Is the NHS safe in Tory (or Labour) hands

The last government, with the best if intentions I'm sure, is the one that changer GP contracts and thus reduced access to healthcare. Also in the 1990's when I worked in A & E the attitude towards the health service by government was changed by the politicians encouraging an expectation of service and treatment with a 'solution' so people went to hospital rather than treating themselves for minor injury.
The risk adversive culture has also ensured more and more tests are done, patients admitted that would have gone home just in case.

When I joined the NHS management overheads were between 6 and 8% when I left it was 18%.

Two things need to be sorted.

Firstly stop non urgent cases from using A&E.

Secondly increase bed space in the wards for those who need to be admitted.

Both of these are complicated issues in themselves.

I have wondered Anya whether the answer may be to allow everyone to use A & E, funding it by doing away with GPs who would then work in the hospital. It isn't a real suggestion but it does appear that culturally we have somewhat outgrown the present set up and, perhaps, we should throw everything up in the air and look at all the possible solutions.

Both A & E and the beds problem seem to stem from the same shortage - that of doctors and nurses. As I understand it isn't a lack of physical beds.

Trouble is Gracesgran we live in a culture where people expect instance service

One answer would be more Minor Injury Units. We have one about 10 miles from us and the waiting time is about an hour.
Another would be to have an out-of-hours service in the hospital.
And of course if people could get a GP appointment more easily that would help.
I've also heard that the 111 telephone service is making matters worse by advising all and sundry to go to A&E - presumably to cover their own backs.

Any other suggestions for steering all but the most needy away from A&E?

Yes, there is a shortage bed space, because many patients can't be sent home due to lack of 'social care'. These are blocking up the flow.

111 service useless IMO, and Ambulance services sick of being diverted to their callers, I've heard of people being sent, by ambulance, with a sore throat to A+E.
GPs in hospitals sounds a good idea, as well as having local surgeries because many would struggle to get to nearest A+E, and probably use ambulance service as a taxi?

Most health services in the developed world are in trouble- due to vast increase in cost due to longer life expectations, but also the availaibility of very expensive treatments, be they surgical or pharmaceutical. These have exploded over the past 20 years- as compared to when the NHS was first created. Can't remember the figures though, will have to look them up, but the % of GDP spent on health care is quite small in the UK compared to many countries.

So perhaps the key is with us- are we prepared (well not me as I live abroad) to pay more taxes to cover NHS costs?

I think Labour is much more dedicated to saving the NHS- but where will they get the money from? The mansion tax is defo not going to cover deficit. Contracting out to private sector by Tories has been the most insidious was or making traditional voters to approve, via providing ops with longer waiting lists and in more comfort- it was a very clever move
but it is clear they are aiming for a two or maybe more tier system- and I wouldn't trust them in any way or shape, with the education, social or health system. I am glad I won't be able to vote in May- neither os us would know what to do- apart that UKIP is NOT NOT NOT THE ANSWER.

I see a risk-averse, increasingly litigious society combined with a rapidly increasing population in the south east and a lack of common sense and informative health education all combining to create chaos within an increasingly tightly funded NHS.

On the one hand, we get bombarded with health advice and told various symptoms to look out for and rush to our GP with. On the other, GPs were, I gather, given an unbelievable new contract in 2004 - one that allowed them to opt out of providing out-of-hours cover and yet gave them a 50% increase in annual income for doing 4.5 days a week! At my local practice, you now can't get an appointment within 10 days unless you say you are an emergency. As someone who hasn't often used the NHS, it goes against the grain to take a deep breath and say, for instance, that a cough that's been going on a bit, is an emergency!! Meanwhile, my GP comes up to me at a public meeting, fawning away and asking to be supported as an independent candidate to 'save the NHS' at the next election!

There are so many fingers in different pies and so many varied responses from any health services person you speak to that it has become impossible for your average Joe in the street to know what on earth to think and mostly, you find out about the changes when you try to get treatment yourself. Ultimately, unless we can stop thinking of the NHS as a market and see it instead as healthcare for people in need, then we can only be heading for some kind of health service that has to be paid for which is a sad way for the UK to go and one only has to look at the health inequalities in the US to fear this greatly.

I'd support the OP - we need to spend more on the NHS, stop contracting out services and stop thinking that Labour are any different to the Tories, they are now just wolves in sheep's clothing.

OOOPS, forgot to say though- that there is a % of the population that has been abusing the NHS for far too long- and some people will have to be encouraged to be more responsible about the way they use said services, ambulances when they are perfectly able to take the bus, or have attendance allowance to pay for taxi, night calls for nothing, A&E for coughs and colds or a bruise or small cut, etc.

Being free at the point use is absolutely marvellous and the best in the world- but it requires all to use it properly to cut cost and make it work. For instance, all those who have prescriptions they just don't use and stock up then throw away, as a minor ex.

We also need to look at the hold pharmaceutical companies have on the NHS and costs of medicines- and perhaps make some hard choices about some very very expensive drugs that provide very minimal improvements.

