Everyone was worried about the Tories and the NHS

[Puzzlemad]

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

I recommend the latest Today podcast, all about the NHS,

Some stats to come out of it,

GDP to spend on healthcare the UK is pretty much up there in the middle, and yet the performance is way behind some of its counterparts.

from 2019 there has been a 19% increase in spending, A 23% increase in staff and yet the amount of clinical procedures has increased by just 3%..... showing that the more is thrown at the NHS the less efficient it appears to become.

Also on the podcast some really interesting insights into the BMA....and why it really resists reform.

Yes of course female consultants also behave like this.

theatre culture and clinic culture are 2 different animals. The doctors I work with are all surgeons and their behaviour in clinic is different to their behaviour in theatre.

As per yesterday's report it's difficult to increase productivity if you don't also improve necessary infrastructure and up to date technology.

"The report said that the hospital workforce had risen by 17 per cent between 2019 and last year. Yet output has not risen at nearly the same rate, leading to a large “productivity gap”, which means waiting lists remain stubbornly high. Darzi said the “central problem” was that the increase in staff had not been accompanied by upgrading infrastructure, such as diagnostic scanners or operating theatres. There is no point hiring more surgeons if they do not also have more equipment and space to work with."

Sadly I think you might be right. I believe wholeheartedly in the NHS but the fact that not a single country has gone down the route we have probably tells us that it is unrealistic given the ageing population, poor state of population health and advancement in modern treatments.

When I think back to my grandparent’s generation in the 80s they got sick, were treated and out of hospital only to deteriorate soon after and died in their 60s/ 70s. Causes mainly smoking/ metabolic disorders which weren’t actively managed. Two of my grandparents died after 3 heart attacks a couple of years apart. Now someone in my family early 50s has better outcomes (thank god) but is 4 years into cardiac care - I’m obviously hoping she gets better and lives much longer but that’s a lot of money on care (and she is still morbidly obese so risk remains high).

Now their children (ie my parents) are diagnosed a lot earlier- they are treated for 20 +years (which is a very good thing!) They will be given antibiotics more frequently and they will live for many more years costing the NHS so much more to manage. Their grandchildren (ie my generation) are now getting diagnosed with long term conditions such as diabetes and hypertension, much younger than their parents and are living in poorer health for many more years.

As you can see, what the NHS is expected to deliver now far exceeds what it was built to provide. We are relying on healthcare far more than we used to, for many more years than we used to. I don’t think the average person appreciates this. But I bet if everyone stopped and thought about generations in their own family they would see increased acuity/demand as they move through the generations.

It is too complex and difficult for the average person to comprehend the wicked problems the NHS is facing and the Darzi report does not offer much in the way of solutions.

Funny how people have been saying for years how the NHS is underfunded, even though billions has been thrown at it. Now Labour are in power and suddenly it's absolutely fine to say more funding isn't the answer. If the conversatives had said that they would have been vilified. Ditto the winter fuel payment.

It’s at the bottom end of the G7 in funding, and it has declined as a % of GDP. The Lansley reforms were an absolute pigs ear.

Low capital expenditure and PFI have impacted NHS efficiency, after 15 years of improvement though admin costs remain very low. A lack of social care clogs up the system. None of these are fundamental to the NHS model. They started with the Tories.

I think Labour’s idea of reform without additional funding is a pipe dream, and more private sector involvement is simply poisonous.

Agree with a few of these points but on this I can't see how it can't be the case

I think Labour’s idea of reform without additional funding is a pipe dream

We are running to catch up with changing demographics year on year anyway, the idea it won't take higher than a real increase which we have had seems difficult

You are agreeing with me.

That sounds unbelievably stressful and rage making. Sympathies

I am yes

Where I differ slightly is what to do about it, I think we might be maxed out on taxes in terms of people opting out and behavioural change

But the rest, yep

I have no issue with the theory of the three things to change, I have posted similarly on those three things. I just don't think it's possible to run with the funding that's there, catch up with demographic changes year on year and do the reform promised.

I guess we'll see

Dunno the private hospital tried to throw my 92yo blind heart failure renal failure etc etc nan out 22h post hip replacement as she met discharge criteria lol. Told them that was absolutely ridiculous and not happening as would be in at least a couple of days in the nhs. Got some moody matron come down immediately to confront me

But id never choose private surgery beyond v minor surgery from my experience of working in them

@Destiny123 i wouldn’t either.