to think if a business operated like the NHS...

[hairytriangle]

then it would quickly go out of business

Just in terms of client communication and customer service.

Today I've been

1. kept waiting for one hour past my appointment time

1. had a snooty receptionist tell me I'll 'just have to wait' when I asked (nicely) whether I'd been forgotten about

1. Had to push for investigations that their own NICE guidelines say I 'should' be offered

1. Been given advice contrary to what another department of the same Trust gave, about a potentially life threatening action.

1. Been examined yet again when they could easily have got the results of the exams I had six weeks ago by lifting the phone.

I know if we treated our clients like this, then we'd quickly lose them.

dilema no body on this thread has begrudged the people before them taking up more time. Of course if you have a serious problem the Dr should be able to spend time with you.

All we would like is that the receptionist to tell the people in the waiting room that the clinic is running x mins / hours late.

Then we could decide if we wanted to make a call to those looking after our children / waiting for our news on our appointment / or go to the loo / or go to the cafe / or go to the newsagent and buy a paper.

Instead the receptionist seems to see through the entire waiting room of people as if they do not exist.

mamatomany, exactly how do suggest the NHS is run financially if not by tax? Honestly curious here.

also the comment about paying the NHS as a compeny if we want to be treated like clients: I want to be treated like a patient. I demand care and I demand polite people behind desks. I demand that receptionist, docotors, nurses and midwives have manners (both bedside and generally). I'm not saying that they don't, I'm only saying that we should be entitled to expecting it.

whether I'm on 100,000 a year or have been on benefits all my life is irrelevant to me to the care they should provide, but when they claim to offer health care and then they don't I have every right to be pissed off.

Thing1Thing2 And there lies the problem, administration staff seem to believe they become qualified Dr's the 2nd week in the post, I've seen it happen a million times, not helped by the fact that the hospitals are giving more and more responsibility to less and less qualified staff.
And the reason for that is Labour tried to recruit the local manager of Tesco's (literally in our area) to run a hospital department and it simply doesn't work.

we would all be so fucked
if we did not have the NHS

be grateful, very grateful

NHS is not a business, nor should it be run like one (ditto education - it just cannot succeed on a business, for profit model, because the "profit" of a concept like education is not monetary).

scatteredbraincells It should be funded by tax there is no other way

On Friday my clinic was overbooked by 13 patients AND my colleague was on holiday but this was not taken into account in the bookings so I had to see all his patients too. By the end I was 2 hours late but it was inevitable there was nothing I as the Dr could do about it. 100% of the people turned up when I was praying for a DNA.
I apologised to all of them and I tried to give them the best service I could and not cut too many corners but by the end their displeasure was clear. I had no tea break or lunch I felt bad even popping to the loo!
It is to do with govt targets. 100% people referred have to be seen in 18 weeks and all urgent ones in 2 weeks but the service is not actually resourced to do it. If the clinic was realistically booked people would wait longer and the trust would be fined for missing targets (no fines for running late). Clearly my clinic needs another Dr or at least a locum to cover hols but there's no budget.
If you run things by centralised targets it creates perverse incentives eg the A&E 4 hr wait target results in inappropriate admissions which cost the NHS more.
I am sorry if receptionists are rude. I have no idea if ours was I hope not. It is not a great excuse but I guess it does wear you down constantly having to apologise and take flack for circs outside your control.

The problem is that healthcare can't really be run like John Lewis (despite our PCT CEO thinking you can...)

Because it's free at the point of delivery many people have no perception of responsibility - the NHS is also a huge and unwieldy beast which is too fragmented and unsustainable in it's present form (IMO).

Healthcare can't always be measured in quantifiable outcomes. Human beings don't perform like machinery.

I have been on the other end of it too and it is maddening to see the inefficiencies.
In my last pregnancy I was referred to the obs clinic because I have an obscure condition that the midwife didn't know if it would affect pregnancy.
I waited 1.5 hours during which at one point I fell asleep on the examining couch where I'd been left waiting for the Dr to arrive!
The outcome was that the obstetrician didn't know if it would affect the pregnancy either so she decided to write to the consultant I see for it.
He sent a letter back saying no it didn't copied to me.
I then had another wasted morning at the clinic for the obgyn to read out this letter I already had and discharge me.
Quite why the GP couldn't write/ ring or e-mail my consultant to ask without the need for me to go to a clinic and waste my time and theirs I have no idea. I suggested this but was told it wasn't protocol.

I get annoyed about how different services are in different areas. Where I live you get 1 mw visit and 1 hca visit after having your 1st baby (I really did not feel this was enough.) My sil (150 miles away) has just had her 1st baby and shes got a mw coming every day for 10 days. That to me seems completely unfair considering we both pay the same amount of tax.

