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?

Alcohol is also a factor in diabetes, kidney and liver failure, mental health issues etc but no politician would dare to say pubs should shut down and alcohol should be rationed!

I agree crunchymint & obviously there are a number of socio economic factors which influence people choices. I strongly believe the NHS should remain “free”. But we can still try & take some responsibility be it wearing a helmet when cycling, alcohol consumption, refusing free paracetamol & buying it ourselves etc.

More funding can only work if the NHS is completely dismantled and rebuilt. At the moment it is a bottomless pit.

I wonder whether one option would be for the NHS to charge for non-essential healthcare. For example I would like two of my DCs to have operations: one needs a prominent scar revising; the other has a bad squint. Neither of these will be done by the NHS so I have to go private. But I would rather pay for an NHS doctor to perform the operations in an NHS facility than go to a private hospital if that was a possibility. When you add up the cost of laser eye surgery, cosmetic surgery, dental care, physiotherapy, etc. it could be a useful source of income for the NHS.

The thing is even if we 'solve' the obesity/alcohol crises we'll still have an ageing population who are living with chronic illness.

It's not just Drs and nurses we are short of. We've had an embargo on a&c staff for a few years, clinical staff are having to pick up more and more admin. The admin is ridiculous at the minute - driven by a performance and target driven culture of reporting. The level of gov reporting is immense and takes resources away from patients- but we have to constantly prove that we are going a good job.

Girls Yes, the lack of GPs and doctors may well need addressing, but we absolutely have to aim for surgeries being open 7 days a week. People are ill 7 days a week, but GPs are only available for 5 - immediately, you're on a backlog. Then hospitals have almost no doctors at weekend (as I discovered twice recently).

You can't have a society and a workforce that is generally operating 7 days a week (Sunday trading came into being in 1994) and still continue a predominantly 5 day a week medical service.

If gps surgeries are open for 50 hours a week 10 hours a day now, a 7 day Service just means they will be open 7 days a week, 7 hours a day. It won’t increase the amount of appointments available because there are not enough gps.

Quirkyturkey I would favour a contributory system.

People look to the US and say their system is a disaster and we're so lucky here. But most countries in Europe have some form of contributory system. And, incidentally, better healthcare outcomes than in the UK.

You can't have a society and a workforce that is generally operating 7 days a week (Sunday trading came into being in 1994) and still continue a predominantly 5 day a week medical service.

Yes, none of my GPs at my local
surgery work full time which also means you don’t have your “own GP” who you can build a relationship with. There are definitely not enough consultants in hospital at the weekends which also leads to a delay in discharging.

Every other European country with better health outcomes pay more for their healthcare. We do not pay enough.

Popcorn I just received a letter from my surgery telling me that my GP was retiring. My new GP was Dr Name who would be working Wednesdays and Thursdays. Let's hope I don't get ill on a Friday then.

Fruit As I said earlier, yes we need to address the lack of GPs, but we have to aim to moving to a 7-day a week system. We just have to.

I agree crunchy but I think it’s a question of how much.

I think the government should bite the bullet, tell the companies that have the PFI contracts that £x amount is what will be paid to end the contract and then enforce it. If the Trusts weren't paying the PFI costs, then money would be saved, If they could shop around for suppliers, or the govt set a limit for what would be paid, then money would be saved.

I think that perhaps we need to start looking at the cost of prescriptions. I'm in Belgium, and we pay full whack and claim it back vis dh's health insurance which he and his employer both fund. I am constantly astounded at the differential between cost of prescriptions in the UK and what the drugs actually cost.

Exactly crunchy!

We have an incredible shortage of GPs nationally with many vacancies. Where there are no vacancies such as in my area, you can get seen the same day or at most the next day. We do not have enough people willing to be GPs. So we have to make it more attractive.

Jeremy Hunt was on Jeremy Vine BBC2 today. What an absolute git he is. He was praising the fantastic staff of the nhs who go above and beyond their job descriptions every single day. And one again....we’re ALL living too long! What an insult to our elderly. No wonder they’re treated so badly....there’s no respect for the. At all and they’re made to feel a burden. We knew this ageing population was coming so, the Govt. cut council funding for social care. Makes total sense, doesn’t it. We know there’s a lack of trainee nurses so, we made it even less attractive by doing away with pay, then bursaries and now even that’s going. And staff shortages? Let’s see where we are in the winter of 2019, shall we?

