Everyone was worried about the Tories and the NHS

[Puzzlemad]

https://www.bbc.co.uk/news/live/c0qejx03zjnt

Everything is just awful, credit crunch, covid, brexit, Ukraine has all been tories fault and we are in the most dire state we've ever been in.

Labour has to make hard decision.

I think we have to talk about weight loss medications now. They are about to become much cheaper due to all the competition. Threads on here show they work. Subsidise them and get beneficiaries to pay a contribution.

The biggest burden by a long way on NHS spending is treating conditions related to obesity. We spend far more treating these diseases than anything else. Our economy loses productivity from the working age population due to obesity which reduces economic activity.

The second priority is to invest in social care and ensure care packages are in place to get elderly people out of hospital quickly. Treat elderly patients in the community in more virtual wards.

This would solve the financial crisis in about 10 years.

The public needs to wake up and stop saying obesity is an individual’s problem, because it ain’t. It’s bankrupting the country. It’s everyone’s problem and it’s not going to help calling people fat and lazy when they’ve had a stroke in their 50s/early 60s and have another 10-20 years in and out of hospital and needing care. Dementia leading cause is also type 2 diabetes. I could go on.

The NHS budget is three to four times bigger now in real terms than in 1987. It has grown above inflation in every single year, including throughout austerity.

What has happened is that people have got older (more expensive) and expectations have increased. Budgets have not gone down.

We need to decide what we are prepared to pay for.

If thirty seven years of this system, under different governments, hasn't given you what you want, maybe it's time to try a different system.

The NHS also needs to stop wasting on money on activist groups and freelancers brainwashing the NHS. My local hospital has a massive Stonewall trans pride flag painted on the side of it. How much did that cost? Ditto inside the hospital, rainbow coloured bunting, lanyards & marketing materials everywhere. This all needs to stop and they needs to exit the Stonewall diversity index scheme or whatever it's called & get on with treating the sick instead of asking for their pronouns.

Yet the admin in my local hospital is abysmal, 4 cancelled appointments in 3 months without proper notification. Too much money is spent on unnecessary things and better budget management is needed. For reform to be effective & have an impact, they need to cut out the rot from top to bottom without hiring expensive consultants to do it.

Lol. The NHS needs to sort out its admin first and send the right letters to the right addresses to arrive before the date of the appointment. Also a proper chain of communication, so when an appointment has to be changed or circumstances have changed then the message is passed on.

Since my Dad became ill I've been shocked by the amount of cock ups with his appointments. I'm very suspicious now of the blame put on patients for no shows.

I don’t work in oncology but both of these scenarios are identical to behaviours I regularly see in my department. In fact, in my department clinics It is absolutely normal to need a quick out patient prescription writing but the consultants will absolutely refuse to write them for 2 reasons:

1. They want me to schlep round the department to find a FY1 or 2 to do it
2. They don’t actually know how to use electronic prescribing properly and regularly fuck prescriptions up meaning patients go to pharmacy, pick up drugs, get in car, open bag, see the drugs are wrong (in vials instead of tablets, or tablets instead of pre loaded syringes). Go BACK to pharmacy, who can now never re-issue those untouched unused drugs that may have cost hundreds. I then have to find another Dr to correct the prescription and do the whole stupid dance again.

They also refuse to put paper in a photocopier, staple paper together, file anything, turn off computers or even remove used mugs from their rooms.

Anyway. Let’s chuck some more money at it eh?

@GenderRealistBloke our healthcare expenditure per capita is the second lowest in the G7. It is not the system which as fault. Under to Tories health expenditure as a % of GDP actually fell. Your comparison with 1967 is just ridiculous.

Overall if the UK had matched EU14 levels of spending per person on health, day-to-day running costs would have been £39bn higher each year, on average, over the past decade (£30.5bn of which would have been additional government spending). For capital spending, matching the cumulative EU14 average over the past decade would have resulted in the UK investing £33bn more in health-related buildings and equipment. These are significant gaps in spending. Had UK spending kept up with European neighbours it is fair to assume the NHS would have been more resilient and had greater capacity to provide care during the pandemic and reduce the large backlog of care that is its legacy.

https://www.health.org.uk/news-and-comment/charts-and-infographics/how-does-uk-health-spending-compare-across-europe-over-the-past-decade

THIS.

Every day I see at least 3 patients who say ‘I got 2 letters and 3 text messages and they were all different and no one ever answered the phone’.

