Manifestos, Mandates and Mendacity

[bluewolf]

Yes, I do work 60 hours a week -and more when needed and you will find that a lot of people do. As I understand it, the doctors are not expected to work more hours, just different hours on different days and they get an 11% pay increase into the bargain. The need for more doctors is a seperate issue. If more are needed to operate a 7 day service then more should be recruited. I do believe that the money that the NHS receives could be used more efficiently.
The amount I pay into the NHS in my taxes is the biggest "policy" I have, by far, so I do pay a lot for it. On top of that, it is getting harder and harder to access its services. As I say, a 3 week and counting wait for an appointment at my surgery, but it's closed at weekends and before 8am and after 6pm in the week. Can you imagine any business in the private sector that would only open those hours if they were so busy?
A 7 day NHS is exactly what it says on the tin. 24/7/365. That is what would happen if the private sector actually did run the NHS. And you cannot ignore the point that with a rapidly expanding population, we cannot keep this service going with anything less. There simply is not the time and it's all part of understanding that more people does not simply mean more tax. Every single person needs investment in amenities, like education, transport, water services etc etc and yes, the NHS.
Lets look at it another way. Would you be happy with a reduction of hours? No? So do we have it about right then? If that is the case, why are people dying on waiting lists and others can't even get to see their GP within the next 3 weeks?

In reference to the "Surgery appointments" comments, have you considered changing Surgery? My local Surgery is already open 7 days a week (albeit with reduced staffing at the weekend).. I've never had to wait more than a few days for an appointment, and when I've really needed to see a Doctor I've been able to visit an "out of hours" surgery, that I'm fairly certain all towns have..

 

[Hobbit]

TBH, going private gives far better access to medical care. I've had private healthcare for 20yrs, and its brilliant. Access to good Consultants, not spotty house doctors. Access to an MRI, not starting with an x-ray. It costs but its money well spent. I'd love to put the portion of money I'm paying in NI into more private healthcare, or alternatively pay what I'm paying for private healthcare into the NHS for the same level of care.

Appointment with the local GP starts with a ring back from the Practice Nurse, and then either a call from the GP or an appointment. 3 days for a ring back from the nurse, and 2 weeks for a call from the GP. 3 weeks to see him. Referred to the local BUPA, and seen within two days...

 

[Ethan]

Yes, I do work 60 hours a week -and more when needed and you will find that a lot of people do. As I understand it, the doctors are not expected to work more hours, just different hours on different days and they get an 11% pay increase into the bargain. The need for more doctors is a seperate issue. If more are needed to operate a 7 day service then more should be recruited. I do believe that the money that the NHS receives could be used more efficiently.
The amount I pay into the NHS in my taxes is the biggest "policy" I have, by far, so I do pay a lot for it. On top of that, it is getting harder and harder to access its services. As I say, a 3 week and counting wait for an appointment at my surgery, but it's closed at weekends and before 8am and after 6pm in the week. Can you imagine any business in the private sector that would only open those hours if they were so busy?
A 7 day NHS is exactly what it says on the tin. 24/7/365. That is what would happen if the private sector actually did run the NHS. And you cannot ignore the point that with a rapidly expanding population, we cannot keep this service going with anything less. There simply is not the time and it's all part of understanding that more people does not simply mean more tax. Every single person needs investment in amenities, like education, transport, water services etc etc and yes, the NHS.
Lets look at it another way. Would you be happy with a reduction of hours? No? So do we have it about right then? If that is the case, why are people dying on waiting lists and others can't even get to see their GP within the next 3 weeks?

You understand it wrongly. Hunt promised an 11% increase in basic pay but also a reduction in overtime, so most doctors will gain nothing and many will get a reduction.

You pay for the NHS out of general taxation. National Insurance is not hypothecated for health. Sorry if you feel you pay a lot - you really don't/ Move to America if you want to know what paying a lot for healthcare looks like.

