What Measures Would It Take To Fix NHS

Mishap, you are not the only one who thinks everything should come back inhouse.
www.neweconomics.org/blog/entry/the-market-is-failing-public-services
Lots of local authorities are bringing back services inhouse because of rising costs and declining quality. The NHS was always behind in things like this.
Holydaze, if hospitals charge for any procedures, where does it stop?
My ex daughter in law's mother has had a hip replacement. She could not have it done on the NHS because she is a Jehovah's Witness and would not agree to a blood transfusion if needed. It cost her £12000.
Many of you have had hip or knee replacements. That is considered elective surgery. Do you really choose to have it done? Same with cataracts. Would you be able to pay for those if necessary?

This might be of interest.

In May this year, Hinchingbrooke Health Care NHS Trust was named the top hospital in England, based on 12 indicators for ‘outstanding performance in high quality care to patients’. Hinchingbrooke, in Cambridgeshire, had been the only small hospital even to make it onto the shortlist in the 25th year of the annual CHKS Top Hospitals Awards. Yet the expert panel awarded it the coveted first prize ahead of such leading NHS foundation trusts as Guy’s and St Thomas’ and Chelsea and Westminster. But Hinchingbrooke is unique: it is the only NHS district general hospital to have been put under the control of a private company — the Circle Partnership, which is co-owned and run by doctors and nurses.

In 2011, Hinchingbrooke was failing, having had three notices served because of ‘inadequate’ results in accident and emergency, colorectal and breast cancer treatment.

I'm not saying this is necessarily the answer, but I do like the idea that a hospital is run/managed by doctors and nurses. What do others think? It would certainly address some of the points raised.

I watched a repeat of a James Martin programme yesterday, he said that over 9 million meals are thrown away in the NHS every year. He addressed it from a simple business point of view, and asked that wards rang down their requests every morning in order that the preparation of meals bore at least some resemblance to what was needed. he was banging his head on a brick wall from what i could see, and (slightly off topic) was having to deal with a woman who was flicking her waist length hair around in the kitchen as she was talking to him. There was discussions with therapists who worked on a stroke ward about what they needed for their patients recovery and treatment. All common sense, so yes, perhaps we need a board of no NHS people who can bring their individual expertise in.

durhamjen

So what's the difference between paying extra tax and paying for treatment? I'd rather pay hypothecated tax than for treatment itself.

The thing that would bother me about raised taxation is - would it change anything? In a few years, would there be more bleating that there isn't enough money? Politicians have a canny knack of making money disappear with no little rhyme or reason as to where it has gone. If hospitals charged for aethetic procedures, the money could stay within the hospital framework and not have to go anywhere near the authorities.

I agree the cleaning/caretaking should be taken back inhouse, as you say the cleaners would take a pride in making sure the wards were clean and well taken care of.

The cleaners would also be more readily accountable should cleaning procedures be not up to scratch.

durhamjen

most of the cleaning/caretaking is performed by private companies rather than the NHS itself. If it coulod be taken back inhouse it would possibly improve, as it would not be agency staff, but people who have a pride in their local NHS.

I would wholeheartedly agree with that - contracting out the cleaning was a very poor move. I remember being in hospital after the birth of my daughter. She was a premature baby so we were in hospital for a while longer than usual but every two days, all the beds on the ward (must have been over 20 beds - 10+ each side of the ward) were pulled into the middle of the room, all floor swept and mopped, windowsills wiped down, beds dragged back to the walls again, centre tables and chairs moved and the middle of the floor area was then swept and mopped. Recent stays in hospital for up to 5 days, I didn't see the floors getting more than a cat lick and a promise!

Perhaps fewer "management" levels, hollyd?

I've heard this a few times about management and would have to profess to not knowing how recent this is (having management running things). Does anyone know who was in the 'driving seat' to begin with? I know matron used to run the wards but now I'm wondering about the hospitals themselves.

I think you did offer an answer gillybob:

Why can't we have a board of governors elected on their merit only with no affiliation towards any party. That way there would be no chopping and changing and everyone would work together.

It is one I would echo - politics should have no place in healthcare at all. We have had decades of the NHS being used as a political football.

I agree with gilly and bags and I also think that central purchasing, with all the clout of such a huge organisation would seem like a good idea as sunseeker says. I don't agree all things should be brought back in house but catering and cleaning definitely should.

