demand is interesting. The population is not any more sick than it was 10 years ago. In fact, people are generally a bit healthier. So where is the demand coming from? A lot is coming from the toxic combination of raised expectations and low quality referrals. 111 is a curse, and send far too many people to EDs and too many ambulances out. The 111 algorithms are very very risk averse. A GP reported a recent case where a patient found a feather in her infant sons nappy, and called 111. They advised her to go urgently to the local ED. Not sure if they thought the kid was at risk of metamorphosing into a bird and flying off, but time wasted round. Doctor forums are full of similar stupid referrals. If you ever say you are having difficulty breathing, there will be a blue light ambulance at your door, even if you have had difficulty since 1976. The Govt have also raised expectations by promising this and that, putting targets and giving health advice to see a doctor if ... lets of things. 

All is made worse by the staffing pressures in GP land and hospitals. There is a major 5 alarm bell head to the lifeboats crisis coming in the NHS and it is the fault of successive Governments, mostly Tory but also New Labour who have driven morale, pay and conditions and career prospects down so far that Aus and NZ are much much better options. Canada is pretty popular with young doctors too. When I was a lad, it was next to impossible to get onto the GP training scheme in Northern Ireland, such was the demand. Now they can't fill the posts. The situation is EVEN worse in most other parts of the UK. 

My wife and I are both doctors and we will be doing what we can to persuade our scientifically minded sons to choose something else.


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## SocketRocket (Mar 19, 2016)

Ethan said:



			Triage arose in war, as a way of sifting the walking wounded (who could wait) and the hopelessly wounded (who were too far gone) from those who needed immediate care not to fall into the latter category. It is a widely held view amongst medical circles that triage should be performed by the best trained person available, as it is a very challenging task. 

Triage in EDs serves a slightly different purpose. ED managers are most worried about breaching the 4 hour target, so triage also serves to move people through the sausage machine. It means that complete wasters who have sod all wrong with them still need to get seen, so people that actually have something not too serious but worthy of an ED visit wait longer than they should. It also means that Trusts game the system. When waiting times rise, they do not allow ambulances to check in unless with serious cases, so others drive around the car park, or park offside for a while. Ridiculous. The punters are just as sick, but the managers top the clock starting until they are ready. 

The issue of demand is interesting. *The population is not any more sick than it was 10 years ago. In fact, people are generally a bit healthier. So where is the demand coming from? *A lot is coming from the toxic combination of raised expectations and low quality referrals. 111 is a curse, and send far too many people to EDs and too many ambulances out. The 111 algorithms are very very risk averse. A GP reported a recent case where a patient found a feather in her infant sons nappy, and called 111. They advised her to go urgently to the local ED. Not sure if they thought the kid was at risk of metamorphosing into a bird and flying off, but time wasted round. Doctor forums are full of similar stupid referrals. If you ever say you are having difficulty breathing, there will be a blue light ambulance at your door, even if you have had difficulty since 1976. The Govt have also raised expectations by promising this and that, putting targets and giving health advice to see a doctor if ... lets of things. 

All is made worse by the staffing pressures in GP land and hospitals. There is a major 5 alarm bell head to the lifeboats crisis coming in the NHS and it is the fault of successive Governments, mostly Tory but also New Labour who have driven morale, pay and conditions and career prospects down so far that Aus and NZ are much much better options. Canada is pretty popular with young doctors too. When I was a lad, it was next to impossible to get onto the GP training scheme in Northern Ireland, such was the demand. Now they can't fill the posts. The situation is EVEN worse in most other parts of the UK. 

My wife and I are both doctors and we will be doing what we can to persuade our scientifically minded sons to choose something else.
		
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I guess that there are a lot more people in the country and using the system is not worth of mention.


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## Ethan (Mar 19, 2016)

SocketRocket said:



			I guess that there are a lot more people in the country and using the system is not worth of mention.
		
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No, not really.

http://www.independent.co.uk/news/u...ting-times-there-research-finds-a6686501.html


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## SocketRocket (Mar 19, 2016)

Ethan said:



			No, not really.

http://www.independent.co.uk/news/u...ting-times-there-research-finds-a6686501.html

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From 1987/8 to 2002/3 â€“ attendances at A&E were fairly static at around 14 million per year. But in 2003/4 when the EU was enlarged they jumped by nearly 18 per cent â€“ to 16.5 million, and rose to 21.7 million by 2012/13. This is an overall rise of around 7.5 million (a 50 per cent increase) over the past decade.


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## Ethan (Mar 19, 2016)

SocketRocket said:



			From 1987/8 to 2002/3 â€“ attendances at A&E were fairly static at around 14 million per year. But in 2003/4 when the EU was enlarged they jumped by nearly 18 per cent â€“ to 16.5 million, and rose to 21.7 million by 2012/13. This is an overall rise of around 7.5 million (a 50 per cent increase) over the past decade.
		
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And in addition, NHS Direct, known as NHS Redirect amongst doctors, and later 111 started to send loads of unnecessary patients to EDs, whilst the ability to staff medical posts dropped due to a variety of changes enacted by Govt. And the same in GP land where pressure on appointments due to staffing and incased bureaucracy, as well as bed blockage because of reduced social provision all conspired together. 

As for your 2003/4 jump, which you attribute to EU expansion, and which is obviously wildly improbable to be due to that, the King's Fund says:

_In 2003/4, the number of attendances jumped â€“ by nearly 18 per cent â€“ to 16.5 million. This reflects the decision around this time to incorporate data relating to attendances at walk-in centres and minor injuries units (referred to as â€˜type 3 unitsâ€™ in the figures). These aimed to improve patientsâ€™ access to primary care, modernise the NHS to be more responsive to patientsâ€™ busy lifestyles, and offer patients more choice (Monitor 2014)._

But I think you knew that. 

Similar counting tricks have been played since, for example requiring GP admissions to be admitted via A&E even though they don't see a doctor there, as well as ways Trusts inflate figures to show greater levels of activity to attract funding and meet targets. Some of these numbers are not real. 

The A&E crisis is NOT due to immigrants.


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## SocketRocket (Mar 19, 2016)

Ethan said:



			And in addition, NHS Direct, known as NHS Redirect amongst doctors, and later 111 started to send loads of unnecessary patients to EDs, whilst the ability to staff medical posts dropped due to a variety of changes enacted by Govt. And the same in GP land where pressure on appointments due to staffing and incased bureaucracy, as well as bed blockage because of reduced social provision all conspired together. 

As for your 2003/4 jump, which you attribute to EU expansion, and which is obviously wildly improbable to be due to that, the King's Fund says:

_In 2003/4, the number of attendances jumped â€“ by nearly 18 per cent â€“ to 16.5 million. This reflects the decision around this time to incorporate data relating to attendances at walk-in centres and minor injuries units (referred to as â€˜type 3 unitsâ€™ in the figures). These aimed to improve patientsâ€™ access to primary care, modernise the NHS to be more responsive to patientsâ€™ busy lifestyles, and offer patients more choice (Monitor 2014)._

But I think you knew that. 

Similar counting tricks have been played since, for example requiring GP admissions to be admitted via A&E even though they don't see a doctor there, as well as ways Trusts inflate figures to show greater levels of activity to attract funding and meet targets. Some of these numbers are not real. 

The A&E crisis is NOT due to immigrants.
		
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So where did the the additional 5.1 million come from?    You seem to take any view other than immigration, do you not attribute any rise in numbers due to it?


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## Hobbit (Mar 19, 2016)

Ethan said:



			The issue of demand is interesting. The population is not any more sick than it was 10 years ago. In fact, people are generally a bit healthier. So where is the demand coming from? .
		
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3 of my regular playing partners, before moving north of the borders were medics. Two GP's and a nephrologist. They had a different slant on this, although the absolute numbers may be the same.

They said that the 20's to late 40's are healthier but those that were older, not so. Further to that they felt that in later life the health service can keep people alive longer but their quality of life, as they fought critical illness that used to kill, was actually worse.

Splitting hairs maybe but I wonder if there's some truth in it?


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## Ethan (Mar 19, 2016)

Hobbit said:



			3 of my regular playing partners, before moving north of the borders were medics. Two GP's and a nephrologist. They had a different slant on this, although the absolute numbers may be the same.

They said that the 20's to late 40's are healthier but those that were older, not so. Further to that they felt that in later life the health service can keep people alive longer but their quality of life, as they fought critical illness that used to kill, was actually worse.

Splitting hairs maybe but I wonder if there's some truth in it?
		
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I think the evidence suggests that most people are healthier at all ages, but it catches up with you eventually. People live longer healthier but then consume at least the same amount of healthcare resource in a shorter period. It is known as compression of morbidity. There are also a lot of survivors that in times gone by would be dead, people surviving cancer, heart disease and stroke, so they remain heavy consumers of healthcare as a result. There are also an awful lot more older people. Each year of increase in life expectancy generates a disproportionate number of older people so even if each one only consumes as much healthcare as an 80 year old ever did, that is still a lot more than the average 70 year old and there are a lot of 80 year olds, so the bill rockets. 

Funny enough, most doctors are more sanguine about a lot of health intervention near the end of life and would mostly prefer that heroic measures are not used on them.


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## Tashyboy (Mar 19, 2016)

Just got back from hospital with Missis T. Missis T loves her job and won't have a bad word said re the NHS, but her faith has been tested to the limit. She called me at 10.35 to say she could go home once her analgesia was sorted. 
I arrived at 11.35, no sign of prescription. She had her dinner. Agency nurse walks in and asks to see her drain, Missis T hasn't got one, Oh. 
She comes in three hours later and I am sat in Missis T's chair, she asks me if I am ready for my medication. As Missis T is ready to go she asks to look at Missis T's wound to see if she is OK to go home. Missis T hasn't got one. She should of checked the woman's next door who has already gone home, but the agency nurse never knew had. At 15.30 I asked how long before her prescription arrives. At 16.00 the tell us it has not been "written up" or sanctioned yet by dr. I was not happy. At 18.00 they told us that it still had not been written up. I had to go for a walk to calm down. now don't get me wrong it was not just about us. But get rid of us and a bed is empty. They went down to physically fetch it. 
It does not help when two of the three nurses are agency. Coupled with the fact that the only trained nurse was kicked by a patient and spent an hour in A and E did not help.
In the end Missis T was glad to get out and her eyes have been opened.
Thursday night when Missis T first went into A and E, it was classed as " black alert" for the hospital. The way in which they were seeing patients in A and E and discharging them probably does not help matters.
When the news first broke that Kings Mill was being first taken over by Nottingham hospitals, there was a lot of apprehension. Now the news has sunk in, the realisation that the management at Nottingham is rated better than Kings mills so may actually bring a lot more to the table.
The bottom line is that periods of brilliant care were mixed with periods of utter tripe.
Happy that Missis T is home.


