NHS ??????

[Swinglowandslow]

could not agree more.
In the name of austerity/belt tightening / privatisation etc, subsequent govts (Tory & Labour) have decimated the NHS supply chain

Exactly. I remember nursing numbers being cut and the training of nurses being cut. Then a few years later there weren't enough. Who would have thunk it!
Short term thinking is running the Government's policies and not a few businesses in this Country.

 

[Hobbit]

I think part of the problem is more people are going private and basically jumping the queue.
I admit my wife and I have did this on a few occasions.
Usually seeing the same NHS consultant, but in a private hospital.

Not sure that creates a problem. If a consultant is doing private work on, say, a Friday and you go on the Friday you're not impacting on the NHS. And, in effect you're freeing up your NHS slot that you would have taken if you'd stayed within the system..

 

[Hobbit]

Thats Ok but we disagree, for me health is a special priority and something we as a wealthy nation should be prioritising funding.
problem is that if I agree with you we would both be wrong 😉

The problem with everyone agreeing is no one questions the status quo. How do you move forward/improve if the status quo isn't questioned.... respectfully of course

 

[chrisd]

The problem with everyone agreeing is no one questions the status quo. How do you move forward/improve if the status quo isn't questioned.... respectfully of course

If we did we'd all be down the dustpipe😣

 

[williamalex1]

Not sure that creates a problem. If a consultant is doing private work on, say, a Friday and you go on the Friday you're not impacting on the NHS. And, in effect you're freeing up your NHS slot that you would have taken if you'd stayed within the system..

I just checked , the wife's consultant only seems to do private appointments Tuesdays and Fridays, at varying times .

 

[Colonel Bogey]

Every time I have to visit the NHS, and this is everyone I've ever had to go to, people seem to be wandering around aimlessly. On Sunday, I lost count of how many times staff looking though papers in a particular tray of for patients and didn't pick one out. Just what were they looking for if they didn't find it? No sense of urgency whatsoever. And just what do those people who sit behind the desks in the ward get paid to do? Two sat their for two hours and did nowt but natter. So I'm not impressed with calls for the NHS to get more money. A bloody good time and motion man and Logistics EXPERT would be a better idea.

 

[Mudball]

Every time I have to visit the NHS, and this is everyone I've ever had to go to, people seem to be wandering around aimlessly. On Sunday, I lost count of how many times staff looking though papers in a particular tray of for patients and didn't pick one out. Just what were they looking for if they didn't find it? No sense of urgency whatsoever. And just what do those people who sit behind the desks in the ward get paid to do? Two sat their for two hours and did nowt but natter. So I'm not impressed with calls for the NHS to get more money. A bloody good time and motion man and Logistics EXPERT would be a better idea.

To quote a very wise man... We had enough of experts, we dont want them anymore.. JFDI

 

[SocketRocket]

Every time I have to visit the NHS, and this is everyone I've ever had to go to, people seem to be wandering around aimlessly. On Sunday, I lost count of how many times staff looking though papers in a particular tray of for patients and didn't pick one out. Just what were they looking for if they didn't find it? No sense of urgency whatsoever. And just what do those people who sit behind the desks in the ward get paid to do? Two sat their for two hours and did nowt but natter. So I'm not impressed with calls for the NHS to get more money. A bloody good time and motion man and Logistics EXPERT would be a better idea.

Maybe more of it wants privatising. No wait a minute, that can't be allowed.

All I care about is that we have treatment free at the point of delivery and it's first class. I don't give a toss who provides it.

 

[SwingsitlikeHogan]

My Mrs retired from the NHS a year ago after nearly 40yrs dedicated service. She has just very recently started a 2 day a week job with one of the main cancer charities. When she looks from outside of the NHS at the service the team she was in was providing - but in exactly the same cancer area - she sees how quite poor in many ways the NHS service was. And they thought they were doing a good job.

She can now see that actually they weren't doing that well. Much of the issue was pressure - but much of it she can see very clearly is due to some members of the team over the years being simply in it for themselves, not interested in caring and sharing with each other, and her team manager being a great nurse but a useless manager. The elephant in the room being the fact that her team manager seemed incapable of going to HR to call out poor performance and bullying within the team and seek support on what to do. And my wife's experience of maybe the last decade at least is that that is endemic throughout the NHS - and whjy so many nurses leave.

She has also been speaking with a new colleague - an very experienced nurse who also still works in the NHS. And their agreed view is that the NHS is being held together by an ever and rapidly reducing number of very experienced nurses and doctors going above and beyond what is actually required of them. And they fear for what will happen to the NHS when the huge tranche of experienced nurses and doctors who started out in the 1970s and early 1980s leave as they will do so in in the coming 5-10 yrs. Because they do not see that same commitment to the NHS and patients across the board in the tranche of nurses that will be expected to replace that 1970s/80s tranche.

And when the NHS starts to absolutely fail patients left, right and centre, sadly the only answer seems to be privatisation - unless something dramatic and rather unexpected happens.