There must be treatments which are better bought on an ad hoc basis from a specialist provider rather than having specialists on hand 'just in case'!

Patients could also do with people on wards who can help feed, toilet and bathe them.

But, the NHS isn't only GPs and hospitals - there are dentists, audiologists, physiotherapists, mental health specialists etc etc

I think most people would accept having to pay additional NI contributions if that money was ringfenced for the NHS in order to keep to the "free at point of access" philosophy

I do think a lot of the "cosmetic" surgery should not be provided on NHS, if a woman wants bigger or smaller boobs then she should pay for that herself, if someone is overweight and wants a gastric band then either pay for it themselves or (if their weight is simply down to overeating and not a medical problem) attend one of the many slimming clubs, tattoo removal should not be done by NHS.

I accept that there are some cosmetic procedures which need to be carried out by the NHS

All those services that have been farmed out should be brought back in-house - that is how you get teamwork and a sense that everyone is working together and contributing their bit to the patient's recovery.

I was working in the health service when this process of out-sourcing began and the difference was immediately apparent:

- dirt left on the floor (the cleaners I knew would never have allowed that to stay in "their" hospital)
- patients not fed (no-one now has that responsibility - the caterers bring the stuff round, but if the patient cannot see it/reach it/ get a hand to mouth, then that's just tough)
- mountains of paperwork and form-filling

I cannot tell you how depressing it all was.

I understand the reasoning behind it, as someone thought market forces would drive down costs; but they missed the psychology of the whole thing - the sense of teamwork that makes a good institution; and failed to consider that going for the cheapest option usually gets a cheap result; or that monitoring of standards amongst several disparate organisations might be impossible.

Above all else there was a failure to understand what a public service is - oops that was a bit political!

Sunseeker, most people's only contact with the NHS is when they need it themselves, usually when they are vulnerable. That's why it's important to get it right.
I think it's the largest employer in Europe, I heard a few days ago.
The money spent on it is not reasonable, as according to the Nuffield Trust we will have to start paying for treatments in ten years time.
So what's the difference between paying extra tax and paying for treatment? I'd rather pay hypothecated tax than for treatment itself. The NHS is supposed to be for everybody, not just those who can pay.
One thing to do is to stop the NI ceiling, and make sure all the extra money goes on the NHS.

durhamjen I agree the cleaning/caretaking should be taken back inhouse, as you say the cleaners would take a pride in making sure the wards were clean and well taken care of.

I remember being in hospital as a child and the wards were regularly cleaned, including the bed frames. When DH was in hospital I watched one cleaner who just swished a (not very clean) mop around the central part of the ward, not bothering to do under the beds or between the beds. There was a spill of what looked like fruit juice on the floor beside my DHs bed when he was admitted, after a couple of days I pointed this out to a nurse who merely shrugged her shoulders and said it was down to the cleaners! I always carry hand wipes with me and used one to clean it up myself.

More money. Money has been taken out of the NHS over the past four years. We now spend less GDP on it than most equivalent countries.
Sunseeker, most of the cleaning/caretaking is performed by private companies rather than the NHS itself. If it coulod be taken back inhouse it would possibly improve, as it would not be agency staff, but people who have a pride in their local NHS.

My only connection with the NHS is when I have needed treatment so perhaps I am not qualified to answer but I think a complete review from the top down. How often is the cost of basic supplies checked - I'm not talking specialist equipment or drugs but things like loo paper, soap, hand sanitisers etc.

When making regular visits to hospital with DH there seemed to be a large number of people walking about with clip-boards, now they may have legitimate and necessary jobs but to the visitor they seemed to spend a lot of time just chatting to each other. Why is it necessary to fill in forms for each department (as we did), in this technological age can't the information be entered once in a computer and then be accessed by each department?

Perhaps fewer "management" levels, hollyd?

Sorry HollyDaze my rambling answer didn't really answer your question did it?

I think the NHS should be taken out of politics altogether. It is there for the common good of every member of our society however they vote and therefore it's about time the parties stopped trying to score political brownie points by spouting what they would/wouldn't do if they were in power. Why can't we have a board of governors elected on their merit only with no affiliation towards any party. That way there would be no chopping and changing and everyone would work together.