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## Ethan (Mar 20, 2016)

SocketRocket said:



			So where did the the additional 5.1 million come from?    You seem to take any view other than immigration, do you not attribute any rise in numbers due to it?
		
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Try to apply some modicum of common sense. You cuted a rise in ED attendance figures and attributed it to EU expansion. That was obviously ridiculous at face value. I showed you that the number was actually due to a different way of counting attendance, as stated by a leading UK think tank which has no reason to deny immigration and in response you appear not to understand what that even means so accuse me of denying it is due to immigration. Sorry, but the increase you cited was NOT due to immigration. That is a fact. You may not like it but that is just too bad. The increase in ED attendance is due to rising demand created by unreasonable expectations, GP pressures, 111, silly targets, staffing shortages and social care shortages creating bed blocking.


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## Old Skier (Mar 20, 2016)

It's a shame that so many trained medical professionals feel they are personnaly better of working in the private sector no matter what their politics after receiving thousands of pounds in publicly funded training.


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## Ethan (Mar 20, 2016)

Old Skier said:



			It's a shame that so many trained medical professionals feel they are personnaly better of working in the private sector no matter what their politics after receiving thousands of pounds in publicly funded training.
		
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Private medicine is not a major factor in UK medicine, unless you are referring to the Governments strategy to hand over more and more services to private providers. Private patients in NHS hospitals bring in nice income and Trusts encourage this. 

The irony is that the Govt want the healthcare sector including the NHS to operate like a market. But it turns out they only want it to be a rigged market, so they impose stupid and damaging rules like a cap on locum fees, which is currently adding to the pressure on staffing. 

Have you a problem with the NHS being staffed by people who got their expensive training outside the UK? Should we refund those countries?


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## Old Skier (Mar 20, 2016)

Ethan said:



			Private medicine is not a major factor in UK medicine, unless you are referring to the Governments strategy?
		
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I believe this was a major Labour strategy not so long ago but I like you have little real idea what is really going on in the NHS other than what is reported in the media.


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## Ethan (Mar 20, 2016)

Old Skier said:



			I believe this was a major Labour strategy not so long ago but I like you have little real idea what is really going on in the NHS other than what is reported in the media.
		
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Speak for yourself. I have a pretty good idea what is going on in the NHS. 

I was speaking of the Tory strategy of preparing the NHS for piecemeal privatisation. The key steps for this were not Labour, and include the Health and Social Care Act 2012, the TTIP and bringing in Simon Stevens, former DH Civil Servant and later United Health Group executive to oversee.


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## Tashyboy (Mar 20, 2016)

Missis T was being nursed by one agency nurse who quite frankly was useless, verging on dangerous. She spent Some time talking to the other agency nurse. He now works at Donny but has cut his hours to do his masters. He works for the agency when it suits, by his own admission he gets paid a fortune. Furthermore he understands that he is resented when he walks onto a word due to him being paid more than anyone else on the ward including the ward leader. ironically Missis T helped to train him as a student and was over the moon to see him, he was the polar opposite to previous mentioned agency staff.
The bottom line is that Missis T who was removed from her role as " Bank nurse coordinator" due to cutbacks now gets nursed by agency staff who are costing the NHS hundreds of millions.


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## Old Skier (Mar 20, 2016)

And I've recently been in conversation with Micheal Fallon but he didn't update me on NATOs nuclear strategy .

I m not sure why you have such an in depth knowledge into the NHS, I presumed from the EU thread you worked for a private pharmaceutical company, an industry much loved by the NHS.


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## Ethan (Mar 20, 2016)

Old Skier said:



			And I've recently been in conversation with Micheal Fallon but he didn't update me on NATOs nuclear strategy .

I m not sure why you have such an in depth knowledge into the NHS, I presumed from the EU thread you worked for a private pharmaceutical company, an industry much loved by the NHS.
		
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I don't need to explain myself to you. If you don't believe what I have to say, fine. I could care less. But try to bring some facts and reasoned arguments rather than personal attacks. There's a good chap.


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## Old Skier (Mar 20, 2016)

Ethan said:



			I don't need to explain myself to you. If you don't believe what I have to say, fine. I could care less. But try to bring some facts and reasoned arguments rather than personal attacks. There's a good chap.
		
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Personal attacks not my style old man, unlike some, but we can agree to disagree on our relevant knowledge of a subject.


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## Ethan (Mar 20, 2016)

Old Skier said:



*Personal attacks not my style* old man, unlike some, but we can agree to disagree on our relevant knowledge of a subject.
		
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Oh, but they are. You chose not to debate the substance of what I said, preferring to say that because I worked in pharma, I didn't know what I was talking about. That is the definition of an ad hominem. 

Could you cite a source or reference for your assertion that many medical professionals are heading into private medicine? So as I can determine objectively what your relevant knowledge is.


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## Old Skier (Mar 20, 2016)

Ethan said:



			Could you cite a source or reference for your assertion that many medical professionals are heading into private medicine? So as I can determine objectively what your relevant knowledge is.
		
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Well,I am taking the good word of those on here, including you that many hospitals are reliant on bank and agencies nurses and staff. And I didn't write private medicine, I thought I wrote private industry.


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## Hobbit (Mar 20, 2016)

Ethan said:



			Speak for yourself. I have a pretty good idea what is going on in the NHS. 

I was speaking of the Tory strategy of preparing the NHS for piecemeal privatisation. The key steps for this were not Labour, and include the Health and Social Care Act 2012, the TTIP and bringing in Simon Stevens, former DH Civil Servant and later United Health Group executive to oversee.
		
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Apart from clinical services, I'm inclined to think the NHS is pretty much already privatised. A number of hospitals, or parts of them, are PFI's. Most ancillary services are outsourced, and central purchasing, NHS Supply Chain, is majority owned by DHL.

Pretty much all of that, well actually all of that came about under Labour. Without a doubt the rest of the NHS is being privatised under the Tories, but both Labour and the Cons are responsible for its privatisation.


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## Ethan (Mar 20, 2016)

Hobbit said:



			Apart from clinical services, I'm inclined to think the NHS is pretty much already privatised. A number of hospitals, or parts of them, are PFI's. Most ancillary services are outsourced, and central purchasing, NHS Supply Chain, is majority owned by DHL.

Pretty much all of that, well actually all of that came about under Labour. Without a doubt the rest of the NHS is being privatised under the Tories, but both Labour and the Cons are responsible for its privatisation.
		
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I agree that New Labour were complicit, especially Milburn, but the pace has accelerated since. The Health and Social Care Act was almost the point of no return, and there TTIP opens the door for the big US HMOs to move in.


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## Ethan (Mar 20, 2016)

Old Skier said:



			Well,I am taking the good word of those on here, including you that many hospitals are reliant on bank and agencies nurses and staff. And I didn't write private medicine, I thought I wrote private industry.
		
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You taught wrong, you wrote the private sector. 

Many hospitals are reliant on bank/agency/locum staff, but the problem is that they choose to staff themselves so thinly in the first place, so are at risk if there is a change in demand or sickness. Most of these bank etc staff are people who would like permanent positions or are supplementing a regular job. If the Govt thinks health is a market, than this is the free market in action, except the Govt has chosen to rig it. Pity they didn't take the same attitude to their friends in the City who are making millions on predatory PFI contracts.


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## delc (Mar 20, 2016)

Ethan said:



			PFI is the scandal the public knows little about. Private companies build hospitals, and rent them to the NHS at extortionate rates, with crippling maintenance contracts for 30 years, then can kick the NHS out and walk away. The deals were negotiated between skilled private sector negotiators and numpties at the DH. Guess who got the better deal? Many of the contracts were sold on at he profits after completion, such was the obvious profit contained within. 

PFI was a way for politicians to deliver shiny new hospitals, and off balance sheet (not part of the public debt). If there ever was a selling off the family silver, and throwing in most of the family's gold too, it is PFI. 

The ultimate irony occurred when HMRC sold off their buildings on a leaseback basis to a company which then turned out to be offshore.
		
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Problem is politicians!  They like to boast about how many shiny new hospitals have been built in their term of office, but the Treasury is unwilling to fund them. Therefore the only way to do this has been PFI. Unfortunately Civil Servants and Hospital Managers are pretty hopeless at negotiating with private finance companies and have allowed themselves to be Royally shafted. The old hospitals may have been old and crumbling, but at least they were owned by the NHS and us the tax paying public.


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## SocketRocket (Mar 20, 2016)

Ethan said:



			Try to apply some modicum of common sense. You cuted a rise in ED attendance figures and attributed it to EU expansion. That was obviously ridiculous at face value. I showed you that the number was actually due to a different way of counting attendance, as stated by a leading UK think tank which has no reason to deny immigration and in response you appear not to understand what that even means so accuse me of denying it is due to immigration. Sorry, but the increase you cited was NOT due to immigration. That is a fact. You may not like it but that is just too bad. The increase in ED attendance is due to rising demand created by unreasonable expectations, GP pressures, 111, silly targets, staffing shortages and social care shortages creating bed blocking.
		
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The increase in demand at A&E matches exactly the increases in Immigration.   To suggest there is no link is to be in denial of the facts.   Immigrants are more likely to use A@E as many do not register with GPs


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## Ethan (Mar 20, 2016)

SocketRocket said:



			The increase in demand at A&E matches exactly the increases in Immigration.   To suggest there is no link is to be in denial of the facts.   Immigrants are more likely to use A@E as many do not register with GPs
		
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Show me the data which proves that.


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## Hobbit (Mar 20, 2016)

SocketRocket said:



			The increase in demand at A&E matches exactly the increases in Immigration.   To suggest there is no link is to be in denial of the facts.   Immigrants are more likely to use A@E as many do not register with GPs
		
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I'm inclined to think that's coincidental. Without a doubt, an increase in population, including the current baby boom, will have led to an increase in A&E admissions but that vast, vast majority of increase is very much down to the changes in GP led services.


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## Old Skier (Mar 20, 2016)

Ethan said:



			Show me the data which proves that.
		
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They must have got it from somewhere http://www.bbc.co.uk/news/uk-england-london-34789785


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## Old Skier (Mar 20, 2016)

Ethan said:



			You taught wrong, you wrote the private sector.
		
