NHS

[Andrew MacLean]

Jay

I do not disagree with anything you say. I am just amazed that the NHS has been able to limp on in a state of perpetual crisis for as long as it has.

I also foresee the day when the NHS moves out of the provision of hospitals and concentrates on Primary Care, contracting hospital episodes from the private sector.

But I don't think it will take as much as 20 years for that to happen.

Andrew

[Sweet]

Having worked privately as an agency nurse for over a year as i was going to emigrate i was much better paid and valued. Now back in the NHS as i needed some training for a new job i'm stuck with staff who don't want to be there to work and not enough members of staff in general, so we are working much harder with little resources and support.

I don't dislike the NHS and am back in paying a pension but the politics and constant expectations from patients demanding their rights when we are really struggling with a lack of staff and equipment really drags you down. I cna understand where they are, i get mad as well when Moorfields can't be quicker with an appointment! But as with me being upset with them for not being able to book me in and getting frustrated with the system so patients in all hospitals feel the same about their care. Only thing is we can't shout at the messengers about a system which just does not work.

I don't personally believe that the NHS will fall apart, although be privatised maybe. As the biggest employer in the UK it stands to lose a lot and have a lot of members to answer to. But as with the recent news broadcastings agency staff and temp workers are again being told that they will be laid off due to lack of funds! Well give hospital staff more money so that we will be better staffed and so not need temp staff in the first place!

And friendly hard working nurses who genuinely enjoy their job will return and for once patients might get some continuity of care back!

Sweet X x X

[Andrew MacLean]

And friendly hard working nurses who genuinely enjoy their job will return and for once patients might get some continuity of care back!

Sweet X x X

that gets my vote!

Andrew

[jayuk]

Andrew

Do you think itll take longer or shorter than the quoted 20 years?....I think a brave step of last year was the Waiting list reduction method they employed.....ie to refer them to the BUPA chain and NHS pay for the operations at a slightly inflated rate!?

Sweet / Claire

I can understand the frustration from someone on the other side who does have more visibilty of what occurs; but the fundamental issues with the NHS lays with extremely inept management......where money is squandered on thickening the middle management' as opposed to supplying front line. I cant see this methodology changing to be honest, as sadly one of the biggest Political Toys parties have when running for election is NHS, followed by Education and Pensions. An another example closer to myself was when I was involved a while ago for a IT Systems procurement within the North West. It became apparent that the TRUE cost to deploy a SINGLE Server (big computer) within the Trust was some 320% higher than if they made the procurement themselves and hired there own team!.....That to me is astonishing!....No wonder the Patient Records IT Infrastructure is failing and will fail!.....thats a wastage of £4 Billion!..which could have been better spent and utilised!

J

[Sweet]

Yes every nursing job i have had has seen a lot of management and those there 'to manage' and not enough workers there 'to work'!

So we have less staff on the ground floor actually nursing and helping discharge patients, but we have a hell of a lot of people telling us that we need to do it!! So the patients keep coming in, the queues get longer, people get frustrated as no-one is being seen to do anything, staff get upset and shouted at, no-one is happy with anything and so this messy circle continues ...

But i think i will always be a sheep and work hard, as to fall into the political trap of wanting the power in being a shepherd is far from helping.

Sweet X x X

[Andrew MacLean]

Andrew

Do you think itll take longer or shorter than the quoted 20 years?....I think a brave step of last year was the Waiting list reduction method they employed.....ie to refer them to the BUPA chain and NHS pay for the operations at a slightly inflated rate!?

J

jay

I really think that the initiative to reduce waiting times by the nHS meeting the cost of a private hospital referral was the beginning of what will be normative in future for hospital treatment. I envisage a move to the universal application of this principle well before the 20 year timescale.

This looks inevitable to me, no matter which party is in government. I also think it is highly desirable, but that is another question.

Andrew

[jayuk]

Its interesting you share my opinion...as when I suggest this in conversation to others many become defensive....probably more out of not adopting an element of realism!....I just see the NHS as a Black Whole...we put in £92,700 Million in Fiscal 2005!....thats some serious wonga!....

I think if we look at areas such as Opticians and Dental; we can see what occurs when you dont address the needs!...Dentistry has just been given up on the NHS and majority are now private!....But it would interesting to see if Opticians adopt the same route......which has already started!

[BusyLizzy]

I think it's quite charming that you're so easily pleased!

[Andrew MacLean]

Well, I guess that people are strongly attached to the NHS, so their reaction may be motivated by emotion, almost as if their family were under attack.

I also am strongly attached to the principle of a health service delivered free at the point of need, but I have not really been impressed by any overwhelming sense that the State is good at running things.

I do not think that the NHS needs to die. The role of the Primary Care provion is probably well handled as it is, but then this part of the NHS is not delivered by the State. Each GP practice is an independent firm, and each 'partnership' employs ancillary workers such as nurses, sometimes radiotherapists, physiotherapists etc.

The development of hospitals provided by private finance and hospital time and space contracted by the NHS is really just an extension of what is already common in Primary Care.

Interestingly it has become increasingly common, also, in care of the Elderly. At one time great Geriatric Hospitals or Psycho Geriatric units were full of old people who were under stimulated and expected to create the minimum of fuss as they declined into their dotage and death. Now it is far more common for the elderly patient to be in hospital for a therapeutic intervention, and then to return home or to go into a special residential setting where they receive far better stimulation than was every possible in giant PGU's.

In Scotland we (the Church of Scotland) pioneered an approach to the care of the elderly confused where the minimum of drugs were applied and people attained and retained a level of independent living that would not have been thought possible on the old PGU model.

There has also been some read-across from this experience into the re-settlement of people with other sorts of Psychiatric disorder, but this work is still very underdeveloped.

Andrew
ps I also think we do ourselves no favour when we call places where sick people are cared for "hospitals". the metaphor here has to do with "hospitality". Old fashioned words like Infirmaries or Sanitariums would be far better ways of describing the places we all need to go while we are in aprticular need of some clinical intervention.

[Val G]

After returning to work for the NHS, after working in industry, I can clearly see the need for many changes in order for it to survive. I don't think the majority of people realise the state it is in and are shocked when they need it and provision does not meet their expectations.
There are problems within the NHS itself and major difficulties because it has been abused.
I agree with Jay that middle management is lacking, nothing seems to get done efficiently, systems need to be more business like to be effective. The attitude that staff have a job for life and can put in as little effort as they feel like and take as many paid days off sick as they wish, would not wash in the private sector.(I appreiciate that all staff do not have this attitude but it certainly does exist)
Most people would like to hang on to the NHS, as being entitled to healthcare is worth so much. But are that drunks that fill the A+E departments every weekend, draining resources, entitled to care. Or how about the massive increase of compensation claims in the last decade, which have crippled the NHS and are discouraging would be healthcare workers from entering the profession, in case they get sued in their attempts to help people!