To ask what can be done immediately to take the pressure off the NHS?

[Twinklenoseblows]

I've been reading stories about people waiting 4 days in A&E, people being taken into A&E in the back of a van with a broken hip as there are no ambulances ,and doctors and nurses pleading for something to be done right now as lives are at risk. But what can be done that would make a difference within the next week or two?

Promises of more money and more staff will presumably take years to filter through and make a difference.

I guess what is worrying me beyond the immediate crisis is that some bright spark in government is going to say we need a circuit breaker lockdown to reduce flu and covid admissions for the next few months to take some immediate pressure off. The thought fills me with horror so I'm hoping there is something else.

E.g. as a very short term measure could some people be diverted to make use of any spare private GP capacity to try to reduce the number of people going to A&E who could instead be dealt with by a GP if only they could get an appointment. Or is that madness?

Also tax rebates for private - used in some countries but outcry if here? Likely I imagine

@MarshaBradyo We need to pay more but most of all the government need to stop being corrupt with taxpayers money and allowing extensive fraud and misuse of public funds. This government has acted like a corrupt banana republic.

German health care system for dummies off reddit ! Looks complicated !

And nominal charging would not work. It would cost more to administer and would prevent those who most need it from accessing healthcare.

In terms of privatisation look at dentistry. Dentistry has been de facto privatised in the UK. It is very difficult to get an NHS dentist and if you can, often all but basic services are excluded. Most around my way will only take on children as NHS patients. And as a result you have the blossoming of cosmetic dentistry for well off people, and dreadful teeth in a significant part of the population.

This is what happens. It encourages services that make money in this case cosmetic dentistry, with those with a social conscience focusing on the most needy - usually children. Everyone else gets no service except emergency dentistry or only a partial service. Is that really what we want for healthcare generally?

Extend GP opening with what staff exactly? We can barely staff five days let alone seven. Two more nurses leaving next month, no replacements. I can work all the Sunday mornings you want, but then won't be there Monday afternoon for example. No one wants overtime.
Plus you'd lose a chunk of staff who went general practice, shock ... not because of the misconception that it's a vocation, but because it fits in with childcare plain and simple.

I definitely agree with people taking responsibility for their own health and trying to maintain healthy habits, but the thing is, you can't design your health service based on perfect behaviour from the public. You need to design it for reality, and the reality is that there will always be some people who engage in unhealthy behaviours.

That's not even getting into how complex many unhealthy habits, including overeating and alcohol use, are, and how much they are tied to factors outside individual control.

Yes, let's encourage healthy living and personal responsibility, but it's no use designing a system that only accommodates a public with perfect lifestyles.

If we encouraged personal responsibility we would tell people not to ride motorbikes or go horse riding. Both have frighteningly high odds of requiring hospital treatment.

I agree the bounce back loan situation / and mini budget which were upsetting and frustrating other than that I’m ok mostly.

We’re still paying for PFI now, stuff goes wrong and it costs.

We’re high on list for non corrupt countries though and also inequality has been stable for last decade.

I get some have the perception you do and Labour could be braver with changes for NHS due to that. But unless Streeting has said something recently as mentioned below then I’m not hearing it.

So moving away from funds will be there when Labour get in - they won’t - I’d be interested to hear who pays more with any changes.

I’m not trying to be unkind but you might change your mind later. My mother is a nurse for the elderly and she has witnessed very sick old people getting resuscitated several times. She came home crying because she once witnessed an elderly man have his ribs broken three times in the same month because he kept having heart attacks because his bones were so fragile. The third time we woke up he started crying and sobbed “Won’t you people just let this old man die already?” Sometimes DNRs are the kind thing to do. His children finally signed a DNR and he passed away peacefully in his sleep a week later with his daughter at his side. DNRs don’t exist just because people can’t be bothered. Death is natural. It’s not all about “giving up” sometimes it’s because there is a time that our spirit must rest.

Theyre not 1% of the issue that obesity is.

This is a good thread about it
www.reddit.com/r/germany/comments/s2uiwi/introducing_the_german_health_care_system_to/

DNRs are a good thing. People do need to know it is not the same as on the telly.