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Fair does but I didn't mention private medicine


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## Ethan (Mar 20, 2016)

Old Skier said:



			Fair does but I didn't mention private medicine
		
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Well doctors working in the private sector are providing or practising private medicine, aren't they?


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## Ethan (Mar 20, 2016)

Old Skier said:



			They must have got it from somewhere http://www.bbc.co.uk/news/uk-england-london-34789785

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There have always been plenty of indigenous who are not GP-registered. I wasn't registered myself for years. The question is whether the EDs are now overrun by immigrants using the ED as a primary care service and whether, if that is the case, it explains the huge growth in ED attendance. Unless these immigrants are totally crocked, and that is unlikely given their demographics, it couldn't possibly explain the rise. Other factors must be involved, some of which I have described previously.


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## Old Skier (Mar 20, 2016)

Ethan said:



			Well doctors working in the private sector are providing or practising private medicine, aren't they?
		
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Some do, but many have branched out.


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## Foxholer (Mar 20, 2016)

SocketRocket said:



			The increase in demand at A&E matches exactly the increases in Immigration.   To suggest there is no link is to be in denial of the facts.   Immigrants are more likely to use A@E as many do not register with GPs
		
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I'm pretty sure you are guessing/BS-ing on this!

Can you provide reliable evidence of your claim?

Here's an independent charity's view on the effect of immigration on the (total) NHS.
http://www.kingsfund.org.uk/projects/verdict/what-do-we-know-about-impact-immigration-nhs


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## delc (Mar 20, 2016)

Ethan said:



			There have always been plenty of indigenous who are not GP-registered. I wasn't registered myself for years. The question is whether the EDs are now overrun by immigrants using the ED as a primary care service and whether, if that is the case, it explains the huge growth in ED attendance. Unless these immigrants are totally crocked, and that is unlikely given their demographics, it couldn't possibly explain the rise. Other factors must be involved, some of which I have described previously.
		
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For the record, there are 8.3 million people living in the UK who were not born here, which includes 3.0 million in the Greater London area. I guess that this figure excludes their children who were born here. No wonder our roads are now gridlocked, schools are packed out, and the NHS is under strain!


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## Ethan (Mar 20, 2016)

Old Skier said:



			Some do, but many have branched out.
		
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Into what?


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## Ethan (Mar 20, 2016)

delc said:



			For the record, there are 8.3 million people living in the UK who were not born here, which includes 3.0 million in the Greater London area. I guess that this figure excludes their children who were born here. No wonder our roads are now gridlocked, schools are packed out, and the NHS is under strain!  

Click to expand...

Which record is that for? One that is stuck, perhaps?


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## Old Skier (Mar 20, 2016)

Ethan said:



			Into what?
		
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There appears to be at least 1 working in the pharmacy industry.


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## Ethan (Mar 20, 2016)

Old Skier said:



			There appears to be at least 1 working in the pharmacy industry.
		
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Pharmacies are shops that dispense medicines and sell toothpaste. Pharmaceutical Medicine is a recognised medical specialty related to the development of new medicines. The NHS needs those medicines and the revenue from conducting the clinical trials is very valuable to NHS hospitals that conduct them.   

That is not what most normal people understand by private medicine and only a very small percentage of UK doctors work in the pharma industry, not enough to make any noticeable difference to NHS staffing.


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## delc (Mar 20, 2016)

Ethan said:



			Which record is that for? One that is stuck, perhaps?
		
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A lot of immigrants came into the UK during the Blair/Brown New Labour Government. I don't remember "We will turn the UK into a multi-ethnic, multi-cultural society" being in their manifesto, but that is what they achieved. I also don't remember being asked to vote on this issue as a born and bred UK citizen!


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## Old Skier (Mar 20, 2016)

Ethan said:



			Pharmacies are shops that dispense medicines and sell toothpaste. Pharmaceutical Medicine is a recognised medical specialty related to the development of new medicines. The NHS needs those medicines and the revenue from conducting the clinical trials is very valuable to NHS hospitals that conduct them.   

That is not what most normal people understand by private medicine and only a very small percentage of UK doctors work in the pharma industry, not enough to make any noticeable difference to NHS staffing.
		
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Thanks for that, very informative, I meant pharmaceutical but didn't know how to spell it :lol:. Don't they also make weedkiller and overcharge the NHS for their products


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## Old Skier (Mar 20, 2016)

delc said:



			New Labour!
		
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 what is it called now. New New Labour. It's the Labour Party. The term New Labour is now used by Labour supporters who don't wish to be associated with the sins of the Blair/Brown era even though they still voted for Labour.


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## Liverpoolphil (Mar 20, 2016)

delc said:



			A lot of immigrants came into the UK during the Blair/Brown New Labour Government. I don't remember "We will turn the UK into a multi-ethnic, multi-cultural society" being in their manifesto, but that is what they achieved. I also don't remember being asked to vote on this issue as a born and bred UK citizen!  

Click to expand...

Immigrants have been coming into the country for centuries now.
Its been multi cultural and multi ethnic for decades and decades.


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## delc (Mar 20, 2016)

Old Skier said:



			what is it called now. New New Labour. It's the Labour Party. The term New Labour is now used by Labour supporters who don't wish to be associated with the sins of the Blair/Brown era even though they still voted for Labour.
		
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It was called 'New Labour' at the time, so that is the term I used.


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## Tashyboy (Mar 20, 2016)

Ethan said:



			You taught wrong, you wrote the private sector. 

Many hospitals are reliant on bank/agency/locum staff, but the problem is that they choose to staff themselves so thinly in the first place, so are at risk if there is a change in demand or sickness. Most of these bank etc staff are people who would like permanent positions or are supplementing a regular job. If the Govt thinks health is a market, than this is the free market in action, except the Govt has chosen to rig it. Pity they didn't take the same attitude to their friends in the City who are making millions on predatory PFI contracts.
		
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Up until Missis T was employed as a bank nurse coordinator, hiring and firing and training new care assistants. Doing yearly mandatory updates on all bank staff. I would of been of the way of thinking that your comments re bank and agency staff is purely an opinion.
However since Missis T's role was made redundant which caused much upset to her having built up an excellent dept. It has since cost me and you, Kings mill trust millions in agency staff. This is fact based upon the local MP asking through the freedom of information act on how much is Kings Mill paying in agency fees. Ironically since Missis T's role was finished.
It then begs the question, WHY?.
Having worked in the mining industry, you do not have to be blind to notice that if the government do not want something, they will do whatever it takes to make it look well ugly. 
What happened in the mining industry is happening in the NHS.

PS, the guy who was treated before Missis T in A and E with a cut to his finger was of Eastern European origin. Whether he or this is a problem within the NHS I don't know, but the system that allows cuts to be treated before severe abdominal/ back pain is wrong


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## SocketRocket (Mar 20, 2016)

Foxholer said:



			I'm pretty sure you are guessing/BS-ing on this!

Can you provide reliable evidence of your claim?

Here's an independent charity's view on the effect of immigration on the (total) NHS.
http://www.kingsfund.org.uk/projects/verdict/what-do-we-know-about-impact-immigration-nhs

Click to expand...

Read the BBC link previously, also try reading my post before making your normal acidic comments. I have suggested there is a link between the rise in A&E numbers and the increases in immigration, the tandem increases in the two factors are more than coincidental.  Also John Heyworth, the president of the College of Emergency Medicine, has said that migrants routinely visit A&E instead of going to their GP. 

Please explain how around 8 million people can come to the UK, have families and not make an increase to public services.


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## delc (Mar 20, 2016)

Liverpoolphil said:



			Immigrants have been coming into the country for centuries now.
Its been multi cultural and multi ethnic for decades and decades.
		
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Yes we have always taken a few, e.g. Jews fleeing persecution in Hitler's Germany, West Indians to fill public sector jobs after WW2, Ugandan Asians, etc, but not millions of mainly economic migrants, as we have had more recently.


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## Liverpoolphil (Mar 20, 2016)

delc said:



			Yes we have always taken a few, e.g. Jews fleeing persecution in Hitler's Germany, West Indians to fill public sector jobs after WW2, Ugandan Asians, etc, but not millions of mainly economic migrants, as we have had more recently.
		
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Taken just as much during the last two Tory Governments as well - or is Blair to blame for that as well

There is nothing wrong with people arriving into the country to work and be a part of the country and contribute to its working 

There are a lot of immigrants working in key roles that make your life better and save other people's lives.


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## Old Skier (Mar 20, 2016)

delc said:



			It was called 'New Labour' at the time, so that is the term I used.
		
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It was a brand it was still called the Labour Party.


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## delc (Mar 20, 2016)

Liverpoolphil said:



			Taken just as much during the last two Tory Governments as well - or is Blair to blame for that as well

There is nothing wrong with people arriving into the country to work and be a part of the country and contribute to its working 

There are a lot of immigrants working in key roles that make your life better and save other people's lives.
		
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Yes, a fair proportion of NHS staff are immigrants themselves, but as we have a million or so of unemployed UK young people, shouldn't they be trained for this work? Apart from anything else, it seems unfair that we can cherry pick trained health care professionals educated by other countries!


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## Liverpoolphil (Mar 20, 2016)

delc said:



			Yes, a fair proportion of NHS staff are immigrants themselves, but as we have a million or so of unemployed UK young people, shouldn't they be trained for this work? Apart from anything else, it seems unfair that we can cherry pick trained health care professionals educated by other countries!
		
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Why is it unfair ? 

And just because someone is unemployed doesn't mean they can fill any role - i didn't expect you to take such a simplistic stance.


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## SocketRocket (Mar 20, 2016)

Liverpoolphil said:



			Immigrants have been coming into the country for centuries now.
Its been multi cultural and multi ethnic for decades and decades.
		
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Has it?   Previous immigrants were on a much smaller scale and many were of a similar culture anyway.


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## SocketRocket (Mar 20, 2016)

delc said:



			Yes, a fair proportion of NHS staff are immigrants themselves, but as we have a million or so of unemployed UK young people, shouldn't they be trained for this work? Apart from anything else, it seems unfair that we can cherry pick trained health care professionals educated by other countries!
		
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That's correct and countries least able to afford to train people for us to steal away.


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## delc (Mar 20, 2016)

SocketRocket said:



			Has it?   Previous immigrants were on a much smaller scale and many were of a similar culture anyway.
		
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Exactly!  :thup:


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## Deleted member 16999 (Mar 20, 2016)

delc said:



			Yes we have always taken a few, e.g. Jews fleeing persecution in Hitler's Germany, West Indians to fill public sector jobs after WW2, Ugandan Asians, etc, but not millions of mainly economic migrants, as we have had more recently.
		
