To think its time to reform the NHS

[ScreamingLadySutch]

There was a brilliant post on a dog who is telling H there is something in his abdomen, but I didn't want to derail it.

But someone talked about access to the GP: "Good luck. We get the Spanish Inquisition from the surgery receptionist whenever we try and book appointments. You could tell them you have blood dripping from your arse and they'd still be reluctant to give you an appointment. I'd love to see how they'd respond to "my dog keeps sniffing me"."

• which is why the NHS needs to be reformed. The NHS is a socialist construct. Therefore, the provider 'decides' which supplicating peasant is worthy. That is what socialism does (The State will Decide), and it doesn't work!

If the provider is linked to the consumer, then the whole system gets more responsive. In capitalism, if a service is not provided, the provider doesn't get paid. Its forced altruism.

I don't know why the British treat the NHS like a religion (Do Not Question God!!!). It is complete brainwashing. Reforming the NHS to create this link does not mean privatisation (I was hospitalised in Germany and the whole thing from X-rays to overnight stay cost me Eu37 - and they don't have the NHS structure). Nobody longs for the days when there were waiting lists for telephone lines before BT, do they.

Well it probably needs reforming but not in the ways you dedcribe. Love a bit of socialism me.

Btw...there are plenty of private hospitals in the uk..why bother with the nhs if it irks you so much?. Get health insurance.

The problem is lack of available appointments.

I've seen other threads on here including one where it seemed the OP was having an ectopic pregnancy, where people can't afford to seek medical care, that's why. Piss off Farage.

How about instead of 'reforming' it we adequately fund it for the first time since its conception

The NHS glaringly needs reform, but every reform that involves consultants and consultations simply seems to add another expensive layer of middle management, taking away funds and power from front-line caregivers. And no politician wants to say “Sorry folks, no more IVF, replacement knees or bariatric surgery” or whatever, because it’s political suicide.

What EssentialHummus says. Each layer of management just seems to make things harder for front line staff as you inevitably have to compromise between providing a good service for patients and pleasing managers.

The NHS does a lot for the money it receives. It has been damaged by constant structural changes that don't actually improve services and the introduction of internal market forces that just cost more to implement
I've been treated in both private and NHS and the treatment was far better in the NHS hospital. The room and food were nicer in the private but the aftercare was shocking
No recovery room just put in my own room after an op.

I don’t think I have been brainwashed by seeing the NHS save my dd’s life on several occasions. She has received open heart surgery and amazing after care which will continue for life. She has seen the inside of a hospital more times than I care to think about and has always had the best care. I have never had to think about money at all which I am eternally grateful for. I watched an American tv show yesterday where a child had had a heart transplant but became very ill afterwards because his parents couldn’t afford the £9k a month anti rejection drugs.

I agree the nhs needs to change, it's not fit for purpose anymore, under funded and short of resource. But it's such a hot topic no one with the pull to do anything about it is willing to.

The country and population has changed so much since the conception of the nhs that the system simply doesn't fit.

As controversial as it is, I also believe that ivf should not be offered as an nhs service, anyone wasting nhs resources should be charged for it (as in missed appointments, hoax 999 calls), the 'free' medicine for children should be scrapped and any elective surgery be made chargeable.

The receptionists have to triage appointments up to a point, nobody is asking them to do nurse or doctors work.
When you ring in for an emergency appointment you only have to give them brief details so they know whether to refer you to a doctor or a nurse. It's just more efficient.
An awful lot of patients at my practice ring in for an emergency appointment for a routine check that could wait a week or two.
I don't work at the practice but I've heard them having a minor seizure at reception wanting to be seen "now" for their problem which should be in a routine app slot.

Because when the NHS is contracted out to private providers (like Virgincare) - it is a stinking shit show. We must not go down this route.

The last thing the NHS needs is to become any more capitalistic.

Do people seriously think receptionists refuse to give patients appointments for shits and giggles?

Many clinics are rammed full of ill patients and not enough slots. The receptionists or appointments team just get told "you have to manage these clinics efficiently" and don't want to know that the maths simply doesnt work

It needs to be properly funded and for actual medical people who work with patients to have a much greater say in what the hospitals, staff and patients need.

