I think the NHS could be fixed, AIBU?

[Dreamer14]

i am inspired to write this thread after two events:

1. my kid needs to see a doctor for a face to face appointment. A part of her body needs examining, in person. I have tried the virtual GP service. They were useless. It’s also not possible to get a face to face appointment in my GP surgery without first doing a stupid phone appointment.
2. my relative has an infection. She’s had it before and knows she needs antibiotics. No one will help her. 111 say go to GP. GP say no appointments.

Surely we can do better than this?

Ideas I have;

• give people more choice about appointments… if it is inefficient to do a phone one let’s not force people to do it
• we need to open up more GP surgeries and hospitals
• We need a separate service for elderly people -so many don’t need to call 999 but have no choice as there is no help elsewhere
• we need to help mental health patients before crisis (watching Ambulance the other day, so many people calling 999)
• We need to get with the times… stop sending letters and start Emailing people. Or texting. The NHS IT systems and processes are shameful.
• payment for some services (I’m happy to pay a small amount to my GP)
• attract more people to NHS jobs. I’d love to work helping people. But I’m a mum of 3 and I can’t afford to retrain. Some of these jobs could be done on the job and salaried. I’m not gonna pay £30k to go to uni for 3 years to be a biomedical scientist.
• sort salaries out. How much do execs earn? How many woke jobs can we do away with?
• I think we should pick a few areas in the uk and trial different things In Each one. Then we can scale up if it works.
• strip it back to only crucial services. Nothing woke. If you want something doing that is beyond the list. You pay for it.
• I’m a supporter of people that want to pick when and how they die if they get given an awful diagnosis. There are many people that get diagnosed with terminal diseases and don’t want to suffer.

ultimately we need the government to spend more but we also need the nhs to spend better.

The obvious disease to mention in all of this is Type 2 Diabetes, which already soaks up 10% of NHS resources and which is only going to increase as the population obviously not you and me gets older and fatter.

You can build hospitals and surgeries and open more beds but if you do not have the staff to work in them they are just buildings and furniture.
The health and social care sector needs properly funding by central governments in line with the demands of an ageing population with increasing health needs.
The government needs to develop, commit to and fund a workforce plan. It needs to either pay cost of living bursaries for nurses to train and put in place some sort of system where student loans are written off after X years of service. We need more nurses and other HCPs - tens of thousands more, to even begin to solve the massive issues in the health & care sector.

I find it hilarious that anyone who hasn’t worked in the nhs thinks they’re qualified to say how I should be ran. It’s like me (a nurse), going into McDonald’s or PWC and trying to offer an opinion.

it is such a complex of issue and will never be a quick fix.

Dreamer14 the biggest factor would be people being responsible for their own health. Yes some ailments are unavoidable but most are self inflicted.

I didn’t know ageing was self inflicted?

common sense would tell you that’s why the poster put MOST in there post not all

MOST ailments are age related not “self inflicted”

Are people who train and qualify (e.g surgeons) via the NHS restricted from leaving for any period after qualification? I recently saw something on SM where a young chap in scrubs was gloating about qualifying and then legging it to Australia to forge his career the first chance he'd got.

See, past age 45 the per capita health spending increases rapidly.

@torquewench no, but one potential route the gov could explore if it wants to find a workable solution to the workforce crisis and erosion of patient services is to go down the loan forgiveness path where graduates work for a certain number of years in the NHS and then have their loans written off.
Why shouldn't the guy you mentioned, who paid for his degree with no gov support, take his skills and passion for medicine to another country that will pay him more and value his skills, potential and abilities, if he can't get that in the UK?
The problem is with the system, not the people within it.

I dint disagree with what youre saying, but why didnt the guy just pay for his degree and train in the country he's chosen to work in if he knew the NHS was a poor choice (I.e. less lucrative) to start with?

Do you have a source for this? What is the ratio roughly do you think.
And then what do you suggest we do about the age related ailments?
And what do you suggest we do about the self-inflicted ailments?

Two main things amongst others imo are social care - get people out of hospital

And population health - help prevent them going in

Discoveryreads, so smoking, drinking, drugs and obesity don't contribute massively to hypertension, diabetes, cancer and cardiovascular problems ? I'll think you'll find they do no matter how old people are. These problems are hitting people NOW in their forties, not those past three score years and ten!

This is bearing in mind the latest stats I could find which state it costs £230000 for the NHS to train a doctor.
Did this proposal come to fruition? (Genuine q as I honestly don't know)

www.gov.uk/government/news/more-undergraduate-medical-education-places#:~:text=This%20will%20increase%20by%20up,a%20return%20on%20this%20investment.

Not enough care workers, far too many EU ones left and many more are leaving to work in sectors that also have worker shortages.

Its a problem purely of our own making.

The problems with discharging medically fit people from hospital is shocking, as is discharging people who have care at home far too early.

Health improvements in the population take many years to come through, plus healthier people live longer... which brings its own problems.

