A question for NHS staff

[Glowinginthedark]

AIBU to think that no amount of money throw at the NHS in it current state will fix the issues? What is the real problem? Lack of funds or people completely abusing and misusing A&E or both?

"if we don't collect stuff that day it will go to a charity shop as they want the house cleared before the funeral/ the family return "

If the place is rented the HA usually wants it cleared within a week ................had to do this when my MIL died in 2003.

I cost the NHS a fortune but I'm grateful it's there. My meds are £700+ for 12 weeks and I pay the prescription charge. But long term it stops me getting infections and sepsis so saving money I guess? I see the haematology consultant every 12 weeks too
I also have hidradenitis supprativa which often means a GA plus treatment from nurses after with wound packing etc
Then I got cauda equina and needed 4 x MRI scans plus emergency surgery (and yes I was laughing in a&e and probably looked fine that was the morphine)

think it would really help if we could somehow stop the quasi-religious veneration of the NHS and have a honest discussion of the main options there are. It's not NHS or US-style private insurance: there are other options.

@Phineyj, I don't disagree that there is a conversation to be had at looking at other European models of funding, but no political party is doing this and our current government are simply opening up more and more of the NHS to for profit private companies, aka US model. This saddens me.

I had a brief look online about French and German healthcare, both considered good. The French system has citizens having pay automatically deducted from their wages to go into a national health fund. This fund covers 70% of health care for most citizens . The long term sick and disabled and I think some unemployed get 100% healthcare cover. The remaining 30% of healthcare is covered by private insurance that people take out. Companies will often contribute. Crucially very few of these private insurance companies are for profit companies but mainly mutual insurance societies.

89% of German citizens have a healthcare payment automatically deducted from their monthly salary. The top 11% of earners can opt out and pay for private insurance but it's more expensive. Both these countries spend more per head than we do in the UK.

@Ollivander84, that's good to hear. This is what national healthcare is for everyone who is able to works pays into a system that means those unfortunate to get sick or born with health problems will have health cover. Some may be fortunate to need little healthcare in their lifetime, others will need more. What is important is that everyone has the security of knowing should they get sick there is healthcare there without bankrupting them or being able to even afford basic healthcare as can happen to citizens under the US for profit model.

waitingformiracles Here in the US they take your credit card when you are given a wheelchair. If you don't return the wheelchair as agreed you are charged for it. Guess what? Everyone makes damn sure their equipment borrowed is returned. If they damage it they will buy it themselves and return the new item rather than be charged through their insurance or credit card.

I don't see why we can't do something similar in the UK.

There has been a test around for donkeys years. I spoke to someone who does work at the surgery in a social occasion and they said it was short term the test costs quite a lot of money and they would rather have you back day in and day out and have you in pain and discomfort rather than pay for a test that would sort you out

Friends husband got a job in a European country 3 years ago. Friend
was on every pill under the sun

My friend got ill and went to see a doctor who sent her for tests.

The test results came back. There were 42 pages of results. The doctor told her she didn't have the things the NHS doctors had said she had but the combination of symptoms related to another issue that they resolved and now her health is great.

Doctors to "save money" are treating each and every symptom one symptom at a time. Not looking or listening to the patient as a whole. Whilst this may look like it is saving money in fact it is ending up wasting a whole lot of everyone's time and money.

Alone I must have cost with all related costs because I couldn't work, so couldn't pay tax, was on disability around £500000 over 5 years.
A £300 MRI scan would have saved the NHS at least £499000 and me years of pain.

In the end I saved them the £300 and cost of the subsequent treatment which was a result for them

I know it's only a small point but the equipment return is something that people could do easily. My old flatmate slipped at the station and sprained her ankle; she was given crutches by the hospital.

After a couple of weeks I got fed up of falling over them in the flat hallway, so I drove her down to return them. The hospital staff were amazed - they said nobody ever bothers.

How difficult is it to take back something like that when you don't need it any more?!

Lots of hospitals don’t accept equipment back due to hygiene reasons and because of potential damage.

