Do non NHS people realise how bad it is at the moment?

[DoyouknowJo]

I had to justify to my managers manager why I needed to spend £7 on stationery. Stationery. Some biros, some staples and a box of envelopes.

One of my colleagues chairs broke and she was told to apply to charitable funds to get a new one.

Everything is held together with sticky tape and blu tac (literally and figuratively)

We have four members of admin staff bunched into a desk meant for two, because there is no money to pay IT to put a new port in on their desks.

Waste toner cartridges are on lockdown. If yours is full you should take a scalpel, cut the seal open, empty it and then stick it back together and put it back in the printer. Don't worry about all your printing then being covered in smudgy ink. We're broke ya know.

And some fucking idiot turned up to A&E today...because their arm has been hurting for two months and they are off on holiday tomorrow and could we sort it please.

I'm thinking of starting an anonymous instagram account to get all this crap out.

SootySueandSweeptoo - well, could you argue that junior doctors are dropping like flies because the consultants are too busy with their private practices to help take the strain, then?

I’ve spoken the GPs about what they think will happen in the future and a few have said that, with the struggle to fill jobs, there will be one GP and more practice nurses/community nurses/nurse practitioner and we will be given more and more of their jobs

How can it be a surprise there's a shortage when so many are only working 2 or 3 days per week? Did no-one realise and plan for this?

Goes right back to Blair and the famous "too good to be true" contract for GPs where they got more pay for less hours. Whether or not that was the right thing to do is irrelevant. Did no-one stop and think just who was going to do the work if the doctors worked fewer hours.

Add in more doctors wanting "family friendly" hours, and then the pension tax and marginal 62% tax rate, it was blatantly obvious doctors would work fewer hours.

The shortage of doctors should have been foreseen 20 years ago. If proper action had been taken back then to deal with it, we wouldn't have this problem today.

So the doctors HAVE to put a certain amount into their pension by NHS rules, that is then taxed at a high rate by HMRC rules. This is why many go part time, as then they can keep below the HMRC threshold.

It's also why huge numbers go down the locum/personal service company route. Where they "retire" from their NHS practice on a Friday and then work through their newly created personal service company as a locum on the Monday, often at the same practice, seeing the same patients.

Kazzyhoward - yes, of course it was entirely predictable. The cost of training a doctor, however, is high, and society is very poor at joining the dots between all the things it claims to support. I seriously doubt it suited the feminist agenda to point out that changing society so that men and women shared well paid and domestic work more equally should result in more people doing fewer hours of paid work so that family life is not detrimentally affected. From a capitalist perspective, it should mean more people being overworked for less pay, no more flexibility unless it suits the employer, and the family missing out on time with both parents.

Society supports family life - except when parents don't like teacher jobshares, part-time GPs, consultants who cannot see them any day of the week, solicitors who are working too slowly on their case because they don't work full time and it's confusing who they are supposed to be dealing with, etc, etc, etc. Nobody has really had a sensible discussion about how to restructure society so that things work...

Hospital culture and leadership is responsible for how juniors get treated everywhere, in all disciplines.

The EWTD is often over ridden by a get out clause which is signed by the employee agreeing to extra hours. See doctors example below:

www.bma.org.uk/advice/employment/working-hours/ewtd-juniors-faq/ewtd-juniors-opting-out

"I meant do you know any socially either as a friend or colleague."

What difference does that make?!! Fact is we need GP's, either full time or more of them part time (but not on excessive salaries and pensions!) enough to cover the appointments required. The issue of lack of recruitment has at least in part been noted on the thread as possibly due to the lack of Drs being trained overall. There's certainly not a lack of applications to medical school!

The conversation is getting bogged down now in details I think not many of us "lay people" necessarily understand. I certainly don't!

But at a basic level and I suspect many would agree, paying a dr a full time salary for part time hours plain shouldn't be happening!

I also really don't feel sympathy for them working fewer hours in order to avoid paying more tax, when they're earning FAR more than many of their patients could ever DREAM of earning!

Yes their work, their knowledge is important but they're not gods! And they're not beyond reproach - or they shouldn't be, but certainly far too many seem to think they are and should be.

If part time is going to be predominantly how in particular GPs work then they need to accept that means less pay, so we have enough money to pay for there to be enough GP's to cover the appointments needed - that is basic common sense!

Seems to me they've had it too good for too long pay wise and they're too used to it working in their favour and being able to call the tune!

"Bubble" and "ivory tower" are right!

SootySueandSweeptoo - well yes, that was my df's opinion on part time GPs and dropping nighttime call outs for your own patients, too. Nobody has ever had a proper discussion on any of this, though, have they? What is reasonable and what is unreasonable? Is it reasonable to expect a part time career in medicine, or isn't it? How do you assess what are genuinely part time hours when it is not a profession where you can clock off at a specific time, anyway, because that is not how patient need works? Where is the balance between what was expected 50 years ago, when, eg, hospital nursing was not considered compatible with family life and you had to leave if you married, and women doctors were like hens' teeth and the married male doctors had very little to do with domestic arrangements, and now? Are we supposed to have an army of domestic servants again, like in the past, while wealthy, busy parents remain somewhat distant from their offspring? What of the less wealthy who have no choices? What is it reasonable to expect?

I know two doctors. The one who is a GP and partner in a practice, always seems much richer with a better work life balance, than the surgeon in a hospital.

The appeal of general practice used to be the getting to know patients and whole families. Now the only real appeal I can see is the possibility of well paid part time work.