Not easy, that is for sure.

Now for comparison- and I know comparing has irritated some GNters in the past, so apologies. Here in Switzerland, everyone has to, by law, have health insurance. Basic insurance cannot be denied to anyone, irrespective of pre-existing conditions- these are provided by an array of non profit-organisations. They make the money on providing extra cover for those who want it, private, private-room, etc. Those who cannot pay, have the insurance paid by the gvt (via social services) and families on low-income get subsidies, etc. But even here, exploding costs of treatment and medicines is causing problems.

There are moves afoot to combine health and social care, something that should have happened decades ago. Eg consultant insists 84 year old who lives alone, and had a double mastectomy earlier in the week, goes home on a Friday afternoon. Team manager at social care gets involved as consultant won't speak to sw. Team manager patiently explains, no we can't provide instant social care, this woman lives alone, is very frail and in the past refused services. We need to come in and see her, discuss her care plan and put services in place to support her. No, we don't have an emergency bed in residential social care available, they're all full with emergencies. The real debate was is this social or health care, something I'm sure most of us will have come across either in our work or personal lives. I was that team manager and this was mid 1980's so things don't change much.
What has changed is that social care funding, along with funding for the nhs has been slashed at a time of increasing need and demand.

I'd pay more tax granjura, in answer to your question. I suspect many of us would, providing we knew the tax money would go directly to support the nhs, rather than on wars in the middle east

I remember the days in the late 60's early to mid 70's when a patient automatically went for 2 weeks convalescence following a hip or knee replacement, having spent at least 12 days in hospital prior to that!

Where did the money come from then?

Pensioners do not pay NI but in all probability receive a greater amount of the resources of the NHS.

How many pensioners would be willing, indeed happy, to pay a very much reduced NI contribution if their pension is above a certain level? - provided the whole amount went to the NHS of course.

I know we will have contributed over the years but I see no reason why those in receipt of a good pension income should not pay say 2%. I don't know how much that would bring in but it would make some contribution.

I heard on the radio yesterday that we are now going over to Spain to recruit nurses, many of whom can't get jobs in Spain. This apparently is because we have not trained enough nurses. Perhaps if they had not made nursing a degree profession, more people would be encouraged to become nurses. I'm not saying it's a bad thing; just that having to work for a degree may be putting potentially good candidates off. We have NHS walk in centres here, but they close at 10p.m., so where are people going to go after that? No prizes for guessing.

Bed blockers can block beds for 3 months or more.
That is an enormous amount of times that bed could be used for say 3 or 5 days at a time. Probably about 20 other patients?

I am beginning to think that part or a lot of the problem is not necessarily the NHS but social care.
Do social care need a lot more money, rather than the NHS?

Agree with Greyduster about nurses.

There was a spokesman from one of the London hospital trusts on the BBC news last week saying that yet again, funding is the issue when it comes to recruiting nurses. There were 20,000 applicants for 2,000 training positions, the number of training positions had been slashed. So yet again, more short term measures of cutting the costs in training nursing staff then having to go overseas to recruit. So, not a case of people not wanting to go into nursing.

If push came to shove I would trust Labour more than the Tories to look after the NHS, but saying that none of them have come out of it over the past few years - well since Thatcher introduced the "internal market" against the BMA's wishes - with shining success.

I don't believe the problem with nurses is that it has become a graduate profession - we need those skills. As I understand it is as Gillt57 says - they have cut the number of training positions available. Who made that decision?

The cut in the money going to the local councils is also a big problem as it has led to a cut in the social care services. I am not completely sure that care at home is always appropriate. Good convalescent care could mean less home care in the long run.

I don't like the term "bed blocker" - words can be used to de-humanise,
and the word "blocker" seems to me to subtly reinforce the increasingly popular notion that elderly people are problematic.







Elderly people who through no fault of their own are

Sorry about that, I was going to say that elderly people who through no fault of their own are "trapped" in hospital should not be referred to as if they are inanimate objects.

I agree Eloethan, delayed Transfer of Care (DToC) is the correct term

I'm personally sick and tired of hearing that the problem is due to an 'aging population' - perhaps we should all be euthanised?

No one can help getting old, but what about those whose illness are due to their lifestyle?

I agree Anya and it's not as if they didn't know they were going to have a bigger aging population.

DC seemed to be blaming all the extra people going to A & E on PMQs. Never the politicians fault is it?

A lot of the "old" people in hospital did not (for instance) turn up at A&E, when they were younger and more capable, with minor problems that they could have fixed for themselves, or taken to a GP. Did I read on another thread that this accounted for 31% of A&E attendances?

If they are in hospital, it is usually either for things that can't be fixed as outpatients, or because it is not safe for them to be discharged yet to an empty house. Are those who complain of them "bedblocking" saying that it would be better for them to be sent home just to be readmitted as emergency cases a fw days later? Do they think that everyone has a family who can leave work to spend 24 hours a day with them, or the money to check into a nursing home to convalesce?

As someone was saying, what happened to convalescent homes?