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Your level of ignorance and racism knows no bounds! A few? Do these few include a few of those few that so many owe so much to? Or families of the 60,000 Sikhs that died fighting on our side during WW2?


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## delc (Mar 20, 2016)

pauldj42 said:



			Your level of ignorance and racism knows no bounds! A few? Do these few include a few of those few that so many owe so much to? Or families of the 60,000 Sikhs that died fighting on our side during WW2?
		
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Yes, most of the British Empire/Commonwealth countries fought for the Allies in WW2, but what has that got to do with what's happening now? My father, who was in the RAF, was based in India for a couple of years during WW2 btw.


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## delc (Mar 20, 2016)

Liverpoolphil said:



			Why is it unfair ? 

And just because someone is unemployed doesn't mean they can fill any role - i didn't expect you to take such a simplistic stance.
		
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Out of a million, I am sure that you could find 2 or 3 hundred thousand that would be suitable.  How many do we need?


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## Liverpoolphil (Mar 20, 2016)

delc said:



			Out of a million, I am sure that you could find 2 or 3 hundred thousand that would be suitable.  How many do we need?
		
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Ok Delc - the opportunities are there for everyone to wokr for the NHS - so why do you think the people who are unemployed are not working.

You make it sound so easy.


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## Deleted member 16999 (Mar 20, 2016)

delc said:



			Yes, most of the British Empire/Commonwealth countries fought for the Allies in WW2, but what has that got to do with what's happening now? My father, who was in the RAF, was based in India for a couple of years during WW2 btw.
		
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Because it's nothing new, you quote British Empire and Commonwealth, so nothing to do with our history going around the World creating problems and issues and telling the locals how great we are, that it is now coming back to bite us on the ar5e. Immigration is nothing new apart from blaming every problem we currently have on it.


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## delc (Mar 20, 2016)

Liverpoolphil said:



			Taken just as much during the last two Tory Governments as well - or is Blair to blame for that as well

There is nothing wrong with people arriving into the country to work and be a part of the country and contribute to its working 

There are a lot of immigrants working in key roles that make your life better and save other people's lives.
		
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Problem is that the Labour Party think that the immigrants will vote for them, while the Tory Party regards them as a source of cheap labour for their Big Business buddies!  We are in a no-win situation!


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## Liverpoolphil (Mar 20, 2016)

delc said:



*Problem is that the Labour Party think that the immigrants will vote for them*, while the Tory Party regards them as a source of cheap labour for their Big Business buddies!  We are in a no-win situation!
		
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Im guessing they have told you that ? 

You really do like your generic statements.

But its nothing new - as mentioned previously - its broken record time.


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## delc (Mar 20, 2016)

pauldj42 said:



			Because it's nothing new, you quote British Empire and Commonwealth, so nothing to do with our history going around the World creating problems and issues and telling the locals how great we are, that it is now coming back to bite us on the ar5e. Immigration is nothing new apart from blaming every problem we currently have on it.
		
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But a lot of immigrants are coming from countries that were nothing to do with the British Empire (or Europe)!


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## delc (Mar 20, 2016)

Liverpoolphil said:



			Im guessing they have told you that ? 

You really do like your generic statements.

But its nothing new - as mentioned previously - its broken record time.
		
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Doesn't mean it's wrong though! The UK is becoming seriously overpopulated!


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## Liverpoolphil (Mar 20, 2016)

delc said:



			But a lot of immigrants are coming from countries that were nothing to do with the British Empire (or Europe)!
		
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Do you mean Immigrants who come to the country to work legally 

Or Asylum Seekers looking for protection ?


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## Liverpoolphil (Mar 20, 2016)

delc said:



			Doesn't mean it's wrong though! *The UK is becoming seriously overpopulated*!
		
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no its not - plenty of space.


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## Ethan (Mar 20, 2016)

Old Skier said:



			Thanks for that, very informative, I meant pharmaceutical but didn't know how to spell it :lol:. Don't they also make weedkiller and overcharge the NHS for their products 

Click to expand...

Some of them (not mine) make chemicals too. The NHS rarely pays list price and there is a cap on the total medicine cost for the country.


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## Deleted member 16999 (Mar 20, 2016)

Liverpoolphil said:



			Do you mean Immigrants who come to the country to work legally 

Or Asylum Seekers looking for protection ?
		
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^^This Delc^^


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## Ethan (Mar 20, 2016)

delc said:



			Yes we have always taken a few, e.g. Jews fleeing persecution in Hitler's Germany, West Indians to fill public sector jobs after WW2, Ugandan Asians, etc, but not millions of mainly economic migrants, as we have had more recently.
		
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Well maybe we should stop starting unnecessary wars that destabilise an entire region leading to the collapse of the local society and millions of displaced people. The U.K. (with help from the US) broke it, so they need to clear up the damage.


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## Liverpoolphil (Mar 20, 2016)

Ethan said:



			Well maybe we should stop starting unnecessary wars that destabilise an entire region leading to the collapse of the local society and millions of displaced people. The U.K. (with help from the US) broke it, so they need to clear up the damage.
		
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The U.K. broke Syria ? 

And unnecessary ? 

Are you really blaming the UK for the destabilisation of the Middle East ? ( unless you are going back to the crusades )!


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## Deleted member 16999 (Mar 20, 2016)

Ethan said:



			Well maybe we should stop starting unnecessary wars that destabilise an entire region leading to the collapse of the local society and millions of displaced people. The U.K. (with help from the US) broke it, so they need to clear up the damage.
		
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Maybe simplistic, add a few more countries to who broke it and I'd agree wholeheartedly.


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## delc (Mar 20, 2016)

Ethan said:



			Well maybe we should stop starting unnecessary wars that destabilise an entire region leading to the collapse of the local society and millions of displaced people. The U.K. (with help from the US) broke it, so they need to clear up the damage.
		
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Think it was more the US with a little bit of help from Tony Blair! We should not have invaded Iraq or Afghanistan, as this hardly solved the problems, and actually made things much worse.


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## SocketRocket (Mar 20, 2016)

Liverpoolphil said:



			no its not - plenty of space.
		
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Space isn't the problem, there are plenty of remote areas that you could drop people off into.   The problem is how do you create support services for them?    England is seriously overpopulated, it is one of the highest populated countries in the world per sq kilometer.  People coming to these shores will want to live where there is housing, jobs, hospitals, schools, shops etc.


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## Liverpoolphil (Mar 20, 2016)

delc said:



			Think it was more the US with a little bit of help from Tony Blair! We should not have invaded Iraq or Afghanistan, as this hardly solved the problems, and actually made things much worse.
		
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Which problems exactly are you talking about ?

A dictator murdering thousands of innocent people or a terrorist organisation responsible for killing thousands and one controlling a country by fear with no hope for the locals ?


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## HomerJSimpson (Mar 20, 2016)

As someone directly involved in NHS recruitment, we will employ from any nation providing they are NMC registered. For some that's a straightforward process as their home qualification will be recognised by the NMC. Others need to do an Overseas Nursing Programme to translate their home based skills and prove to the NMC they are fit to practice. Others will need to go through the recognised nursing qualifications. The issue we have is that my trust along with most others simply cannot get qualified nurses of any ethnicity through the doors quick enough and so the reliance on agency nursing and the cost and differences in level of care remain


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## Ethan (Mar 20, 2016)

Liverpoolphil said:



			The U.K. broke Syria ? 

And unnecessary ? 

Are you really blaming the UK for the destabilisation of the Middle East ? ( unless you are going back to the crusades )!
		
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All recent stuff. Richard the Lionheart is not directly to blame. 

The activities of the US and UK since the 1950s, but particularly since the 1980s have included encouraging Islam to combat Communism in Afghanistan, and in doing so supported the Mujahideen, the forerunners of the Taliban, Al Qaeda and ISIS. The UK and US didn't give a toss when Assad was being a despot, just as they didn't care when Saddam was doing likewise, but once the oil was threatened, that was a different story so they blundered in and wrecked the place. Added to which the UK and US knew Saddam had nothing to do with WMD or 9/11 yet they started that war and destabilised the balance of power in the region, thus emboldening Iran, supporters of Assad, and encouraging them to develop their nuclear capabilities, thus getting Israel all het up.


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## HomerJSimpson (Mar 20, 2016)

SocketRocket said:



			Space isn't the problem, there are plenty of remote areas that you could drop people off into.   The problem is how do you create support services for them?    England is seriously overpopulated, it is one of the highest populated countries in the world per sq kilometer.  People coming to these shores will want to live where there is housing, jobs, hospitals, schools, shops etc.
		
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Well put. Add in the inevitable cost of benefits once they become entitled, and the bill is massive. You simply can't keep building and building and where do these people go?


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## Liverpoolphil (Mar 20, 2016)

Ethan said:



			All recent stuff. Richard the Lionheart is not directly to blame. 

The activities of the US and UK since the 1950s, but particularly since the 1980s have included encouraging Islam to combat Communism in Afghanistan
		
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Should they have stood back and let Russia invade then and offer no help ? - What was the UK role in that exactly ?




			, and in doing so supported the Mujahideen, the forerunners of the Taliban, Al Qaeda and ISIS. The UK and US didn't give a toss when Assad was being a despot, just as they didn't care when Saddam was doing likewise, but once the oil was threatened, that was a different story so they blundered in and wrecked the place. Added to which the *UK and US knew Saddam had nothing to do with WMD* or 9/11 yet they started that war and destabilised the balance of power in the region, thus emboldening Iran, supporters of Assad, and encouraging them to develop their nuclear capabilities, thus getting Israel all het up.
		
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When did you give your evidence at the enquiry ?  With that sort of information you would have solved the whole thing ?

Did Hussain not murder tens of thousands of innocent people then invade another country ? 

Wrecked the place ? There are a damn sight lot of places in both Iraq and Afghan that are far better off right - schools , hospitals , people being educated and looking after themselves now - democracy being given a chance and people having a voice - the country now looking after itself. 

People and terrorists from that region had already branched out before any invasion causing terror all over the world.


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## HomerJSimpson (Mar 20, 2016)

Liverpoolphil said:



			Should they have stood back and let Russia invade then and offer no help ? - What was the UK role in that exactly ?



When did you give your evidence at the enquiry ?  With that sort of information you would have solved the whole thing ?

Did Hussain not murder tens of thousands of innocent people then invade another country ? 

