What NHS needs is not more money but needs to be better run

LovesBach

The NHS is in such a parlous state in Wales - run by Labour - that people cross the border to be treated in England. Something to look forward to...

nation.cymru/opinion/blaming-westminster-for-the-state-of-the-nhs-in-wales-wont-wash-any-longer/

LovesBach

The NHS is in such a parlous state in Wales - run by Labour - that people cross the border to be treated in England. Something to look forward to...

Oh dear. People from England come to Wales for treatment all the time too. It’s so common it even has a name and a policy. Cross border flow. It also happens between England and Scotland.

M0nica

Oh stop all this blaming the right wing press nonsense. there are left wing papers as well: The Guardian, The i. the Daily Mirror and The Observer. All well read and I haven't seen anything in them either.

Monica, you accuse me of knocking the right wing press without looking in the more left wing papers first yourself to see if if what you say of their reporting on this is actually true- or commenting on the Welsh Governments report.
This is the latest comparative article on waiting lists I could find from the Guardian, for example.
www.theguardian.com/society/2023/aug/14/which-uk-nation-has-got-the-longest-nhs-waiting-list
As I’ve said it’s a complex picture and believing in what is reported in right wing papers about the Welsh NHS performance is prejudiced.
It is, of course, very nuanced, between different services, and different systems, I’m not denying that the services here have issues - I’m just really surprised that somebody who normally makes valuable contributions to threads as you do would fall for it.

The NHS is in such a parlous state in Wales - run by Labour - that people cross the border to be treated in England. Something to look forward to...

Oh stop all this blaming the right wing press nonsense. there are left wing papers as well: The Guardian, The i. the Daily Mirror and The Observer. All well read and I haven't seen anything in them either.

SGBoo

This is a little off centre - Western countries pay more for meds. The nhs charges trusts more for meds and kit too. The nhs is also top heavy - salaries are high for people in management.

The NHS is currently treating emergencies which by nature costs more because it can't get on top of more preventative/routine care.

I want the nhs we had when I was growing up. It was well funded and staffed. We had matrons or sisters who made sure wards were ran well, we had health professionals in schools providing vaccines and check ups.
This means we need more qualified health practioners employed not via a bloody agency in our nhs.

The tories have fd up our health care. Get them out. The nhs was making great progress under the last Labour government.

I totally agree with everything you said

62Granny

The collection of data for government figures is something that takes many hours for ward managers, I am not sure anything is ever done with this information, but is definitely something that needs to be cut back on , as is the number of " managers".

Data collectors aren't managers, whatever their job title might be.

One of the problems the King's Fund has identified is that NHS management isn't allowed to manage. There are so many government directives and targets that so-called managers spend most of their time ensuring that targets are met within budgets and have little flexibility to use their initiative. This became worse after 2011, when trusts were supposed to compete for business and became more accountable.

M0nica

Casdon it may or may not be the whole story, but i have yet to read aanything else.

Well there’s clearly a concerted effort by the right wing press to portray the Welsh NHS in a poor light compared with England, but it’s politically rather than factually driven.
This is the latest Welsh Government report.
www.gov.wales/health-minister-response-latest-nhs-wales-performance-data-august-and-september-2023#:~:text=Once%20again%20we%20have%20outperformed,than%2071%2C000%20calls%20in%20September.

Casdon it may or may not be the whole story, but i have yet to read aanything else.

The collection of data for government figures is something that takes many hours for ward managers, I am not sure anything is ever done with this information, but is definitely something that needs to be cut back on , as is the number of " managers".

Freya You've overlooked an essential difference, which is that the total spend on healthcare in Germany is higher than in the UK, both as a percentage of GDP and per capita.

PS. I had three MRIs last year, one of which had to be done on a specialist machine because it involved an MRI guided biopsy. All were done within a few days of being booked.

M0nica

Every time I read about the NHS in Wales, it is because waiting lists have just grown even longer.

I know you know better than to believe that’s the whole story though Monica, don’t you?

growstuff

Freya5

growstuff

M0nica

growstuff Both superficial and merely moving the deckchairs on the Titanic

What is needed is a thorough study of how other health services are run, especially those that produce better results for the same or less money. An enquiry thaat brushes asidethe vested interests that managers, consultants and GPs each defend in their separate laagers. I think we should look at the balance between what is provided in-house and what is bought in. merely changing superficial structures and bringing in extra layers between GPs and referrals to consultants.

An enquiry that talks in detail to significant samples of managers, consultants, junior doctors, nurses, GPs and PATIENTS to find out the diffivulties they have accessing thw service.

So which health service produces better results for less money?

Germany and Spain. Know nothing about the French system.
According to family, although Germany suffering from same staffing crisis as we are, and are recruiting from overseas. Which let's face it has always been done, worldwide. No matter how much we dislike it, Nursing and medicine are still a vocation, not just a job. NhS is badly managed, in fact top heavy. I remember one wave of redundancy, yes this under Labour Gov, , my friend was told, on shift, by a sideways moved manager, that she was being made redundant, friend obviously fought it and won. Managers put in place that do not know how to manage. They escaped redundancy, most that were disposed of were Nursing staff.

The German healthcare system costs more as a percentage as GDP and for the individual.

German healthcare also spends more on management.

I wonder if their management of running their service is as bad. Gov run alongside private, all pay healthcare, even those on benefits, that is paid from Gov coffers. All have to have health card. Difference is, their health payments go into health, not a general free for all pot.Pay more, get more choice. MRI done within 6 weeks, or sooner, results handed to patient on cd, taken and looked at by GP. You can see a Dr , not an associate. They certainly have more beds per hospitals than we have. Compulsory social payments too from when first start work.
Good idea, now gone down the pan since introduction of Trusts.

