Manifestos, Mandates and Mendacity

[delc]

"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?

The NHS seems to be beset with bureaucracy and form filling, rather than actually treating patients. Surely this could be simplified?

 

[Sweep]

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.

I am sorry, but where did I say that time taken from clinical contract time has nothing to do with increasing demands and availability??? I agreed with you that the NHS could be run better and that the money could be better spent. What I said was that the case for a 7 day NHS is separate from the way it is run.
I am not sure what you mean when you say its a supply based system rather than demand based, but it should be demand based. I absolutely agree that the surgeries are full of people trying to get a sick note and old people coming in for a warm. I have seen it myself, they wear a prescription like a badge if honour, but all that is a separate issue and needs to be dealt with separately. It's a poor excuse to use for offering a poorer service than possible for those who need it. Again, the NHS just needs to ask itself, how would it operate if it was charging money not spending it? Then it would provide the service we need and deserve.
Too much of this argument is based around the people who work in the NHS and not about the people who pay for it. An ex colleague of mine retired and did some work in the NHS for a charity. He told me he was shocked about the culture, saying that the main conversation in breaks was how quickly after 50 they can retire on big pensions (probably not as big now) and how quickly they can come back and earn their wage again whilst still drawing said pension. You have to face facts. This could never happen in the private sector and that's because companies who operated such policies would fail. The NHS and other public services need to adopt similar cultures in all aspects of their business, including personnel and service.
So if you say the NHS has no issue with coping with demographic change and can do so without a 7 day service, how come it can't cope now? How come people are dying on waiting lists? How come it takes 3 weeks just to see your GP? So it's all OK then? We just carry on as we are?

 

[SwingsitlikeHogan]

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.

Agreeing with what was quoted above I think is the way of it.

You change it if it needs changing and what you change doesn't break what is already there. The NHS is very far from perfect - but is a 7-day NHS the #1 priority?

 

[SwingsitlikeHogan]

And I read today Osborne won't abandon his aspirations for Tax Credit - whatever anyone in his party says - irrespective of what the electorate might think and say - as a U-turn would damage his ambitions to be PM. That's OK then.

 

[SwingsitlikeHogan]

I am sorry, but where did I say that time taken from clinical contract time has nothing to do with increasing demands and availability??? I agreed with you that the NHS could be run better and that the money could be better spent. What I said was that the case for a 7 day NHS is separate from the way it is run.
I am not sure what you mean when you say its a supply based system rather than demand based, but it should be demand based. I absolutely agree that the surgeries are full of people trying to get a sick note and old people coming in for a warm. I have seen it myself, they wear a prescription like a badge if honour, but all that is a separate issue and needs to be dealt with separately. It's a poor excuse to use for offering a poorer service than possible for those who need it. Again, the NHS just needs to ask itself, how would it operate if it was charging money not spending it? Then it would provide the service we need and deserve.
Too much of this argument is based around the people who work in the NHS and not about the people who pay for it. An ex colleague of mine retired and did some work in the NHS for a charity. He told me he was shocked about the culture, saying that the main conversation in breaks was how quickly after 50 they can retire on big pensions (probably not as big now) and how quickly they can come back and earn their wage again whilst still drawing said pension. You have to face facts. This could never happen in the private sector and that's because companies who operated such policies would fail. The NHS and other public services need to adopt similar cultures in all aspects of their business, including personnel and service.
So if you say the NHS has no issue with coping with demographic change and can do so without a 7 day service, how come it can't cope now? How come people are dying on waiting lists? How come it takes 3 weeks just to see your GP? So it's all OK then? We just carry on as we are?

In being critical of this you need to understand how it works - it's not quite as simple and commonplace as your friend suggests. And your friend might ask why some NHS staff are looking to do what he describes. Well I'll tell you - they are demoralised, fed up and knackered.

 

[Hobbit]

In being critical of this you need to understand how it works - it's not quite as simple and commonplace as your friend suggests. And your friend might ask why some NHS staff are looking to do what he describes. Well I'll tell you - they are demoralised, fed up and knackered.

No one forces them to stay.

During the last 6 years we've had a lot of dealings with the NHS. There's some great people in the NHS but, equally, there's some absolute rubbish. The Acute Care areas are as good as you'll find anywhere in the world. However, the general wards are a disgrace. To quote the German Doctor I shared a flat with whilst still in the NHS, "your hospitals are very good but I'm going back to Germany when I get old. Your elderly care in non-existent. You reach a certain age, and then you are forgotten." The last 6 years of mum's life have certainly confirmed that.

Its not just the mess the politicians have made of it. There's a number of staff that need sacking! They might well be fed up and demoralised, but there's no need to take out their woes on the patients.

 

[SwingsitlikeHogan]

No one forces them to stay.

