What Measures Would It Take To Fix NHS

Sorry POGS, I should have stated that I didn't see the programme mentioned - I was just commenting on meals provided and that 'in the old days', you ate what you were given which was, to an extent, nutrionally balanced.

From memory, there was a long centre table that all patients (that could leave their beds) sat at and were served their food - I don't recall (during my stays) many leaving an awful lot - even the prunes were eaten!

People have changed I suppose and I do agree with what you are saying. My comment re fussy eaters are those who turn their noses up at being served with meals they wouldn't normally eat. My last stay in hospital, one woman at our table pushed her food away because 'she doesn't do rabbit food' - it was a bit of salad!

I do agree that the NHS is poorly run, as an institution. There are so many examples in commerce of people who have no indepth knowledge of a company/organisation finding themselves in charge of things and then making a pig's ear of it all.

HollyDaze

The James Martin programmes have concerned the quality, taste and patient requirements for nutrition, ability to swallow etc. that were basically stating the bleeding obvious but not for the hospitals.

It had little to do with patients being 'too fussy'.

For an example he went to a Birmingham hospital which literally threw away 40-50% of the food prepared, daily. The chef admitted he just prepared food and had no idea of the numbers, who wanted what etc. Absolute disgrace and the management just stood by and watched, as happens with many public services, it's not their money after all. The food naturally had to go straight into the bin!!!!

He took them to visit a hospital in Scarborough who had worked with him before and they took onboard their system of food ordering, they went back to Birmingham and on just one ward used the 'patient ordering' system and it proved how little wastage their was compared to the other wards. They could save over £26.000 a year by using the ordering system, run that with ordering proper amounts of food, providing better quality food for purchase by staff and visitors in the restaurant, hence making more profit and the money soon racks up.

I was amazed this wasn't already in use as the hospitals I have been in for one reason or another have used the 'patient ordering system'. It's utterly shameful that the NHS wastes so much and that is only on food. The shocking thing to me is the ease the NHS allows poor service and to me the management must take responsibility.

There is no overall guidance is there. Surely it is not beyond the wit of man to look at what works well and what doesn't and put in place good practice over the NHS as a business. It just proves that even by very small issues such as food ordering the NHS is a beaurocratic, poorly run institution that is too big to apparently be governed in a sensible manner in an awful lot of areas.

It was, apparently, not an uncommon practice Elegran - one of his main complaints was the lack of care and attention for delicate equipment on the wards or in theatres. I don't think the whole blame can be put in the political arena, very often, when someone else picks up the tab for repairs, the cost of repairs can often not come to mind.

GillT57

I watched a repeat of a James Martin programme yesterday, he said that over 9 million meals shock are thrown away in the NHS every year.

Maybe people have just become too fussy! I remember being in hospital after my daughter was born and introduced to the delights of sausage, mash, brussel sprouts and gravy - followed by Arctic Roll; granted I wouldn't normally put sprouts with sausage and mash but the upshot of my post is, it did me no harm, it was edible and, to be honest, well presented and didn't taste too bad (I hate brussel sprouts). Hospitals are not 3/4 star hotels so maybe patients need to stop expecting meals that would come out of such establishments.

hoolydaze Perhaps the Cd players were plonked on the robot arm because it had stopped working as normal?

janerowena

Ex FiL was in charge of all the maintenance for the TW hospital. He said that the waste horrified him. He went there when he got fed up with his electrical contracting business (councils always paying him late) and found that instead of repairing equipment, it was all thrown away. From razors in the bathrooms to hand dryers to expensive medical equipment. He said that one good electrician would have been able to keep things mended and working on a fraction of the cost

I had a boyfriend a few years ago whose job it was to look after all the hospitals in the North of England (included the Isle of Man as well) - when the hospital engineers couldn't get equipment working again, he would be called out to see what the problem was and to get things up and running. He has a degree in Engineering but specialises in robotics - he said that in operating rooms, there are robotic arms that assist the surgeons and he has lost count of the times he has been called in to fix the robotic arm as it has ceased functioning and yet all he ever sees on it is a cassette/cd player playing music for the theatre staff to listen to. He felt it was a scandalous waste of money to repair an item like that for it to be then used as a coffee table!

Interesting article durhamjen

I am particularly pleased to hear this:

And a recent survey of 140 local authorities across the country showed that the majority are bringing services back in-house or considering doing so, mainly because of rising costs and declining quality.

And very much agree with:

What’s more, when you work in or use services, day in, day out, you get a real sense of what’s working and what needs to change.

Public agencies could learn from co-operative governance structures by including elected worker and citizen representatives on their governing bodies.

Meanwhile, a slow and steady move towards a 30 hour working week, alongside measures to address low pay

The latter especially so. I don't think it's all that surprising that people are put off training to become doctors/nurses when the hours expected to be worked are so long and with a pay grade that doesn't really reflect their worth to society.

durhamjen

Holydaze, if hospitals charge for any procedures, where does it stop?

Sorry, I think my typing went a bit awry in the earlier post - it should have read 'aesthetic' with no underlying medical reason; for me, that would be the stopping point. I don't think it is feasible for the NHS to be all things to all people - it was supposed to be about restoring health (where possible) and I think it should return to that premise.

Quite an innovation - doctors and nurses knowing what is best for patients! Presumably they have advice from other experts but the emphasis would be on the people who use the services.

Aka

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.

That is interesting. I think it's how many of us would prefer to see things run.

Well the carrot of feeling better, and increasing your chances of having a healthy retirement phase is not working. Hence my draconian suggestion.

