How would you fix the NHS?

@Alexandra2001Well personally I didnt vote for Brexit which means we would have a bigger pool to draw on for doctors. Immigration from other parts of the world or make doctors who have trained in UK stay for a minimum period before emigrating. I think we need to look at different levels of healthcare assistants/nurses so not all need to go to university. Higher taxes may be needed or less expensive intervention when quality of life poor. Sad to say but we really cannot afford to spend to keep people alive at any cost.

How many MPs did UKiP get in 2010 and 2015? & just 900k votes n 2010

You said votes, not MPs - and UKIP received three times as many votes as the Greens in 2010 as well, not 'hardly any more.'

What do you mean by non-white EU citizens were included in FOM?

Net immigration under Blair 210k per year

Net estimates for 2004-2007 are nearer 300,000 following EU expansion (and that is probably an underestimate);

e.g. net immigration 2004/268,000, 2007/273,000 or excluding British citizens, 2004/349,000, 2007/330,000.

https://migrationobservatory.ox.ac.uk/resources/briefings/long-term-international-migration-flows-to-and-from-the-uk/

How would you get more people to train as Doctors Nurses etc? there is only a finite number of people clever enough who can do these jobs & if they become HCP's, then who does engineering science law accounting etc etc

Where does the money come from to pay for more staff and then pay them more? people leave the care sector to work in other so called low skill sectors that pay more.
If you pay carers more, then what happens when other sectors up their wages to keep them in Hospitality Retail etc...

As seen in Reeves budget, everyone thinks they shouldn't be paying more taxes and will protest very loudly when they are forced too.

I would focus on coordinated care between GPs, hospitals, social care and bring back convalescent homes to stop bed blocking. More doctors, nurses, dentists and care workers and less administrators. Focus on prevention rather than cure and a big debate needs to happen about keeping people alive when they have poor quality of life/terminal illness/ severe disabilities. That is a sensitive subject and I understand some may not be comfortable with it but when resources are scarce it is important they be directed to where they do the most good.

You could have health insurance schemes set up by mutuals, like the few remaining mutual insurers and building societies. The NHS isn't an insurance based system.

How many MPs did UKiP get in 2010 and 2015? & just 900k votes n 2010.

Bottom line, migration wasn't why DC gave a referendum, one that his chancellor strongly advised him against but stupid Cameron didn't take this.

As the UK didn't count in or out EU migrants, figures are at best guesses but non white EU citizens where included in FOM....

Although, not forgetting that one million people who applied to the EU settlement scheme were not in fact born in the EU;

'There are roughly one million people living in the UK under EU freedom of movement rules, who were born outside of the EU ...'

'during the UK’s membership of the EU, freedom of movement was a major driver of immigration to the UK of people born outside of the EU'

Continent of birth:
Africa - 245,770
Americas - 182,066
Asia - 392,128...
https://ukandeu.ac.uk/diversity-eu-national-population-uk/

UKIP received nearly 4 million votes in the 2015 general election (12.6% of the vote share) - the Greens 3.8% of the vote with a bit over 1 million votes;

https://www.bbc.co.uk/news/election/2015/results

What caused Brexit was a weak and stupid David Cameron allowing a Referendum, UKiP in 2010 and 2015 hardly got more votes than the Greens.

But this is supposed to be a thread about the NHS...

Link to bbc article may 2016 -errr what caused Brexit….
www.bbc.co.uk/news/uk-politics-eu-referendum-36258541

Insurance schemes are just another cost or tax & create yet more paper work for all.

Yes for responsibility.

Who decides who is under performing?

If not Govt control, who? Direct Govt control is best, as that leads to direct accountability.
Hunt washed his hands of maternity services/staffing because he could blame NHSE and the Trusts.

Net immigration under Blair 210k per year, since we left the EU in 2020, running at around 700k per year.. last year 1m.... pretty much all non white and increasing support for Reform etc.

Yet still the media support Brexit, a large minority of the public too & calls to rejoin pushed to the margins.

Stupidity led to Brexit.

Set up a proper insurance scheme.

you mean a for profit insurance scheme opposed to the not for profit insurance scheme with have now

remove from government control

to the control of a for profit company

Expect patients to take some responsibility.

why would a for profit company want people to take responsibility & profits decline?

Set up a proper insurance scheme.
Expect patients to take some responsibility.
Get rid of under-performing staff.
Remove it from Government control.

I agree.

