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?

You make a good point. TB is rampant in certain London boroughs and all sorts of archaic diseases are making their way back to our shores.

I don’t see a way back for the NHS because anything we do would only be closing the stable door after the horse has bolted.

The NHS is in its death throes and the faster it signs a DNR request the faster we can get to a system that profits from preserving life (think USA) rather one which “saves money” by allowing people to die before their time.

Silly anecdote but I remember watching Sex & The City as a teen when Samantha found a lump in her breast. Of course I thought that was it, she was going to die. But no, the next day she was off for a biopsy and treatment began immediately. I know it’s only a TV show but the speed of treatment in the UK is dire. People die on waiting lists to be seen.

Who isn’t paying up, so those who aren’t net contributors, that would be white british people.

I think the NHS is unsustainable in its current state. Ageing population plus more expensive and complex treatments mean that unless we tax everyone massively more than we are then we cannot afford it.

We need to start charging people for treatment. Means tested and not including vulnerable groups including kids, pregnant women and people with certain conditions.

No, I have no idea how this will be implemented without a riot, but we cannot continue to have a free NHS.

I for one, and many people I know would be happy to pay for a better service. But I don't want those who can't pay to suffer.

@BradfordGirl I see it more as what can realistically be serviced as ‘free’. Being born and having an accident/emergency to me seem reasonable to be free at point of access.

Other than that, I can not see how it can go on offering such a diversity of medication. Well it can’t…to limp forward in such a manner is frankly dangerous to many and requires a bold solution.

Also there is huge waste in the NHS including the amount of patients who don’t turn up to appointments. By asking for a contribution it would fund stuff and put a halt to a lot of those DNA’s.

It needs more money and to offer less - that is common sense not capitalism.

The problem is if they were going to exempt certain groups then chances are the over 60s would be one of them (since they're already exempt from any NHS charges others pay for.) And since it is this particular group who are by far the biggest users of the NHS I'm not sure it would be cost effective.

I’m not for paying more beyond the NI increase which was scrapped, which is a pity.

People seem keen on it but I don’t think it would be that attractive to voters - which is why both parties aren’t going strong on it

I'm hugely conflicted about immigration tbh to the point where I would honestly struggle to 'explain my stance'.

On a humanitarian level I'd like to help everybody possible, but on a rational level I know that the structure can only bear so much weight before it crumbles and we're all fucked.

I understand the view of those that say we don't really have any claim to a particular piece of land, and that ownership changes every few hundred years. However, this is our homeland in that we can't exactly go to the doctor and state that we want to be treated in Germany instead. So for that reason we really do need to maintain the basic function of what we're stuck with.

Why them in particular? Selecting ANY group of people to be untreated - whether first or second generation immigrants, or poor people, or those over 50, or those with blonde hair - will mean increased spread of disease.

And what, I repeat. about people who were born here, but have immigrant 'heritage' (which ultimately means everyone in Britain, but I assume that the poster means those with immigrant parents or grandparents)? Where are we all supposed to go? At least in my case, my parents' countries of origin probably would let me in, but that's not true of everyone, and anyway why the fuck should I be kicked out or discriminated against? Either the poster means all second generation immigrants including me, in which case I am personally outraged, or perhaps I'm exempt because I'm white, in which case it is racist.

A very silly anecdote to base your argument on a fictional TV show from the 90s. Jesus wept. Saying you know it's just a TV show doesn't make it any less of a stupid comparison to make.

You make a good point. TB is rampant in certain London boroughs and all sorts of archaic diseases are making their way back to our shores.

That was actually not my point. I was referring to flu, Covid, scarlet fever, and various other diseases which are common right now. And not brought specifically by immigrants; but if any group, whether immigrants or people with blue eyes, is excluded from treatment, the diseases will be even harder to control than they are already.

Not to mention preventable diseases such as measles and rubella. Vaccination rates are already lower than ideal because of bloody anti-vaxers; I'd expect some serious epidemics if significant numbers of infants are deemed ineligible for healthcare including vaccination.

Read it again. I said I’m second gen and I would be happy to pay a higher contribution to reflect my family’s recent arrival here.