Wrecked the place ? There are a damn sight lot of places in both Iraq and Afghan that are far better off right - schools , hospitals , people being educated and looking after themselves now - democracy being given a chance and people having a voice - the country now looking after itself. 

People and terrorists from that region had already branched out before any invasion causing terror all over the world.
		
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Or maybe he just has a different point of view? :mmm::mmm:


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## Liverpoolphil (Mar 20, 2016)

SocketRocket said:



			Space isn't the problem, there are plenty of remote areas that you could drop people off into.   The problem is how do you create support services for them?    England is seriously overpopulated, it is one of the highest populated countries in the world per sq kilometer.  People coming to these shores will want to live where there is housing, jobs, hospitals, schools, shops etc.
		
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So imagine all those jobs that can be created from developing areas for people to live.


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## Old Skier (Mar 20, 2016)

Liverpoolphil said:



			no its not - plenty of space.
		
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Agreed but unfortunately the infrastructure is not there to support the influx at the moment.


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## Ethan (Mar 20, 2016)

Liverpoolphil said:



			Should they have stood back and let Russia invade then and offer no help ? - What was the UK role in that exactly ?



When did you give your evidence at the enquiry ?  With that sort of information you would have solved the whole thing ?

Did Hussain not murder tens of thousands of innocent people then invade another country ? 

Wrecked the place ? There are a damn sight lot of places in both Iraq and Afghan that are far better off right - schools , hospitals , people being educated and looking after themselves now - democracy being given a chance and people having a voice - the country now looking after itself. 

People and terrorists from that region had already branched out before any invasion causing terror all over the world.
		
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Western Govts don't care about despots murdering their own people. They only care about self interest. The reason the US and UK started interfering by overthrowing the democratically elected Mosaddegh in 1953 was oil, and so it has remained since. 

Dunno if you are keeping up with the news, but the dossier used to justify UK entry into Iraq 2 was dodgy, i.e. faked by the war criminal Blair. I also missed news of any WMD they found. Could you update me on the WMD found? You can use your evidence to the enquiry if that is easier. 

The Lancet estimated that 650,000 people died as a direct or indirect result of that war. They aren't better off. American companies who used it as an opportunity to earn gazillions did quite nicely though. 

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)69491-9/abstract


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## HomerJSimpson (Mar 20, 2016)

Old Skier said:



			Agreed but unfortunately the infrastructure is not there to support the influx at the moment.
		
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Exactly. All very well having this utopian vision of building houses to let them live and contribute, but you are building more and more on green belt and even then, how do you support this influx without extra schools, shops, medical facilities etc and where does that money come from


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## Liverpoolphil (Mar 20, 2016)

Ethan said:



			Western Govts don't care about despots murdering their own people.
		
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 In your opinion of course as opposed to being factual 




			They only care about self interest. The reason the US and UK started interfering by overthrowing the democratically elected Mosaddegh in 1953 was oil, and so it has remained since. 

Dunno if you are keeping up with the news, but the dossier used to justify UK entry into Iraq 2 was dodgy, i.e. faked by the war criminal Blair. I also missed news of any WMD they found. Could you update me on the WMD found? You can use your evidence to the enquiry if that is easier.
		
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I didnt say any WMD were found. But im sire you will provde the evidence to show that they knew there were no WMD's because unless im mistaken the actual findings of the enquiry are yet to be found out.




			The Lancet estimated that 650,000 people died as a direct or indirect result of that war. They aren't better off. American companies who used it as an opportunity to earn gazillions did quite nicely though. 

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)69491-9/abstract

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Its lots of accusations at the end of the day. 

I spent time out there and have seen the good that has been done - have you taken a visit ?


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## Liverpoolphil (Mar 20, 2016)

Old Skier said:



			Agreed but unfortunately the infrastructure is not there to support the influx at the moment.
		
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Perfect opportunity to create jobs by creating infrastructure.


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## HomerJSimpson (Mar 20, 2016)

Liverpoolphil said:



			Perfect opportunity to create jobs by creating infrastructure.
		
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And the money comes from??????? Pie in the sky to suit your argument


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## Ethan (Mar 20, 2016)

Liverpoolphil said:



			In your opinion of course as opposed to being factual 


I spent time out there and have seen the good that has been done - have you taken a visit ?
		
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You are hardly an objective commentator then, are you?

Did you spend time out there before the US and UK starting bombing the crap out off Iraq? That would be the benchmark for comparison, not the point when you have almost destroyed it.


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## Liverpoolphil (Mar 20, 2016)

Ethan said:



			You are hardly an objective commentator then, are you?

Did you spend time out there before the US and UK starting bombing the crap out off Iraq? That would be the benchmark for comparison, not the point when *you* have almost destroyed it.
		
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Nope but saw what conditions a good number of people had to live in and also saw the riches that were blundered by Hussain and his regime - blundered by murdering innocent people.


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## Deleted member 16999 (Mar 20, 2016)

HomerJSimpson said:



			And the money comes from??????? Pie in the sky to suit your argument
		
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So do nothing, let the problems continue and blame them. much better answer.


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## Old Skier (Mar 20, 2016)

Ethan said:



			All recent stuff. Richard the Lionheart is not directly to blame. 

The activities of the US and UK since the 1950s, but particularly since the 1980s have included encouraging Islam to combat Communism in Afghanistan, and in doing so supported the Mujahideen, the forerunners of the Taliban, Al Qaeda and ISIS. The UK and US didn't give a toss when Assad was being a despot, just as they didn't care when Saddam was doing likewise, but once the oil was threatened, that was a different story so they blundered in and wrecked the place. Added to which the UK and US knew Saddam had nothing to do with WMD or 9/11 yet they started that war and destabilised the balance of power in the region, thus emboldening Iran, supporters of Assad, and encouraging them to develop their nuclear capabilities, thus getting Israel all het up.
		
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A lot of negatives there which are hard to argue against however the Middle East has been a very unstable area for many years with and without our involvement and go much deeper than what we have and haven't done in the area.

I wonder what your take on us sticking our noses in Kuwait is/was and should we have kept rolling into Iraq and our continued involvement in assisting Jordon in the defense of their country.


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## HomerJSimpson (Mar 20, 2016)

pauldj42 said:



			So do nothing, let the problems continue and blame them. much better answer.
		
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So how do you fund it? Simple question


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## Deleted member 16999 (Mar 20, 2016)

HomerJSimpson said:



			So how do you fund it? Simple question
		
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Go after the multi-nationals companies who are not paying taxes, 34 Billion owed in unpaid taxes according to the NAO, start there.


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## Ethan (Mar 20, 2016)

Old Skier said:



			A lot of negatives there which are hard to argue against however the Middle East has been a very unstable area for many years with and without our involvement and go much deeper than what we have and haven't done in the area.

I wonder what your take on us sticking our noses in Kuwait is/was and should we have kept rolling into Iraq and our continued involvement in assisting Jordon in the defense of their country.
		
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The Middle East has of course been unstable for a while. a lot of it is Shia-Sunni, with a few regional flavours. 

Any western fix to the area's problems is likely to be doomed and solidify opposition. The fix needs to come from within the region. 

As for Kuwait, at the time, Iraq had good relations with the US but was in an economic debate on oil production and price with Kuwait. Saddam communicated with the US Ambassador to Iraq and was told that the US had no opinion on the escalating economic dispute with Kuwait. He may have taken that a tacit signal that the US would be neutral on a further escalation. The war didn't start for over 5 months after the invasion. There was a lot more going on there than we know about.


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## HomerJSimpson (Mar 20, 2016)

pauldj42 said:



			Go after the multi-nationals companies who are not paying taxes, 34 Billion owed in unpaid taxes according to the NAO, start there.
		
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And how long do you think that will take? The problem is clearly here and now and that's the issue, too many people and not enough funding or resources.


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## Big Whacker (Mar 20, 2016)

English children cannot get on the property ladder due to sky high prices for a simple house.

The demand is much greater now than it ever was because of the influx in immigration.

Why should Johnny foreigner take precedence over a true born and bred English person (or Irish, Scottish or Welsh)?

This country is screwed right now and will only get worse.

Shame on all those bleeding do-gooders in denial.


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## Big Whacker (Mar 20, 2016)

And please spare me the racist shouts because I already know I am one (not the violent type though).


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## Liverpoolphil (Mar 20, 2016)

Big Whacker said:



			English children cannot get on the property ladder due to sky high prices for a simple house.

The demand is much greater now than it ever was because of the influx in immigration.

Why should Johnny foreigner take precedence over a true born and bred English person (or Irish, Scottish or Welsh)?

This country is screwed right now and will only get worse.

Shame on all those bleeding do-gooders in denial.
		
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When did anyone suggest a "foreigner" takes precedence ?


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## Deleted member 16999 (Mar 20, 2016)

HomerJSimpson said:



			And how long do you think that will take? The problem is clearly here and now and that's the issue, too many people and not enough funding or resources.
		
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So we agree we have a problem with immigration as you rightly say it's clearly here and now and your answer is? Do nothing, moan and hope it goes away if it's own accord?


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## HomerJSimpson (Mar 20, 2016)

pauldj42 said:



			So we agree we have a problem with immigration as you rightly say it's clearly here and now and your answer is? Do nothing, moan and hope it goes away if it's own accord?
		
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That's not my answer and in truth I don't have one. I just don't see how building all these extra houses etc is going to solve the problem. To be honest, there are enough vacant properties, including offices that could be used and converted rather than building from scratch but again who foots the bill. It's a problem that won't away and while we need to be doing something, whatever we do will come at a cost and it's one I can't see being footed by anyone other than the taxpayer


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## Deleted member 16999 (Mar 20, 2016)

HomerJSimpson said:



			That's not my answer and in truth I don't have one. I just don't see how building all these extra houses etc is going to solve the problem. To be honest, there are enough vacant properties, including offices that could be used and converted rather than building from scratch but again who foots the bill. It's a problem that won't away and while we need to be doing something, whatever we do will come at a cost and it's one I can't see being footed by anyone other than the taxpayer
		
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I've at least tried an answer, currently we are in cack state and cuts coming everywhere, people like to blame everything on immigrants and benefit cheats, but if the Government made a stand against these business's maybe some of the cuts wouldn't be needed or the extra money could be used to control our borders or to help our kids.
Benefit fraud accounts for 0.7% of the overall benefits bill, tax fraud is 7% of the tax bill, you never hear of Politicians complaining about that or TV companies making programmes about the people doing it.


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## upsidedown (Mar 20, 2016)

Big Whacker said:



			English children cannot get on the property ladder due to sky high prices for a simple house.

