Do the general public know how bad the conditions in the NHS are?

[Gakatsbsk]

Hello

Expecting to be roasted.

However, I’m an NHS staff nurse. Qualified almost 2 years. I’ve worked through the pandemic. I initially worked in England and now work in a different UK nation - which is better but only because England was so poor.

My union is about to start a consultative ballot for industrial action in light of the nhs pay offer. I have had two family ‘acquaintances’ (who do not work or have immediate family that work for the nhs) complain in one breath about delayed appointments, delayed A+E waiting times, cancelled surgeries etc but then in another tell me that nurses going on strike is disgusting, lucky to have a job, NHS more secure employment etc. These are of course English Tory voters who said this

For reference, I have never and will never cross a picket line and will be voting in favour of industrial action (whatever form that takes due to emergency cover staffing etc).

When I was a few weeks qualified as a nurse I was looking after double the safe ratio of patients in my speciality. Completely unsupported, me and my (equally junior) colleagues having to consult google for solutions to our patients problem, if a medical emergency occurred (in ICU there should always be medical cover - this isn’t the case) we had to pull a buzzer, put out a page and get on with it until a medic appeared. This has not improved post pandemic.

In my current workplace (same speciality area), different country we are the only part of the hospital that is safe staffed, because of this every single day nurses and HCAs are sent to general wards, A+E and different hospitals often to be the only RN on a ward for 30 patients. There is such a crisis of care home beds, and ward beds that patients are staying in critical Care for weeks waiting on a ward bed. On the wards patients aren’t able to be washed each day as there might only be 1-3 staff members for 30-40 patients, meds rounds take 4 hours and ultimately patients who are sick go unnoticed until they are peri arrest. Nurses from day shift often have to stay on to night shift as there is no night shift nurse available.

I have only had negatives from the general public - it’s our fault for having degrees and being too posh to wash, bring the matrons back, etc etc. our colleagues who trained in the 80s and 90s pre degree say it is the worst it has ever been for safety and staffing. Racism and xenophobia towards our brilliant overseas colleagues is rife when they keep the NHS clinging on by a shoestring.

Four and a half years ago I was a first year student nurse and times were hard for the NHS, it has only got worse and worse for my patients since then. For the sake of my patients I will take industrial action.

However, it is so concerning how anti union, anti public sector and pro Tory the English public seem to have become? The decisions and government of Westminster negatively affect every nhs patient and worker in the UK. Just look at the widespread abuse, disdain and disgust directed at the RMT workers recently. I fear the same or worse for NHS workers.

So, is this NHS worker wrong for not enjoying being told to be grateful to work for the NHS? Is there any future for the public sector of the UK?

I apologise if I seem to have generalised England but I am English and from a northern Tory heartland. An area completely brainwashed.

@Windypants21 clearly you didn't think about the words and their meaning in my post. If GPS were as bad as that in a particular practice what stopped you from formally reporting them or raising a grievance?

I work in retail, which was a fucking apocalypse over the pandemic (which is rarely ever mentioned, even though these staff mostly do earn minimum wage and a lot of staff have signed a WTD waiver so there are many times where I work until 12am and get up for work again at 5am)

@puffalo that's not legal. You can opt out of the maximum 48hr week, but not out of the minimum 11hr rest.

But @TiredNHS is calling middle and upper class families “entitled” for expecting social workers to do their job, as per the law! Nurses are complaining about how they have nothing more to give, they can’t be expected to do. overtime for free nor live on a 3% pay rise! Carers get paid what is it now, about £67 per week and only a state pension for providing care 24/7 with no respite usually, until they are driven into the ground? 3% of £67 per week is far less than 3% of what nurses get!

Carers are on their knees after Covid, when disabled children were frequently shut out of schools, as no staff to look after them; and day centres and respite centres for adults were all shut round here. What little support they did get all shut down, during Covid and they were left on their own to cope and yet HCPs criticise people for not wanting to sign up for this?

Let's just wait for the announcement that the tories want to privitise health care. Its all part of the plan. No doubt, brexit has further deregulated things to make this possible.

Chunks of it are already privatised. Our health board pays the spire to carry out backlogs. American companies are buying up our GP surgeries. retirement and nursing homes are being hoovered up by foreign companies, ditto dental practices.

Chunks of it are already privatised. Our health board pays the spire to carry out backlogs. American companies are buying up our GP surgeries. retirement and nursing homes are being hoovered up by foreign companies, ditto dental practices.

