How would you fix the NHS?

I think that nhs physio needs to improve.

Also more council housing across the UK asap, including 1 and 2 bedroom homes, and homes suitable for elderly (and younger disabled). More council homes (that are well-maintained) would save the NHS loads.

I agree
Poor housing/homelessness is the root cause of so many problems in the UK. Problem is though, as soon as a planning application is put in for housing, the locals (all nicely housed themselves) object. Council housing is particularly hated by the local community.

A trivial point but it's caused me stress many times...

At our local hospital, paying for parking is really complicated and often the machines aren't working - which of course doesn't get you off the hook necessarily. I allow lots of time for this, but still end up in the relevant department very hot and bothered about it, especially when I haven't managed to pay for some reason.

Had to take my daughter to Poole hospital where they have a brilliant system. You have your appointment first, then go to a kiosk to pay for parking. So much less stressful. I wish this was the norm. It's not rocket science either.

I did no such thing at all. I've just re read my comment and implied nothing of the kind. You're making out I suggested they trotted off to Aldi to buy cheap stuff when on offer in their lunch hour - I said nor implied anything of the kind!

3.2m people are over 80 which is 3 times as many in 1994

You originally implied the staff bought their own consumables.... they did not, they identified cheaper suppliers, saving the trust 150k.

It was a team of 15 staff working with the trust to id savings.

However, i didn't mean to suggest you were lying, just that i doubted very much nurses were queueing in Staples to buy boxes of pens etc etc, which they were not.

Apologies.

You have choice.

This. At my last surgery I had constant evening reminder calls/ letters to attend my cervical smear, and it was pushed at every appointment regardless of what I was attending for. I was going through some serious health stuff at the time which was left untreated, yet all they were interested in was my smear! I'm not saying it's not important but when you go in to talk about a serious health problem and half of the appointment is spent with the gp pushing the smear, there's a big problem. My new surgery couldn't be more different thankfully.

Thanks for accusing me of lying...

https://www.lancasterguardian.co.uk/news/nurses-save-trust-more-than-ps150k-2487648

Feel free to apologise!

What different needs?

Wherever someone is in the UK, they all have the need for easy access to timely and good healthcare (and other essential public services).

If you mean, there's a higher proportion of wealthier people in Weybridge than in Bolton, a) Wealth doesn't prevent ill health. It helps yes but wealthy people still get sick or have circumstances (eg. DV) that require healthcare or other support.

Also in generally wealthy areas, poverty still exists. Just often more ignored because people generalise about areas. So sometimes less help available precisely because of those stereotypes.
A good example actually of how one size fits all being applied to local areas failing people.

And there's the social cleansing issue. Vulnerable older people are more likely to be isolated (a health risk factor) because their children - family support network - have been socially cleansed away from them.

Re local councils. I don't think they should be scrapped (they represent the local areas) but I do tink all essential public services should be provided on a national level - with equally good access and quality - across the UK.

Personally I'd scrap council tax, and increase income tax instead. Possibly though keep some form of local income tax - to be used for local nice-to-have but not essential services or facilities.

When I used to have yearly diabetic checks, they were more concerned with asking questions and ticking boxes on their screen than actually listening to my answers and answering questions etc. Every sodding year, I was asked if I was depressed - apparently they got extra funding based on the number of "depressed" patients. They were deliberately only interested in asking questions that led to higher funding, and showed no interest at all in anything I mentioned that didn't trigger more funding.

Do explain how that would be materially different

GPs themselves are also the largest obstacle to change. They can say no to everythign and then threaten to leave the service if change is imposed. I say fuck em frankly

I don't like the current NHS system anyway. I want a European social insurance model

Agree with the first bit, but what about if you get cancer or have a rta in your 20s?

Are child-rearing women entitled to less care than men who worked during those years?

Do poor people get lesser care than the wealthy?

I would focus more on wellness rather than illness. That would be a good start.

After that, I would change the funding system, so that patients pay into a 'pot' that's theirs, to use on NHS care when they need it. The idea that I pay monthly into a system which, in turn, hasn't remotely been there when I've needed it, is utterly preposterous!

There was a good rationale for localising healthcare though. The needs and requirements of patients in Bolton, are very different from the needs of those in Weybridge. You have to have a flexible, local, management addressing the needs of the local population. Just like you have regional, local and parish councils, would you want those to be nationalised too?? One size fits all??

You're so right.

It's not only extra layer of bureaucracy and so more expensive. It's also led to a postcode lottery re access to decent healthcare.