I get every doctors letter twice. Ridiculous waste and yes of course I have reported it. Crap management and martyred attitude of staff

neil well that's an attitude that needs to change. I'm in America, and at our non profit hospital equipment is returned and reused. DH had an ankle problem and needed a boot. It was $100 to pay cash, insurance would have billed us $350 or we could borrow for free. He borrowed for free for a week. There were people borrowing wheelchairs that were 10+ years old. Obviously must have been good quality ones when purchased but in good condition because they had been looked after.

@Julie8008

People dont bed block for fun Hopefully not, but if they are able to be discharged and cant be, then a charge should be made against their estate for the full cost of their stay in the NHS hotel.

And if they can't be discharged because there isn't a care package in place? Why should people pay to stay in hospital when it's not safe for them to go home? What if they discharge themselves anyway, go home, have a fall and end up back in hospital and costing the NHS more?

Lots of people have NO estate. That is why they are still in hospital because a home that accepts local authority funded patients can be hard to find. If you are self funded you pay more so it is much easier.

oliversmummy Totally agree with you. Another example I have seen is women being pushed to have a vaginal birth when their labour is slow to progress and lack of epidurals to help manage pain. The result is a load of women left with MH and urinary incontinence issues which are far more expensive to fix when compared to the cost of a CS delivery.

With my own father they have now spent multiples of what the cost would have been if they had acted on the results instead of passing him between three different trusts and trying to stick him with a second life limiting illness so they could justify not giving treatment.

Meanwhile I have 2DC with autism. Looking to move back and the lack of private and public healthcare in this area was why we declined the move. Our tax bill would have been over £300k a year. We would be sending our DC to private school paid for independently. If the UK wants to attract the best immigrants we need a healthcare service that works. The NHS is completely broken.

I see a number of people on here pronouncing about things they obviously do not understand.
Sorting out social care would make a massive difference to the NHS. The NHS picks up the failings elsewhere. Lack of social care means people stay in hospital longer. Lack of mental health care means police bring people to A&E who are psychotic. Lack of GPs means people turn up at A&E with things their GP should be treating.

Although I disagree with her a little re: supplier costs as they are BONKERS and it does seem easily solved!

Takes time to check out multiple suppliers for quotes every time you need to order something. I know locally our Health Board seems to have cut back on admin staff so I would guess they don't have anyone to do that.

mirime That's why you normally have centralized procurement. As an example, Tesco will negotiate a contract for supplies for a certain time period at a fixed cost, normally low because of the volume purchased, and each store will order in their supplies under this contract. The NHS doesn't do this. Each trust can order independently from whichever supplier they choose which drives up costs because you don't have the volume discounts.

Massive underfunding since 2010. Jeremy Hunt can lie all he wants about having more money than ever, but the facts on the ground don’t bear it out. My Trust overall has to save £50m a year, £8m to avoid fines for being in deficit. Where I used to work in maternity, the delivery suite alone had £2.3m cut from its annual budget. We’re no longer allowed to provide sanitary towels or nappies, we have to ration inco pads. We have to buy our own pens! We even had an email asking if people could hunt round cupboards for pillows. You could think it’s a lone problem in one Trust...but 80% of Trusts are in deficit. The only ones that aren’t are in affluent rural areas like Devon. It’s not a case of throwing limitless money at it either. As a % of GDP we spend hugely less on healthcare than most OECD countries. Apparently we don’t have £20bn to rescue the NHS but there’s money for Brexit, Trident and the DUP.

Sure, people going to A&E with a cold don’t help. But that’s small fry. The underfunding of health care and, in elderly care, the knock on effects of cuts to social care are what’s killing us.

I don't think the NHS is underfunded. I think the problem is that everyone is trying to cut corners and save pennies when if they spent a few minutes more and actually listening to and treating the person as a whole instead of one symptom at a time.

Over my life time i would think the NHS has wasted £1million on me by not listening or treating me but treating my symptoms, one symptom at a time.

Now multiply that with say 1 in 10 or even 1 in every 100 people and that is where the money is going.

