A&E Crisis - What's going on

[Kellfire]

But why can't people wait a couple of hours or so if A&E is busy? The fast food mentality is filtering into every aspect of life - "I want it and I want it now!" There's middle ground in this, and a decent triage followed by immediate sending for an X-ray/mri would be a start.

This.

We can hardly afford one to one care. If you have a minor injury, shut up and wait. Simple as that.

 

[blackpuddinmonster]

The missus is a practice manager at a mid sized surgery. They may not be typical but i can only write what i know.
Each doctor has a patient list of over 2000 patients, yes 2000.
They work five days a week from 8am to 6pm.
They also do 2 nights a week on call at our local out of hours service.
Two of them also do a lot of voluntary work for the local hospice.
Are they well paid ? Yes
Do they deserve it ? Every penny. :clap:

PS
Sorry Doon for answering my own questions.

 

[SocketRocket]

Increase the population by millions in a decade, keep services like Hospitals and Schools at a similar level and you create a problem. Cause and effect! So! throw more money at it or accept that this is one of the benefits of our wonderful seam splitting Britain.

Another cause seems to me to be related to the folly of unrestricted licensing hours. The naive expectations of this creating a continental cafe culture has instead made a British battlefield in City and Town centres that generate large numbers of casualties for A&E to fix and clean up after.

 

[blackpuddinmonster]

Increase the population by millions in a decade, keep services like Hospitals and Schools at a similar level and you create a problem. Cause and effect! So! throw more money at it or accept that this is one of the benefits of our wonderful seam splitting Britain.

Another cause seems to me to be related to the folly of unrestricted licensing hours. The naive expectations of this creating a continental cafe culture has instead made a British battlefield in City and Town centres that generate large numbers of casualties for A&E to fix and clean up after.

Totally agree. The problem isn't the staff, its cronic under funding in the face of a growing and ageing population.
But which political party is going to have the nuts to say a small increase in personal taxation is needed to keep our nhs?

 

[SocketRocket]

Totally agree. The problem isn't the staff, its cronic under funding in the face of a growing and ageing population.
But which political party is going to have the nuts to say a small increase in personal taxation is needed to keep our nhs?

Hopefully none of them. Getting us out of the EU money eating monster state would be a step in the right direction. Slashing the monstrous welfare bill would be another. We would then have some serious money to build and staff more hospitals. On the other hand, we will not be responsible as a country if we don't make suitable tax increases to support the healthcare and welfare of Romanian and Bulgarian fellow citizens when they stream in next year.

 

[blackpuddinmonster]

Hopefully none of them. Getting us out of the EU money eating monster state would be a step in the right direction. Slashing the monstrous welfare bill would be another. We would then have some serious money to build and staff more hospitals. On the other hand, we will not be responsible as a country if we don't make suitable tax increases to support the healthcare and welfare of Romanian and Bulgarian fellow citizens when they stream in next year.

Thought it was too good to be true. :whoo:
Your nothing if not consistent.
Wrong of course, but consistent. :thup:

 

[SocketRocket]

Thought it was too good to be true. :whoo:
Your nothing if not consistent.
Wrong of course, but consistent. :thup:

Lets see next year if I'm wrong.

 

[blackpuddinmonster]

Raise vat from 17.7 to 18.5% = 4.65 billion
Raise NI 1% = 8.825 billion
1p on basic rate of tax = 4 billion
If a political party promised to put all this extra revinue into the nhs would you be for or against?
Its just a different way of looking at things, instead of stomping the least affluent members of our society even further into the merde.

Whoops forgot, i got my figures from The Institute for Fiscal Studies.

 

[SwingsitlikeHogan]

with many friends in these areas I assure you its as bad now if not worse than 5 years ago. The weekends at night in A&E are quite scary places and they need more security for the staff than they currently have. The verbal and physical abuse is horrific.

I don't disagree - I have a friend who is a senior nurse in A&E. But I don't think druggies and drunks have made that much difference and caused the overload we see today compared with how it was - let's say - 5yrs ago.