During the last 6 years we've had a lot of dealings with the NHS. There's some great people in the NHS but, equally, there's some absolute rubbish. The Acute Care areas are as good as you'll find anywhere in the world. However, the general wards are a disgrace. To quote the German Doctor I shared a flat with whilst still in the NHS, "your hospitals are very good but I'm going back to Germany when I get old. Your elderly care in non-existent. You reach a certain age, and then you are forgotten." The last 6 years of mum's life have certainly confirmed that.

Its not just the mess the politicians have made of it. There's a number of staff that need sacking! They might well be fed up and demoralised, but there's no need to take out their woes on the patients.

I can certainly agree with some of your comments about some NHS staff - my wife's job is difficult and very stressful at the moment because of difficulties in the team she works in - in may ways some of them are more concerned about themselves than delivering the service - one especially seems to be going out of her way to disrupt and undermine the moral of the whole team. But try and get rid of that individual...unbelievable.

And because of this my wife will be one who will look to finish her current job in the next couple of years; take her lump sum and start taking her pension. She will probably also apply for another post in the unit, working maybe 2 or 3 days a week - that is if there are any posts for her to apply for. Has she earned the right to finish in her mid-50s and do this? - damn right she does - she has worked all her life in the NHS and given a huge amount to it without a huge amount in return.

 

[HomerJSimpson]

I can certainly agree with some of your comments about some NHS staff - my wife's job is difficult and very stressful at the moment because of difficulties in the team she works in - in may ways some of them are more concerned about themselves than delivering the service - one especially seems to be going out of her way to disrupt and undermine the moral of the whole team. But try and get rid of that individual...unbelievable.

And because of this my wife will be one who will look to finish her current job in the next couple of years; take her lump sum and start taking her pension. She will probably also apply for another post in the unit, working maybe 2 or 3 days a week - that is if there are any posts for her to apply for. Has she earned the right to finish in her mid-50s and do this? - damn right she does - she has worked all her life in the NHS and given a huge amount to it without a huge amount in return.

I sympathise with your wife and sadly the job and the whole publicity regarding the NHS right now is making the job of trying to recruit staff particularly hard. Clearly we don't want just anyone and so ensuring as best as possible before appointment that we have the right nurse or other staff for the job takes some work. Of course it could perhaps be streamlined (we have just gone through a major restructuring) but it's hard to get people in the door quick enough. If we don't agency spend continues to rise, sucking money that could be used elsewhere.

Sadly there probably isn't an answer at this juncture of NHS history. What I would like to remind even the most hardened though is that you still have a wonderful free service available to you and irrespective of what you think and how you may find them I'd say 95% of the staff you deal with are doing their best to give as good a service as they can amidst a host of financial and political constraints

 

[Hobbit]

Sadly there probably isn't an answer at this juncture of NHS history. What I would like to remind even the most hardened though is that you still have a wonderful free service available to you and irrespective of what you think and how you may find them I'd say 95% of the staff you deal with are doing their best to give as good a service as they can amidst a host of financial and political constraints

I'd say 99% of staff in the Acute Care areas are worth far more than they are paid. In the main, they are highly trained and highly motivated. However, if you think 95% of staff elsewhere are doing their best... lazy and uncaring doesn't come close. On the last ward mum was on the Ward Sister and 1 nurse were excellent, but after that.

As for we should be grateful because its free. Its not free! Who do you think pays for it, the tooth fairy? It doesn't matter whether its free or not but it does matter if its fit for purpose.

 

[HomerJSimpson]

I'd say 99% of staff in the Acute Care areas are worth far more than they are paid. In the main, they are highly trained and highly motivated. However, if you think 95% of staff elsewhere are doing their best... lazy and uncaring doesn't come close. On the last ward mum was on the Ward Sister and 1 nurse were excellent, but after that.

As for we should be grateful because its free. Its not free! Who do you think pays for it, the tooth fairy? It doesn't matter whether its free or not but it does matter if its fit for purpose.

OK, so how many of those nurses were staff nad how many were agency. I would suggest quite a few as sadly in areas like respiratory, gastro, elderly etc (basically the totally necessary but unglamorous areas) there is a lot of shortages, certainly in my trust and not through lack of trying.

As for "free" of course I accept it isn't in the true sense of the word but still a use as required service and one which I, and my family are very pleased has been there

 

[Hobbit]

OK, so how many of those nurses were staff nad how many were agency. I would suggest quite a few as sadly in areas like respiratory, gastro, elderly etc (basically the totally necessary but unglamorous areas) there is a lot of shortages, certainly in my trust and not through lack of trying.

As for "free" of course I accept it isn't in the true sense of the word but still a use as required service and one which I, and my family are very pleased has been there

If they're agency, who's responsible for employing them and who's responsible for managing them? That's a cop out and you know it.

 

[HomerJSimpson]

If they're agency, who's responsible for employing them and who's responsible for managing them? That's a cop out and you know it.

