[quote jacks11]@BovaryX
The NHS has failings. God knows, I work with them daily! A LOT is related to funding, rota gaps, and quite frequently being used as a political football with periodic meddling for positive spin. There is the issue of politicians promising the NHS can be all things to all people, can provide better/faster care with less funding and fewer staff. There are issues related to lack of preventative medicine.
I know the NHS is not perfect, but as we spend less per head of the population on healthcare; have fewer HCP per patient; fewer hospital beds per head of the population; fewer laboratories and do lower baseline levels of capacity for testing of all kinds; less diagnostic equipment per patient, and so on, than many developed nations, it is only to be expected that waiting times are longer and outcomes are poorer in some countries. I’m not wedded to the current funding model bring the only way, but other ways do have their issues too (I have worked in both Germany and Australia, the latter for a relatively short period of time, admittedly).
FWIW I found the “clap for the NHS” unnecessary- especially every week.
With regards COVID, there are many things the NHS should have done differently. There were clear warnings/areas of weakness shown when the simulated pandemic” was run a few years ago. Those areas were not addressed at a national level or at a regional one. PPE and the “just in case” contracts we had with Chinese firms was just the tip of the iceberg. Don’t lay those failures the door of the workforce. That was a political/dept of health decision, as was the failure to implement changes to address the issues raised by the simulation.
Another issue was that the UK very clearly an issue with the fact that we had a SARS plan- one which very closely copied and successfully implanted by Singapore- but did not implement it initially. For as yet unclear reasons, the powers that be initially implemented the influenza pandemic plans, belatedly switching to a plan which had only a semblance to the official SARS plan. This meant that everything related to Covid was rushed. GP’s surgeries were given less than 24 hours notice of the sudden change to the locked door policy, for instance.
When you take into consideration that many areas (mental health, for instance) are underfunded, when many specialties or areas do not have a full complement of staff (whether that is medical, nursing, allied health professions, cleaners, admin or laboratory staff) with waiting lists extending even before Covid due to some of these problems- it seems more remarkable to me that more people do not fall through the cracks.
When you put a system into chaos, it is hardly surprising that things don’t always run smoothly. The NHS has been required to run 3 parallel services within the same hospital, further stretching staffing and reducing the number of beds.theatres etc. That was a decision taken at a national level, not by individual clinicians like myself. I am actually working more hours than usual. The last few months have been the busiest and toughest I can remember. Many of our staff have been significantly affected by what they’ve dealt with and some are on their knees (leave having been cancelled initially and still not caught up).
None of this is a defence for individual malpractice, local inefficiencies or failures. Nor is it an excuse for cases of poor care- for those affected it is unacceptable- but i hope that it may be (part of) an explanation. Which is what I was actually trying to explain- it is obviously far from acceptable that cancer treatments are not being carried out in some areas, or that patients such as hearhooves has been deemed an urgent case but has still not been seen. Though in the latter case perhaps it’s less of a systemic issue and a local failure, I can’t say- but it is inevitable that a system already under strain, thrown into chaos by the pandemic, has not delivered well for all patients.
If we don’t understand where the problems are and why (and very little is due to sheer laziness IMHO), then how can we even begin to address them? But, equally, let’s not pretend that there are not good things about the NHS and many patients who do receive excellent care.[/quote]
I am not unsympathetic to what the nurses and drs have been through. I still have friends in the NHS - I know what's gone on but as ever, the biggest issue is with the NHS refusing to accept responsibility for what's gone wrong, like multiple cancelled appointments not being re booked or the inability to realise that asking patients to observe clinical features and then describe them accurately over the phone is not without grave risk.
I am totally sympathetic to pressures that clinicians are under - I suffered a serious injury due to a complication during a procedure. In my view it was a recognised potential complication, it wasn't due to negligence, it was compounded and probably caused by another condition I have. The Dr blames himself but I never have and ice repeatedly told him that. There wasn't anything he did wrong, it just happened.
Now though, not having a system in place to stop patients getting lost to follow up, not even having staff to respond to patients who flag up forgotten appointments, not being able to assess urgent patients - that isn't an uncharacteristic error, that's a system failure and people should be held accountable.