The Tories are gonna get in, it's inevitable do you care? Is there an upside?

[TheDullWitch]

Oh why not have the election NOW. Let the buggers get in, show their true colours, become universally loathed, then get kicked out after one term. Come on, let's get on with it!

Absolutely with the matrons,and in house cleavners that actuallya re part of the place instead of contracted out to buggery and no sense of jobb whatsoever.

If you are going to charge for missed appts make it so you can get through to cancel one, I often try and rarely succeed- lines always busy.

Am for patient led initiatives for long term health conditions- if you have to live with a disease / condition / syndrome then you know best what you need alongside it. Apart from a very few specialists, most people you encounter are specilaist in a particlur issue and you know your presentation far better than anyone. In fact if they want to now how to improve health services they need more user input- for the disabled kids services a few sessions at our SN group would change laods I think.

But amending the NHS we have is irrelevant as the NHS we will ahve in a few years will be massively elderly-focussed. It will ahve to be, and it will take a sea change to cope.

We can't afford the NHS to which we've all come to expect as our birth-right.

I am thinking £5 a visit, not £50. There has been a strong correlation shown between people's respect for things they regards as 'free' and those they pay for. A charity worker once told of a village elder who told the charity to charge a small sum for schooling they were about to provide for free to MAKE people attach a value to it.

As for the cut-off, we constantly draw lines in the sand as to who can or can't access things. It's not hard or innovative to do so!

The 'bring back matron' idea is hackneyed- a great sound byte but coming from a very different era to the one we have now. Health care has changed beyond recognition. We'd be rioting on the streets at the death rates those 1950's dormitory wards with matron in charge 'enjoyed'. And can you imagine a modern patient falling subservient to Matron (images of Hattie Jacques!)? We 'expect' young nurses to do so but we sure as hell wouldn't ourselves! It apparently 'worked' as a system because EVERYONE was scared of Matron!

MRSA and C Diff aren't actually MADE in secret laboratories in hospitals, contrary to what the red tops would have you believe: Their prevalence has come about due to unimaginable old age being attained by the majority of patients these days; a plethora of modern drugs that have the side effect of weakening the immune system of a challenged patient yet further; the way we the public DEMAND antibiotics for every twinge then, because we're not THAT ill and 'don't like taking drugs', we take half the course; our belief that 'good medicine' is measured in minimal length of hospital stays.

The 1950s patient would, at 65, considered himself to have had 'a good innings' and be more sanguine about the reality of what was then considered to be 'old age', the illnesses and mortality.... whereas today I know of relatives who have come marching into hospital demanding recompense because 'Grandma came in here, fit and healthy and you killed her!'... OK she was 89, she HAD spent the last 9 years in a care home, she DID have an intractable chest infection and kidney failure, she WAS bed bound, but none the less! She was only 89!... seriously. With that anecdote, I touch on a well-spring of community attitude towards illness, wellness, the NHS. We cannot meet people's crazy expectations and if we want to improve, even save the NHS, we may have to be a bit more 'creative' in our health-care delivery.

Whilst this is all not entirely relevant to the OP (and yes I have actually read all 17 pages!) I think it has a bearing, and the message: Be careful what you wish for.

We do pay for it ampere! It's free at the point of delivery, not funded by wizardy and spell mongering.

'MRSA and C Diff aren't actually MADE in secret laboratories in hospitals, contrary to what the red tops would have you believe' I hope to God that wasn't to me becuase I trained as a Nurse in the nineties......
I walked out after two years but nonetheless I then went into healthcare for another five.

bringing abck Matron is about bringing back both authority and somewhere for the buck to stop.Experienced professionals know that the worst palce for dust is X or that such and such a cleaner doesn't do the bathroom with a separate mop unless you hangue them; the manager knows that the cleaner (who skips A and B ) is faster and gets more done.

The PERCEPTION is that it's actually 'free'. THAT needs to be changed.

Contract cleaners are an issue, yes. Thing is We the People demanded a 'cheap' NHS. And we got it via 'hot-bedding' and contracting out non-front line services (And some that ARE front line!). A cleaner CAN be trained as to where to clean and how, and yes, it would be a huge help if it were the same 3 or 4 people in the team (and ahem- if they could speak English). But it is more 'financially efficient' to bring in a company who will throw just enough bodies at a cleaning situation. And 'financial efficiency' seems to be the name of the game.

The buck cannot stop with one person anymore. The whole improvement in health care globally has come about due to a multi-disciplinary approach to it. It is an inter-dependent web that USUALLY works fantastically well, but can provided a frustrating lack of scape-goats when it doesn't.

ampere - I think it's interesting that as soon as someone says 'matron', Hattie Jacques is automatically brought up.

It's definitely the image we all hold in our mind's eye - Carry On and all that. However, just because you are bringing back something from a previous era, it doesn't necessarily mean you have to bring back all the baggage that comes with it.

At the end of the day, hospitals are like any other workplace - there are people there who are more experienced than others. Just as I can't ever see a junior doctor ignoring a Consultant, I don't see why a junior nurse would ignore a more senior Matron. As BobbingforPeachys said, it's about someone taking responsibility at a lower level to ensure compliance with policy sent down from the Board.

...'MRSA and C Diff aren't actually MADE in secret laboratories in hospitals, contrary to what the red tops would have you believe' I hope to God that wasn't to me because I trained as a Nurse in the nineties......'

the point I was making was entirely that the red tops simplistically blame 'nasty, lazy nurses' for the spread of these infections whereas I'm saying the issues are way more complex than that!

But you do say 'I walked out after 2 years...' did you?

'The buck cannot stop with one person anymore'

but in orderfor any palce to work effectively there has to be one person at any time held acocuntable for what goes on in their doman- be it ward, admissions unit or whatever.

Someone who knows the name of every person on that ward working, and who to call if the pipes implode. Not a Hatty Jacques, but a Charlie from cCasualty (disclaimer : havent watched it for ten years so if he has taken up smack and shooting up in the hospital toilets, I will withdraw that example natch)

ALL hospital workers 'take responsibility'. It's just that it seems we expect them to 'take responsibility' for things they can have no control over!

And the Matron thing IS just that because we imagine an all powerful, omnipotent all-knowing, all-seeing being that will somehow make it All Right in the ward. Not someone CALLED Matron but stripped of most of that, ie 'the baggage'!

I did Ampere, I was part of a trial nurse training scheme called Project "00 where even after that time I had barely spoken to any real life people, let alone practised any nursing procedures; I went into homecare and did stints in LD and Psych care until I (via a brieg stint temping) ended up in the charity sector. Lots of loose ends that ended up tied together at the end, although I packed that infor Uni 6 years ago anyway (MA now).

So it was a long time ago, and was not the most fun I have had on a Sunday YKWIM

Knowing the names of your cleaners won't necessarily stop the spread of MRSA, though! Were it that simple!

As for who to call- all well and good as long as that fount of knowledge were on duty when the pipes explode! Personally I'd imagine that Estates would have a hot-line to sort it.. and a maximum 'fix time' to adhere to in order not to breach their 'contract'.

P2k, damn my typing!

'ALL hospital workers 'take responsibility'. It's just that it seems we expect them to 'take responsibility' for things they can have no control over!
'

Possibly true but then that needs remedying in itself.....

I think many people do have that baggage attached to matron tbh but there does need to be that authority figure; if you titlesd them ward manager you'd be back into the remit of empty bureaucracy even though TBH it'd be the same person.I do think a Matron can be both a modern adaptation of the old ideal and have the sense of respect (and reassurance) that older people used to get from his / her presence. A difficult micx but then it'd be a difficult role anyway.

There has to be that link; something firm and substantial.

Ampere you're being icky, you know exactly what I mean about having a wide and general knowledge about dealing with emergencies I think, having the experience and ability to make that call.

And I do think knowing the names of the cleaners massively works at a higher level- people who feel they belong and are valued as people contribute far more than faceless operatives. It'saprt of team building and tends to bring out the best in people.

Yep, arse covering is a huge issue in the NHS (that's where barium enemas for the over 90s comes in- 'do it then we can't be sued for failing to do it'). Every decision is ultimately made to prevent litigation. That's because the cost of litigation is so huge to the NHS (and makes the Shock Horror headlines in the red tops). Even consultants have, in some instances, been known to lay out the options to a patient and then tell THEM to make the decision, all in the name of 'patient involvement' and of 'owning' the process... but also to effectively force the patient to be complicit in any failing that MAY ensue.

Once again, the public got what the public wanted....

For 'the buck to stop' at someone, that person would have to be given a scarily large amount of unchallenge-able authority, and a deep purse, a situation that isn't necessarily conducive to good health-care outcomes.

I have no problem with the term 'Ward Manager': It's what they DO that counts!

'Ampere you're being icky, you know exactly what I mean about having a wide and general knowledge about dealing with emergencies I think, having the experience and ability to make that call.'

no, I'm not being 'icky', I'm telling it like it is: modern health care doesn't need or want A Singular Person standing, godlike, as The Authority in these matters. ALL health care workers need to and largely DO take responsibility, not stand by and wait to be told what to do. They use their initiative, intelligence and experience to inform what they do.

I did mean picky,as I am sure you realise- I have poor eyesight and struggle with seeing a PC screen.

I think we may have to differ on this pint then as clearly we see it from different standpoints.

Well said HH!

I actually thought you DID mean 'icky' and was perfectly happy to accept that that might be a word people use for, well, nit-picking as opposed to 'sick'! I wasn't taking the mick!

It wasnt an accusation of taking the mik LOL- an apology from me (been hauled over coa;s a bit on MN lately)

OK, sorted! (I'm always 'getting into trouble' on MN!)

Now shall we get back to DISAGREEING LOUDLY with each other??!

ampere, I'm sorry I absolutely cannot disagree with you!
esp re your views on the NHS, as someone who's seen it from the inside much of what you say rings v true, sadly so...

LOL @ this