Like most of our public services the last thing the NHS needs is more reorganisation. It needs proper funding and then to be allowed to get on with the job. 14 years of Tory meddling to avoid the need to provide proper funding hasn't worked. The Daily Mail and other tabloids really aren't telling the truth by the way, nor the far right think tanks.If you actually care about the NHS, the worst thing you could do is pretend everything is all ok and money will just solve all the problems.
It’s wishful thinking and even Labour accept that is not a tenable long term solution. There’s no easy answers and without meaningful reforms, the NHS is on borrowed time, frankly.
The staff are underpaid, patient satisfaction is low and our health outcomes are ‘middle of the pack’. In any case, the NHS is not the envy of the world and we could, and should, learn what we can from other healthcare systems.
From my experience with my Dad being in hospital for an extended amount of time (which brings us to another issue of hospitals being full of people waiting to be discharged to care which doesn't exist because we've essentially privatised care and the profit lies with non-complex cases so nobody wants to take on cases like my Dad) it was less that the agency staff weren't as good, more that there was no continuityThe extra money from agency/ work doesn't go to the worker it goes to the agencies. Of course the problem is the quality of agency staff is often much lower than permanent staff, even though they cost much more.
Every time I've used 111 they've sent me to either an out of hours centre or A&E. I've ignored them as often or not but yeah it's a totally irrelevant service, may as well cut that bit out and just go to A&E first!I think 111 needs massive reform. It pushes everyone to A&E by default out of fear cos the staff aren’t medically trained, GP receptionists as well perhaps, should be pushing far more people to pharmacy first then GPs.
We’re in an age where medically tuned MoE LLMs are shown to be as effective as a panel of doctors at diagnosis, time to use the tech and make 111 what it was supposed to be in terms of low cost self triage.
The service is far too fragmented with different private companies running different parts and not really being concerned with the overall care of the patient.Exactly this type of stuff. GP appointments ‘cost’ around £30-40 yet A&E costs something like 400. GPs aren’t available out of hours and many not at weekends….where does everyone end up
It's really sad this. I remember when I was last in a hospital, fortunately but unfortunately, I was not the patient, but a sibling, and I was apologising for being in the way, while the staff were apologising for asking me not to be in the way.From my experience with my Dad being in hospital for an extended amount of time (which brings us to another issue of hospitals being full of people waiting to be discharged to care which doesn't exist because we've essentially privatised care and the profit lies with non-complex cases so nobody wants to take on cases like my Dad) it was less that the agency staff weren't as good, more that there was no continuity
It was different staff practically every day who weren't really familiar with the history of the patients they were looking after so only the basics were getting covered
This was from a senior consultant at the QE mate so I’ll take it as fact. That’s not to say many won’t choose to do agency/locum work for the extra cash as well, that’s their personal choice but hardly a plan to privatise the nhs - if individuals didn’t choose to do agency work they’d be no business
It’s like there’s two extremes here, the nhs is perfect and just needs more money or let’s scrap the whole model. I’m somewhere inbetween ie increase funding but get some proper longer term plans in place and make some rather obvious changes and improvements (culturally and management)
Facebook history tells me that some of the memories and memes are just not true over the last 12-13 years including ones about this is the last election to save the nhs ones
If we want grown up solutions to complex problems we need to be willing to engage in more meaningful debate
The NHS has been restructured, the influence of the structure is the American accountable care organisation (ACO). The NHS is, similarly to an ACO divided into systems covering a geographic patch. The systems, funded by an Integrated Care Board with a fixed budget to fund all primary and secondary care in that area. We are part way down the road Pete.Every election the tories won my left leaning friends were saying if the tories won the nhs would be broken up and sold and we’d have us style health delivery
It was bollox
So let’s have a bit more of a grown up debate
I actually wouldn't be against it, as long as there is universal healthcare where required.On the NHS private/public debate, does anyone think it could go the way of pensions, and employers being made to enrol employees onto private healthcare? Small contribution by employee and majority by employer?
Obviously not ideal, but if those saying that having private healthcare frees up capacity and eases pressure on the NHS, then this for me would seem a better way of doing it as it's more equal than just having whoever can afford it for themselves as the onus isn't on the individual.
How long do people think would Starmer actually last as leader of the Labour Party and Prime Minister?Back to the UK election now, I just find it miraculous that Labour is deciding to have petty ‘civil war’ over Diane Abbott at the start of a general election campaign.
Rayner (and others) undermining Starmer is ridiculous. You’re on the cusp of forming the next government if you don’t fuck it up.
A disunited party could cost them a majority or somehow even lose it.
Given that Iran was historically Persia which had a huge empire created and sustained by military conquest - including the taking of slaves, your argument is probably not correct. Not forgetting Britain’s leading role in ending slavery.I think historically it could be argued that Britain has the worse governance just in terms of people dead, enslaved, or occupied etc but I would be happy to be corrected.
The colocation of GPs in A&E was a feature on the Isle of Wight for some time.It’s not really the physical cost I’m bothered about, more the fact that 14-15m appointments are wasted and other people have missed out. Understand though in terms of docs playing catch up so the fines could be used for giving GPs extra to extend hours in evenings/weekend. I’d also consider using it to have a GP stationed at night in the busiest A&Es to try to get through any standard GP type queries/appts on entry to A&E.