Otoh my 9mo ds has a chest infection . I called our gp surgery this morning, got an appointment for this evening, he was seen at the correct time by a lovely gp who was polite, friendly and thorough. He prescribed him antibiotics which we didn't have to pay for and hopefully hes on the mend now thanks to the nhs. We couldn't have asked for better service

hairytriangle - I know - I'm saying they wouldn't because they wouldn't need too, due to a near monopolistic poisition.

I am glad that the pursuit of profit is not the purpose of the NHS

We would all be fucked if it were

I think part of the problem is how badly the NHS generally treats it's staff. I have worked in the NHS both as a nurse and a counsellor in the past. In my experience the NHS as an organisation does not strive to motivate their staff or demonstrate that they value them.

They pay quite a bit less than the private health sector, which is understandable in the public sector but there then has to be other compensating factors to working for them.

In my experience the NHS is often not interested in providing training for their staff, often due to staff shortages they are unable to allow staff time off for training and also do not have the budget for it. However this can lead to staff feeling stuck and demotivated without the opportunity for career progression.
Managers in the NHS are very motivated about achieving targets but not in finding out how to retain and motivate the staff they have.
I found that management style was all about the stick and very little carrot - do what you are told and don't cause any trouble and don't expect any favours from us.

mamadoc's experience is not unusual. Does the private sector regularly use and abuse staff in this way?? [I guess they may do dependant on the industry/company?] Although I suspect not if they want a happy and productive workforce that will make them money. And I guess this is where the NHS differs, staff only cost money, they do not earn money for the organisation.
It is just a shame that patients may be bearing the brunt of NHS workers dissatisfaction and demoralisation...

The fact that NHS is not commerial is what makes it so great. If someone is run over they are treated whether it is a homeless person or a millionaire. No one checks the person's credit card before they are admitted to intensive care, unlike many countries in the world.

The fact that the NHS is non commerial means that patients aren't subjected to pointless tests. There is no advantage in doctors prescribing pointless (and painful) proceedures.

In the US healthcare is not universal. It costs more and outcomes aren't any better.

Just watch the film "The Business of Being Born" by Rikki Lake and you will realise how lucky we are to have the NHS.

I'm not suggesting commercialising the nhs or making it 'for profit'

I'm suggesting a little common courtesy and respect
for it's clients, in the way a business has to

A business is there to make money, therefore it behaves in a different way - you cannot therefore make the not for profit NHS behave like a business because it has different objectives.

It is like Davey saying that he needs to run the country like a business........what a crock. The country is not a business and therefore will never behave like one. The analogy does not work.

HT if your business had more work than existing employees could cope with you would employ more I guess?
You would be able to do this because more clients = more profit. The NHS doesn't work like that.
Logically the solution to my clinic problem of too many people needing to be seen within a reasonable time will only be solved if more Drs are employed or GPs refer less patients.
The PCT cannot afford to pay for more Drs time.
The NHS has tried to stem demand by limiting GP referrals but that leads to bad feeling from patients too.
It cannot run like a business because it doesn't get paid for doing more work.
I do personally always try to be courteous but I don't always feel like it. If someone complains about the lateness under the conditions I've described where it is in no way my fault I just say that I am sorry but really I would sometimes like to explain how it feels to be under such pressure.

I haven't read all the replies as its bloody late! But someone asked early on how the symstem is abused. Listen up

I used to work in A&E. Every saturday night a pissed up man called for an ambulance saying he had chest pain. He was brought to our department, where he promptly discharged himself and walked the few yards home

Cost of an ambulance and crew several hundreds of £ per journey

The upshot of this is that one saturday night they took him to a hospital 20 miles from home and left him there - they had no obligation to get him home - the drunken twunc never did it again ha ha.

I think on reflection that if I had announced to the waiting room that we were one Dr down and that there would be unavoidable delay it would have made it easier for them to bear and stopped them thinking it was because I was slow.
The reason I didn't do it is that the reason wasn't exactly unavoidable in the sense of sickness. (It was forseen but management take a tactical decision that they can't cancel half the clinic slots in August because of holidays or targets will be missed). I would have felt I was lying.
I also worry I might get in trouble, be seen as rocking the boat, making a fuss.
No-one will cover my holiday either it is quid pro quo, normal life. I am a bit desensitised to it so I fail to appreciate how bad it is from the other side I suppose.

The NHS is structured and run for the benefit of its staff, not its users/patients.

It is the final bastion of Stalinist, centrally-planned, state-controlled "public" service and as such needs as good a kicking as you can stomach, in order to encourage reform.

Don't get me wrong, many of the staff are absolute diamonds and loyal and caring and professional and awesome. But they deserve better, as do we, the British public.

Let's stop controlling it fron the centre and allow healthcare to be run by those closer to those that use it.

Sounds like some attempts to introduce efficiency into the NHS to me, which can be no bad thing.
The European Working Time Directive is a good example of a centrally-imposed diktat, seemingly introduced for the benefit of patients (who wants tired doctors etc etc??) but which actually works against them as junior doctors simply cannot receive the necessary training (and basic 'face-time' with patients) as a result.