To think the NHS will eventually have to be privatised ?

[Felixsmama]

When the NHS was founded 1 in 2 people died before the age of 65. It's now 1 in 8, the last 10 years of people's lives can be spent with multiple co-morbid conditions which are expensive to treat and keep under control. The NHS wasn't designed for what it's not having to do, we have an aging population. Shouldn't we start to have conversations about what going forward our health service should look like? There's multiple models not just the US one.

Yes I'm very familiar with the costs of this kind of infrastructure project which is why its so bloody frustrating when the fiefdoms refuse to cooperate or work together even on basics which massively hikes up costs.

Each fiefdom doing its own thing, often providing a mish mash of small providers because they looks cheap up front but lack the ability to turnaround a complex piece of work. So a series of cheap bodge jobs happens. I've lost count of the costs I've seen burned by bad decisioning on IT in the NHS, usually because the areas flatly refuse to work together and each insists its too special to share. The degree to which basic data entry is still manual is shocking - and causes errors in records regularly - its not just because hospitals have insufficient cabling (and tbh, cabling, like plumbing and water should be part of infrastructure and attract dedicated funding). Of course its always easier to blame providers and delivery partners than bad management.

Your point about Derriford making appointments work so why can't others is a very good one. Why can't they? Its evidently not a cost reason if some can run good appointments systems and others treat patients as an inconvenient obligation.

Around here the standard model for appointments is the same as that described by @Kazzyhoward - everyone rocks up at 9.30 and you sit there, sometimes all day, waiting to be seen. Because obviously patient time is of no value or importance. You have to arrange school pickups and pay for parking, cover for work, lose a day's pay as if you were going on a day trip somewhere.