Idea is to more to try to deter missed appointments (not even calling to cancel)
One of my heroes is Granville Sharp, one of the earlier abolitionists and key player in Somerset vs StewartGiven that Iran was historically Persia which had a huge empire created and sustained by military conquest - including the taking of slaves, your argument is probably not correct. Not forgetting Britain’s leading role in ending slavery.
On one of my 3 recent trips to A&E I spent pretty much all night sat with the nurses as there were no beds / cubicles and I needed my obs done every hour.Is the high cost of A&E because of the types of things people come in for or because of the way they’re treated?
On one of my 3 recent trips to A&E I spent pretty much all night sat with the nurses as there were no beds / cubicles and I needed my obs done every hour.
From what they were saying there are several issues. A huge increase in people turning up with things they can't identify and struggle to treat, this has started since covid. Dealing with people who should be dealt with by other services, such as the homeless and those with mental health problems - they have people under those categories turning up several times a week because they have nowhere else to go. People who have a genuine health need but can't access any other service due to the services either not existing or not having capacity (mainly GP appointments).
Which all in all is putting the system under huge strain and no doubt costing a fortune.
So it's arguably not the health service that's failing, it's a lot of other services.On one of my 3 recent trips to A&E I spent pretty much all night sat with the nurses as there were no beds / cubicles and I needed my obs done every hour.
From what they were saying there are several issues. A huge increase in people turning up with things they can't identify and struggle to treat, this has started since covid. Dealing with people who should be dealt with by other services, such as the homeless and those with mental health problems - they have people under those categories turning up several times a week because they have nowhere else to go. People who have a genuine health need but can't access any other service due to the services either not existing or not having capacity (mainly GP appointments).
Which all in all is putting the system under huge strain and no doubt costing a fortune.
I will just clarify, RBS bought the bank at the centre of the deal, because its management made consistently bad choices.Fresh Sunak story breaking. Apparently he “earned” £5M bonuses as his hedge fund was at the centre of the deal that ultimately took down RBS which led to the taxpayer £45B bailout.
Not exactly a shocking story that a hedge fund made a fortune out of the crash but the optics are once again awful for Sunak
Don't think it's a case of below their skill level, more that they have to be ready for everything at the drop of a hat. From a very quick google A&E consultants are on around double what GPs earn. There's also far more infrastructure to maintain and operate.I meant more what makes A&E expensive generally. Like if I go to A&E for something does it cost more than if I go to the GP for the same thing and if so what’s the reason for that? Like is A&E staffed by more expensive emergency trained staff who are doing work that’s below their skill level or something?
think you could say that for other parts of the system as well. Certainly the police who spend a lot of time and money dealing with people with addiction, mental health issues etc that should be covered by other services that either can't cope with the numbers or simply don't exist anymore.So it's arguably not the health service that's failing, it's a lot of other services.
The most recently published figures (21/22) show average cost of an Emergency Care episode to be £242, not £400 as suggested elsewhere. Yes, more than a GP attendance, but not much major trauma ends up at a GP surgery.Is the high cost of A&E because of the types of things people come in for or because of the way they’re treated?
The most recently published figures (21/22) show average cost of an Emergency Care episode to be £242, not £400 as suggested elsewhere. Yes, more than a GP attendance, but not much major trauma ends up at a GP surgery.
It’s cover your arse medicine. If they hadn’t done all those investigations and you had dropped dead on the way home, I doubt your relatives would have been sufficiently comforted and advised not to sue.Yeah, looking at the latest it says cost starting at £418 for visit to a major A&E department that involves more complex investigation (which is the figure I’d heard/seen quoted) but a lot less for routine visits to care centres. So a current average of around 250-300 (inflation) now would make sense
How Much Does an A&E Visit Cost the NHS? - NowPatient
In this comprehensive guide, we will explore the cost of an A&E visit to the National Health Service (NHS) in England.nowpatient.com
Either way its multiple times the cost of just seeing a GP or walk in centres for less urgent matters.
To answer shmmeees question I presume the additional cost is triage, tests and ultimately the cost involved in seeing a consultant. Last time i went to A&E for returning afib after being directed by 111, I saw a triage nurse, had blood tests, ECG with different nurse, then consultant (after getting blood tests redone after first lot were lost). I didn’t need all that as I’d had afib before which had initially been rectified by a Cardioversion. A ten minute GP appt could’ve given me sufficient comfort/advice
It’s cover your arse medicine. If they hadn’t done all those investigations and you had dropped dead on the way home, I doubt your relatives would have been sufficiently comforted and advised not to sue.
They're paid for in different ways, if you go to your GP for something there is no specific payment for the episode of care as the GP practice gets a capitated payment for its registered list.Appreciate that and thanks for the reply. And I agree with everything said, it’s another example of penny wise pound foolish spending.
I meant more what makes A&E expensive generally. Like if I go to A&E for something does it cost more than if I go to the GP for the same thing and if so what’s the reason for that? Like is A&E staffed by more expensive emergency trained staff who are doing work that’s below their skill level or something?
Farage to stand for reform.
Man's got an ego the,size of the moon!
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