No idea what Woke jobs are or woke treatments nor how much money these would save... probably SFA.

population health - help prevent them going in

Which means hiring people for some of these "woke" jobs that many comments here hate so much to run things like "stop smoking" campaigns or encourage healthy eating etc.

I think you would be hard pressed to say there isn’t chunk of drug,smoking and alcohol related conditions that could be avoided and place a big burden nhs they are nothing to do with age

The vast majority of type 2 diabetes is lifestyle related and avoided
type 2 diabetes takes up 10%of the nhs budget
also the thing is poor lifestyle choices catch up with you in later life
if you’ve been overweight in your 30’s the impact of this will present later in life
heart disease,joint/knee problems and diabetes nothing to do with natural ageing just a build up of the effects of poor choices earlier in life

I agree there is a chunk of lifestyle caused health issues, I just think poor lifestyle choices don’t cause MOST health issues or cause MOST of the costs to the NHS.

Even type 2 diabetes is more complex than you represent. Only two of the many risk factors could be lifestyle related. For example, a wheelchair user is more likely to be overweight and less physically active due to disability, not lifestyle choices.

You’re at an increased risk for developing type 2 diabetes if you:

have multiple gene mutations associated with type 2 diabetes
have a family history of diabetes
have been diagnosed with high blood pressure
are age 45 years older
are overweight
are physically active less than 3 times a week
have had gestational diabetes (diabetes while pregnant)
have given birth to a baby who weighed more than 9 pounds
have a low level of HDL, known as “good cholesterol”
have a high level of triglycerides
were assigned male at birth; people in this group are more likely to have undiagnosed diabetes, possibly because anecdotal evidence indicates they are less likely to regularly visit a doctor
have depression
have a history of heart disease or stroke
have polycystic ovary syndrome (PCOS)
have acanthosis nigricans

So there’s a bit of chicken and egg. Some people are obese and diabetic because they’re disabled, not disabled and diabetic because they’ve chosen to be obese.

There’s a bit of dammed if you do, dammed if you don’t. Athletes and physical labourers gets plenty of physical activity so diabetes risk is lower, but knee/back/joint/injury risks are higher. So really both good and bad choices all catch up to you with age.

Treat all ailments and stop trying to sort people into deserving sick and undeserving sick.

People drink, smoke, take drugs, over eat for many reasons. These things are the answer, not the problem.
You can't condemn people for having issues. You can't condemn people for not being able to cope.
It's a vicious circle. No mental health services, no support, poverty, misery, stress, more problems. If you can't help the root cause, you can't solve problems, just patch up people as best you can.
The NHS is on its knees. No staff, due to brexit, shit pay, pressure, removal of the bursary, underfunding, closing wards, hospitals, ageing resources, an ageing population. Its a mess in all sorts of ways, often the stuff that's outsourced, cleaning, food, maintenance...
I think it can be fixed, but it needs to start everywhere.

For example, it’s a slippery slope to decide what is self inflicted and what is not.

Breast cancer- choices that increase risk include, 1) overweight, 2) taking hormonal birth control, 3) taking HRT, 4) alcohol, and 5) being inactive.

How many women can hand on heart say they have chosen to always be a healthy weight, never taken hormonal birth control, never taken HRT, never drank alcohol and are always “sufficiently” active? And where do you draw the line between its “self inflicted” breast cancer vs, it’s not? Does a women get to choose 1 in 5, 2 in 5 and get a deserving sick so the NHS will treat you pass?

And this is ignoring all the other risk factors that cannot be avoided.
www.cancerresearchuk.org/about-cancer/breast-cancer/risks-causes/risk-factors

'The NHS is on its knees. No staff, due to brexit, shit pay, pressure, removal of the bursary, underfunding, closing wards, hospitals, ageing resources, an ageing population. Its a mess in all sorts of ways, often the stuff that's outsourced, cleaning, food, maintenance...
I think it can be fixed, but it needs to start everywhere.'

I guess this depends on your definition of 'fixed'. If you mean to continue to firifight through the crisis after crisis without any major restructure - yeah probably can do that. If you mean going back to the times when the were short on no waiting lists, enough staff, good funding, free healthcare for all possible health needs - not going to happen. We are heading towards a two tier system, some places going faster than others.

Lets agree to disagree but honestly there is a portion of illness that can be avoided
so rather than tit for tat responses
let say a portion of illness can be avoided ( we all have an opinion on how big or small it is)
so avoiding it would definitely have an impact on the health service resources I think we can all agree on that

The Govt has refused taxes on unhealthy foods, the car owning population, backed by Schapps, seem intent on getting cyclists off the road and supports getting rid of the last remaining leisure centres and sports fields for development.

So whilst improving the general health of the public might well, longer term, help the NHS, its not going to happen.

The NHS will sink further and further into the mire, i predict private ambulances will become the norm for emergency transport to private AE depts, this is the direction of travel we are heading towards.

Inflation at 10% will wreck the finances of the NHS, let alone the predicted 18% that may be the rate next year.

The UK has voted time and time again to wreck its own country and its relations with Europe.