DD was bed blocking for 4 days because they were testing her for all sorts of stuff. Instead of listening to her.

@Want2bSupermum I get that, but things aren't done like that.

The organisation I work for works closely with the Health Board, there used to be a lovely part time admin worker I had a fair bit of contact with, she used to have to buy her own notebooks and pens and used to come to us to do photocopying and this was ten years ago. She left and wasn't replaced.

People giving their time up for free wouldn't be offered a tea or coffee because of the cost, which I always thought was terrible.

Tbh I don't see an excess of managers and admin staff, and those I know are doing their canned best to improve services in the face of continued lack of funding - this is mental health services, so a 'cinderella service' at the best of times.

Damned not canned. Autocorrect fail!

Failed discharges/readmissions cost more than bed blocking.
Thats why you cant force people out of hospital if their care/housing isnt ready/adequate. So no to fining! False economy

Agree that sometimes cost cutting leads to more cost in the long run. Cutting of social care is an example of this. My DF stayed in hospital for 4 days longer than necessary because there is a shortage of staff to sort out care packages and visit patients homes to assess them. Also not paying staff enough and having poor working conditions, means paying high costs for agency staff.

I was admitted as an emergency not long ago to hospital. Another patient who had been discharged had just been readmitted by ambulance. The hospital wanted to discharge me on a Sunday. Another patient said to me she could not believe they were going to discharge me in the state I was in. She went and spoke to the nurses. The nurse came to my bed and asked me if I felt the same, I said yes, I could not manage at home alone and my partner worked long hours and would not be there. I had also been told at A&E that I would have to stay in hospital until my results on a test were at a certain level, and they were not. The nurse said they would not make me go and I stayed another night, although I was treated as an annoyance. My test results were much better the next day and I was happy to go home.

I think that ward were discharging people too soon. I was in hospital because with my low test results I was at risk of collapsing any dying.I needed someone there to monitor me, not to be at home alone for 12 hours. I had told them I would be alone. My DP is self employed and if he had not went into work that day, could have lose his main contract. I had been off ill for a long time and was not getting paid, so we needed that money. I guess if we had been a nice middle class family he would have stayed at home and I would have been fine to be discharged and made sure he was with me. I live close to a hospital so could be readmitted quickly.

The NHS problems are many but lack of long term planning is one of the most serious. Population demographics would have predicted the numbers of elderly people with long term health complications needing health care years before it hit crisis levels. Politicians who control the NHS purse strings choose to ignore them as it would involve difficult and unpopular decisions and not win them any votes. Firefighting seems to be their preferred method of dealing with the NHS by politicians and I don't expect this to change.

Also there is amongst some users an incredibly entited attitude towards the NHS. The number of people we see in receipt of DLA who could use but refuse to pay for a taxi to an appointment but want us to organise hospital transport for them. Others also getting DLA want us to supply them with nappies, baby feeding bottles, paper towels, micro tape which they then use to repair their curtain rails sadly the list goes on.

All those who say making nominal charges for NHS services will be the end well seems to work ok in other Developed countries such as Scandinavia and Japan and you don't see people dying on their streets. In fact the health of their populations are better than the UK probably because there is an incentive to look after themselves. Research shows services which are given free of charge are abused and misused and paying even a nominal sum increases their worth to the user.

IMHO If we want the NHS to continue to be free at the point of use it'll have to trimmed right back and concentrate on core services and other treatments will have to be charged for. Unfortunately the NHS is the ultimate money pit give it more money and some group will demand an expansion on services. For example this morning an the British fertility group wanted the NHS to collect, freeze and store the eggs of female teens transistioning to males in case their gender reassignment treatment (on the NHS) made them infertile so if they were later on they could have IVF (on the NHS).

Has Jeremy Hunt had the balls to do the live debate with Ralf Little yet?
Ralf Little on twitter pulled apart Hunts facts and figures and Hunt claimed Ralf Little was being rude to him but Ralf was just stating how his statistics were wrong