 

[Kellfire]

Raise vat from 17.7 to 18.5% = 4.65 billion
Raise NI 1% = 8.825 billion
1p on basic rate of tax = 4 billion
If a political party promised to put all this extra revinue into the nhs would you be for or against?
Its just a different way of looking at things, instead of stomping the least affluent members of our society even further into the merde.

Whoops forgot, i got my figures from The Institute for Fiscal Studies.

You've got VAT wrong there... 20% and has been for a good while...

 

[SocketRocket]

Raise vat from 17.7 to 18.5% = 4.65 billion
Raise NI 1% = 8.825 billion
1p on basic rate of tax = 4 billion
If a political party promised to put all this extra revinue into the nhs would you be for or against?
Its just a different way of looking at things, instead of stomping the least affluent members of our society even further into the merde.

Whoops forgot, i got my figures from The Institute for Fiscal Studies.

Sounds good. Hit the workers harder and let the feckless prosper. Seems like there is money for anything but hard work.

 

[blackpuddinmonster]

You've got VAT wrong there... 20% and has been for a good while...

Well done, 4/1/2011 to be exact.
The principle remains the same though. Small rises for everyone, can generate large amounts. After all we are supposed to be all in this together.

Benefit fraud, a fraud not just perpetrated by the work shy costs this country £7 Bn.
Tax fraud, a fraud usually perpetrated by the better off costs £14 Bn.
I'am just saying, instead of blaming people on benefits for all our woes, wouldn't it make more sense to go after the affluent criminals as well ?

 

[blackpuddinmonster]

Sounds good. Hit the workers harder and let the feckless prosper. Seems like there is money for anything but hard work.

Are you seriously suggesting everyone on welfare is a sponger?
Does that include the pensioners who account for over half of our welfare budget?
How do you slash that? Euthanasia?

People claiming child benefit?
No breeding if you don't earn enough?

The disabled and chronically ill?
A nice trip to Switzerland perhaps?

Yes there are people who don't deserve what they get of the state and take advantage, but they are the minority, not the majority. If i find a cracked egg in an egg box i throw the egg away not the whole box.
I know your not going to agree with me SR, but to blame this countries problems on a few thousand, as you say, feckless individuals, frankly amazes me. But hey, each to their own.

PS, We might have some common ground when it comes to the EU and how much we contribute, but don't get me started on UKIP. :thup:

 

[Hacker Khan]

I'am just saying, instead of blaming people on benefits for all our woes, wouldn't it make more sense to go after the affluent criminals as well ?

But as anyone who reads The Daily Mail will tell, you they are the cause of all our woes. And foreigners eat babies

 

[Ethan]

The Emergency Departments (as they like to be called now) crisis is a multifactorial one. Contributions include rising demand, mostly of a trivial nature. Real pathology has not got more common, there aren't more heart attacks or strokes (there are fewer, in fact), more RTAs (again, fewer), so the inflation is due mostly to unnecessary rubbish. But we have a system now where, for political reasons, nobody is allowed to wait more than 4 hours (otherwise they "breach"), so the dross has to get seen. Triage is important, but is done wrong. Triage needs to be done by the most experienced who can take serious decisions and chuck out the rubbish. It is not done that way currently. The GPs get a lot of blame from the Govt. But that is a lot to do with a Govt strategy to bash general practice so that Govt can make reforms (Govt speak for cutbacks or selloffs) with less protest. I know a lot of GPs in various parts of the country. I don't know any who are happier with their workload or pay over the past few years, and I know a few who have had serious drops in pay and are considering either early retirement or emigration to NZ or Canada. GP Out of Hours (OOH) has been an issue. One of the problems is that the old model of OOH became unsustainable because of rising demand. If you have docs doing nights, they can't do days too, so you rob one part of the system to run the other. This new 8-8 thing is a con trick. Unless everything else is open 8-8 too, there is no point and it is a political stunt. The private OOH companies have been a disaster, massively expensive and offering questionable service levels. And NHS Dire didn't help by pushing a lot more people to EDs. In the past many GPs got direct admissions for patients by calling a hospital doc and arranging it. Now they have to call bed managers and go through lengthy questionnaires designed to avoid taking admissions. Then the patient is often directed to the ED anyway. Govt will tell you that NHS spending has been at an all time high. Perhaps. But an increasing percentage of that is not going on direct healthcare. It is going on payments for expensive PFI projects in marginal constituencies and to McKinsey and management consultants, and to Foundation Trust managerial and marketing staff and material. The fundamental problem is that the main political parties are all pretty much doing the same thing, so if Jeremy Hunt is repaved by Andy Burnham, not much will change.

