To think the NHS’s biggest problems aren’t management but an ageing population, unrealistic expectations and over-medicalisation?

Don't blame the ageing population, they have been here 60/70 years and the NHS knew they were here and would age, the NHS never prepared many years ago as they should have.
I't not fit for purpose and we need to change it to something like the rest of Europe.

Yes, we know the situation with the cost of healthier food, now. What someone's parents did decades ago tells us nothing at all about 2025.

https://news.sky.com/story/poorest-fifth-of-uk-would-need-to-spend-45-of-disposable-income-to-afford-healthy-diet-13298853

The poorest fifth of the UK would need to spend almost half their disposable income on food to achieve the government's recommended healthy diet, a new report has found.
It comes alongside a warning that healthier food is getting more expensive at twice the rate of less healthy options, with food that is lower in fat, salt and sugar now twice as expensive per calorie as its less nutritious counterparts.

It means the most deprived fifth of the population would need to spend 45% of their disposable income on food to achieve a government-recommended healthy diet.
This rose to 70% of disposable income for those in households with children.

@Bumpitybumper I would never make light of your experience. It's hard and you have my empathy, but none of us can speak for a.n.other (unless there is no capacity). Just because there is a severe lack in excellent, caring, empathetic palliative care, too many folk want to throw the baby out with the bath water.

However, I wasn't being sarcastic. It's the potential towards I can foresee things going if we were to follow the thinking of the opening poster. I would be being wryly cynical if I were to say one easy quick-win way of dealing with the expense of piss-poor self-serving expensive managers would be to save money by killing off the elderly, infirm, disabled ... rather than deal with the real issues.

And don’t get me started on the international students who sign up for mickey mouse degrees only to rock up to the NHS with a new diagnosis of a certain disease that needs expensive treatment like cancer etc.

Not to mention the bed blockers who “won’t budge” from their hospital bed as during their admission they have become homeless. The homelessness then becomes the NHS’ problem
to find them a lovely new flat in an expensive part of central London.

t

I don't agree. Of course life isn't equal. Even someone sat in a lovely home in a leafy idyll can be going through hell. The assumption that money is the great divider is wrong. Trauma and hardship doesn't discriminate. Money can take the edge of some things but so can having a great support network or experiencing a stable childhood that has equipped you well for adult life. We are all dealt different hands.

It is completely wrong though to lean into the victim mentality associated with this. Just because someone is poor it doesn't mean they have to smoke an expensive cigarette to feel better. I come from a deprived area and yes there were more unhealthy choices being made but there were also people doing the opposite. It is totally possible. My mum would give us an apple instead of a cheap chocolate bar but we seldom had expensive fruit. We would have veg with every meal etc. It really really is possible!

Don’t get me wrong I know that poverty drives many bad choices - although not everyone who is poor and stressed makes those choices

i am more mad at a society that leads people to those choices

and I am very mad at people who “blame” older people and bring out hateful remarks because old people can’t help being old either but that’s ok to hate them and it seems people would like them Al to kill tejmselves rather than be a burden - so that other people can be a burdon

rhe focus should be on stopping anyone drom
being a burden and not picking on the old - my mother costs the nhs a lot less than many people half her age

Amen to this.

True I think you can self refer actually in some trusts. It was an example but I think there would be better ones I could have used. The gist is there though... Ha!

Because in the time the patient is sitting there leafing through their diary and then calling their friend to see whether they can give them a lift that day, the GP could have seen another patient or two!

There may be a more efficient system than the current one but to change it to something better will require investment ie Money!

Even better would be the ability to self-refer directly to physio when it's blatantly obvious that it's the right treatment for a shoulder pain in the first instance. Why waste GP time. We don't need a GP referral for spectacles or dentists.

What is the European model?

I 💯 agree here. I work in the NHS and the stuff I see going on in front of my eyes I could sell stories to the tabloids.

1. Doctors themselves showing favouritism

with fellow patient doctors- patients (who are doctors) skipping waiting lists for procedures or appointments purely because they are friends of doctors. This can lead to patients being cancelled off procedure lists (and being told an emergency came in!).

1. patients who are vocal and write complaints been given financial compensations for unreasonable issues.