.
		
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So they do what my Brother did in the 60's buy a flat first and as has my daughter at 24 buy a flat and then rent out a room.

As an aside chatting after golf yesterday to guy who's daughter is getting married and bemoaning the daft amount of money being spent on stag/hen do's and then complaining they've no money to put down a deposit on a house


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## Old Skier (Mar 20, 2016)

Ethan said:



			The Middle East has of course been unstable for a while. a lot of it is Shia-Sunni, with a few regional flavours. 

Any western fix to the area's problems is likely to be doomed and solidify opposition. The fix needs to come from within the region. 

As for Kuwait, at the time, Iraq had good relations with the US but was in an economic debate on oil production and price with Kuwait. Saddam communicated with the US Ambassador to Iraq and was told that the US had no opinion on the escalating economic dispute with Kuwait. He may have taken that a tacit signal that the US would be neutral on a further escalation. The war didn't start for over 5 months after the invasion. There was a lot more going on there than we know about.
		
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Tim BL has a lot to answer too.


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## delc (Mar 20, 2016)

HomerJSimpson said:



			That's not my answer and in truth I don't have one. I just don't see how building all these extra houses etc is going to solve the problem. To be honest, there are enough vacant properties, including offices that could be used and converted rather than building from scratch but again who foots the bill. It's a problem that won't away and while we need to be doing something, whatever we do will come at a cost and it's one I can't see being footed by anyone other than the taxpayer
		
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In my home town of Rickmansworth, many former industrial and commercial premises, a Police and Fire Station, and a large former hotel have all been converted into flats and apartments. The draw is a Metropolitan/Chiltern Line station with a fast(?) service into London. Therefore there are less employment opportunities in the area and more traffic on the road caused by those who travel to work or school by road from these new dwellings. The housing shortage has been partly solved, but only at the expense of the quality of life of the local residents. You cannot cram 3 million extra people into a small area like Greater London without consequences. It is getting particularly difficult to book a doctors' appointment before you either die or get better!


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## HomerJSimpson (Mar 20, 2016)

delc said:



			In my home town of Rickmansworth, many former industrial and commercial premises, a Police and Fire Station, and a large former hotel have all been converted into flats and apartments. The draw is a Metropolitan/Chiltern Line station with a fast(?) service into London. Therefore there are less employment opportunities in the area and more traffic on the road caused by those who travel to work or school by road from these new dwellings. The housing shortage has been partly solved, but only at the expense of the quality of life of the local residents. You cannot cram 3 million extra people into a small area like Greater London without consequences. It is getting particularly difficult to book a doctors' appointment before you either die or get better!  

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There will be issues. I think that whichever side of the argument you are on, you'll see that and while Rickmansworth as your example has clearly sort to resolve issues by utilising existing buildings, of course that has a knock on effect with other services. As I've said before, who funds the extra surgeries, builds the new schools, and while these would create jobs during construction and beyond there has to be initial capital to do so and I don't see where that comes from


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## Tashyboy (Mar 21, 2016)

Anyway back on track WITH THE NHS RANT.&#128077;

Went to to see our quack today who has put Missis T on the club til 6th April. It may be a practice for when we are both retired. IE, If we don't kill one another. If I don't post on here for 2 week call the police.
Anyway Missis T asked why the hospital could not refer me and asked the GP to do it. He said "money". If the hospital refers it gets no money. If the GP does, then he has to pay. It is BS that once more did nothing for my tyrets.
I took Missis T's " club note" into the hospital and told her boss of our probs they told me to contact PALS and fill them in with all the details.


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## Deleted member 16999 (Mar 21, 2016)

Well, was back to hospital today for another appt with the missus, seen both sides of the NHS but firmly believe there is more to be thankful for than not.


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## Tashyboy (Mar 21, 2016)

pauldj42 said:



			Well, was back to hospital today for another appt with the missus, seen both sides of the NHS but firmly believe there is more to be thankful for than not.
		
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Yup &#128077;but for me, the system and some poor nursing was over shone by some quality nursing and Drs.

its a bit like me shooting 84 the other week, 80 shots was sky sports viewing but the other 4 stuck in my throat and are the ones I cannot get outta my head.


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## Deleted member 16999 (Mar 21, 2016)

Tashyboy said:



			Yup &#128077;but for me, the system and some poor nursing was over shone by some quality nursing and Drs.

its a bit like me shooting 84 the other week, 80 shots was sky sports viewing but the other 4 stuck in my throat and are the ones I cannot get outta my head.
		
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Sadly that's what we do, my son was born at 28 weeks weighing 1lb 10oz and we owe everything to the Doctors and Nurses that looked after him at St Thomas's in London he's 22 now and a great young man.
On the other side we took Sunderland Royal to the GMC after one of their Doctors nearly killed the father-in-law, very little trust in that place.


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## Foxholer (Mar 21, 2016)

Tashyboy said:



			...Anyway Missis T asked why the hospital could not refer me and asked the GP to do it. He said "money". If the hospital refers it gets no money. If the GP does, then he has to pay. It is BS that once more did nothing for my tyrets.
		
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Seems to me that this is the petty accounting issues that Ethan has oft referred to! The effect is to delay treatment, therefore the overall cost will almost certainly increase - unless, of course, the patient dies (which I have certainly heard of!)!!

Someone needs to shake this particular practice sufficiently that it stops - as it not only costs more, but endangers patients health! There should be sufficient simple ways around it to stop this obscene waste!


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## SocketRocket (Mar 21, 2016)

pauldj42 said:



			I've at least tried an answer, currently we are in cack state and cuts coming everywhere, people like to blame everything on immigrants and benefit cheats, but if the Government made a stand against these business's maybe some of the cuts wouldn't be needed or the extra money could be used to control our borders or to help our kids.
Benefit fraud accounts for 0.7% of the overall benefits bill, tax fraud is 7% of the tax bill, you never hear of Politicians complaining about that or TV companies making programmes about the people doing it.
		
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As the welfare bill is around 217 Billion per annum then .7%  is rather a lot of money.   There is also a difference between tax fraud and tax avoidance.


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## Deleted member 16999 (Mar 21, 2016)

SocketRocket said:



			As the welfare bill is around 217 Billion per annum then .7%  is rather a lot of money.   There is also a difference between tax fraud and tax avoidance.
		
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Absolutely go after the benefit fraudsters, but go after the tax dodgers as well, win win to get both, just what woukd be more beneficial to the Country?


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## Ethan (Mar 22, 2016)

Tashyboy said:



			Anyway back on track WITH THE NHS RANT.&#128077;

Went to to see our quack today who has put Missis T on the club til 6th April. It may be a practice for when we are both retired. IE, If we don't kill one another. If I don't post on here for 2 week call the police.
Anyway Missis T asked why the hospital could not refer me and asked the GP to do it. He said "money". If the hospital refers it gets no money. If the GP does, then he has to pay. It is BS that once more did nothing for my tyrets.
I took Missis T's " club note" into the hospital and told her boss of our probs they told me to contact PALS and fill them in with all the details.
		
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This is the new order. Back in the day, if you went to a dermatology out-patients, say, and complained of something that sounded neurological or renal, the doctor could ring round to the neuro or renal clinic and ask for you to be seen during that session. No more. Now the doctor will have to write to the GP, and ask for a new referral, which will be delayed by 6 weeks or more compared to the old version. That wastes specialist time, GP time and most importantly, your time. But the idea is to inflate activity figures. In the old model, that was 1 patient episode. Now it is 2. That means, in the future, 2 sets of bills and charges levied by the company delivering NHS services.


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## SocketRocket (Mar 22, 2016)

Ethan said:



			This is the new order. Back in the day, if you went to a dermatology out-patients, say, and complained of something that sounded neurological or renal, *the doctor could ring round to the neuro or renal clinic and ask for you to be seen during that session*. No more. Now the doctor will have to write to the GP, and ask for a new referral, which will be delayed by 6 weeks or more compared to the old version. That wastes specialist time, GP time and most importantly, your time. But the idea is to inflate activity figures. In the old model, that was 1 patient episode. Now it is 2. That means, in the future, 2 sets of bills and charges levied by the company delivering NHS services.
		
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I think that may have been in the day when the Neuro or Renal Clinics had some spare capacity.   I suspect those days have long gone.


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## Ethan (Mar 22, 2016)

SocketRocket said:



			I think that may have been in the day when the Neuro or Renal Clinics had some spare capacity.   I suspect those days have long gone.
		
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Not necessarily. The clinic may not have appointments, but the docs will respond to a doc to doc request. The patients are usually added as 'extras'. The rules were not changed because of pressure on clinics, but due to maximising billing and activity levels.


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## Hobbit (Mar 23, 2016)

*have you seen what the drug bill is for 2015??? Any drug rep, Ethan, that can support that without blanching is a hypocrite! Supporter of the NHS my ar5e!*


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## Big Whacker (Mar 23, 2016)

I've never seen a smackhead wait for their methadone yet often see long waits for others for their medicine.

I wonder how much the horrible crack rats cost the NHS?

Why drip feed them their addiction when cold turkey is an option?

Cancer sufferers get denied treatment yet these scum of the earth don't.


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## Old Skier (Mar 23, 2016)

Hobbit said:



*have you seen what the drug bill is for 2015??? Any drug rep, Ethan, that can support that without blanching is a hypocrite! Supporter of the NHS my ar5e!*

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Good rant, but he's one of the good guys


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## Ethan (Mar 23, 2016)

Hobbit said:



*have you seen what the drug bill is for 2015??? Any drug rep, Ethan, that can support that without blanching is a hypocrite! Supporter of the NHS my ar5e!*

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I am sorry. I am not a drug rep. Could you restate your rant as an answerable question, please?


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## williamalex1 (Mar 23, 2016)

First class service for me on Monday from the NHS. Doctors appointment 8.30  , after examination said an ex-ray was required.

I was given the choice of 3 hospitals , I choose the Monklands hospital in Coatbridge the nearest, expecting a long wait , but hey ho seen straight away and back home before 10.30.
Results will be available from my surgery in 7 to 10 days. 

Sadly I may have Rheumatoid arthritis in my hands , so fingers crossed, ouch !.


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## Tashyboy (Mar 23, 2016)

Listening to Missis T earlier today talking to my daughter. Missis T has had a lot of time on her hands last few days when she was not asleep or wriggling about in pain. Anyway she said to daughter she is saying something to her manager when she's gets back. She said some of the things she saw and heard " whilst on the other side" was scary. I asked her about it when daughter had gone and she says she has a duty to say something.