This new Keogh report has caused a feeding frenzy of activity. Some of the underlying intention is reasonable, but it needs resource and clarity to work. Those commodities are usually scarce in the NHS. The paramedics are happy, at least for now, because they get a better position in the system. But it is laughable to hear paramedics say that they have almost as much training as doctors. They really don't.

The problems with EDs at present are largely a political and material creation. Govt increases patient expectations and therefore drives demand, but also cuts back resources to the front-line where this demand is serviced. It is an unsustainable model.

 

[CMAC]

The Emergency Departments (as they like to be called now) crisis is a multifactorial one. Contributions include rising demand, mostly of a trivial nature. Real pathology has not got more common, there aren't more heart attacks or strokes (there are fewer, in fact), more RTAs (again, fewer), so the inflation is due mostly to unnecessary rubbish. But we have a system now where, for political reasons, nobody is allowed to wait more than 4 hours (otherwise they "breach"), so the dross has to get seen. Triage is important, but is done wrong. Triage needs to be done by the most experienced who can take serious decisions and chuck out the rubbish. It is not done that way currently. The GPs get a lot of blame from the Govt. But that is a lot to do with a Govt strategy to bash general practice so that Govt can make reforms (Govt speak for cutbacks or selloffs) with less protest. I know a lot of GPs in various parts of the country. I don't know any who are happier with their workload or pay over the past few years, and I know a few who have had serious drops in pay and are considering either early retirement or emigration to NZ or Canada. GP Out of Hours (OOH) has been an issue. One of the problems is that the old model of OOH became unsustainable because of rising demand. If you have docs doing nights, they can't do days too, so you rob one part of the system to run the other. This new 8-8 thing is a con trick. Unless everything else is open 8-8 too, there is no point and it is a political stunt. The private OOH companies have been a disaster, massively expensive and offering questionable service levels. And NHS Dire didn't help by pushing a lot more people to EDs. In the past many GPs got direct admissions for patients by calling a hospital doc and arranging it. Now they have to call bed managers and go through lengthy questionnaires designed to avoid taking admissions. Then the patient is often directed to the ED anyway. Govt will tell you that NHS spending has been at an all time high. Perhaps. But an increasing percentage of that is not going on direct healthcare. It is going on payments for expensive PFI projects in marginal constituencies and to McKinsey and management consultants, and to Foundation Trust managerial and marketing staff and material. The fundamental problem is that the main political parties are all pretty much doing the same thing, so if Jeremy Hunt is repaved by Andy Burnham, not much will change.

This new Keogh report has caused a feeding frenzy of activity. Some of the underlying intention is reasonable, but it needs resource and clarity to work. Those commodities are usually scarce in the NHS. The paramedics are happy, at least for now, because they get a better position in the system. But it is laughable to hear paramedics say that they have almost as much training as doctors. They really don't.

The problems with EDs at present are largely a political and material creation. Govt increases patient expectations and therefore drives demand, but also cuts back resources to the front-line where this demand is serviced. It is an unsustainable model.

Ever heard of a paragraph :ears: (yes yes I know there's 3 but maybe spacing to enhance the reader experience)

I was going to read it but hurts my eyes...wonder if it was interesting:ears:

 

[GreiginFife]