As for ease of access, that is because a greater proportion of medical time is devoted to useless form filling. My wife is a Consultant Psychiatrist, and it used to be that every new patient she saw it took roughly the same amount of time to complete the paperwork as it did to see them. Now it takes 3 to 4 times as along. She has to complete radicalisation forms, dangerousness forms, a lot of coding designed to make future billing procedures easier. That has effectively extended her waiting list because there only is so much time in the week, and the Trust is full of people whose job it is to harass staff to get these forms filled in, which further increases cost and waste. The same happens in general practice, and they also have to deal with the nonsensical procedures for referrals. When I was doing hospital clinics, if I was doing a general medicine clinic and saw someone with a dermatology problem, say, I could pick up the phone, call round to the derm clinic and ask if they could say the patient today. No longer. I would now have to write to the GP and ask the GP to make a referral to the derm clinic. Why? Because that would count as a new patient and be billable as such. So the GP writes a new referral, it comes into hospital where it is screened by an admin who rejects it is some irrelevant box isn't properly filled in, because that helps manage their patient flow and waiting times. Likewise prescriptions. I used to issue prescriptions you could take to the pharmacy. No more, now the GP gets a letter asking them to prescribe.

You are kidding yourself if you think the NHS has learned anything from the private sector. The best companies value their staff. The NHS treats theirs with contempt.

You haven't answered the question about 24/7 services, though. "exactly what it says on the tin". Do you mean routine clinics on weekends, elective operations and investigations, full diagnostics, facilities and all? If so start looking for another £30 billion a year.

As for the weekend effect, read further than the Daily Mail. The BMJ, which published the paper that Hunt refers to (which was conducted by some of his own staff, by the way) had to issue a statement refuting Hunt's soundbite, and even one of the paper's authors had to do the same. There was also evidence published last week that Sunday clinics in GP have a very low and wasteful uptake and early pilots in them are closing down. I know lots of GPs and there is not one of them who finds the current state of GP tolerable, and most would retire or leave tomorrow if they could. If you want to blame someone for your not being able to get a GP appointment, blame Jeremy Hunt.

 

[Sweep]

So at least you agree with me that the funds the NHS receives could be better spent. The way the NHS completes its paperwork has little to do with the need for a 7 day NHS, though I am sure if it was better handled, more patients could be seen within current hours.
I did answer your question on what 7 day means. The NHS needs to be run like it would if it was earning not spending money. For example, the last time I needed to see a doctor I phoned for an appointment and the phone rang out for maybe an hour. In the end I gave up and went round to the surgery. When I was granted my appointment for 3 weeks time on the proviso I hadn't died in the meantime, I asked why my call hadn't been answered. I explained to the receptionist the real reason. When the phone rings in in my company, it's an opportunity to sell, to make the money we need to survive. When the phone rings at my surgery, it's just someone like me who is going to cost some of the money they have already been given. It's all done the wrong way round. The NHS should be given funds on the basis of the number of people it serves. Just like everyone else. Then you would see the appetite for 7 day change.
Obviously, if there is not enough custom for a diabetes clinic 24/7 then you put the resources where they are needed, but as soon as there is demand it should absolutely be 7 day.
Now, you didn't answer my question on how are we going to cope with a rapidly expanding population without a 7 day NHS?

 

[delc]

P

I am waiting on them not to deliver a third runway at Heathrow...

As promised by DaveCam himself...

What's the point of a third runway anyway? The roads around Heathrow are getting so gridlocked these days that you would never get there!

 

[Ethan]

So at least you agree with me that the funds the NHS receives could be better spent. The way the NHS completes its paperwork has little to do with the need for a 7 day NHS, though I am sure if it was better handled, more patients could be seen within current hours.
I did answer your question on what 7 day means. The NHS needs to be run like it would if it was earning not spending money. For example, the last time I needed to see a doctor I phoned for an appointment and the phone rang out for maybe an hour. In the end I gave up and went round to the surgery. When I was granted my appointment for 3 weeks time on the proviso I hadn't died in the meantime, I asked why my call hadn't been answered. I explained to the receptionist the real reason. When the phone rings in in my company, it's an opportunity to sell, to make the money we need to survive. When the phone rings at my surgery, it's just someone like me who is going to cost some of the money they have already been given. It's all done the wrong way round. The NHS should be given funds on the basis of the number of people it serves. Just like everyone else. Then you would see the appetite for 7 day change.
Obviously, if there is not enough custom for a diabetes clinic 24/7 then you put the resources where they are needed, but as soon as there is demand it should absolutely be 7 day.
Now, you didn't answer my question on how are we going to cope with a rapidly expanding population without a 7 day NHS?