I also spend about 90 mins a day on DNA appt calls, 99% of which are NHS mistakes. An absolute classic is posting an appt for an appt in 3 days time (your letter will sit in a departmental out tray for up to 23hrs & 60mg a depending on when it was stuffed in an envelope). Or, a text message with the date and time of the appt and no mention of WHERE the appt is.

I personally DNA’d a pre op appt last year as the letter didn’t tell me what it was for and no one ever answered the phone number in the letter. They rang me, very affronted I hadn’t attended. Turns out I was to have a hysterectomy. A surprise one. I declined.

How do you reform without funding

Why is it a surprise the NHS is broken when we dont fund it properly in the first place, so 'throwing money at it' is very much a solution, as well as joined up programmes to get more nurses/doctors/practitioners, building more hospitals or clinical centres, providing more MRI and scanning options/times, joining up initiatives like cycle routes, leisure centres for exercise in local communites otherwise people just live in their cars.

we are on holiday at the moment rural/coastal part of the country, absolutely no pavements in between villages and towns and utterly dangerous fast roads. How do people get to work and school or visit people without their cars? A small thing but important.

Absolutely this!

NHS head count is not comparable with other health care systems, because they are counted on a different basis. % of GDP or per capita expenditure is the benchmark. On that basis, it needs more money.

Your comparison with [1987] is just ridiculous.

@DadJoke -- clearly we should expect real terms expenditure to rise as demographics change.

The pp's claim though was that the NHS budget had been cut in every administration since 1987 though. That's just plainly false. Do you agree?

@DadJoke I agree with you that healthcare investment needs to rise.

That's why I wouldn't apply an ideological purity test to how we arrange that funding.

I'm not saying you would either. You seem to admire the funding that European systems provide, so maybe you'd support the kind of mixed insurance-based model that many of those countries use.

Healthcare cost as % of GDP is a deeply flawed measure though.
By that standard the US's system is the best in the world by a mile.

You are making wild leaps of logic here.

Headcount comparison doesn’t tell you anything about whether the NHS is well funded.

”We don’t spend as much other countries” does not mean I want their systems.

The NHS can easily be funded through taxation using the current model.

@DadJoke - I think you've confused me with a different poster. I have made no headcount comparisons.

If you haven't, which bit of my logic do you think is a wild leap?

Apologies. When compared with other similar countries the NHS is woefully underfunded. Your leap of logic was from “the NHS shouid be better funded” to “the NHS should adopt the systems of better funded services”

Care of people with long-term conditions accounts for about 70% of the health and social care budget. A lot of long term conditions are caused by lifestyle factors, with obesity the leading cause.

It costs the NHS double to care for an obese patient v a healthy weight patient.

I think this is what the “Prevention” part of the strategy must focus on- and this will require diversion of funding. From where, I don’t know.

This is true. Insurance would also add another layer of scrutiny which would increase control over how the money is spent. (Less waste, less misuse, more preventitive care, better targeting of resources).

How do you reform without funding

I'm not sure if there is more capacity for tax but this seems a valid question

It strikes me that people aren't correlating the under management of the NHS with it's poor administrative capacity

Thanks, no problem. I agree the NHS could be a lot better funded on the current model, but all the evidence of the past several decades suggests it won’t be (because aging+politics). So I’d look at models that open up additional funding sources, like a mixed insurance model, and/or co-pays. That has some other advantages like creating incentives for efficiency. Not the US model (which has its own absurdities), but some of the many other mixed models.

So the Labour party will finally be the ones to bite the bullet no Tory dared, and privatise the NHS? All the while saying, "the Tories made me do it". You couldn't make it up. Party of the people, my arse.

Did you read reform and understand privatise? Nowwhere in the speech did he say anything about privatising.

This is the problem - the NHS being seen as some sort of untouchable embalmed icon that actually slowly rotting because everyone is too scared to face the truth.

This list is endless.
The examples of poor process, incompetence and laziness at all levels are shocking.

Throwing more money at NHS is like giving salary increase to an underperforming employee. It needs fundamental reform.

In many businesses regular performance reviews include stakeholders (users) feedback and rating is linked to salary increases and bonuses. I don't understand why the same cannot be implemented for NHS and civil services, why patients' satisfaction does not influence GP's/consultant's/nurse etc performance rating.

You cant run public services like business, this is where half of it has gone wrong with contracting out, commissioning services which costs far far more than in house and ties health trusts into rigid and non patient centred processes.