The Emergency Departments (as they like to be called now) crisis is a multifactorial one. Contributions include rising demand, mostly of a trivial nature. Real pathology has not got more common, there aren't more heart attacks or strokes (there are fewer, in fact), more RTAs (again, fewer), so the inflation is due mostly to unnecessary rubbish. But we have a system now where, for political reasons, nobody is allowed to wait more than 4 hours (otherwise they "breach"), so the dross has to get seen. Triage is important, but is done wrong. Triage needs to be done by the most experienced who can take serious decisions and chuck out the rubbish. It is not done that way currently. The GPs get a lot of blame from the Govt. But that is a lot to do with a Govt strategy to bash general practice so that Govt can make reforms (Govt speak for cutbacks or selloffs) with less protest. I know a lot of GPs in various parts of the country. I don't know any who are happier with their workload or pay over the past few years, and I know a few who have had serious drops in pay and are considering either early retirement or emigration to NZ or Canada. GP Out of Hours (OOH) has been an issue. One of the problems is that the old model of OOH became unsustainable because of rising demand. If you have docs doing nights, they can't do days too, so you rob one part of the system to run the other. This new 8-8 thing is a con trick. Unless everything else is open 8-8 too, there is no point and it is a political stunt. The private OOH companies have been a disaster, massively expensive and offering questionable service levels. And NHS Dire didn't help by pushing a lot more people to EDs. In the past many GPs got direct admissions for patients by calling a hospital doc and arranging it. Now they have to call bed managers and go through lengthy questionnaires designed to avoid taking admissions. Then the patient is often directed to the ED anyway. Govt will tell you that NHS spending has been at an all time high. Perhaps. But an increasing percentage of that is not going on direct healthcare. It is going on payments for expensive PFI projects in marginal constituencies and to McKinsey and management consultants, and to Foundation Trust managerial and marketing staff and material. The fundamental problem is that the main political parties are all pretty much doing the same thing, so if Jeremy Hunt is repaved by Andy Burnham, not much will change.

This new Keogh report has caused a feeding frenzy of activity. Some of the underlying intention is reasonable, but it needs resource and clarity to work. Those commodities are usually scarce in the NHS. The paramedics are happy, at least for now, because they get a better position in the system. But it is laughable to hear paramedics say that they have almost as much training as doctors. They really don't.

The problems with EDs at present are largely a political and material creation. Govt increases patient expectations and therefore drives demand, but also cuts back resources to the front-line where this demand is serviced. It is an unsustainable model.

Ever heard of a paragraph :ears: (yes yes I know there's 3 but maybe spacing to enhance the reader experience)

I was going to read it but hurts my eyes...wonder if it was interesting:ears:

It was indeed interesting. And very well written (despite spacing issues :ears
It also gave a more realsitic view of the core issues than the usual "them immigants" and "drugs and drink" shouts that get bandied about.
No, the volume on non-nationals, drunks and drug users do not help the system by any stretch, there is something underlying this much more though and the above, insightfully, points at what is really wrong. We expect too much from people already strecthed to their limits and being squeezed further every day. And why? Because the politicos tell us that this is what we deserve in order to score voting points all-the-while stripping away the very fabric of what they are telling us to utilise.

 

[SocketRocket]

Are you seriously suggesting everyone on welfare is a sponger?
Does that include the pensioners who account for over half of our welfare budget?
How do you slash that? Euthanasia?

People claiming child benefit?
No breeding if you don't earn enough?

The disabled and chronically ill?
A nice trip to Switzerland perhaps?

Yes there are people who don't deserve what they get of the state and take advantage, but they are the minority, not the majority. If i find a cracked egg in an egg box i throw the egg away not the whole box.
I know your not going to agree with me SR, but to blame this countries problems on a few thousand, as you say, feckless individuals, frankly amazes me. But hey, each to their own.

PS, We might have some common ground when it comes to the EU and how much we contribute, but don't get me started on UKIP. :thup:

A few thousand!! Give me a break.

'There is no so blind as those that don't want to see' Of course the genuinely disabled and sick should be cared for along with those who have fallen on hard times through no real fault of their own while they are temporarily out of work. Pensioners have by and large funded themselves by paying for at least 30 years into the pot. If you cant see what is going on around you and wonder why the welfare bill grew by 60% under Labour in times of relative prosperity then you are delusional .

 

[Ethan]

Ever heard of a paragraph :ears: (yes yes I know there's 3 but maybe spacing to enhance the reader experience)

I was going to read it but hurts my eyes...wonder if it was interesting:ears:

No, I just made an assumption.

About the reading ability of people.

Who might read it.

Can't get it right.

All the.

Time.

I.

Guess.

 

[CMAC]

No, I just made an assumption.

About the reading ability of people.

Who might read it.

Can't get it right.

All the.

Time.

I.

Guess.

:rofl: :thup: