To think you don't quite realise how badly the NHS is suffering until you witness it first hand

[DaisyCat33]

My parents are sitting in A&E today. They've just hit 12 hours. My dad was sent there by his GP for severe neck pain this morning. He's had morphine and an MRI scan, but they're now endlessly waiting to see a Dr about results. He hasn't even got a bed to lay on, despite debilitating neck pain. Many people are standing or sitting on the floor.

The couple sitting next to them have been there since 3am, for difficultly breathing.

I'm shocked. Honestly I knew the NHS had it's issues, but this bad?! It's frightening. I also had an email the other day saying my NHS dentist is closing, and it's basically a "well sorry no dentist for you any more, bye bye"

I don't really know the point of this thread really, I just feel shocked and upset that this is how it is. And I think a lot of people don't even realise? My parents definitely didn't until today. They are losing the will to live sat in that hospital.

Does anyone else just feel utterly helpless and anxious about this?

We need a European-style hybrid system for a rapidly swelling and rapidly ageing population. The NHS system and the US system are two equally undesirable ends of a spectrum. There are many options between that, used all over Europe, with better results.

I agree with Notonthestairs that it's not as straightforward as that. This is also an excellent series of pieces that explore that thinking around the following myths:

1. We already spend too much on our health and despite this our outcomes are poor
2. The NHS is a ‘sacred cow’ and has not been reformed
3. We should copy other countries and adopt a social insurance model
4. There is not enough use of competition and choice

https://www.nuffieldtrust.org.uk/comment-series/through-the-looking-glass-myths-and-magical-thinking-about-the-nhs

Yes... Livewell CEO earns almost 200k p.a plus bonus, so we have multiple CEOs running health in the S/W.... why????

Livewell is supposed to be a community enterprise, not for profit set-up.

Reality is it just sucks money out of the system.

Every government since the late 80s has known that due to the huge recruitment of nurses and GPS in the late 80s there would be mass retirement in the 2020s.
NOTHING was done to mitigate this, just kick the problem down the road, for years and years.
As much as I loathe the Tories, the issue has been brewing for years.

It's worth reminding ourselves about the wonders we were told Brexit would bring for the NHS.

Labour boosted NHS pay massively, Tories removed bursaries and froze pay, even went against the pay review body

Who has been in power for most of the last 40 years?

Tell me again who is to blame for staff shortages?

@Winberry

So why not for example have fully funded doctor and other medical related ‘in need’ university training years ago.

The BMA wanted to limit the number of medical school places and wanted a ban on new medical schools being built "to avoid “overproduction of doctors with limited career opportunities.”

This is their website in 2008:-

https://www.bmj.com/content/337/bmj.a748#:~:text=Delegates%20at%20the%20annual%20BMA,on%20opening%20new%20medical%20schools.

Yes, I know the BMA are "Only" the doctor's union and weren't the ones making the decision as to medical schools/places, but it shows their mindset at that time of basically wanting to limit the number of doctors, presumably to keep them in short supply and therefore keep their pay levels etc.

It amazes me how often people are fooled by the not for profit bollocks. The argument is that NFPs don't have investors or shareholders and are therefore more focused on the good of the company but when you look even a little bit closer you see that all that happens is everyone takes a huge salary and no one gives much of a fuck about how well it provides a service - as long as it has the fat NHS contract and keeps costs down to ensure the huge rivers of cash keep flowing, everyone's happy.

Anyone who actually believed that is such an irredeemable nincompoop there's no hope for them.

Indeed and these falls impact on ambulance, a and e and mau department etc.

The problem is people using A and E when they could go to a pharmacy or wait for a GP appointment.
When I had a dvt I was in A and E, I'd see people knock on the door to doctors triage asking if they had time to go for a fag.

A few weeks ago my son was in A and E paediatrics for bronchiolitis. Waiting there was kids running around or shoving Monster Munch and various other food into their gobs.
The same parents moaning, asking how long the wait was and then getting told staff were dealing with very sick children first.

One of my friends is a nurse in a GP practice. She says that at the practice meetings they are typicallly told ‘we won’t see patients for x or y’ ‘we are no longer treating people with c or d type illnesses’ ‘we won’t offer s or t vaccines as they can go to their local pharmacy’ etc. She says the most vulnerable patients just aren’t bothering to get necessary treatment until they have a crisis which is when end up in A&E. She is just hanging on with her job until she retires within the next few years.

Most medical students don’t want to become GPs for obvious reasons of lack of funding, work pressure, working conditions and not being able to help patients in the right way.

One of my DC is a hospital doctor and says that the NHS problems aren’t just about money and shortage of staff. The organisation is too big and inefficient and there needs to be a cross party political agreement to reorganise the whole NHS and social care which won’t happen any time soon.

Yes, they increased GP pay and removed their need to work unsocial hours "to save the NHS" - well that worked well didn't it? All that happened is that GP reduced their working hours because they could afford to work fewer hours because of the higher pay, and out of hours GP provision is virtually non existent. Well done Blair!

Re bursaries, pay, etc., medical universities/medical schools are vastly oversubscribed and it's ever more difficult for prospective students to get places, so the number of "willing" students applying isn't a problem. It's retention once qualified, vast numbers only working part time, etc.

Blair and his ilk were all for "family friendly" hours for GPs to encourage more women and older GPs to stay working for longer on a part time basis, but completely forget that we need to train 2 GPs for every "full time equivalent" role when so many are only working part time hours. Medical school places should have been doubled about 30 years ago just to provide enough doctors to cover family friendly hours. And then increased even more to cope with the population increase.

It's been a fundamental planning failure for several decades.

We paid on credit with PFI last time so of course the spending spree feels better than the bill

But those who want a huge increase in spending there’s nothing in the offing for it, hitting up a few private school for votes isn’t it

One thing I want to flag up here is the push towards trying to get people to see other professionals besides doctors - the Pharmacy First programme, for example, which means pharmacists can prescribe drugs for minor illnesses such as throat infections and impetigo. In principle it's a good idea - it spreads the load across multiple services - but in practice it's extremely difficult to make it work properly and the risk level for patients goes up massively. One of the major issues with it is the risk of patients being sent round the houses - go to the pharmacist, get medication, that doesn't work, go back to the pharmacist, get 'referred' to the GP (referred to the GP, wtf), where you're seen by an advanced nurse practitioner, ANP can't diagnose so you have to wait for the GP, by which time you're either better (good result) or very much worse (very bad result). Most patients will be fine but some will suffer and die. I know a lot of pharmacists are keen on the PF programme but I think in the long run they're going to refuse to participate because the stress of seeing patients and having to decide on diagnoses when they're not doctors will be too much.

You could say the same of GP surgeries, most of which are private businesses, either owned by big firms or by the GP partners themselves.

It really is broken and terrifying to see and experience.

I was in with my elderly dad recently. Ambulance came fairly swiftly which I was surprised but but all downhill from there. Waiting on the ambulance trolley (he could not move to sit in a chair) for 10+ hours round the corner from any staff - and as well as his serious physical symptoms my dad was suffering delirum and so kept trying to escape so I was physically pinning him down every few seconds. Doctor came and said to expect a 2+ day wait like that. It was like a war zone field hospital.

Once admitted nothing much happened for a week with some doctors saying the problem was one thing and other something else. Physio and pain service apparently hadn't communicated with doctors and had no idea what was going on with him, all suggesting different courses of action. Came to a head one week after admission when one doctor suddenly realised they couldn't feel a pulse in his leg so rushed off for scan - arterial embolism.

We were told he needed immediate blue light transfer to a specialist hospital. However this was Friday night and nothing happened over the weekend as no beds available at new hospital. Come Monday, the specialists came to him, look one look at the leg and said he needs to go now. Went straight into surgery at new hospital to try to save his leg but by then it would not be saved so full amputation.

No idea if this could have been prevented in the preceding week if the NHS wasn't broken. Honestly feel quite traumatised by the whole thing and left terrified at the prospect of getting ill. No idea what the solution is but something has to give.

I can't fault my GP and I think the new online forms where you can ask about a problem and either get a telephone appointment or a face to face appointment or advice.

I hurt my back, sent message to doctor explaining issue, got a message back saying phone this number for physio appointment, let me know if you need a prescription for painkillers. Phoned last Thursday and offered a video appointment which I declined, they said well nothing available till Wednesday. I asked which Wednesday as I assumed it would be a long wait and the answer was this Wednesday. Went to my appointment, lovely young man spent 45 minutes with me to assess what was wrong, if I needed help with balance issues (not uncommon in your 70s) and then went through exercises he wanted me to do. He left my notes open for 8 weeks and said if I'm not OK by then to phone in for a further appointment.

I'm feeling loads better, pain is very manageable now. Fantastic treatment on this occasion.

My son took an overdose 2 weeks ago and needed a drip to stop the damage to his liver. We was sat in a room with numbered chairs (1-27), not beds, no curtains, for 20 hours. One man in there was having a suspected heart attack and a 93 year old lady had been waiting 25 hours.

It is absolutely broken.

Thanks for that link. Wow. I see the vote was very narrow in favour. It’s so recent, 2008, surely there was some prediction of future need then. Looks like they were voting in a total bubble, self interest, and without a workforce plan against which their decision could be made.

We’ve been chucking money at it for years.
Meanwhile they spend millions on sex change operations and diversity training/non jobs when it should spend it on essential services.
Having open borders and unlimited immigration doesn’t help either.

The 10 minute appointment is what ruined GP in my opinion. Doctors who want to go into GP and who make good GPs are doctors who want a relationship with their patients - they want to talk to patients, understand them and help them. 10 minute appointments drain all the job satisfaction out of GP and turn your job into a conveyor belt of complaints that you can never fully resolve. It makes the job horrendously stressful. It also doesn't solve any capacity problems because a problem that could be dealt with in one half hour appointment instead turns into 5 or 10 ten minute appointments.

There have been multiple studies that show that if you deal with everything a patient needs in an appointment, their health goes up, attendance goes down and everyone's satisfaction goes through the roof. I had to laugh when I read a BBC article last year (can't find it now) about some health centre that's instituted a revolutionary system where everyone gets the help they need on the spot and how effective it was. Of course it's effective! It's so fucking obvious! But they simply won't change the system, partly because GP practices have been squeezed so tightly to get every inch out of them that GP partners are now watching every penny and can't provide good care.

Not read the whole thread but I'm a student nurse and when I did my placement at A&E a lot of time is taken up with non emergency patients- a lot of lonely people who come in most days with symptoms that have to be explored just in case, alot of people with things like tummy aches or cold type symptoms...possibly googling and panicking? Homeless people who want to sit somewhere warm and get some food and a drink ...I don't know what the answer is just wanted to give this insight.