 

[Mudball]

(to protect the innocent)... close relative a dentist.. Till about 10 years ago, evryone was shouting that the Dentists are making money and not enough care and most NHS dentists were moved to contracts based on Dental units. then most practices were sold off to major dental companies like Bupa, Oasis etc. The money the dentists makes on each 'dental unit' has been decreasing YoY and they have to hit higher targets. Too much pressure, so all the better dentists are moving/have moved to the few remaining private practices (who still care about their patients).

The result is that the traditional dental clinics are now in corporate hands where dentist have 10 mins or less to do their jobs, hit targets. patient queues are longer and they just go to hospitals. The only people who have benefited are the company bosses. I can understand why Corbyn wants free check ups

I would rather have my Dentist drive a Porsche than the company boss.

 

[Swinglowandslow]

My Mrs retired from the NHS a year ago after nearly 40yrs dedicated service. She has just very recently started a 2 day a week job with one of the main cancer charities. When she looks from outside of the NHS at the service the team she was in was providing - but in exactly the same cancer area - she sees how quite poor in many ways the NHS service was. And they thought they were doing a good job.

She can now see that actually they weren't doing that well. Much of the issue was pressure - but much of it she can see very clearly is due to some members of the team over the years being simply in it for themselves, not interested in caring and sharing with each other, and her team manager being a great nurse but a useless manager. The elephant in the room being the fact that her team manager seemed incapable of going to HR to call out poor performance and bullying within the team and seek support on what to do. And my wife's experience of maybe the last decade at least is that that is endemic throughout the NHS - and whjy so many nurses leave.

She has also been speaking with a new colleague - an very experienced nurse who also still works in the NHS. And their agreed view is that the NHS is being held together by an ever and rapidly reducing number of very experienced nurses and doctors going above and beyond what is actually required of them. And they fear for what will happen to the NHS when the huge tranche of experienced nurses and doctors who started out in the 1970s and early 1980s leave as they will do so in in the coming 5-10 yrs. Because they do not see that same commitment to the NHS and patients across the board in the tranche of nurses that will be expected to replace that 1970s/80s tranche.

And when the NHS starts to absolutely fail patients left, right and centre, sadly the only answer seems to be privatisation - unless something dramatic and rather unexpected happens.

If I read you correctly it seems we might be in agreement for once😀

The principle of the NHS is right and I would not want it to be a body or institution from which business makes a profit.
But, over the years, ( and not only in the NHS ) management has become awful because managers are frightened to insist on proper standards.To say to someone that they are not up to the job, so improve or else;
All because they will be accused of upsetting staff, or being a bully or racist etc.
People excel, and people fail. If they fail and don't learn to succeed in the NHS then lives can be , and will be, lost. As I write there is a big enquiry into maternity deaths in a NHS Trust, and it seems like failing in skills has gone on unchecked.
I have been saying, somewhat tongue in cheek, for some years that the way it has been going, one day there will be a surgeon stood over a patient, about to operate ,saying, " I didn't pass all the exams in training, but I qualified because they said I tried very hard"
Until standards are set properly and maintained, and supervisors are hard when they need to be, then things will only "improve worse".
and unscrupulous people will then say it is the ideology of the NHS which is at fault. And it isn't, because in the fifties and sixties, supervision was properly done. When Matron was about, you better be doing things right!

 

[SocketRocket]

If I read you correctly it seems we might be in agreement for once😀

The principle of the NHS is right and I would not want it to be a body or institution from which business makes a profit.
But, over the years, ( and not only in the NHS ) management has become awful because managers are frightened to insist on proper standards.To say to someone that they are not up to the job, so improve or else;
All because they will be accused of upsetting staff, or being a bully or racist etc.
People excel, and people fail. If they fail and don't learn to succeed in the NHS then lives can be , and will be, lost. As I write there is a big enquiry into maternity deaths in a NHS Trust, and it seems like failing in skills has gone on unchecked.
I have been saying, somewhat tongue in cheek, for some years that the way it has been going, one day there will be a surgeon stood over a patient, about to operate ,saying, " I didn't pass all the exams in training, but I qualified because they said I tried very hard"
Until standards are set properly and maintained, and supervisors are hard when they need to be, then things will only "improve worse".
and unscrupulous people will then say it is the ideology of the NHS which is at fault. And it isn't, because in the fifties and sixties, supervision was properly done. When Matron was about, you better be doing things right!

I agree with almost all of that. The only point I would question would be whether it would be an institution from which business makes a profit. Surely suppliers to the NHS of equipment, drugs and so many other things would be expected to make a profit, if not how would they invest in product development or attract inward investment to allow them to expand and improve.

