#ImInWorkJeremy

[wonkylegs]

Doctors across the UK hit back at Jeremy Hunts attack on the professions weekend working with #ImInWorkJeremy Twitter campaign.

Hunt is trying to blame Doctors for a failing in providing a joined up and properly funded service rather than looking at the problem and coming up with
proper solutions he's looked
at consultants to be a scapegoat
Various news sources to appeal to all political bents
www.independent.co.uk/life-style/health-and-families/health-news/iminworkjeremy-doctors-send-jeremy-hunt-photos-of-themselves-working-over-the-weekend-10398504.html

www.dailymail.co.uk/news/article-3166330/ImInWorkJeremy-Doctors-Twitter-post-pictures-work-Jeremy-Hunt-claimed-medics-weren-t-doing-weekend-shifts.html

metro.co.uk/2015/07/18/iminworkjeremy-nhs-workers-inundate-jeremy-hunt-with-247-selfies-5301742/

You're very much right mummy. The thing is we little people (frontline staff) see what we need, we ask for what we need, and we don't get it. We need more staff, more resources, less red tape. But that costs money, money they don't claim to have. But money they're willing to spend on ridiculous restructure.

The 7 day NHS will only make this worse. Cameron's focus has been on hospitals without considering the wider implications of this.

Lets say he want's elective surgeries all happening 7 days, including weekends. Thats fair enough. But where's the staff coming from? He's focusing on the doctors, what about the auxiliary staff, what about the occupational therapists who have to mobilise our patients, sign them off, how is he going to provide them two days off in the week so they can work the weekend, if there's not enough staff, and presumably not enough money to employ them?

And another big issue is help in the community. Community services are lacking at the weekend. It's absolutely no good having a 7 day hospital service if the community isn't up to a full 7 day standard and able to cope. Many of our patients need support in the community immediately from the district nursing service. I can't in good mind send multiple patients home on a weekend if I know an already strained weekend district nursing service won't be able to see them. So more 'bed blocking'. Or, wanting to discharge to a care home, but the care home manager isn't available on weekends.

The 7 day service could work. But we need more staff across the board, which he hasn't committed to and since we can't staff our current posts and are having to recruit from abroad... well.

mummymeister, I don't disagree with a lot you are saying and I agree that there have been HUGE social changes since the NHS was first conceived and implemented.
Because this is so, and because there is an increasingly aged population with at times v complex needs AND increasing expectations in the population (I cannot imagine that anybody in 1948 would have expected to see a dr for the sore throat they woke up with) politicians promising the world and making unrealistic promises (the promised 5000 new GPs are as likely to appear as a herd of unicorns) and actually fanning the fire of totally unrealistic expectations what the service can (and IMO should) deliver are truly pernicious and at best ill-advised although I fear they know exactly what they are doing.

Also, natural dying is no longer 'allowed'. We overmedicate, we over treat and we over investigate at least as much as we undertreat/investigate etc, particularly the frail elderly. But one cannot be seen to be ageist by suggesting that the frail 96 year should be spared further active intervention, can one?
A fecking form needs to be filled in, signed and filed (AND hopefully be with the person in question i.e. move from their home to the hospital/care home) to 'allow' an attending paramedic/dr to 'not rescucitate'. Nobody is allowed to simply die, looked after, treated for symptoms, but no cure or 'answer' sought.

At the other end of the spectrum are the common self-limiting conditions and again IMO and IME we, as a society, have 'forgotten' how to deal with these.

Sorry, posted too soon.

It's the bit in the middle that I see my role in: treatable (or preventable) conditions. And to pick those out of the deluge of demand is increasingly impossible.

This week's new unresourced, unilateral shift of workload to Primary Care is the 'card' that needs filling in (which we don't have, we don't know anything about and was not designed in collaboration with Primary Care here) to confirm a medical need for people to get the CAB to help them fill in their benefits forms.
A vulnerable patient with severe and chronic MH problems was sent from pillar to post looking for this elusive 'card' (that I have still not seen). I spent 30minutes I did not have trying to sort it out for him.
Barriers are being put up IMO by underresourced services to control their workload which I have huge sympathy with but as we have now way to control demand the buck seems to stop in the community. Which is underfunded and underresourced. Gah.

Oh YY to your points Pacific. You'll have probably heard of this 'good death' thing that's been talked about quite a lot lately. So many people want to die at home but instead end up in hospitals being pumped full of drugs, hooked to machines and recieving pointless intervention because we can't turn round and say sorry but that's enough. In the cases we do, it's plastered across the news that we 'let them die instead of saving them' complete with DM sad face. Such a low percentage of people achieving the death they want - dying at home with their families.

I had a family member lambast me because I said their 92 year old mother wouldn't be able to have a hip replacement. The hip was the least of her worries. She wasn't fit enough for surgery. She wouldn't have survived surgery, let alone been able to withstand healing and rehab. But no, I'm apparently part of why the NHS is failing and we're all shit and just leaving her to rot . Even she didn't want it and understood why, she just wanted some sort of relief. Not a serious bloody surgery.

DoctorTwos … once again you have your factual fingers on the pulse of a cadaver.

Re your ”Jeremy Rhymingslang can get a big dog up him. His party, like the neoberk division of the Labour party want medicine for profit. They forget, or rather fail to mention, that the NHS is, or was until they started monetising healthcare, the most efficient health service in the world.”

You will find that it was a Labour government that seriously introduced private sector competition to the NHS in 2000 and of the approx 6% of NHS budget private sector involvement, around 5% of that was introduced via PFI by …..not the Conservatives…and it is still the best public heath organisation in the world.

“The 2000 NHS Act, meanwhile, called for a ‘mixed economy’ in healthcare, introducing ‘Independent Sector Treatment Centres’ to compete with the public sector in low-risk elective surgery, and expanding the role of private companies in primary care and community health. The same year a Concordat was signed making the use of public funds for operations in private hospitals a normal, rather than exceptional, practice.”
newleftreview.org/II/62/tony-wood-good-riddance-to-new-labour

“What has been the impact of these changes? Though NHS funding rose significantly after 2000—on average, 7 per cent a year in real terms—the costs of creating and operating the internal market now consume 10 per cent of the total NHS budget; sizeable sums have gone on the expansion of new managerial layers.” [26]

“The need for public healthcare providers to focus on the bottom line has brought a damaging combination of staff cuts, dilution of the skill mix, and faster through-put of patients; drives to reduce waiting times have meant a rise in the number of readmissions, while cost-cutting in subcontracted services has brought declining standards of hygiene. “

“While PFI has resulted in new facilities being built, their construction has been guided by the rationalities of investment rather than medical assessment of the population’s needs; in some cases they are too small to serve the area for which they were supposedly built. Most damagingly, payments to PFI investors are locked in for a generation or more a long-term drain on resources out of all proportion to the short-term gains. ”

[26] ‘The Institute of Health Care Managers listed 1,700 separate job categories in 1995. By 2002 this had grown to 5,529 :Jenkins, Thatcher and Sons, p. 289. Figure for internal market from Leys, ‘Reducing Social Democracy’s Last Redoubt’.

“Tony Blair has defended the spread of private finance initiatives under Labour as seven NHS trusts face administration as they struggle to repay large debts from PFI deals.”
www.telegraph.co.uk/health/healthnews/9356942/Blair-defends-PFI-as-NHS-trusts-face-bankruptcy.html

GraysAnalogy … regarding your;
”What the hell has this got to do with anything? If you want to discuss the intricacies and politics of years gone by, go and make your own topic, go to 'politics' for gods sake. I actually sigh when i see you've posted on a thread because you do the same thing all around the forum.”

”You're very much right mummy. The thing is we little people (frontline staff) see what we need, we ask for what we need, and we don't get it. We need more staff, more resources, less red tape. But that costs money, money they don't claim to have. But money they're willing to spend on ridiculous restructure.”

What I find bewildering, but suspect many posts on the internet aren’t from people in the profession and/or have their own agendas, is that day after day we hear someone within a professional association, a trade union or from the front line, that the NHS is ‘in crisis’, but IMMEDIATELY challenge any potential reforms before the FULL plans are even shown.