Yes I know local hospitals have a role for some things.

Durhamjen what does Stevens think people can buy for £1000. Not much?
The Vat rules for food look utterly chaotic. Look at the sections on ice creams and confectionary! Some are standard rate and some zero rated.

customs.hmrc.gov.uk/channelsPortalWebApp/channelsPortalWebApp.portal?_nfpb=true&_pageLabel=pageVAT_ShowContent&id=HMCE_CL_000118&propertyType=document#P9_112

Jess not all health care is so advanced that it needs to be delivered in large hospitals. I agree that advanced care does require specialist facilities and staff. But there is also a place for smaller, community hospitals. And for minor injury units separate from A&E.

As for your other points I am in total agreement. Only problem as Ana pointed out how do we make people take responsibility for their own health?

How?

Yes, in theory that would make a difference, Jess, but what political party would ever propose/implement those measures?

The taxes on tobacco, alcohol and especially petrol are swingeingly heavy already. High petrol prices don't encourage people to walk more, especially pensioners who have bus passes.

What do you think of Stevens new idea to hand over money to people with lots of needs, 5 million getting roughly a thousand each a year, JessM?

I daren't ask, rose. That's one reason to be grateful to the NHS, that I do not have to pay for my prescription, seven separate tablets each month.
Isn't that what happens already, JessM? Even the sugar gets Vat, whereas foods without are exempt, or Vat-free, can't remember which.
Says she with a glass of wine in her hand.

You cannot remove it from politics because politics determines the way it is paid for.
Sounds like the NHS needs better management, not less management.
It is not realistic to think that advanced modern health care can be delivered in small establishments.

The one big measure that would make a difference is if the UK public started taking responsibility and:

stopped smoking
stopped over eating
started taking exercise
and
cut down on the drinking.

That would reduce demand considerably over the next 20 years.

So maybe until the UK public start taking responsibility there should be a swingingly heavy tax on:

cigarettes
sugar
and
alcohol

and maybe hefty tolls or petrol taxes to encourage more walking.

I know all about medication costs; I am reminded every time I pick up my prescription from Boots how much it costs by our friendly pharmacy assistant.

Rose, I do not know what it was like 30 years ago, but I think that Virgincare run many of the NHS services in Surrey now.

opendemocracy.net/ournhs/mike-marqusee/held-hostage-by-big-pharma

An interesting link about medication costs

Yes, I have watched a couple of the James Martin programmes when he was in Wales - he sourced good food locally which turned out to be cheaper than what they were purchasing before. I am not sure if they are still following his recommendations, but I hope so.

I think the NHS does not keep an eye on costs and is being ripped off by everyone from drugs companies to equipment providers etc etc. A much closer eye needs to be kept on purchasing. They are such a huge purchaser surely they could get good deals and not accept the often very high prices quoted?

When I was in a Surrey hospital 30+ years ago it was filthy, filthy, filthy. I am not sure if it had been contracted out or not in those days. The dirt hung off the walls above a certain height because the cleaners would only clean up to a level they could comfortably reach and they could not find any 'peripartetic high cleaners'. The cleaner chucked a few damp tea leaves around and swept around what she could reach; never moved anything. I had never seen such slovenly cleaning. The hospital had Legionnaire's disease which they could not seem to eradicate either.

He seems to be doing it better than Lloyd Grossman, probably because he knows more about the NHS.
He started in Scarborough, I think, then went to York and Leeds. Where is he now?
Hull could definitely do with better food.

Gill 57

I watched today's 'Operation Hospital Food with James Martin'.

He was very good and as you say he pointed out the food wastage in one hospital alone was 40_50% meaning half of the budget for just one hospital was going literally into the bin. A simple act of getting patients to fill out a food ordering card was invaluable. Not only the kitchen staff knew it was happening so did the management? They didn't have a clue what they were doing. All credit to them though they took onboard everything that was suggested and hopefully they will turn it around.

If one hospital could save 40_50% of it's food budget, how many more could do the same and how much would be saved over the NHS nationally. I acknowledge that not all hospitals are run badly but it does make you think.

It sounds like a collector of data, then doing comparisons.

What's the CHKS?

I love the sound of that. I have been talking elsewhere about the smaller cottage hospitals, and maternity hospitals. Small, manageable and friendly - and more importantly local, so that people can visit without huge parking fees, and being able to help with feeding of friends and family and care of their clothing and so on. Many European hospitals do not provide meals at all, perhaps just breakfast, the relatives bring it in and do the feeding. I realise that is impractical here but most people would at least get a little more support and have less worry about transport than they do currently. DBH's cousin is currently working shifts, and having to transport his father to one hospital for tests every week and his father in law to another in the other direction (both an hour's drive) for physiotherapy.

In the meantime, my old local HUGE hospital in Maidstone, formerly easily accessible from the town centre by bus, and only 30 years old, is being shut down and now everyone has to travel all the way to just outside Tunbridge Wells. Very convenient for ambulances, just off a main route, but no better than the old one which was accessible to all.

Ex FiL was in charge of all the maintenance for the TW hospital. He said that the waste horrified him. He went there when he got fed up with his electrical contracting business (councils always paying him late) and found that instead of repairing equipment, it was all thrown away. From razors in the bathrooms to hand dryers to expensive medical equipment. He said that one good electrician would have been able to keep things mended and working on a fraction of the cost of continually buying new equipment, but that his recommendation was rejected.

www.neweconomics.org/blog/entry/the-market-is-failing-public-services-whats-the-alternative
This link should work.