Not that anyone should be excluded, but that you should only be able to be treated to a certain level if you have made enough contributions to the public pot. If not, then you pay for private treatment. Or head back to the mother country and get your treatment in the lands your ancestors have contributed to.

US healthcare is falling apart at the moment. You would not be promoting the US as a good example if you had a clue what was happening there at the moment. Hospitals very short of staff, and very short of basic resources. Hospital Consultants having to phone pharmacies to see what they have in stock before prescribing. Consultants complaining insurance companies will not agree to fund certain drugs meaning they have patients hospitalised 3 or 4 times a year as their condition is unstable. Shocking levels of maternal death on a par with extremely poor countries.

Well you better not look at the demographics on Covid vaccine refusal and vaccination refusal in general then…

The anti vaxers are a nightmare. When I was young TB was a disease confined to street alcoholics.

I’m sorry to hear that. I have extended family spread across both coasts and the Midwest and that is not their experience. When I relate to them the things I’ve gone through with the NHS in the past few years they’ve been horrified.
NHS maternity care is a joke compared to the USA.

Interesting. Are you a fellow white person, Simon?

How do you know? What I mean is - how do you know that those among the "immigrants which the gov is paying £6m a day to house in hotels", who end up being granted asylum here, will not be economically productive, net contributors to society?

You can split hairs this way or that about specific groups and subgroups, but the basic point is that the fundamental argument about immigration presented here is wrong. It's based on blaming everything on the increased demand, while ignoring the increased supply.

People who know more about these things than I do have done the sums and concluded that overall, the economic effect is positive - ie immigrants contribute more to the economy and tax base than they use in public services. If things are not turning out that way, it's because of the choices that the government is making about what to do with the money available.

The optimistic part of me (the little that is left of it) had rather hoped that as the effects of Brexit turn out to be uniformly disastrous, this little piece of nonsensical economic folk wisdom might finally be exposed for what it is. But now I'm not so sure.

I don't know why people are so reluctant or unable to see this clearly in terms of the numbers, the way the government used to before it fell prey to the Bigot Tendency. I don't like overusing the R word but it's difficult not to fall back on it in lieu of any other explanation.

The NHS is in its death throes and the faster it signs a DNR request the faster we can get to a system that profits from preserving life (think USA) rather one which “saves money” by allowing people to die before their time.

Think USA? The life expectancy is significantly lower there than here! According to the 2022 CIA World Factbook, the average life expectancy in the UK is 81.94, and that in the USA is 78.38. It would be one thing to cite Japan, or Canada, or Sweden, or France- they actually do have better life expectancies than the UK. But the USA? They are good at research and development of medicines, but not at administering their health system.

It’s true. It was one of the many factors I researched before leaving the united states for canada. Americans love to talk shit about other countries but they don’t have the numbers to back up their limitless ego and confidence. They say “The hospital HAS to save you!” but that doesn’t mean they have to give you a quality life. Dying of cancer but have no money and no insurance? Sure they will resuscitate you but they won’t cut out the cancer that’s killing you.

What would make the biggest difference, though unfortunately it's not a quick solution, is for us all to take responsibility for our physical health.
And to take responsibility for our parents. Listening to radio 4 yesterday, the interviewer asked the NHS spokesperson if the problem of bed blocking could be blamed on the NHS or the government. It didn't occur to them to consider that our older relatives are our responsibility.
I saw that as someone who would hate to have my elderly mum living with me.
The horrible fact is that the NHS can't deal with an obese and aging population, no matter how much money you throw at it .

What sorts of jobs in the US wouldn’t give you health insurance? Are there many?

@Sausagenbacon That ship has sailed. We would have to go back to women retiring earlier, women having kids younger and families not being dependent on women's wages. It was women who cared for elderly relatives. But anyone not wealthy now has to work until 68 years old. Given the average age of childbirth it does not take a genius to work out that most women in families without money to pay for private care, are still working full time when their parents need care.

Are people arriving at A+E being screened on arrival? Many don't need to be at A+E

@LeccyBillShill Lots of lower paid jobs lay you off before you are entitled to healthcare. Even if you get it, most lower paid workers have basic insurance.

And lots of US insurance policies have an annual limit on claims.