Every time I read about the NHS in Wales, it is because waiting lists have just grown even longer.

Primrose53

Madgran77

The nhs was making great progress under the last Labour government.

Er really?

Labour is in charge in Wales and their NHS is on it’s last legs.
Actually, there are now several Labour run councils that have no money left too.

Is that just a silly throwaway comment or can you explain what you what you mean by the statement that the Welsh NHS is on its last legs Primrose53, and tell us the criteria you have used to compare?

growstuff have a look at the OECD report this thread is based on? Of the 38 OECD countries only 5 countries, contributed more money per head to their health servicen than we did (USA, Germany, France, Japan and Austria). Average number of beds per 1000 population across all 38 nations was 4.3. We have 2.4, only 5 other countries had fewer beds (Mexico, Costa Rica, Columbia, Chile, Sweden). We have fewer MRI, CT or PET scanners compared with most other countries. In 2021 nurses, on average, across OECD countries got 20% above the average wage. But in the UK, Switzerland, Finland and Latvia nurses were paid less than the average worker.

Now no health system is perfect and they are all under strain but it is clear that most other countries are managing to deliver a better equiped health service for less money than we do.

The problem isn't always the medical professionals involved but the systems they have to operate within.

Yes that is my experience too!! Xx

My DH worked for the NHS for almost 50 years. Towards the end of his working life he had was given a line manager. She asked him to come in to see her and, when her arrived, she asked him to explain what his job title meant and what he actually did.

That, to me, sums the state of NHS Management.

I have read the website growstuff and it is digital this, that and the other from start to finish. No section of it concentrates on patient/medical professional interface, which has been the source of all my family's problems and the source of the problems many other people I know have.

The problem isn't always the medical professionals involved but the systems they have to operate within.

I worked in the NHS in the nineties and it was a shambles then. Now I encounter it as a patient and it's a disgrace. My local trust still operates 90% on paper; I had a knee replaced two years ago and when I had my pre-op consultation 2/3 of the consultant's time was spent filling in paper forms, mostly with stuff that should have been collected from me on a web form beforehand. When I commented on this, he gestured at the two computer screens on his desk and said that he also had to enter data separately on seven different programs. So basically the NHS in my area is about 40 years behind the private sector. Unforgivable.

Madgran77

*The nhs was making great progress under the last Labour government.*

Er really?

Labour is in charge in Wales and their NHS is on it’s last legs.
Actually, there are now several Labour run councils that have no money left too.

Louella12

I've worked in the NHS.

I totally agree with the OP. It's a tragedy. The way it's run now we could spend double the amount and very little would change.

I've been hoping for reform for years. Maybe we'll finally see some.

In what specific ways would you like to see change?

Freya5

growstuff

M0nica

growstuff Both superficial and merely moving the deckchairs on the Titanic

What is needed is a thorough study of how other health services are run, especially those that produce better results for the same or less money. An enquiry thaat brushes asidethe vested interests that managers, consultants and GPs each defend in their separate laagers. I think we should look at the balance between what is provided in-house and what is bought in. merely changing superficial structures and bringing in extra layers between GPs and referrals to consultants.

An enquiry that talks in detail to significant samples of managers, consultants, junior doctors, nurses, GPs and PATIENTS to find out the diffivulties they have accessing thw service.

So which health service produces better results for less money?

Germany and Spain. Know nothing about the French system.
According to family, although Germany suffering from same staffing crisis as we are, and are recruiting from overseas. Which let's face it has always been done, worldwide. No matter how much we dislike it, Nursing and medicine are still a vocation, not just a job. NhS is badly managed, in fact top heavy. I remember one wave of redundancy, yes this under Labour Gov, , my friend was told, on shift, by a sideways moved manager, that she was being made redundant, friend obviously fought it and won. Managers put in place that do not know how to manage. They escaped redundancy, most that were disposed of were Nursing staff.

The German healthcare system costs more as a percentage as GDP and for the individual.

German healthcare also spends more on management.

I've worked in the NHS.

I totally agree with the OP. It's a tragedy. The way it's run now we could spend double the amount and very little would change.

I've been hoping for reform for years. Maybe we'll finally see some.

growstuff

M0nica

growstuff Both superficial and merely moving the deckchairs on the Titanic

What is needed is a thorough study of how other health services are run, especially those that produce better results for the same or less money. An enquiry thaat brushes asidethe vested interests that managers, consultants and GPs each defend in their separate laagers. I think we should look at the balance between what is provided in-house and what is bought in. merely changing superficial structures and bringing in extra layers between GPs and referrals to consultants.

An enquiry that talks in detail to significant samples of managers, consultants, junior doctors, nurses, GPs and PATIENTS to find out the diffivulties they have accessing thw service.

So which health service produces better results for less money?

Germany and Spain. Know nothing about the French system.
According to family, although Germany suffering from same staffing crisis as we are, and are recruiting from overseas. Which let's face it has always been done, worldwide. No matter how much we dislike it, Nursing and medicine are still a vocation, not just a job. NhS is badly managed, in fact top heavy. I remember one wave of redundancy, yes this under Labour Gov, , my friend was told, on shift, by a sideways moved manager, that she was being made redundant, friend obviously fought it and won. Managers put in place that do not know how to manage. They escaped redundancy, most that were disposed of were Nursing staff.