I don’t think we’d have brexitted if Blair had controlled immigration

Irrelevant & nothing to do with the current state of NHS.

We have failed to invest in the NHS for an aging and an increasingly fat and unhealthy population.

Fwiw, I'm far more worried about the millions of African and SE Asian migrants allowed in over the last 5 years, some 3m, often older dependents and few workers will ever return, its not as if Manila is a 2 hour flight away.

But then Tories will always point to a Blair migration error 22 years ago, rather than their own policy of 1m net migrants per year invited in to the UK....

Labour lost power in 2010

The Tories have done nothing except run the NHS down from 2010 to 2024

Social care, illness prevention, education, training and outreach programmes were either cut or so severely impaired they were reduced to a pile of leaflets on a table in a corner somewhere

The British population have never been so fat, unfit or chronically sick in it's entire history and with NHS resources so stretched, it's just stupidity to blame one government for anything

The UK was one of only a tiny number of major EU economy who didn't impose some control over immigration from the ascension countries from Eastern Europe admitted to the EU during Blair's reign. He could have limited the numbers like other major EU countries, but he chose not to.

Are you saying these didn’t exist during T Blair’s prime ministership as that was what I was replying to.

Elderly population with more chronic diseases and requiring input from four or five different consultants, carers and district nurses

People with chronic or congenital issues, barely able to look after themselves, having children with the same or similar issues, requiring input from NICU, Social Services, Paediatrand their children's consultants and specialist nurses

Increasing incidence of alcohol and drug dependencies

The elderly parents of special needs adults dying off and leaving their children stranded, as they 'didn't like labels', didn't get any diagnosis, refused all help from social services and now their fully grown adult children are socially, economically and medically fucked, with social care straining at the seams

Many of the immigrants you blame for our problems are the medical and care staff used to look after our increasingly sick and helpless population

To the person who mentioned paramedics on motorbikes. I think that was a brilliant idea given the traffic. As always though, it could turn out that it wasn't a brilliant idea, only when the data is analysed would we really know.

Performance related pay would see surgeons refusing cases with higher risks or complex problems,
How do you measure nurses? They aren't hospitality workers. The smiley, pleasant nurse who doesn't make you mobilise post op is actually not doing her job over the nurse who insists you need to get up for your own good. Which one would patients score higher?
Sometimes patients are their own worst enemies by failing to comply with physio, medication regimes, dietary changes. Who's going to want to take the patients with worse outcomes if they risk a poor performance rating. Because the people who set the targets usually set them on outcomes or patient satisfaction.

Well immigration took off during Tony Blair’s time as PM, we got nearly a million immigrants last year -there may have been less previously but 25 years of it is going to make a huge difference.

It's false economy shutting down huge areas of the NHS in evenings, weekends and Friday afternoons. When patients are left bed blocking because they can't be discharged when the pharmacy is on skeleton staff and won't issue discharge meds.

Take scans/x-rays, etc., it's cheaper to run them a few more hours each week rather than have to buy additional equipment/new buildings etc to duplicate/triplicate the machinery to cope with demand when it's only open office hours. In the real economy, i.e. factories, etc., they don't build a new factory when demand increases - they make better use of the existing factory and ultimately a 24/7 shift system - yes, it costs more to pay overtime and then shift workers, but it's cheaper than buying a second factory, a second set of machinery etc.

In both pharmacies and radiology, etc., offer to pay enhanced rates for evening and weekend working and the staff WILL work. The managers just have to actually communicate between departments and top managers need to reallocate funds/resources between departments "for the greater good". As it is, there's no benefit for the radiology or pharmacy managers to bother paying more for overtime working as they won't see the benefit of the costs saved by reducing bed blocking. Same with social services who could save the NHS a fortune if they invested in more social care to reduce bed blocking. We need people above the management in individual departments and separate PS organisations to look at the bigger picture. Of course, if a pharmacy manager is only looking at their own budget, there's nothing in it for them to open longer, so they won't do it. It needs people above them (civil service and policitican level) to knock heads together and reallocate funding for the greater good.

As for the point about it being up to employers, No, it really isn't. The NHS isn't providing anything "free" to anyone. We're all paying for it, individuals are paying taxes, companies are paying taxes, all employers are paying employers NIC. We're ALL paying for the NHS. Part of it's problem is too many NHS staff with the attitude of "it;s free, so you should consider yourself lucky you're getting treatment at all". That attitude has to change because it is part of the problem!