I am sorry, but you are wrong. Time stolen from clinical contact time has everything to do with the increasing demands and reducing availability in the NHS. If doctors are filling in useless forms, they are not seeing patients at the same time. It is elementary and obvious.

And the political argument for 7 day NHS has little to do with demographic change. Health services can be provided to a larger population in precisely the same way it is now, although you will need more premises and staff. More people don't drive a need for displacement of activity to weekends and out of hours.

In any case we already have a 7 day NHS, and have had once since the NHS was founded. That is for emergency need, although if you are ever in an A&E on a Saturday night you will see many which are far from emergencies. What you are presumably arguing for, although I am not sure you even know what you mean, is a full routine and elective service running at weekend, 24/7 or something. I don't think you really understand the implications of either one. Unless there is a large expansion in staff, and there is no money for that, then the best you can do is displace activity from weekdays to weekends. Then next time you ring the GP surgery, it will be 4 weeks for that appointment instead of 3. The cost for that full 7 day service is tens of billions.

The NHS is a supply based system, not a demand based one (like in the US). Demand in healthcare is different from demand in whatever market you work in. Many of the people who demand healthcare don't actually need it, or don't need it right away. It is amazing how many minor niggles go away when you ask people to wait a few days or weeks. Giving funds on the basis of demand is a recipe for uncontrolled and uncontrollable cost inflation, like they have in the US, where they pay twice as much for somewhat less actual healthcare. You simply can't rely on people's good sense because many don't have any.

 

[Deleted member 15344]

P

What's the point of a third runway anyway? The roads around Heathrow are getting so gridlocked these days that you would never get there!

Because London needs another runway to cope with increased air travel

 

[delc]

Because London needs another runway to cope with increased air travel

No point if you can't get to and from the airport in a reasonable time! You would also need to spend money on the surrounding roads, particularly the M25.

 

[Deleted member 15344]

No point if you can't get to and from the airport in a reasonable time! You would also need to spend money on the surrounding roads, particularly the M25.

I have never had any issue getting to either Heathrow or Gatwick in reasonable time ? I plan my journey accordingly

Wouldn't need to change much with the M25

 

[MegaSteve]

Because London needs another runway to cope with increased air travel

It may well do.... But, it shouldn't be built at Heathrow purely because Dave's mates will be out of pocket otherwise...

 

[Deleted member 15344]

It may well do.... But, it shouldn't be built at Heathrow purely because Dave's mates will be out of pocket otherwise...

Well where is should be built I have no idea but there does need to be more facilities for more flights to land in London

Heathrow would be a logical choice for it to go

 

[HomerJSimpson]

Well where is should be built I have no idea but there does need to be more facilities for more flights to land in London

Heathrow would be a logical choice for it to go

I actually think there is a strong argument for Gatwick and there does seem to be serious hints that it might not happen

http://files.heraldscotland.com/pol...veering_away_from_Heathrow_expansion/?ref=rss

 

[MegaSteve]

Heathrow would be a logical choice for it to go

I am sure the good residents of Gatwick and Stansted will be more than happy to see an extra runway built in their locality... Brings great benefits to the area [apparently]....

 

[Deleted member 15344]

I am sure the good residents of Gatwick and Stansted will be more than happy to see an extra runway built in their locality... Brings great benefits to the area [apparently]....

Would do - just need to improve the rail links to both as well.

 

[SwingsitlikeHogan]

I am sorry, but you are wrong. Time stolen from clinical contact time has everything to do with the increasing demands and reducing availability in the NHS. If doctors are filling in useless forms, they are not seeing patients at the same time. It is elementary and obvious.