Very sad to hear

It's all about the money

I trained early 80's and hated ward work even then. Many many years later and working in District/private all sorts. I went back on the ward. It was 100% worse than I even remember as a newly qualified nurse in the 80's. It's not safe for patients and staff put their PIN on the line each day as you know when shit happens management will drop you in it and cover their own ass.
I left again and went to social care. better, but not great. Pay is better and hours too. But there are days it doesn't feel safe.

Chunks of it are already privatised. Our health board pays the spire to carry out backlogs.

I'd take our local Spire over the local NHS hospital every time. I'm afraid to say that the standard of our local NHS hospital building is more akin to a developing country.

I feel sorry for the NHS staff, it's a grim place to work and looks perpetually dirty inside and out.

I did. Meetings were held. Nothing was done, nothing changed, so I left.

Not all doctors are awful but within certain practices there becomes a culture of patronising and derisory behaviour. I have to get in the same telephone queue as patients even though I'm looking after their patients . This behaviour applies to all their staff, clerical, AHPs and of course nurses. I've been told to call back the next day....and on o e occasion asked to make a referral to me services, even though the gp was standing in front of the patient the day before, I would have had to drive 50 miles to do the referral. I'm long enough in the tooth to not take this kind of nonsense...but it was a telephone battle to get them to see the error of their ways.

I am regularly tutted at because it is inconvenient for them to have to deal with a sick or dying patient....their patient. They conveniently forget though that every other possible measure has been undertaken by nurses before it gets to the point where we have to call them. Most nurses hate getting Gps involved because theyre impossible to get hold of, frequently they don't know what they're doing, don't want to do it, or both. Although most recently any complex case is dealt with by just sending them to hospital which of course just blocks up the system more.

My friend who works in A+e gets shouted at by doctors, not due to her incompetency but because she calls them out on theirs. She doesn't let them get away with treating her badly and thankfully some of the other doctors will reprimand the offending doctor for doing so.

I will never condone shouting at patients and I've been confronted by some challenging patients but I will stand up for myself due to the abuse and attitude of some patients which has escalated exponentially through covid.As a colleague once said we are here for the convenience of the public but we are not a public convenience.

The strike hasn't been voted for yet, and loads of harm is being done anyway, with plenty of preventable deaths. By striking they may draw attention to the need for the system to change and save more lives as a result.

NHS staff aren't working in a free market. They're beholden to a monopoly employer who can abuse that position. If there was a free market in healthcare, staff would be treated much better.

The NHS itself would also function much more effectively if it were one of several authorised healthcare providers operating on the market in competition with each other.

At the moment, quite a large number of people have no option but to pay for the NHS through taxation and then pay again privately if they need something to maintain their quality of life, such as a hip or knee replacement done within a reasonable time. On that basis, it must be one of the most poorly performing healthcare providers in the developed world.

I have a somewhat different experience. Not regarding the terrible state of the NHS I absolutely agree with what you say about that. Where we differ is that everyone I speak to has always been respectful and grateful that I would work in such conditions. The general public who don’t come into regular contact don’t know all the ins and outs of course but I think there’s a good level of public awareness. I can also tell you that Labour were no better, during the Blair/Brown years, things deteriorated drastically. Since I qualified as a nurse in the late 90’s things have just kept going downhill. I’ve left the NHS recently, I couldn’t live with doing the bare minimum for people any longer.

And for those whose illnesses aren't cost effective to treat?

Providers will fall over themselves to provide the cheaper treatments and leave the more expensive and/or labour intensive treatments for someone else.

Forensic science was 'shaken up', exposed to market forces and now costs limit even the most important investigations

The FSS, a major player in training up forensic scientists and technical experts, is now a distant memory (closed in 2012) and there is little by way of training.

There is now a shortage of trained forensic experts, court going officers and technicians and police forces who have taken forensic services in house are now trying to train up staff.

How would the NHS be expected to compete, if it's hamstrung by training costs, more expensive procedures and the medical dregs who aren't suitable for cheaper treatments or drug courses.

@AchatAVendre

The NHS itself would also function much more effectively if it were one of several authorised healthcare providers operating on the market in competition with each other.

What evidence is there for this?

