NHS - oh dear!

Dickens Understanding what is really going wrong would be a mammouth task for anybody. That's why I groan when people write such as a "complete re-organisation is needed". They don't know what's needed any more than you or I (and I suspect most politicians) know. A complete reorganisation would throw everything into chaos.

Ailsa43

I had a consultant write to my Doctor explaining that he'd seen me, and that the patient (me ) is a smoker who admits to smoking 60 cigarettes a day.

I don't smoke.

I had a consultant write to my Doctor explaining that he'd seen me, and that the patient (me ) is a smoker who admits to smoking 60 cigarettes a day.

I don't smoke.

growstuff

Dickens

growstuff

If the average person is not an expert in the field of NHS organisation, why do they persist in coming out with soundbites about "complete reorganisation"? If what you say is true, they haven't a clue what they're talking about.

PS. That's my point really.

Because to the untrained eye, that seems like an obvious solution?

They know that various initiatives and policies have not improved services because of what they read and hear so have come to the conclusion that root and branch reform might be what is needed.

The problem with that kind of opinion is that people will then accept something because it seems like a radical change (so must by definition be good). They don't have the expertise to understand all the consequences.

They don't have the expertise to understand all the consequences.

... well that's certainly true.

For my part, to fully understand the way the NHS functions (apart from the obvious) I'd have to make a detailed study, looking at all aspects - like procurement, etc - and that would be mammoth (for me anyway). I don't pretend to have any answers other than the belief that whatever is required to make it function effectively for the end-user, the patient, has to be properly funded and staffed. How that can be achieved, I have no idea.

Dickens

growstuff

If the average person is not an expert in the field of NHS organisation, why do they persist in coming out with soundbites about "complete reorganisation"? If what you say is true, they haven't a clue what they're talking about.

PS. That's my point really.

Because to the untrained eye, that seems like an obvious solution?

They know that various initiatives and policies have not improved services because of what they read and hear so have come to the conclusion that root and branch reform might be what is needed.

The problem with that kind of opinion is that people will then accept something because it seems like a radical change (so must by definition be good). They don't have the expertise to understand all the consequences.

I don't know if an enquiry or Royal commision could be framed in specific enough terms to be useful. What, specifically ,are they investigating? And there is such variation, from hubs on Scottish isles that function as GP's district nurses,midwives & emergency care right up to the big teaching hospitals in the big cities. There is much more specialism in healthcare as treatments & diagnostics become more sophisticated. That reduces the amount that GP's can oversee. Having different specialties in different hospitals, centres of excellence, does improve the success rates but also increases the logistical challenges of co-ordinating it all. Perhaps an enquiry could address how best to use & co-ordinate IT admin, as that crops up a lot on the above posts. But IT and medicine are 2 of the fastest-changing sectors, & such an enquiry would take at least 4 years from setting terms of reference to report implementation, would the recommendations still be relevant? A good start would be to overhaul social care and mental health provision, if these worked well it would take some pressure off hospitals.

growstuff

If the average person is not an expert in the field of NHS organisation, why do they persist in coming out with soundbites about "complete reorganisation"? If what you say is true, they haven't a clue what they're talking about.

PS. That's my point really.

Because to the untrained eye, that seems like an obvious solution?

They know that various initiatives and policies have not improved services because of what they read and hear so have come to the conclusion that root and branch reform might be what is needed.

The BritishMedicalAssociation (BMA) survey 2022 says Australia and Canada are top destinationsfor UK doctors. The main factor for leaving the NHS is pay and that the majority of doctors feel professionally undervalued. It's a lengthly and costly procedure to emigrate and to obtain a licence to practise but Canada welcomes UK doctors as described below. Quite an interesting article.
www.timescolonist.com/local-news/bc-government-entices-uk-doctors-with-double-the-pay-8368607

Norah

M0nica The NHS is superb in emergencies, and you will read that a lot on GN, but in the ordinary every day running of the service it is awful. The best evidence for that is the way the private sector is growing. Follow this link to this very interesting Gaurdian article

www.theguardian.com/society/2024/mar/08/private-healthcare-could-become-a-new-normal-as-nhs-grows-weaker

The tile of the piece, given in the link, really is sufficient.

Brilliant piece!

Why is it brilliant? Genuine question.

MOnica I agree with you to an extent. There have already been a couple of well-researched studies, but I agree that it needs an (expensive) and detailed analysis before any complete reorganisation could take place.

As you quite correctly pointed out, the NHS is now treating different conditions with a different demographic. In 1948, infectious diseases caused most illnesses. Vaccinations and antibiotics have eradicated many of them. A much higher percentage of people died from cancer, some of which can now be cured or put into remission until people die from something else.