1. Some services are outsourced eg pharmaceutical companies and there is a lot of wastage with massive expense and could have been easily prevented, These companies are making mega bucks from the inefficient NHS.

The list goes on… it’s a total shit show. I work in one of the biggest London hospitals and it’s just completely corrupt it frustrates me on a daily basis.

Good luck with that idea (with which I heartily agree BTW) when there are idiots who will scream "The NHS is being privatised!" at the first hint of any such reform.

[Looking at you P. Toynbee.]

No, OH needs the highest strength which can only be given on prescription. It was a right battle to get it. His oncologist couldn't prescribe it. His GP just referred him back to the oncologist. The hospital pharmacy confirmed it had to be on prescription.

I know you are being sarcastic but using valuable NHS resources keeping people alive for longer than they actually want to live for is something we need to consider in all of this. Believe it or not some people (like my darling grandfather) are capable of making a fully informed decision that they don't want to go on any longer. Death for everyone isn't the worst case scenario but I imagine that you simply can't accept that. You will overrule his desires and rights because it doesn't sit comfortably with you and you think other people potentially be coeerced overrules all of our rights to decide how and when we die.

It is even worse because not only as a family are we all left with the most harrowing memories of my grandad and him asking to die, but this would have cost money that now can't be spent on cancer diagnosis and treatment that is woefully underfunded and the reason why my grandad was in this situation in the first place. Late detection, delays in treatments etc. All of these things would have benefited from the money that was used to keep my grandad alive against his will.

Yes for the first visit then can buy them yourself like I do

That made me smile.

On an entirely separate note I wish we had the option to end our lives.

@LolaLouise i pretty much wrote your post word for word on a similar topic last week.
I think the NHS needs to be run much more like a supply chain also. The NHS is far too disjointed with too much outside noise on the flows. For example somebody goes to a GP with a pain in their shoulder. Normally a GP would write a referal using their system to a physio. Someone then books an appointment for the patient who may not attend. Why do we not have a system whereby the GP can share the system and books the patient with a physio whilst the patient is sat there in front of them? Cuts down the lead time on the patients condition worsening. An appointment letter doesn't go missing or an email to an unused address. The patient can choose from an appointment from a list that the GP can see.

I don't think anyone is 'blaming' the old, are they? Blaming them for what?
The obvious difference is that a premature baby has potentially its whole life - and tax payments - ahead of it, whereas a 90-year-old is, to put it bluntly, a drain on finances.
I have a 87-year-old mum and a 93-year-old FIL, both of who have lots of things wrong with them and are very needy of GP, specialist and on occasion hospital care.
What's the answer? The problem is, we are all living - or existing - far too long now, thanks to medial intervention that in some cases should not happen.
I also have to take issue with the assumption all over this thread that if you take care of yourself you will not be frail in your old age. Spoiler: you will.
My FIL walked at least 60 miles a week (including the Himalayas in his late 70s), went to the gym daily, didn't smoke, barely drank and watched what he ate. He came out of hospital this week after yet another fall.
Taking care may help you until you reach 80, but after that, all bets are off.

Lol fail to see how this was my fault. I first found out about it when a letter arrived at my house stating i have anaemia and need to ring the gp. A few hours later i then received a phone call about it. I did go to the pharmacy with the letter that stated what doses i needed and was told they wouldn't prescribe that without a prescription feom the gp.

So again, blaming the public for the nhs.

Due to her other co morbidities and very low weight, I believe this has been discounted too.

Also if a fee to see a GP was implemented people would expect to be seen on time..........not 45 minutes later

No, full strength iron is available if you ask for it - you may get asked why you need it.
A lot of money is wasted on various skin products moisturisers and soap substitutes - my DSis comes to visit with the children and they always get left (don't worry I'll ask for some more)

None of this unsourced googling addresses any of the points I made about the problems. The whole point is that implementing a system like this is one thing, staffing it in a recruitment crisis whilst also making it pay for itself is quite another.

So show us how it would be staffed and pay for itself in the UK. A country with our labour market and shit postal service. I'm sure these Band 4 ish positions having to be done on site with no flexibility would be incredibly popular!