I also find it frustrating that bright people that can take a public service forward can say ‘we don’t care what happened before’ when 13-years and hundreds of £billions thrown at unreformed NHS services DID leave the NHS in a crisis – and you correct me if I’m wrong - by not preparing for the millions of new citizens we KNEW by policy were coming, with huge numbers of baby boomers reaching old age and placing huge new demands on the system.

So straight away a 2010 Conservative led administration inherited an NHS ‘not fit for purpose’ and a £153 billion government overspend so THERE WAS NO QUICK FIX over one parliament and NO failing private or public business can be turned around without being restructured which after 13-years of incompetence, was ever going to be simple, especially one with 1.3 million employees – but have since paid for themselves.

• You said above that you don’t get more staff, yet I hear number like several thousand new doctors and several thousand new nurses since 2010, is that incorrect?

• You said above that you need more resources and less red tape, yet wasn’t it the Labour government that blew portions of our annual NHS budgets on PFI contracts and brought in the managers and red tape (as shown in a previous links on here) in a typical public sector strategy of ‘quantity over quality’?

What new red tape under this government are you seeing?

I'm fully aware that the Labour govt from 1997 to 2010 was a neotard one thanks. I've never pretended otherwise.

I can understand your ideological need to (get up in the morning) by saying Labour 1997 to 2010 was neoliberal or "neotard".

But as it was Brown not Blair running UK domestic policies/spending AND Labour and Conservative core policies are directly opposite to each other i.e. on the size of the State, taxes and size of bank balance sheets in 1997 - you need to accept that it was socialist INCOMPETENCE - and if not a smokescreen for another parties policies, where is your evidence of this Conservative administration under Hunt "monetising healthcare"?

You said above that you don’t get more staff, yet I hear number like several thousand new doctors and several thousand new nurses since 2010, is that incorrect?
We have, but not enough. I'll concentrate on Nurses because it's those that I think are under the most pressure right now. Since 2009 we've only had a 2.5% increase in nurses across the board. BUT there is actually no data to say whether these are qualified nurses. I've noticed over the past couple of years that more roles which would have previous been HCA are being named 'auxiliary nurse' a term that died out but now seems to be coming back. I suspect this is to be able to include them in the nursing bracket. Our population during that time has increased by 4.5%, and we have an aged population (hospital care for 75+ alone has increased by 65%) and high co-mordbidity meaning they need more time, more resources and we haven't got enough of either to do so. Which has been reflected in places like Stafford. 45% of wards are operating on unsafe numbers

Despite recommendations being made for minimum staffing, these have been widely ignored. The government told NICE to suspend any further work into safe staffing levels, and instead they want to focus on 'quality not quantity'. Which is bullshit. I went on a 37 bed ward with 2 nurses and a single HCA. You can have the most skilled workforce in the world but if there's not enough staff to give the fundamentals of care which is what patients are missing and begging for then it won't work.

We're operating on a shoe string already. How do you think it's going to be when we need to stretch non-emergent services across another 2 days? Where does Gove think the extra staff is going come from? Is he going to pull the extra doctors, nurses, occupational therapists, pharmacists, radiologists, lab techs, phlebotomists, cleaning, clerical.. from his behind? The NHS is already having to recruit from abroad, spending thousands on doing so, putting potential recruits up in hotels at £500 a night.

This is so multifaceted I could be here all day. Another issue is retaining staff. Once this living wage comes in the majority of the NHS staff will be on pennies more than the living wage. It's not worth the stress, they may as well go and work elsewhere.

Staff moral is at an all time low. It's difficult to see the anger and sadness a lot of us have unless you're in the NHS.

You said above that you need more resources and less red tape, yet wasn’t it the Labour government that blew portions of our annual NHS budgets on PFI contracts and brought in the managers and red tape (as shown in a previous links on here) in a typical public sector strategy of ‘quantity over quality’?
You aren't getting it are you? I don't care which government did what. How many times do I have to tell you I don't care for the politics who did what whenever, it wouldn't matter to me who was in power what matter is what they're doing now, which is something we can actually influence and do something about. This I'm In Work Jeremy. What labour did x amount of years ago isn't something we can change, what's done is done.