Same goes for all essential public services. Postcode lottery, which shouldn't be the case.

DH's parents were in both born before WW2. They're in their 80s and are the so-called "Silent Generation".

There's several million over 80s in the UK.

And like I said in my post yesterday, for the next generation - the so-called "boomers", life experiences and circumstances are very varied - as I quoted from the published studies, inequality within older generations is more extreme than for younger generations.

And in fact, although it's supremely unhelpful to generalise by age because of the wide variation within every age group, the age group with the highest poverty rate is aged 60-64. And older people in poverty have often been in poverty for a long time. So not a blessed life at all.

That's the problem with generalising by age - lumping a large group of people with almost nothing in common but age. It ignores the wide variations within any age grouping.

How have people living in their own home "benefited from" house price inflation? They live in the home - so no cash available from it. (Equity release is known to be a rip-off in many circumstances).

And thanks to house price inflation, many are isolated (at a vulnerable age - when especially needing family support). Because their children and grandchildren have been socially cleansed out of the area, and/or can't afford their own home - which is a source of distress for their parents, most of whom can't afford to help their DC buy a home.

And no they can't all just downsize. Even if well enough for the massive upheaval of moving, downsizing has been devastating for childless/child free people and only-child families. Might be area dependent but in many parts of the UK, not only is there a lack of 1-2 bedroom homes full-stop, there's far too few suitable for elderly people (or younger disabled people).

And if you mean even more tax on landlords (who are all generations - more than a few in their 20s and 30s), what a disaster for lower income, or even medium income renters, who'll be without any home - because the landlords will just sell up and no that won't mean people on the lowest incomes will be able to get a mortgage to buy. Btw homelessness including substandard temporary accommodation costs the NHS loads - because bad or insecure housing harms health.

I do, however, agree with slightly increased income tax - with the caveat it's not misspent.

Also more council housing across the UK asap, including 1 and 2 bedroom homes, and homes suitable for elderly (and younger disabled). More council homes (that are well-maintained) would save the NHS loads.

So you want medical staff spending work hours buying "consumables? or do you expect them to go shopping in their own free time, provide storage space for these products & bring them into the work place all free of charge....

Of course getting people to do things for free is going to be cheaper than having a commercial supply chain....

I also doubt very much it even happened, i do not imagine staff are going to buying large amounts of paper towels, loo roll, stationary for a busy ward

GPs are mainly paid for reaching health promotion targets called CQUINS. They have to reach a certain percentage of a target, for example, cervical screening, blood pressure checks, weight advice, flu shots, and vaccination.
They are all important, but it incentivises them to push these. I can't visit my GP without getting a BP cuff on my arm. I get consent vaccination and cervical screening reminders. I get 'invited' for an annual health check with the nurse.
But if I'm ill it's virtually impossible to see them and they are extremely reluctant to refer on unless it's pushed for.

Yes these were businesses/providers that were never part of the NHS in the first place.

I'm talking about Community MH, OT, Physio that were always part of the NHS but then moved across into a private company, totally different.

Its quite incredible the mental gymnastics Tory supporters will engage in, just so they can say that no part of the NHS has been privatised.....

I'd bring GP surgeries properly inside the NHS. Most issues stem from them and their inability to have compatible systems with the rest of the NHS. They are profit making companies who only work for the NHS. Its an insane waste of money that does not deliver good care

I was in the NHS for 40 years. When I started the hospital received a budget as a whole. We had a finance manager who had to sign off on large purchases, in-house maintenance staff, and all equipment was pooled. and apart from medical secretaries, ward clerks, and record clerks, there were very few admin staff.

Fast forward to the introduction of the internal market in hospitals. Each ward now has a budget. If I needed medicine from another ward I could no longer just go get it. I had to generate loan forms, log the fact I had lent it, send the form to pharmacy where they would take it out of our ward budget and give it to the other ward . All of these extra layers required extra finance staff and auditors to monitor spending and budgets. Then they introduced targets and this required more staff to monitor targets. There was an explosion of office staff. Meanwhile in 40 years on the coalface, apart from advances in medicine, nothing much really changed. It worked more efficiently under Labour as in waiting lists improved, but there was a lot of manipulation to reach targets.
The 4-hour wait in A&E was manipulated by sticking labels on trolleys with the words 'temporary bed', or turning areas into an 'observation area'. The actual treatment of the patient didn't change, they still waited in A&E for test results to come back and be interpreted, they were just classed as being in a bed now.