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?

General practice is a very unpopular choice with medical students and there aren't enough suitably trained GPs to train up more than the current batch of students, many of whom will drop out of training.

You fail to realise just how gruelling studying to be a doctor actually is - the courses are unfeasibly expensive, the workload onerous and the rewards are shit by comparison.

What's more, apparently the Labour changes to general practice hours were one factor deterring would-be GPs, so the proposals to extend hours further (which doesn't seem to have much demand according to surveys) would make that worse.

I don't think it's reasonable for all GPs to just work 9-5 but clearly arranging working hours to make the role attractive needs to be considered. There's also a vicious cycle where as conditions for GPs deteriorate, it makes the job even less attractive, worsening the conditions for everyone left. People don't always realise what GP workloads are. Part time can mean 35-40 hours a week. If the GP stops seeing patients at 5pm it doesn't mean they stop working.

This!!

It’s not a solution that will immediately take the pressure off though is it?

True. And ours is always happy to "squeeze in" one of the kids if needed. I have so much admiration for GPS surgeries and the community role they and all the staff do. But we are fortunate in that I really rate our surgery and have never had a problem getting seen, not always by a Gp, they have excellent trained nursing staff too, but definitely by someone suitable.

We’ve had great care with NHS and sometimes faster than private for GP appointments

Overall I wouldn’t radically overhaul system. But go back to fixing social care and population health.

Yet medical schools are grossly over-subscribed!

Because the government allows far too few places. We’re not training nearly enough doctors.

People not bothering with their own health is a main issue, even with all the education in the world about healthy eating and stopping smoking doesn't seem to make a difference.

Every health condition in the families of me, DH and our DC is down to the recessive gene variants we carry. As none of us knew until October, there was nothing we could do - it didn’t occur to DD for instance, that all her MH problems could have been improved by a high protein diet and vitamin B supplements. Her consultant endocrinologist , the county lead for CFS told her last year, there was no treatment for her CFS, when as above it’s caused by a genetic disease, causing nutritional deficiencies, which have the potential to cause 115 symptoms, across practically every system. As it is, I don’t know what to do about the hyperglycinuria, which causes the osteoporosis in my family?

@Kazzyhoward the popularity of medicine as a profession isn't an excuse to exploit them.

On another matter, I was thinking this morning about the newspaper articles on Sunak and the nhs. One or two called him delusional. He isn't, of course. He is from the Johnson stable of government originally, so he was trained to call black white. That in turn was learned by Johnson from Trump, who took lessons from Purim, sending his people over there. . These ways of denying the obvious and playing mind games with the population have been well documented and recorded. It shows what they think of us all. .

They're not talking about people like that. They're talking about those who eat and drink too much, those that don't exercise, etc.

Pay carers in the community more £15 an hour.
Look after your own old folks more.
Private health insurance if you can afford it.
Ban agency staff in the NHS.

Private health insurance is not the answer. In most cases it only pays for a limited range of healthcare and in lots of places in the country there is only some elective private healthcare available anyway. Why would I pay just to see a private GP on zoom? Total waste of money.

How do you look after your own old folk more and earn enough to live on?

And carers are not paid as much as £15 an hour. Not round here anyway.

That last bit is why many people also opt to get part paid under the table, so that they can still qualify. Because depending on where you live, the cost of living is so high that that money gets eaten up in rent and isn't as much money as it seems.

I know my American relatives are shocked at wages in the UK as their costs are much higher. Washington DC minimum wage for example is $16.10.
But I know it depends where you live. The US is very large.

At least £15 an hour

How do you look after your own old folk more and earn enough to live on?

Excellent question @IndieK1d I wonder if what we’re seeing is the long term consequences of women gaining more economic independence and planners and broader policies not realising that this removes massive amounts of unpaid arduous labour from the system. Because men certainly haven’t stepped up todo their share!

BTW I am not advocating that we return to the old 1950s and before days!!!

None of these are practical solutions.

Simply banning agency workers in the NHS will result in massive staffing gaps and the service for the public will get even worse. The working conditions for staff will get even worse.

It is a natural consequence. Women used to do loads of unpaid labour. Now anyone who cant afford private social care for their parents is likely to be working until at least 68. Which means for most women you will be working and raising children at the same point your parents start needing help.
My mum had retired by the time my gran needed help. When my mum started needing help I considered giving up my job, but it would have meant my kids living in total poverty. DH gets not much above minimum wage, so we would have had UC top up which would have meant a very basic standard of living and a massive amount of work and stress for me. It is not as easy as some are making out. Whereas if I had been retired with grown up children it would have been a no brainer.

Yes, it’s a consequence of women doing unpaid labour which is not recognised or acknowledged.
Then nobody realises there will need to be a solution when they are no longer able to do it.
In the community where I live (rural Yorkshire market town) a huge amount is done by retired women in good health in their 60s and 70s, both formally via charities and completely informally where eg Joan pops in on a less mobile neighbour every day and runs her errands.
With the pension changes there aren’t going to be as many women in their 60s to help out. Was this taken into account? Course it bloody wasn’t.

I agree with EasterIsland and BradfordGirl. The nub of the problem is that women aren't available to do the unpaid care work that they used to do. And men haven't stepped up either.
And of course we can't turn back the clock, and I wouldn't want to. But I remember, as a stay-at-home mum, feeling very second rate and that I was failing my duty by not going out into the world and being a cog in the money-making machine. And this message came across most strongly from the likes of Harriet Harman and the Labour Party.
Of course, the world has changed, and most people don't even have the luxury of that choice.

Agreed. Most of our community support run by local charities is staffed by retired women volunteers or women who have never worked. WRVS in our local hospital are pretty essential to the hospital. They distribute drinks and sandwiches to people in the discharge lounge and staff the reception.
When women's retirement age went up, lots of people pointed out there would be an impact. Most women of my mum's generation seemed to take on either care of elderly parents or care of grandchildren.

Instead now we get lectured on how families should look after their own like previous generations with no acknowledgement of how governments policies have made that impossible for many people.