More money is spent on over 60s per head than other age group. Many of these people would have died, if they'd been 60+ before 1948.

Rather than a complete reorganisation, maybe the NHS should concentrate on how it deals with chronic multi-morbidities and enhancing quality of life, which to be honest I think it's trying to do. Unfortunately, people still cling to the idea of having a family doctor and are resistant to change. Rather than being a PR exercise, I would like to see patient groups (of people who know what they're talking about) have a greater voice.

M0nica The NHS is superb in emergencies, and you will read that a lot on GN, but in the ordinary every day running of the service it is awful. The best evidence for that is the way the private sector is growing. Follow this link to this very interesting Gaurdian article

www.theguardian.com/society/2024/mar/08/private-healthcare-could-become-a-new-normal-as-nhs-grows-weaker

The tile of the piece, given in the link, really is sufficient.

Brilliant piece!

growstuff I would start with one of those major judge led enquiries that have been so effective in the tainted blood scandal, like the one looking into the extent of child sex abuse, and Grenfell tower.

A thorough enquiry with experts and non-exports, patients and clinicians. It may take several years, but if in the end it can come up with some concrete proposals to make it work more effectively.

Medecine surgery, medical technology has changed so much since the NHS started. Aneurin Bevan actually expected the NHS to shrink in size as people's problems were picked up and dealt with earlier, a healthier workforce, essentially, would not be ill as much.

Currently the modern health service is like telling an adult person that they must still wear the same size and style of shoes as they did when they were 10. The NHS was designed for a counry of 45 million people, who went to hospital and either died or got better and went back to work.

The number of people over 65 has gone up 80% since 1951. www.google.com/search?client=firefox-b-d&q=How+many+people+over+65+uk+1951 and life expectancy has increased from 66 to 81 for men and 70 to 83 for women and most older people, certainly over 80s, are reliant on daily medication, and regular medical interventions to enable them to live a long time and be active.

This is not what the NHS was designed for and there needs to be a rethink and reset and a Royal Commission ir similar is the best way to do it.

People such as Michael Gove and Dominic Cummings certainly had/have a "will", as does Liz Truss, so they steam rollered changes without considering any of the consequences. Do you think that's a good thing?

If the average person is not an expert in the field of NHS organisation, why do they persist in coming out with soundbites about "complete reorganisation"? If what you say is true, they haven't a clue what they're talking about.

PS. That's my point really.

growstuff

So exactly where would you start?

I have read umpteen tiles that the NHS needs a complete reorganisation, but nobody who writes that ever seems to come up with any concrete suggestions.

So, I repeat, where would you start? Or is this just a case of fighting words, such as "where there's a will there's a way". So what is the way?

But growstuff - how is the average person who is not an expert in the field of NHS organisation and admin expected to know where to start?

Nurses and others who work within the organisation see, from their own perspective, things that are not working efficiently, and patients see these things, also.

The NHS is a mammoth institution so how you can expect the ordinary patient to know where to start, beats me. Which is why we say things like "where there's a will..." because it's true. It's the primary motivation that make things 'work', if you don't have the will or the enthusiasm for it, just the desire to 'fix' a few glaring problems without looking at the whole structure, then it won't.

... Anyway, if I really knew where to start - I'd want to be paid for the knowledge and insight, because it would make me something of an expert.

It’s the reactive and not proactive attitude that we have.
3,000 people died of mouth cancer in 2021, this would have been picked up if they’d been able to see a dentist.
So, they saved how much by screwing the Dentists but how much did that cancer treatment cost and then the awful outcome of people dying some unnecessarily 😡

So exactly where would you start?

I have read umpteen tiles that the NHS needs a complete reorganisation, but nobody who writes that ever seems to come up with any concrete suggestions.

So, I repeat, where would you start? Or is this just a case of fighting words, such as "where there's a will there's a way". So what is the way?

growstuff

westendgirl

I think the time has come for a complete reorganisation of the health service, without politics coming into it.
We hear too many of these stories of complete inefficiency. A friend of mine went for a procedure . she went back for what she thought was a followup only to find she had been booked for the same procedure she had just had . A complete waste of time and money.

Where would you start?

That’s the problem, where do you start. I would start with the analogy, how do you eat an elephant, one bite at a time.
Many experts have come up with the it’s too big excuse, no it’s not!!!! If the will is there it can be done.

Jaffacake2

Visgir1

You hear about these stories, but do you hear about the thousands and thousands of people who are happy with the service, No!
I'm still working in the NHS and like a significant number of NHS staff we get fed up with the noise the disgruntled make.