How? If wards aren't safely staffed they have to close. You'll find that they are employed via agencies and bed management and managed by the ward sister. Not sure how it's a cop out

 

[Hobbit]

How? If wards aren't safely staffed they have to close. You'll find that they are employed via agencies and bed management and managed by the ward sister. Not sure how it's a cop out

You're making an assumption "its not us. We're squeaky clean its them." = Cop out. You are attempting to distance the NHS from them without any facts to base it on. And the NHS is responsible for employing them and managing them on the ward. Put another way, if there is a clinical incident, who gets sued? Is it the Trust or the agency? Responsible for them includes their performance...

 

[Sweep]

And because of this my wife will be one who will look to finish her current job in the next couple of years; take her lump sum and start taking her pension. She will probably also apply for another post in the unit, working maybe 2 or 3 days a week - that is if there are any posts for her to apply for. Has she earned the right to finish in her mid-50s and do this? - damn right she does - she has worked all her life in the NHS and given a huge amount to it without a huge amount in return.

Really? What right is that? I have worked in my industry all my life, since before I left school if you count day release, 40 years full time. Can I retire in my mid 50's? Can I take my lump sum and just go back to work? Absolutely not. Why? Because I work in the the real world otherwise known as the private sector, where it's understood you just can't do those kinds of things and survive. But somehow it's OK in the NHS because it's public money and the money they get comes in whether they perform well or not. Funny. In an earlier post someone said in the private sector they look after their staff, but the NHS treats theirs disgracefully. Sorry, but it doesn't seem like that to me. I am not surprised the NHS are moaning about 7 day. Considering no-one past mid 50's is working full time there won't be enough staff and as they have all taken their lump sum, it's not surprising there isn't enough money. It's this kind of culture that put Greece in trouble.

 

[Sweep]

Sorry, just re-read my last post and realised it may come across as me having a go at your wife, which absolutely wasn't my intention. It was the system that allows this I was arguing against.

 

[SwingsitlikeHogan]

Sorry, just re-read my last post and realised it may come across as me having a go at your wife, which absolutely wasn't my intention. It was the system that allows this I was arguing against.

It's nothing to so with the NHS 'system'. ANYONE can start drawing their pension when they are entitled to and then seek further employment. That is all that NHS staff who are able to start drawing their 'pension' are doing - resigning from their current job and applying for another one in the same organisation - but they could apply for a job anywhere. Besides - there is absolutely no guarantee of a job in the NHS being available for them to apply for once they have resigned from their current one (as they must do to start taking their 'pension').

(btw Osborne's changes to pension schemes make it obvious now that pension schemes are actually now long term saving schemes and not linked in any way to 'retiring')

 

[Deleted member 16999]

It's nothing to so with the NHS 'system'. ANYONE can start drawing their pension when they are entitled to and then seek further employment. That is all that NHS staff who are able to start drawing their 'pension' are doing - resigning from their current job and applying for another one in the same organisation - but they could apply for a job anywhere. Besides - there is absolutely no guarantee of a job in the NHS being available for them to apply for once they have resigned from their current one (as they must do to start taking their 'pension').

(btw Osborne's changes to pension schemes make it obvious now that pension schemes are actually now long term saving schemes and not linked in any way to 'retiring')

You can't in the Forces, your future wage is abated by your pension so you end up on the same money, it's treasurey rules, same as a policeman etc

 

[SwingsitlikeHogan]

You can't in the Forces, your future wage is abated by your pension so you end up on the same money, it's treasurey rules, same as a policeman etc

Same rules apply for the NHS Pension Scheme. You cannot earn more 'pension' plus salary then your previous full time salary. This is one reason why the likes of my wife will see if there is a part-time 2-3 day position.

Actually the main reason she will look for a part-time position that she has decided she doesn't want to keep working full time. Mind you - the situation in her NHS team and the broader NHS is such that she's not sure that she wants to continue working in it anyway. And that is a big issue for the NHS as many thousands of very experienced nurses like my missis (she has over 35yrs in the NHS) are considering jacking it in completely and it is that age group that in many ways are currently holding the NHS together.

I know that without my missis absolutely busting a gut over the last two years and going way beyond the call of duty as others in her team have been off work with long term sickness, anxiety, stress etc - the service her team delivers would have been a mess. And she has had it - it's almost burnt her out.

 

[delc]

The fact of the matter is that the UK, no longer having an empire to exploit, is slowly becoming a Third World country, whichever political party is in power. Things like the NHS and Tax Credits are very desirable, but do we have the means to pay for them any more? We are in some danger of ending up like Greece!

 

[Hobbit]

I know that without my missis absolutely busting a gut over the last two years and going way beyond the call of duty as others in her team have been off work with long term sickness, anxiety, stress etc - the service her team delivers would have been a mess. And she has had it - it's almost burnt her out.

And one of the reasons why I left the NHS. Staff discussing whose turn it was for time off sick on full pay, and who was close to their 6 months off sick... people running a rota for sick holidays. And laziness! Crikey, it was a social club for some. Some were good grafters and some just took the pee. I got a gentle roasting from a senior engineer for spoiling the overtime by getting through so much maintenance work through the week. A minority but, as you said in an earlier post, quite often the management haven't got the guts to do something about it.