 

[SwingsitlikeHogan]

If I read you correctly it seems we might be in agreement for once😀

The principle of the NHS is right and I would not want it to be a body or institution from which business makes a profit.
But, over the years, ( and not only in the NHS ) management has become awful because managers are frightened to insist on proper standards.To say to someone that they are not up to the job, so improve or else;
All because they will be accused of upsetting staff, or being a bully or racist etc.
People excel, and people fail. If they fail and don't learn to succeed in the NHS then lives can be , and will be, lost. As I write there is a big enquiry into maternity deaths in a NHS Trust, and it seems like failing in skills has gone on unchecked.
I have been saying, somewhat tongue in cheek, for some years that the way it has been going, one day there will be a surgeon stood over a patient, about to operate ,saying, " I didn't pass all the exams in training, but I qualified because they said I tried very hard"
Until standards are set properly and maintained, and supervisors are hard when they need to be, then things will only "improve worse".
and unscrupulous people will then say it is the ideology of the NHS which is at fault. And it isn't, because in the fifties and sixties, supervision was properly done. When Matron was about, you better be doing things right!

Absolutely.

My wife has already found that her work with cancer patients on a helpline will be audited by one of the most senior specialists in the charity (who also happens to be one of the most experienced and respected specialists in the UK) twice a year. This specialist will listen in to how she conducts the telephone discussion with a caller, and the information and guidance she provides - and will advise on how she could make improvements - indeed this also happens informally within the team as they help each other to support callers as best the team can.

Within the helpline team if one nurse hears another engaging in a call on a subject that the listener knows something about or has a special expertise in, she will pop a note to the nurse on the call saying 'remember to mention... or 'remember to point the caller to...'. In my wife's experience this sort of sharing of information and support was sadly lacking where she worked - and that the formal auditing would be viewed with great suspicion and would meet with resistance and upset from those to be audited. And so it doesn't happen. And because it doesn't happen, poorly performing staff continue to perform poorly; and information is not properly shared between a team as individuals often seem to want to make themselves special and 'indispensable'.

Such a negative view of one corner of the NHS I'm afraid, The service that my wife's NHS team provide was overall deemed very good by patients - but from where she is looking now in the cancer charity she can see where things are not really that brilliant; are not going to improve; and will only start to collapse when the very experienced nurses and doctors holding everything together - those who started their training in the ten years from the mid-70s to mid-80s especially - when they start to retire in large numbers - and that wave of retirement is starting to crash.

 

[Foxholer]

£1.4m a month is peanuts compared what happens during the 30 year PFI contract. A typical scenario runs thus; new building put up, and equipped on day 1, year zero. Within the contract will, usually, be a clause to renew the equipment at year 10, year 20 and year 30. That 4 full equipment renewals for the hospital.

A decent ICU will be, say, 15 bed. 15x intensive care ventilators at £40k. 6x transfer ventilators. Each bed will have about 6x infusions pumps. Each infusion pump will have dedicated tubing(giving sets) which are changed for each patient, and sometimes several times for one patient. Each bed will have networked patient monitoring(ECG, Breath rate, Pulse Blood pressure, arterial blood pressure etc). The bed itself costs thousands, and doesn't last 10 years. Then there's the High Dependency Unit, and Coronary Care and cardiac intensive care, and the Renal Unit, and the paediatric intensive care, and the Special Care Baby Unit. Add, maybe, 30 general wards.

A decent size hospital will have upwards of 40 operating theatres, which means they have 40 induction rooms for those theatres = 80 anaesthetic machines @ £40k. All theatres will have patient monitoring, as will the recovery room.

A PFI landlord might be Balfour Beatty but there'll be a whole host of PFI partners tied in with Balfour Beatty.

The hospital Trust will approach its landlord for equipment renewal. And the landlord will talk to its PFI partners. The Trust will also alert NHS Procurement(hearty bloody hahahaha - now there's a huge misnomer). NHS Procurement will charge the Trust for its services and will charge the PFI partners for its services......... and thanks to Tony Blair, NHS Procurement is majority owned by DHL.

Whatever you might have heard about how bad PFI might be for draining money out of the NHS... don't get me started...

To me this demonstrate/documents 2 separate issues/problems!

1. How much it actually costs to fund the NHS
2. An inkling of why PFI was/is a disastrous way of trying to fund NHS Capital costs! And, FWIW, other government projects! There have been plenty of other such projects that have not provided the supposed VFM, but simply lower 'entry' costs!

 

[Tashyboy]

Posts 69 and 71 should be read by every politician that is standing for election re what is wrong with the NHS. It endorses a lot of what I have said.
My problem is this, everyone seems to think that the solution to the NHS problems can be solved by throwing money at it. As has been stated some of the management are simply not up to standard. You can include senior management and chief execs in that list. How can they be trusted with extra Billions of pounds. By giving them more money, you are pouring petrol on an already big fire.

 

[Swinglowandslow]

I agree with almost all of that. The only point I would question would be whether it would be an institution from which business makes a profit. Surely suppliers to the NHS of equipment, drugs and so many other things would be expected to make a profit, if not how would they invest in product development or attract inward investment to allow them to expand and improve.

Fair point, what I was meaning to say was making a profit from the actual owning of hospitals and implementing medical,practices, done by Drs and surgeons etc .IOW the country owns and runs the NHS , theoretically paid for by NHS contributions from the working populace. No money is made by the Government from those contributions, I.e. no profit.
If privatised, there would be investors etc expecting the NHS to give them a profit, as would be the case in "ordinary" privately owned businesses.
Unthinkable that that should be done from people being sick, IMHO.