Case 266/84, British Leyland v Commission [1986] ECR 3263 [1987] 1 CMLR 185

Case T-299/94, Deutsche Bahn AG v Commission [1997] ECR II-1689 [1988] 4 CMLR 220

Case T-288/97, Irish Sugar plc v Commission [1999] ECR II-2969 [1999] 5 CMLR 1300

Case 27/76, United Brands and United Brands Continental BV v Commission [1978] ECR 208 [1978] 1 CMLR 429 paras. 91-94, 122, 161, 189

Case C-62/86, AKZO Chemie BV v Commission [1991] ECR I-3359 [1993] 5 CMLR 215, para. 60

See Case T-201/04, Microsoft Corporation v Commission, case on appeal before the ECJ; not yet reported, cf Commission Decision of 24 March 2004.

Case 85/76, Hoffman La-Roche v Commission [1979] ECR 461 [1979] 3 CMLR 211, para. 41

Case C-52/09, Konkurrensverket v TeliaSonera Sverige AB [2011] ECR I-527 [2011] 4 CMLR 982, para. 22

Case C-457/10, AstraZeneca AB v Commission, ECR II-000 [2010] 5 CMLR 1585, paras. 242-254

I cant read them?

Are any of them health care?

I do sometimes get tired of non-lawyers asking for "evidence" as if they think they're the new Rumpole who has hit upon a genius tactic and should be entitled to detailed advice entirely free of charge because they demand so in one sentence on a social media discussion group) but thats the standard Article 102 case law on abuse of a dominant position in competition law which forms the basis of evidential discussion into the merits of the issue in the medical or similar sectors. You have to read the case law or at least the highlighted passages in order to understand the thinking behind the dangers of market dominance and lack of competition on the market. If you can't digest the case law then at least read the formal sources of law themselves, beginning with Article 102 and if you must, supplement it with an article like the one below. However, since there is evidence relating to specifically to the UK market, standard market evidence is what is relevant and the Dutch system based on the competitive various ziekenfonds is a good place to start. They leave consumers free to abandon one scheme if they feel it under-performs and take their business elsewhere. The government guarantees minimum standards, including no increases due to ill health/accidents, etc, coverage of the unemployed, no exclusions and so on. Of course, the single market and four freedoms do not necessitate competing sickness fonds in favour of a good state provider because of the public health exemption but they do create the legal and regulatory environment where, if a state chooses it, it can set it up so as to benefit consumers. The Dutch system is a good comparator to the UK system as it is also one of the relatively cheaper ones in the EU.

read.dukeupress.edu/jhppl/article/46/1/49/166938/Applicability-of-European-Union-Competition-Law-to

You asked for "evidence". You got evidence. Evidence which is used in court cases. If you don't want evidence, then use another term.

You can read them, if you google the case names and the case number, you will find most of them through google anyway.

But why ask for "evidence" if you don't want evidence? Its a legal term.

The NHS is not a commercial organisation - it is a tax payer funded service.

Yes. It is poorly organised, inefficient organisation and that is, in part due to the part privatisation of some services and the bureaucracy associated with it - clinical commissioning, procurement, buying and distribution of goods and services.

It doesn't help all the money spent on painting rainbow zebra crossings, rainbow lanyards and pin badges. I don't give a shit who the staff are shagging, only the healthcare is important.

From the article (not a formal source of evidence, but of some evidential value), in the view of the biggest competition regulator in the world, the EU Commission:

"The analysis conducted in the article reveals that private health care providers and private health care providers performing health services in a public health system are, based on the approach taken by the commission and the CJEU, considered to be undertakings for the purposes of competition law. Regarding public health care providers, the analysis revealed a complex and uncertain picture emerging from two different approaches taken by the commission and the CJEU. In the FENIN case, the CJEU established an “attenuated” functional approach, which departed from its previous “classic” functional approach taken in cases concerning private health care providers. ... In this light, the article proposes a set of principles or guidelines that would help determine if public health care providers should be considered undertakings for the purposes of competition law. The article proposes a two-step approach consisting of (1) separate classification of each activity performed by the entity, and (2) accurate assessment of both constituent elements that determine the economic nature of each activity or the provision of each type of health service provided. "

However, you are missing the point. I suggested that the NHS, in the future, become one of several competing healthcare providers in the British market. I would suggest that be achieved by people being able to opt out of it and use another supplier of those products, under a governmental regulatory umberella.

Another poster then asked me to provide "evidence" of it. Obviously, you cannot provide evidence relating to something which has not happened, so I interpreted that to mean that she wanted to see evidence of how the issues is dealt with in other countries, particularly because the NHS really sits alone as a national model of a healthcare provider and is an anomaly.

I've recently finished reading The Secret Midwife about a real midwife working in the nhs and how bad it's got. Was a real eye opener!