And the political argument for 7 day NHS has little to do with demographic change. Health services can be provided to a larger population in precisely the same way it is now, although you will need more premises and staff. More people don't drive a need for displacement of activity to weekends and out of hours.

In any case we already have a 7 day NHS, and have had once since the NHS was founded. That is for emergency need, although if you are ever in an A&E on a Saturday night you will see many which are far from emergencies. What you are presumably arguing for, although I am not sure you even know what you mean, is a full routine and elective service running at weekend, 24/7 or something. I don't think you really understand the implications of either one. Unless there is a large expansion in staff, and there is no money for that, then the best you can do is displace activity from weekdays to weekends. Then next time you ring the GP surgery, it will be 4 weeks for that appointment instead of 3. The cost for that full 7 day service is tens of billions.

The NHS is a supply based system, not a demand based one (like in the US). Demand in healthcare is different from demand in whatever market you work in. Many of the people who demand healthcare don't actually need it, or don't need it right away. It is amazing how many minor niggles go away when you ask people to wait a few days or weeks. Giving funds on the basis of demand is a recipe for uncontrolled and uncontrollable cost inflation, like they have in the US, where they pay twice as much for somewhat less actual healthcare. You simply can't rely on people's good sense because many don't have any.

This^^^

Anyway - NHS Scotland is short of doctors and GPs - and as NHS Scotland is quite separate from NHS (England) - though in his pronouncements I am not sure Hunt remembers this - and there is less appetite in the Scottish government for what Hunt wants. So maybe then if things come to pass in England as Hunt intends a good number of doctors in England will look to move to Scotland.

 

[HomerJSimpson]

I am sure the good residents of Gatwick and Stansted will be more than happy to see an extra runway built in their locality... Brings great benefits to the area [apparently]....

There will never be an answer to please anyone in the locality of the chose airport. I think we can all understand their issues. However, clearly there's obviously an increasing demand and something has to be done. Not sure where or when and can see legal ramblings dragging along for many a year to come

 

[delc]

There will never be an answer to please anyone in the locality of the chose airport. I think we can all understand their issues. However, clearly there's obviously an increasing demand and something has to be done. Not sure where or when and can see legal ramblings dragging along for many a year to come

An extra runway at Heathrow involves either completely demolishing the town of Sipson, when we need more housing in the area, not less, or doubling the length of one of the existing runways (with separate arrival and departure sections), in which case an underpass will have to be built to take the M25!

 

[Deleted member 15344]

An extra runway at Heathrow involves either completely demolishing the town of Sipson, when we need more housing in the area, not less, or doubling the length of one of the existing runways (with separate arrival and departure sections), in which case an underpass will have to be built to take the M25!

If it helps the country progress then surely there is no issue :thup:

 

[HomerJSimpson]

If it helps the country progress then surely there is no issue :thup:

Of course it is. Same as there are issues with Gatwick and Stanstead and why these have to be looked at pragmatically and for a long term outcome and not a quick fix for now and some easy bucks for those involved

 

[Hobbit]

This^^^

Anyway - NHS Scotland is short of doctors and GPs - and as NHS Scotland is quite separate from NHS (England) - though in his pronouncements I am not sure Hunt remembers this - and there is less appetite in the Scottish government for what Hunt wants. So maybe then if things come to pass in England as Hunt intends a good number of doctors in England will look to move to Scotland.

"This" what?!?

You seem to want the NHS to continues as is. How on earth will that sort out the ever increasing waiting lists? If you keep doing the same thing, then you will keep getting the same results. Something needs to change. An ever increasing population being crammed into the same size NHS. It just doesn't work.

Depending on the condition, i.e. recovery could be at home, bring them in to Outpatients/Day Surgery on a Saturday/Sunday. Yes, more staff/funding is required.

All we seem to see at present is healthcare professionals saying no and JH saying yes. Its pathetic! And the people suffering, whilst all the posturing is going on, is the patients. When will someone put forward a workable solution?