Yes we do know. The NHS is great for emergency care, but for everything else it is atrocious. Anyone who actually needs to use it (and ends up having to fork out thousands to get the services they actually need) knows how bad it is. The people ranting about how great it is either don't use it or only use it for emergency care. It should be stripped back to emergency care only, as in reality that's what it is, it's just pretending (and wasting a lot of money in the process) to be anything else!

Yes, of course, because the answer to improving an underfunded, creaking service is to strip it all away, leaving people who can’t afford to pay for healthcare without any. Any excuse to take us backwards. Try reading this.

www.theguardian.com/society/2014/jun/04/coalition-attacks-nhs-return-britain-age-workhouse

Mummyontherocks what are you on about??? How on earth do you think people will afford private healthcare plans? Even if they could afford a basic plan once you’ve had a serious diagnosis the premiums would soon rocket. And what about pre existing health issues? You do realise they wouldn’t be covered?
Who are you proposing does all the non emergency care and how will it be paid for? We absolutely must not lose our NHS.

Maybe there needs to be some sort of protection for employees whereby they can not be refused permission to attend medical treatment during working hours could ease some of the strain. A small thing perhaps, but it might help. Similarly to how you have a legal right to time off for antenatal appointments. Although when I was pregnant, my employer did try to insist that I schedule my appointments at certain times, and were most put out when I pointed out that the antenatal clinic only ran on a Tuesday afternoon, so no I couldn't schedule my appointment for Fridays no matter how much they stamped their feet.

The downside is that there would probably have to be some compromise on privacy with employers because it's not viable to expect it to work on trust because too many people are piss takers. But it needn't involve intimate details of the medical condition, just an appointment letter by way of proof. And obviously it would probably have to be unpaid, but better that than a flat out refusal by employers to allow employees to manage their health, which often happens at present. It might at the very least ease some of the strain on out of hours clinics.

You mean like GP surgeries, dentists, opticians, pharmacies, etc. It's the way it's been ever since the NHS was formed. It's never been truly wholly state owned.

Agreed Kazzy, but I was thinking of all the elements that have been privatised in recent years, enabling shareholders to gain.

After an operation, OH needed certain items to help her mobility around the house - they were ordered by the hospital but were provided by a private company - Millbrook. We paid for carers to visit, but those who are deemed eligible for NHS care (getting fewer) use the same private company but paid from the public purse.

My re-hab team and physio support comes from a private company - despite all their paperwork carrying the NHS logo. Some hospitals still use outside cleaning services and some scanning units etc., are private providers.

In Somerset there was a huge ‘scandal’ not so long ago with a private company doing cataract operations, some of which went horribly wrong.

My cataract operation performed at the local hospital was carried out on a Saturday by a group of hospital doctors/consultants forming their own private company.

And consultants letters are out-sourced and sometimes take four weeks to reach GP's and patients. Had to use PALS to solve that one.

Interesting documentary recently on fraud in the NHS. Mind blowing.

Also, I’d like to mention Carrillion. A company that having paid dividends to its shareholders and directors managed to go bankrupt - costing the taxpayer £148m. The new hospital being built in Liverpool contained expensive equipment which the NHS had paid for but Carillion hadn’t paid the suppliers. Not sure if the NHS trust had to pay again or the government.

The UK needs a joined up system to pay for our public services, so that Philip Green can't pay his wife £1.2 billion (based in Monaco) who will not pay tax. I gather in America it doesn't matter where you work in the world, tax is paid to the USA.

missyB1 I know exactly what Mummyontherocks means.

In our family we have all been messed around by the NHS. Then had to fork out thousands to actually get treated.

I have allergies that bring me out in psoriasis. I have been back over and over all they will give me is hydrocortisone cream. Asked about allergy testing and was told it didn’t exist.

I am nearly 60 so I think at my age they have given up on me.

I actually don’t trust doctors anymore.

Especially when I went in with dd and the dr started to google her symptoms

I suggest that @oliversmummysarmy and @Mummyontherocksand anyone else who agrees with them should pop off and use the private healthcare they can obviously afford, thus removing some of the pressure on the NHS for the benefit of those of us who trust and depend on it.

Yes we do know. The NHS is great for emergency care, but for everything else it is atrocious. Anyone who actually needs to use it (and ends up having to fork out thousands to get the services they actually need) knows how bad it is. The people ranting about how great it is either don't use it or only use it for emergency care. It should be stripped back to emergency care only, as in reality that's what it is, it's just pretending (and wasting a lot of money in the process) to be anything else!

I have a variety of smallish health issues, none currently life threatening but most are limiting. Arthritis, nerve damage in a foot, back pain, a large cyst that will need surgical removal, and a torn tendon (waiting to see the consultant about that one. I am virtually un-insurable, having had cancer in the past and of course as half the other problems relate to an accident at 20 those wouldn't ever be covered anyway.

I am currently temping so low income. How would you suggest I get the torn tendon treated, which if I leave it will leave me unable to work at all very soon? How shall i pay for the cyst to be removed, which is now interfering with sleep & causing some movement issues due to the location? How will i pay for the next set of nerve blocks in my back to allow me to keep walking without excessive pain?

SootySueandSweeptoo - yes, that's all it would be if you didn't know your patients. In all honesty, increasing mental health issues are fairly inevitable for stressed, worried people who never get to see the same doctor twice and who don't feel understood or supported. The art of general practice is entirely in knowing your patients well enough to know when to worry, and knowing them well enough to know how to reassure them. Hospital consultants have the luxury of knowing that if someone has made it that far, they are likely to have something seriously wrong with them. GPs could have absolutely anything thrown at them at any time, including things the consultant they refer the patient to has never actually seen before in his career, either. It's an entirely different mindset.