To wonder what's happened to the NHS?

The usual ignorance that some people love to spout, overlooking the fact that without immigration the NHS would not even be.

This.

When in doubt, blame Brexit. It's run like councils and universites - nonsense unnecessary job titles, top heavy overpaid senior management and an inability to allocate funds appropriately. Throw as much money at it as you like, it will just be wasted.

Add to that the far greater number of things that get treated on the NHS that didn't before, and new drugs and treatments available.

It’s been a gradual process, despite increasing amounts of money thrown at it. It’s just an inefficient monolith that needs root and branch reform. As does the social care system. 🤷‍♀️

So pop has gone up by approaching a half - has there been a 50 % increase in the number of hospitals across the land, No. a 50 % increase in the number of doctors and nurses no but they’ve probably gone up a bit.
But overcrowded A/Es across the land demonstrate an acute shortage due to increased population

I think a lot of trade unions are harmful and use their voice to push preferred ideologies of their management teams rather than represent their members. But do you really think Labour are going to try and dismantle unions? If so, I have a bridge to sell you.

It’s no good demanding more doctors when there’s no money to pay them

Great post. The number of people that think doctors and nurses can run the NHS is insane. Most people have no idea how the NHS is run and seem to prefer a doctor to do admin rather than an administrator. Make it make sense!

Also, this isn't new. Before I met DH (28 years ago) his blind and deaf grandma was in hospital. The staff used to put food in front of her, then come and take it away trilling 'not hungry today Mrs X?'. If her husband wasn't there to help her she went hungry, but he wasn't allowed to stay with her all the time.

Since labour have been in power we've had an up tick in junior doctor strikes, pay rises with no expectation of better performance.

The BMA needs disbanding, there needs to be a huge increase in medical school places and nursing places to British students only, with a lock in policy of having to then work a certain number of years for the NHS (or repay your training fees).

Private healthcare should be tax deductible, thereby easing pressure on the NHS.

Appointments should be prebooked with a bank card, if you fail to show up you get charged.

More temporary care homes to plug the social care gap and get people out of beds when they no longer need care.

And someone does have to go later/last on the list…when admissions are staggered it usually reduces theatre efficiency and then people complain because they have to wait longer for their operation dates.

What do you mean by this?

Nail on the head. Hugely inefficient. DH has had multiple repeated tests, X-rays, scans etc because the results were lost or they scanned or X-ray-d the wrong thing. Very expensive cancer drugs issued and then told to throw away when they decided to change the dose or drug. It’s a complete circus of utter incompetence and no care for costs nor patients. It’s just a self serving fiasco now.

Absolutely agree with underfunding both in terms of infrastructure and workforce.

We don't have a pipeline of consultants because we make it far too hard to access university courses, limited spaces available and you must have 4A*s at A level. Many applicants that meet these standards then get turned down. The numbers of students dropping out is very high. Lack of funding then means there isn't junior jobs for the people that do qualify. If we had better staffing models and more money we could support more junior doctors onto shift rotations. This would mean more clinical staff and better work life balance - we currently run junior doctors into the ground and then wonder why they quit or go elsewhere.

There have been numerous studies showing that the NHS has significantly less managers than needed and less than comparable health care institutions across the world. I dont think we have too many managers. The management vs clinical debate is old and tired. There's a role for both.

Unfortunately, the industry that is the NHS relies on rafts of data, admin, operational process and assurance. These shouldn't be the responsibility of our clinical teams. Nurses are taking on more of the work that consultants used to do, there isn't enough of them to also take on the work of management - we need our clinical staff delivering hands on clinical care. Management working on operational delivery and improvement planning and for all stakeholders to respect each other and work together.

having had a previous failed spinal doesn’t necessarily mean a second attempt would be difficult and it sounds like they’d got pretty close to the right spot this time. For quite a few operations there’s real advantage to having a spinal and in addition if someone’s had a difficult GA in the past often a spinal may be the safer option and at least worth a go.

completely normal to not have anything in the bedside whiteboard…patients complain about their details being visible. You can’t win.

Labour are in power now and have a term to show the difference. The NHS is still paying PFI back from last time.

Let’s see if they meet pro Labour expectations and it’s any different. Or it’s difficult to keep up with growing demand delivering more and elderly with complex needs.

And we have nurses promoted to managers who may have been great nurses but not great managers. Then managers who are not nurses who shuffle people around like tins of beans in Tesco.

Yes the GP contracts brought in by Blair were ill advised

God, get a grip. He's barely got his feet under the desk. Given the previous 13 years of underfunding Labour were never going to sort it out all at once.

I'm not a Tory, but I am an ex NHS worker of many years. Two of the most damaging changes to the NHS were made by Blair - the new GP contract and PFI.

What an absolute crock of shit! I don’t even know where to start with what bollocks this is 🙄. So he sold the NHS in secret for good press? Yes of course he did. Fuck sake.

I don't think it's just underfunding. It's so massive and so un-joined up and fragmented and old fashioned. The comms and tech and systems are just not up to scratch. And poor practices are now so entrenched. It's so depressing. We have become used to accepting such a poor service which would never be accepted in any other area or situation.

With respect, I don't recall too fab a service between 1997 and 2010/15. At least prior to Bliar we still had the notion of the family doctor. Durong the Bliar period both my DC were refused grommets on the NHS and I was refused a bladder repair arising from a botched NHS birth.

Absolutely @dreamingofgoodhair and there is a theory that because nursing was often traditionally a "pink job" wages were kept low so less budget needed on that than can be gotten away with now.

You’re right about underfunding.
We absolutely need staff from other countries but in my hospital the standard of spoken English from some of them is terrible, this is dangerous.
NHS is very top heavy with management.
Every ward on every shift operates Sat minimum staffing so as soon as anyone phones in sick that area is unsafe.
Nurses have more responsibility than ever.
Our trust now has electronic drug rounds , this has added time to each drug round.
We have spent hundreds of thousands on IT systems no one uses.
Our infrastructure is falling to bits (lifts which regularly break down with patients in) but non money (allegedly) to repair.
Cheapest possible SLAs which are inadequate.
Severe lack of onward care , so around 100 people a day are in a bed they no longer need.

I could go on …