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## Old Skier (Mar 23, 2016)

williamalex1 said:



			First class service for me on Monday from the NHS. Doctors appointment 8.30  , after examination said an ex-ray was required.

I was given the choice of 3 hospitals , I choose the Monklands hospital in Coatbridge the nearest, expecting a long wait , but hey ho seen straight away and back home before 10.30.
Results will be available from my surgery in 7 to 10 days. 

Sadly I may have Rheumatoid arthritis in my hands , so fingers crossed, ouch !.

Click to expand...

I had an initial diagnosis of that and then my chiropractor asked if I take statins which I did. Once off them everything back to normal. Thank heavens for chiropractors.


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## williamalex1 (Mar 23, 2016)

Old Skier said:



			I had an initial diagnosis of that and then my chiropractor asked if I take statins which I did. Once off them everything back to normal. Thank heavens for chiropractors.
		
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I've been prescribed 2 different types of statins both for a few months but they didn't agree with me.
I think there maybe an issue/problem/ conflict of interest  in prescribing mass medication .


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## Ethan (Mar 23, 2016)

Old Skier said:



			I had an initial diagnosis of that and then my chiropractor asked if I take statins which I did. Once off them everything back to normal. Thank heavens for chiropractors.
		
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Statins may stop you having a heart attack or stroke though. 

Chiropractic is an unscientific voodoo discipline. Chiropractors have no training in cholesterol or cardiac management and have no business interfering with prescribing decisions.


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## williamalex1 (Mar 23, 2016)

Ethan said:



			Statins may stop you having a heart attack or stroke though. 

Chiropractic is an unscientific voodoo discipline. Chiropractors have no training in cholesterol or cardiac management and have no business interfering with prescribing decisions.
		
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My heart consultants exact words to me were  " I wouldn't be embarrassed to take you off statins, quote from  Mr Pell cardiac unit Monklands hospital.


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## Old Skier (Mar 23, 2016)

Ethan said:



			Statins may stop you having a heart attack or stroke though. 

Chiropractic is an unscientific voodoo discipline. Chiropractors have no training in cholesterol or cardiac management and have no business interfering with prescribing decisions.
		
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I prefer the information received from my qualified doctor (rather than the site exSpurt) who agreed with the witch doctor and all symtoms have now gone. I am now on a different kind of statin.

This happened several years ago and I obviously spoke to a (my) qualified Doctor before taking any action.


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## Jacko_G (Mar 23, 2016)

Big Whacker said:



			I've never seen a smackhead wait for their methadone yet often see long waits for others for their medicine.

I wonder how much the horrible crack rats cost the NHS?

Why drip feed them their addiction when cold turkey is an option?

Cancer sufferers get denied treatment yet these scum of the earth don't.
		
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Witnessed this last week. Handed in a prescription and was told it would be 20 minutes as they were busy. At my back in walks junkie boy. Chemist immediately drops what she is doing and ushers him into the "consultant room" to save him the embarrassment of taking his "medicine" in front of others who are waiting the 20 minutes to get their prescriptions!

Now I obviously don't know this lads background or what led him into the life of drugs nor am I going to judge him but I do question why he gets preferential treatment.


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## Golfmmad (Mar 23, 2016)

Old Skier said:



			I prefer the information received from my qualified doctor (rather than the site exSpurt) who agreed with the witch doctor and all symtoms have now gone. I am now on a different kind of statin.

This happened several years ago and I obviously spoke to a (my) qualified Doctor before taking any action.
		
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But you're still on statins.


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## Old Skier (Mar 23, 2016)

Golfmmad said:



			But you're still on statins. 

Click to expand...

Simfastatin (spelling)


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## williamalex1 (Mar 23, 2016)

Old Skier said:



			Simfastatin (spelling)
		
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I was prescribed Lipitor 10mg Atorvastatin and Simvastatin  and both nearly crippled me.


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## Ethan (Mar 24, 2016)

williamalex1 said:



			My heart consultants exact words to me were  " I wouldn't be embarrassed to take you off statins, quote from  Mr Pell cardiac unit Monklands hospital.
		
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Well, it isn't a matter of embarrassment, it is a matter of risk-benefit. 

I don't know Dr Pell, but he is a Dr (physician) rather than an Mr (surgeon). He will have made a judgement based on your risk score, which takes into account gender, cholesterol, age, previous medical history and whether or not you have diabetes, high blood pressure or other risk factors. There are some people taking statins who could come off without any appreciable increase in risk, and others in whom it would be very unwise. And if you were having side effects, often muscle pain or increases in liver enzymes, those would be factored in too.


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## Ethan (Mar 24, 2016)

williamalex1 said:



			I was prescribed Lipitor 10mg Atorvastatin and Simvastatin  and both nearly crippled me.
		
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At the same time?


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## Ethan (Mar 24, 2016)

Old Skier said:



			I prefer the information received from my qualified doctor (rather than the site exSpurt) who agreed with the witch doctor and all symtoms have now gone. I am now on a different kind of statin.

This happened several years ago and I obviously spoke to a (my) qualified Doctor before taking any action.
		
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Please yourself. Chiropractic is based on supposed relationships between joints and organs in the body and has been comprehensively proven to be nonsense. There are often reasons why someone should come off a statin. Statins are known to cause myalgia (muscle pain) in some people, as a side effect of their primary mode of action. They are not known to cause joint pains and if you had joint pains on them, you should ask your qualified doctor to report that. 

There are lots of reasons doctors take people off meds - no longer needed, side effects, better med comes along, patient is a moaner and it is just not worth the earache ....

By the way, I am fully qualified, but I will not be providing a list of my qualifications because the day I need to justify my qualifications to you is the day I bite off my arm and beat myself to death with the bloody stump.


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## williamalex1 (Mar 24, 2016)

Ethan said:



			At the same time?
		
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No, first Simvastain for about 3 months then changed to Atorvastatin.


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## Old Skier (Mar 24, 2016)

Ethan said:



			Please yourself. Chiropractic is based on supposed relationships between joints and organs in the body and has been comprehensively proven to be nonsense. There are often reasons why someone should come off a statin. Statins are known to cause myalgia (muscle pain) in some people, as a side effect of their primary mode of action. They are not known to cause joint pains and if you had joint pains on them, you should ask your qualified doctor to report that. 

There are lots of reasons doctors take people off meds - no longer needed, side effects, better med comes along, patient is a moaner and it is just not worth the earache ....

By the way, I am fully qualified, but I will not be providing a list of my qualifications because the day I need to justify my qualifications to you is the day I bite off my arm and beat myself to death with the bloody stump.
		
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Thank you for your informed response, just to further increase your knowledge to assist with your future comments the information leaflet in the statin box did say muscle and joint pain as a possible side effect. Further more many NHS practitioners see the benefits of adding chrioprators to the list of treatments available and don't see them as some kind of voodoo. I appreciate that as your not practicing it is easy to get a bit behind.


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## Foxholer (Mar 24, 2016)

Ethan said:



			Chiropractic is an unscientific voodoo discipline. Chiropractors have no training in cholesterol or cardiac management and have no business interfering with prescribing decisions.
		
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While I have only had good experiences, several times over the years, with Chiropractors, but that has purely been restricted to manipulation for lower back pain. I certainly agree that they should stay away from areas that a Doctor is the appropriate reference!


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## Ethan (Mar 24, 2016)

Foxholer said:



			While I have only had good experiences, several times over the years, with Chiropractors, but that has purely been restricted to manipulation for lower back pain. I certainly agree that they should stay away from areas that a Doctor is the appropriate reference!
		
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If they do physio, that is fine. There are reported cases of people suffering stroke after their intervertebral artery was torn. The idea behind chiropractic is that the alignment of certain joints in the spine affects other organs. That is demonstrably nonsense.

https://en.wikipedia.org/wiki/Chiropractic

There is a chiropractor in the town I live advertising treatment for infertility. If he treats female infertility, the only effective method will be the laying on of an organ other than his hands.


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## Kellfire (Mar 24, 2016)

Ethan said:



			There is a chiropractor in the town I live advertising treatment for infertility. If he treats female infertility, the only effective method will be the laying on of an organ other than his hands.
		
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:rofl:


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## SocketRocket (Mar 24, 2016)

Ethan said:



			Please yourself. Chiropractic is based on supposed relationships between joints and organs in the body and has been comprehensively proven to be nonsense. There are often reasons why someone should come off a statin. Statins are known to cause myalgia (muscle pain) in some people, as a side effect of their primary mode of action. They are not known to cause joint pains and if you had joint pains on them, you should ask your qualified doctor to report that. 

There are lots of reasons doctors take people off meds - no longer needed, side effects, better med comes along, patient is a moaner and it is just not worth the earache ....

By the way, I am fully qualified, but I will not be providing a list of my qualifications because the day I need to justify my qualifications to you is the day I bite off my arm and beat myself to death with the bloody stump.
		
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You listed them some time ago on this Forum.   I will understand if you decide to forego the arm chewing though.


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## Foxholer (Mar 24, 2016)

Ethan said:



			If they do physio, that is fine. There are reported cases of people suffering stroke after their intervertebral artery was torn. The idea behind chiropractic is that the alignment of certain joints in the spine affects other organs. That is demonstrably nonsense.

https://en.wikipedia.org/wiki/Chiropractic

There is a chiropractor in the town I live advertising treatment for infertility. If he treats female infertility, the only effective method will be the laying on of an organ other than his hands.
		
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While that may have been the original hypothesis, I believe very few, if any, current chiropractors believe this - and their association states, rightly imo, that it should be treated as 'historical concept, not current theoretical model'. Remember that not long ago, 'Doctors' were advocating EST and Lithium and to use Bleeding as a universal cure! Health has made huge advances in the last hundred years or so! I believe Leeches actually even have a valuable use in current/recent Medicine!!

It is, of course, important to check that any Professional (or Tradesman) is suitable. Membership of the appropriate professional body is probably the best starting point. Unlike Doctoring, lack of membership of a particular body does not prevent shysters from practicing, but then there have also been cases where Doctors have breached their duty of care too!

Btw. Shouldn't you be 'out'-ing that shyster?


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## Kellfire (Mar 24, 2016)

Foxholer said:



			'Doctors' were advocating EST and Lithium and to use Bleeding as a universal cure! Health has made huge advances in the last hundred years or so! I believe Leeches actually even have a valuable use in current/recent Medicine!!
		
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Shock therapy is still used. As is Lithium. As is some bleeding like leaches...