I was a nurse for 26 yrs. I’m now retired but nothing would make me want to go back in, even if I could.

Instead of tax payers bailing out banks/failed businesses/Richard Bran son and Chris Graylings transport disasters, we, as the funding tax payer, ought to have a say in what we spend our taxes on. For instance, didn’t we spend 8million on George Osborne’s (it was Joanna Lumbley’s project) garden bridge? Now scrapped! We, because it’s OUR money, should get a Statement every quarter in what this Govt spends our money on. They rarely have to account for it, at all.

Heads should roll for misuse of funds/job failures....like in any ordinary job. Instead, the British Tax Payer throws more and more cash at what this Govt considers a priority.

Oh dear....bit of a rant but...Jeremy-fucking-Hunt. See how you feel when your 78yr old mother’s knee operation has been cancelled 3 times.

No, we don’t have to. It’s a primary care service designed to manage long term conditions and triage the need for hospital appts. What we need are more nurse led services eg urgent care centres and walk in centres so those that need triaging the same day can be without clogging up GPs.

shatners A lot elderly people I’ve dealt with really like to see the same GP. I’m not fussed but I guess if I had a chronic condition I would want some continuity.

Crunchy I said earlier, if people want a decent service, then it has to be paid for and I believe it would be a MINIMUM of 5 p on the basic rate of income tax. The knock on from that could cause problems in other areas. This is why it needs to be a more radical solution of BOTH increased taxation but the NHS focusing on life-threatening and life-limiting or conditions that impact your day to day ability to continue productively. Fertility treatment is just one area that has to become "if you want it, I'm afraid you pay for it".

30/40 years ago operations wouldn't have been offered to anybody over the age of 60. Why? It was assumed they wouldn't survive the surgery. That isn't true, I remember my gran having surgery when I was 13, I'm in my 60s now. Maybe some operations wouldn't have been offered and I know when kidney dialysis machines were in short supply in the 60s that age was a factor in who got treatment.

30 years ago my MIL had a hip replacement and she was 70.

Yes it is not true. Just as today, people were assessed as to whether they would survive the operation and medically benefit.

NHS needs, I'm afraid, to focus solely on life-limiting and life-threatening surgeries. It's doing things it was never designed to do, nor should it, in my view. Sorry, unpopular as it is, treating life-threatening illnesses or conditions which have serious day to day impact on leading a normal life outweigh things like elective surgery ... What do you mean by elective surgery, though? When they're talking, as today, about cancelling elective surgery to cope with the flu crisis, they're talking about things like knee and hip and cataract surgery. Non of these are life threatening - if you don't get your knee surgery, you'll still be alive in a month's time, still in pain, but a little less fit and a little less able to be economically active.

What we need are more nurse led services eg urgent care centres and walk in centres so those that need triaging the same day can be without clogging up GPs

That’s a good point. They have just closed our local walk in centre which I tended to use as it’s hard to get an appointment at my GPs. The walk in centre was open on weekends. Since it’s closure the GP only offers appointments Sat 9-12.

meredinto I said, as you highlighted "OR conditions which have serious day to day impact on leading a normal life". That would clearly include knee, hip and cataract surgery.

If you cancel all those kinds of surgery, you simply increase care needs. My dad has had cataract surgery on the NHS. Without that his sight would have progressively got worse. He cares for my mum. When he was no longer to care for himself, there would suddenly be a tax burden of two people to care for - they are poor and do not own their own home. Similarly with things like speech therapy - massively impacts on people long term to be able to lead decent lives including working.

There are very few surgeries that don't contribute to this. Basically you are talking about fertility treatment.

Agree though that the expectations on mental health services are unrealistic. Those with severe mental health issues need better treatment than they are getting. But I don't see how we can begin to meet needs of the younger generation who have much higher levels of anxiety.