As I said earlier I worked for 42 years as a senior nurse in the NHS and am fully aware of the millions of people who have had successful treatment over the years. My own family has had life saving operations and I have been in resus with anaphylaxis.
However the NHS is struggling and people are voicing their concerns and frustrations at being left in pain and at threat of disablement. This is not a criticism of the staff but an acknowledgement that the NHS needs urgent reorganisation and realistic increase in funding for staff salaries and treatments.
Meanwhile I am no nearer to seeing a neurologist,or a gp, and my foot is numb and my arm is now also losing strength.

However the NHS is struggling and people are voicing their concerns and frustrations at being left in pain and at threat of disablement. This is not a criticism of the staff but an acknowledgement that the NHS needs urgent reorganisation and realistic increase in funding for staff salaries and treatments.

... and care-in-the-community.

But I've not heard anything about this (apart from Starmer talking about reducing waiting lists) from any party leaders. If people are being treated in cupboards, dying in corridors and staying in ambulances for multiple hours because there are no beds... this is a national emergency as the RC has stated.

Meanwhile I am no nearer to seeing a neurologist,or a gp, and my foot is numb and my arm is now also losing strength.

That is alarming and frightening. I'm so sorry you're going through this with no help in sight.

Can you call your GP surgery and tell the receptionist that you are no longer able to function?

Visgir1

You hear about these stories, but do you hear about the thousands and thousands of people who are happy with the service, No!
I'm still working in the NHS and like a significant number of NHS staff we get fed up with the noise the disgruntled make.

As I said earlier I worked for 42 years as a senior nurse in the NHS and am fully aware of the millions of people who have had successful treatment over the years. My own family has had life saving operations and I have been in resus with anaphylaxis.
However the NHS is struggling and people are voicing their concerns and frustrations at being left in pain and at threat of disablement. This is not a criticism of the staff but an acknowledgement that the NHS needs urgent reorganisation and realistic increase in funding for staff salaries and treatments.
Meanwhile I am no nearer to seeing a neurologist,or a gp, and my foot is numb and my arm is now also losing strength.

This is the point foxie48, the emergency service is superb. I cannot speak too highly of it. It is just the rest of it which is the problem.

I am glad you were so well looked after. DH jad a pace maker fitted a few months ago - after being blued and twoed direct to the cardiac ward.

Perhaps if less money had been spent on computer systems that didn't work and rebuilding and upgrading, the NHS would have more money for the people who really matter ie the frontline staff and the patients.

It's incredibly patchy. I've unfortunately had two emergency admissions via A&E this year for unrelated events. On both occasions I was straight into Resus and seen by medical staff within 20 minutes. TBH I think they saved my life and I'm extremely grateful. However, I know I was fast tracked and when OH came to to see me he said there were sick people on chairs and beds in the corridor. That's just not acceptable is it? I've also had a pacemaker fitted, my appointment came more promptly than I thought it would, was done as a day case very efficiently and my follow up appointment arrived the following day. I can't fault my treatment but I know it's not the same for lots of people with painful but perhaps not life threatening conditions and for those with worrying symptoms, it's also really not right. The NHS needs a complete overhaul. I'd happily pay more and can afford to but I do think there's a lot of wastage in hospitals.

PFI, the rip off that just keeps taking.
Read and weep 😥

www.lrd.org.uk/free-read/pfi-rip-just-keeps-taking

I think GN reflects the general opinion of people. When we have good experiences with the NHS, we say so, when we do not, we do the same.

The NHS is superb in emergencies, and you will read that a lot on GN, but in the ordinary every day running of the service it is awful. The best evidence for that is the way the private sector is growing. Follow this link to this very interesting Gaurdian article www.theguardian.com/society/2024/mar/08/private-healthcare-could-become-a-new-normal-as-nhs-grows-weaker The tile of the piece, given in the link, really is sufficient.

Yes of course there are a lot of people getting good treatment in the NHS, but the majority of people are not. It is very rarely I speak to anyone these days who is happy with their treatment.

I have a DH in constant pain because his breast bone is split and completely out of alignment following heart surgery nearly 4 years ago. He has had scans and tests and everyone agrees something ought to be done, but evry time he goes to the hospital he sees a different doctor, who agrees it should be dealt with, but does nothing. He feels too ill to face trying to contact his GP, becaus eit is so difficult and he is not up to trying to fight his way through to getting treatment.

We have now decided that I will deal with the GP for him and get a private referral and pay for treeament he should be getting on the NHS, but nobody really cares.