I never understand why we have people with no front line/no experience in the area at all taking charge and making decisions about such things. Same goes for education etc. It’s madness.

I can now book routine appointments with my GP or practice nurse using an automated phone system or online, so obviously don't have to give a reason.

If I wanted a same-day appointment, I would have to speak to a receptionist and I would always volunteer the information about why I needed an appointment that day. I have never been refused an appointment on the day, but then I only ask for a same day appointment if it is really necessary (and I think I've only ever done it when very worried about elderly relatives or (when they were young) my children. I imagine many people ask for same day appointments when they are not really necessary, so receptionists are told to ask for the reason.

It needs investment. Not another reform. It’s constantly being reformed, by each new political party-costing loads, achieving nothing but more managers.

I think the biggest issue is the lack of joined up care.

Ds is under multiple trusts and the communication between in shocking. I have three different points for medication ordering.

He is under two different people at CAMHs - both are classed as different trusts so neither can access the full notes of the other (or other linked information)

Our front line care is generally spot on. It’s the background stuff which for us let’s iy down

It needs actual doctors and nurses. The reason people can't get GP appointments is because there aren't enough GPs. There's something like 40k nursing vacancies. DS2 is a nurse, he lives away. He was home for a few days a couple of weeks ago and his phone was constantly going off with requests for him to go into to work. He'd already done 5 long days that week. The NHS will crumble if we don't start treating the staff better, and that means receptionists too.

The NHS is being constantly reorganised, that's the problem. Its organisation and funding are constantly being messed up by politicians so there is not enough consistency and too little time to properly embed change.

I agree that some areas could be reviewed to save money. I can’t afford private medical care, but could afford to pay £25 to see a nurse/doctor and I’m sure there are many others who also don’t need the service to be free. If a charge was introduced to see a nurse/doctor for each new medical condition (i.e. the Dr recommends further medical appointments these wouldn’t be charged for ongoing conditions) it would prevent people wanting to see a Dr for sniffles and sore throats, and cut NHS costs. Of course, this would be salary dependent and no one requiring medical treatment without funding should be turned away.

Another example is free contraception! I’ve purchased my own contraceptive pills (approx £50 a year) for years, as I don’t feel like I should be asking the NHS to provide it for free ...

The NHS was set up to provide simple care, not the massive increase in procedures now in existence.

The practice near me puts up the numbers of people who do not turn up for appointments, this is one reason for waits to see a GP. More money will not solve this.

The sacred cow of free at the point of delivery is the problem, the person who quoted the small cost she paid in Germany is an example, I don’t think healthcare is ‘free’ any where else.

If the provider is linked to the consumer, then the whole system gets more responsive. In capitalism, if a service is not provided, the provider doesn't get paid. Its forced altruism
That’s what payment by results was which the NHS was funded by for most of the late 90s/2000s.
It didn’t help just created false market of competition and a whole industry to move the money between commissioners and providers. We spend loads of money each year pushing the money between different NHS entities and squabbling about which bit is going to pay. Would be better if we just went back to block contracts imo. Ie this is your budget don’t spend it all.

the 'free' medicine for children should be scrapped and any elective surgery be made chargeable.

But then children may have to go without because their parents can't afford the medication; and elective surgery becomes for the well off only.

I think more stuff should be means tested. Ivf, means test it. Prescriptions, means test, elective surgery means test it.

I also never understand GP emergency appointment. A GP isn't for emergencies, it's for minor and routine appointments. If you have an emergency go a&e.

What they actually mean is on the day appointments, i.e needing medication that day, ointment, antibiotics or whatever. And stuff that can wait a bit.

Another way commissioning fails the patients is you only get paid for care if you follow workflow which is there to serve the commissioners not the patients . Eg GP refers patient for to specialist A but specialist A says they need to see specialist B. If specialist A refers direct to specialist B the hospital doesn’t get the money so they have to send back to the GP to refer the patient to specialist B because it’s been decided only GPS get to decide which specialist they go to because they hold the budget. Waste of time for all concerned. Thanks Andrew Lansley.