It works in other countries. Aus is the one I know well. People are used to it though and we are not.

Are we too different?

Culturally quite similar, similar inequality levels but maybe it would cause worse outcomes.

However in so many posts people list models that use it and say they want that, I’m open to either argument but it seems posts are just it’s better in x country but not the detail.

@MarshaBradyo There has been massive corruption in this country in the last few years, blatantly so.

An easy fix is proper inheritance tax. But we also need to grow the economy. The government handling of the economy has been negligent. Our productivity is very low. Look at other countries like Singapore that understand the role high quality manufacturing plays in the economies productivity. Instead all we get in the UK is the idea that if workers rights are reduced that will boost the economy. They are totally fucking clueless.

I've never met a single person who has gone to A&E to get a bandaid put on their cut finger or paracetemol for a headache, let alone been willing to wait 12 hours for an ambulance and 2 days in A&E to do so. Nor have I seen a single piece of evidence indicating that abuse of the service has increased since the time when it used to work properly, and is therefore the reason why it no longer does . . .

Can anyone point to anything from the NHS itself - and I don't mean randoms on some internet forum claiming that they are "on the frontline" - indicating that increasingly wasteful abuse of the system is the reason for its problems and the key to solving them?

So nothing then?

Yes and it’s not a mystery who has one and who doesn’t. In my mothers facility they put a big red DO NOT RESUSCITATE sign above their heads. There’s not going to be any confusion who needs to be saved. There was one patient who kept going back and forth and the facility changed their policy that you can only change your mind 3 times in six months though because it was a lawsuit waiting to happen. This is in the US though so things are a bit different there.

@MarshaBradyo I am totally against spending the billions it would require to introduce a totally different bureaucratic system.
Sort out social care and that will mean hospitals can run fine again. An insurance system for healthcare does nothing to tackle the real issues.

People taking responsibility for their own health, don't just go to AnE, the system is being misused

Better GP service, appt availability etc

Better working conditions for NHS staff

Better mental health and care for the elderly

Govmnt to pay private health hospitals to help with back log of operations etc

What level of inheritance tax would you like?

Our productivity is low, not convinced Labour is the answer to the problem though. They seem to just say pay more, tax more, target ‘the rich’. Like I say they have more bandwidth for NHS reform (and the SM too while I’m at it) but they aren’t suggesting much to give me hope it’ll improve.

@scaredoff I have heard of someone with dementia living alone going to A and E for something very minor. But it was ultimately because of a lack of good social care.
But all systems have this. US has people turning up inappropriately to their private A and E as well. Some of this will happen in any system.

@MarshaBradyo In terms of productivity that is when I would like Ministers to listen to Civil Servants for a change. Some Ministers appear to think productivity refers to how hard staff work!! They do not even appear to properly understand the concept. It is laughable.

I completely agree here.

why not open up the nightingales

Because the Nightingales were handed back to the companies that owned them some time ago. They aren't just sitting around empty waiting for an emergency, and even if they were they'd have to be equipped and staffed.

@MarshaBradyo inequality has been stable for a decade ? So no longer improving ? Isn't life expectancy declining for the first time in years ?
I guess I'd like to know why you think Sunak is inherently a better bet than
Starmer ? What policies are the Conservatives promising that will improve the situation ? How are they proving that they are capable of the job on the basis of their past performance ?
The last elected tory PM was sacked because of his ineptitude, the last tory PM was close to destroying the economy, but Labour are still worse ? Mind boggles.
I suspect you and your family are doing well and you cannot see beyond that. That's fine but why post on threads like this if you are not open to changing your mind.

From the look of that piece, it seems the author (Nigel Edwards) agrees with you that it's likely that such a drastic shift would be "unpopular among staff" (never mind the necessary level of disruption and reorganisation).

Edwards discusses more about competition, competitive markets, and social insurance systems in various countries in the next installment.

www.nuffieldtrust.org.uk/news-item/myth-4-there-is-not-enough-competition-and-choice-in-the-nhs

Edwards N (2022) ‘Myth #4: “There is not enough competition and choice in the NHS”’. Nuffield Trust blog, 2 December.