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## Ethan (Mar 24, 2016)

Foxholer said:



			While that may have been the original hypothesis, I believe very few, if any, current chiropractors believe this - and their association states, rightly imo, that it should be treated as 'historical concept, not current theoretical model'. Remember that not long ago, 'Doctors' were advocating EST and Lithium and to use Bleeding as a universal cure! Health has made huge advances in the last hundred years or so! I believe Leeches actually even have a valuable use in current/recent Medicine!!

It is, of course, important to check that any Professional (or Tradesman) is suitable. Membership of the appropriate professional body is probably the best starting point. Unlike Doctoring, lack of membership of a particular body does not prevent shysters from practicing, but then there have also been cases where Doctors have breached their duty of care too!

Btw. Shouldn't you be 'out'-ing that shyster?
		
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Like I said, if they do physio, fine.

I have administered ECT and it is still administered today, albeit less often. It is a much maligned treatment and highly effective for the right patient, as with most treatments. Lithium is also used for bipolar and other psychiatric disorders, and bleeding, well that is only used for haemochromatosis, an iron overload disorder. 

In this day and age, people are allowed to waste their money with shysters. They can be warned, though.


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## Tashyboy (Mar 24, 2016)

Ethan said:



			Like I said, if they do physio, fine.

I have administered ECT and it is still administered today, albeit less often. It is a much maligned treatment and highly effective for the right patient, as with most treatments. Lithium is also used for bipolar and other psychiatric disorders, and bleeding, well that is only used for haemochromatosis, an iron overload disorder. 

In this day and age, people are allowed to waste their money with shysters. They can be warned, though.
		
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When missis T had her MIR scan week last Friday which showed the extent of her knackered back. The registrar ran through everything that was wrong with it and finished with the line " for gods sake do not see a chiropractor he will cause you permanent damage".
She does not need to be told anymore.


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## Foxholer (Mar 24, 2016)

Ethan said:



			Like I said, if they do physio, fine.
		
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That's pretty much all those that I have used had done - though they called it 'manipulation'. I don't care what it's called as long as it works! The 'physio' I was due to receive through NHS was an abject failure, simply demonstrating some of the communication issues that it had (was forced to have) at the time - and appears to still have!


Ethan said:



			I have administered ECT and it is still administered today, albeit less often. It is a much maligned treatment and highly effective for the right patient, as with most treatments.
		
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How did you determine the patient is 'the right patient' for EST (ECT?) or, more importantly. whether EST (ECT) is 'right' for the patient?


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## Ethan (Mar 25, 2016)

Foxholer said:



			That's pretty much all those that I have used had done - though they called it 'manipulation'. I don't care what it's called as long as it works! The 'physio' I was due to receive through NHS was an abject failure, simply demonstrating some of the communication issues that it had (was forced to have) at the time - and appears to still have!


How did you determine the patient is 'the right patient' for EST (ECT?) or, more importantly. whether EST (ECT) is 'right' for the patient?
		
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Electro Convulsive Therapy (ECT). There is quite a bit of evidence that shows that ECT is a suitable treatment for people in a catatonic state or with treatment-resistant depression or schizophrenia (or both). These days it is only used after meds have failed, and is carefully reviewed before being allowed. In the past when more widely used, some patients really wanted it because it worked fast for them and there were no side effects apart from during the immediate period afterwards.


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## Foxholer (Mar 25, 2016)

Ethan said:



			Electro Convulsive Therapy (ECT). There is quite a bit of evidence that shows that ECT is a suitable treatment for people in a catatonic state or with treatment-resistant depression or schizophrenia (or both). These days it is only used after meds have failed, and is carefully reviewed before being allowed. In the past when more widely used, some patients really wanted it because it worked fast for them and there were no side effects apart from during the immediate period afterwards.
		
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Thanks. Seems 'properly' monitored these days then. I knew someone who was one of the last to be 'treated' by it in the 'old' way - an wasn't  fan! Treatment was actually performed at the 'now posh gated estate' near Wentworth where David Howell used to live.

Oddly, we were discussing 'Awakenings' (the catatonic reference) at work!


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## Tashyboy (Mar 30, 2016)

Missis T Saw the GP last Monday who has referred her for an MRI scan, waited until today to ring hospital and to see when her appointment is. The appointments secretary has not recieved owt, rang GP who said it was sent last Monday. Rang hospital back who they said it is sat with "gateway". ? Drs, consultants or whoever will decide if it is important enough for her to have a scan soon. 10 pigging days tomorrow and still no nearer.


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## Deleted member 16999 (Mar 30, 2016)

Tashyboy said:



			Missis T Saw the GP last Monday who has referred her for an MRI scan, waited until today to ring hospital and to see when her appointment is. The appointments secretary has not recieved owt, rang GP who said it was sent last Monday. Rang hospital back who they said it is sat with "gateway". ? Drs, consultants or whoever will decide if it is important enough for her to have a scan soon. 10 pigging days tomorrow and still no nearer.
		
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My missus has got her MRI next Sunday at 8:30am, took 3 weeks for the appt to come through and surprised it was so quick.


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## Tashyboy (Apr 8, 2016)

Missis T ended up in hospital on weds morning in severe pain. Exact same symptoms as three weeks ago when she went in, it was so bad an experience that on Monday whilst calling in at the hospital to drop off her club note. We called in at PALS ( now renamed PET) to leave them a complaints letter  titled " from the other side". 
This time however the treatment was world class but highlighted the dire treatment she recieved the first time she was admitted, eg this time they noticed that she has been on prescribed ibuprofen for three weeks with no stomach protection medication. May seem trivial, but one of the things she may have is a stomach ulcer which will be checked on Monday when she swallows a camera.
They asked why she never had DVT injections last time, because they were not offered.
She has had more scans and tests this last few days than is imagine able , but why were they not done three weeks ago.
If she had been abducted by aliens she would not of been probed as much. This last three days has been a nightmare. They found a distended stomach but had no explaination as to why. Unfortunately Mr Google does not paint an happy picture, which caused much distress to Missis T and family inc me.
The first night in bed on my own I thought the bed was massive, the second night I realised it was not massive but empty. 

The nurses have been brilliant, she had her stomach drained today by one of her pals. Not the most pleasant of procedures. But Missis T said that if it had to of been done by the agency nurse the other week she said she would of told her to get lost such was her incompetency.
Not been the best of the last three days, but Missis T is home giggling at corro on the telly and life is sweet at the moment. But when your beloved says if this time is like last time then I will go to another hospital, then something is seriously wrong.

This last month has been a nightmare and one cannot help but think that politics is harming the NHS, which is held together by the goodwill of excellent nursing staff and Drs. 

Sorryfor the rant, have a good weekend folks.


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## Deleted member 16999 (Apr 8, 2016)

Glad to see she's home mate and the test finally sort it for her.


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## HomerJSimpson (Apr 9, 2016)

Tashyboy said:



			Missis T ended up in hospital on weds morning in severe pain. Exact same symptoms as three weeks ago when she went in, it was so bad an experience that on Monday whilst calling in at the hospital to drop off her club note. We called in at PALS ( now renamed PET) to leave them a complaints letter  titled " from the other side". 
This time however the treatment was world class but highlighted the dire treatment she recieved the first time she was admitted, eg this time they noticed that she has been on prescribed ibuprofen for three weeks with no stomach protection medication. May seem trivial, but one of the things she may have is a stomach ulcer which will be checked on Monday when she swallows a camera.
They asked why she never had DVT injections last time, because they were not offered.
She has had more scans and tests this last few days than is imagine able , but why were they not done three weeks ago.
If she had been abducted by aliens she would not of been probed as much. This last three days has been a nightmare. They found a distended stomach but had no explaination as to why. Unfortunately Mr Google does not paint an happy picture, which caused much distress to Missis T and family inc me.
The first night in bed on my own I thought the bed was massive, the second night I realised it was not massive but empty. 

The nurses have been brilliant, she had her stomach drained today by one of her pals. Not the most pleasant of procedures. But Missis T said that if it had to of been done by the agency nurse the other week she said she would of told her to get lost such was her incompetency.
Not been the best of the last three days, but Missis T is home giggling at corro on the telly and life is sweet at the moment. But when your beloved says if this time is like last time then I will go to another hospital, then something is seriously wrong.

This last month has been a nightmare and one cannot help but think that politics is harming the NHS, which is held together by the goodwill of excellent nursing staff and Drs. 

Sorryfor the rant, have a good weekend folks.
		
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Not good at how it's all gone to date but good she's home and hopefully going forward everything will be positive


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## Tashyboy (Apr 9, 2016)

Fingers crossed Homer, she jumped on the scales this morning and has lost 8lb in the three days she was in. She had a good nights kip, glad one of us did. Took young Bradley Tash in to see her as a suprise. It was an hour of glorious mayhem. Bed goes up, bed goes down, bed bends. Beds a climbing frame. Special toilets, special baths. 

Of to footy in an hour with me old man so she can chill for the afternoon.


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## HomerJSimpson (Apr 9, 2016)

Tashyboy said:



			Fingers crossed Homer, she jumped on the scales this morning and has lost 8lb in the three days she was in. She had a good nights kip, glad one of us did. Took young Bradley Tash in to see her as a suprise. It was an hour of glorious mayhem. Bed goes up, bed goes down, bed bends. Beds a climbing frame. Special toilets, special baths. 

Of to footy in an hour with me old man so she can chill for the afternoon.
		
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Good to have some you time too. Hope she carries on relaxing


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## Tashyboy (May 12, 2016)

Quick update, three weeks ago Missis T saw a gastroenterologist at a private hospital coz the wait was to long to see her in NHS hospital. They never had any notes on her condition ( never requested them) bloke she saw said he was 99 % sure she had a hernia. Had to go back today so guy could confirm diagnosis when he had looked at her scans which had not been requested. 
Missis T's boss gave her a back to work assesment Monday and and rang private hospital to see if they had requested films of ct and ultrasound scans, they had not. 
She went today and saw gastro guy, they have now lost her notes from initial consultation with him. The guy asked if she was new patient. Er no. He then said I have seen your ct and ultra sound scan films and you DO NOT have an hernia. Mint.
He said I want you to have an ultrasound scan on you site of pain, but have it done here at the private hospital. We went to the desk to make an appointment, woman says it will be next week. When, "don't know coz we don't know when he will be in to do them"." We will ring you tomorrow or maybe Monday".
At that point me head went and I had a walk to the carpark to calm down. Tomorrow said private hospital will be at the end of one of tashyboys famous rants.


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