Dessimation of the NHS

www.pulsetoday.co.uk/views/blogs/copperfield/lmcs-need-to-get-this-message-across-seeing-your-gp-is-no-longer-safe/20030973.blog

From a practising GP, who admits to sending more people to A&E because of the pressure of work.

Nonnie the reported huge increase in numbers attending A & E is not actually moe people turning up, it is due to the fact that there are progressively fewer A & E departments so they are trying to squeeze a pint into a half pint glass. No wonder staff are leaving when they are put under such pressure.

Probably due to a number of reasons, certainly more people using A&E these days, a bigger population, not being able to see a GP at the weekend, and less 'awe' at the prospect of turning up at a hospital with only a cut finger!

And a shortage of GPs - poor planning and again, immigration restrictions. The NHS has, since its beginning, relied to some extent on recruiting English speaking staff from the Commonwealth. That is now much more difficult, due to changes introduced by coalition government.
Another big problem (the one I forgot in my list above) is a big cut in the money LAs have for social care. Bound to lead to more frail people ending up in hospital if carers are dashing in, making sure pills are swallowed and dashing out again, without the opportunity to notice if someone needs a GP appointment. Also if frail people are struggling more at home, more likely to have falls, trying to get to the loo without help etc. The other end of this is that with less social care available it is more difficult for hospitals to discharge patients and so beds under more pressure.
The coalition put huge pressure on hospitals to "increase bed occupancy". Had it straight from horse's mouth (horse being a chest consultant in my extended family). One of the reasons for his retiring at 60 was he was fed up with this - how is he supposed to have v high bed occupancy when his patient intake is much higher in the winter. Can't make them plan to get pneumonia in the summer.
None of this is ineptitude or mismanagement on the part of the government or hospital managers. It's a deliberate policy of body blows to the NHS buy a secretary of state who is committed to undermining it, and whose family have many business interests in private healthcare companies.
Really not fair at all to blame the hospital managers.

Add to that a significant number of people who don't have a GP anyway-because there isn't one where they live or they are homeless, itinerant or simply haven't registered and of course more people will turn up at A&E. As far as decimate goes it is entirely accurate. Based on the Roman armies method of dealing with rebellious soldiers. 1 in every 10 was killed so the Legion (100 soldiers) became incapable of operating. The private companies are now circling our NHS selecting the services they can make a profit from, once they have taken the cherries and left the rest we will have an NHS service which doesn't function at all.

Since getting rid of matrons there have been far too many chiefs and not enough Indians in the NHS. It's about time the NHS was run without government intervention.

By the time the next election comes there will be no such thing as the NHS which is exactly what the Tories want.

People were warned before the last election that the Tories want to get rid of the NHS and social housing and now it's coming true.

Something needs to be done now before it's too late.

nhap.org/16263-2/

Richard Branson has been awarded a £126 million contract to take over hospital services in Kent. This was against the NHS Community Trust.
Anyone who lives in Kent and wants to keep the NHS, I hope you object strongly.
This contract is for seven years.

‘Breaking up services in this way is not only expensive but causes disruption and removes parts of the NHS from public scrutiny, as private companies have no obligations to answer Freedom of Information requests, as the public sector does. We need transparency and accountability in the NHS.

‘Contracting out services is an expensive business which is just one of the ways in which privatisation takes money away from front line care. It has been estimated that the cost of this market system is at least £4.5bn and may be as much as £10bn. That’s £1 in every £10 that the NHS spends.’

Decimation? Taking one tenth of the money away from frontline care, to go into profits which go offshore.

Another problem for A and E is cutbacks in psychiatric services, so people in crisis end up there. Not the right place for them.

www.theguardian.com/society/2016/jan/30/gp-surgeries-operating-state-of-emergency-leading-family-doctor

From the head of the BMA's GP section.
GPs should be the front line, but they are being prevented from doing their work because they do not have the finance.

www.independent.co.uk/life-style/health-and-families/health-news/care-homes-face-crisis-as-inspectors-threaten-mass-walkout-over-pay-cuts-a6840401.html

It's the CQC as well. Not hospitals yet, just care homes, but if the CQC cannot inspect care homes, more residents will end up in hospital.

My DH was the local government correspondent for 'The Times' in the 1980s and had insight into PFI which the Conservatives introduced in a small way to keep public borrowing off the balance sheet as there was a PSB borrowing limit.

When New Labour succeeded they ramped PSI up to pay for hundreds of capital projects. It was a huge and feckless spendathon where bad deals were made all round the country on a 'buy now, pay later ' basis that will see councils paying for substandard buildings and services at an eye watering rate for decades to come.

I remember at the time one of the first hospitals, Kidderminster, was built too small so that people and equipment, it was said, couldn't be got round the beds. Procurement has never been the public sector's strong suit and Labour is particularly poor at it.

The current case posted seems to be an heir to these times whereby services must be cut for some to pay for an expensive PFI deal. It is hugely regrettable but playing the blame game won't keep the services. A well orchestrated protest or legal challenge might do better.

The population in this country is now some 65 million and the NHS was not created to deal with such numbers (and increasing every year) and is creaking under the weight of the added burden. It has new and expensive treatments coming on stream every day. It is tasked with ever expanding public health issues ( like the so called sugar 'tax' and other 'sin' campaigns.) It has just expanded its emit for mental health services. In the twenty first century the roles of the NHS change and expand every year, month and day. I read that the NHS spends a £hundred million a year on translators, for instance.

It is perhaps a reminder that we need to think rationally about our free medical service in order to improve it and not to respond with emotive polemicism.

PFI was used by the Blair government as a relatively minor % of the investment that was made in a crumbling national infrastructure.
Under Thatcher and Major schools across the UK were allowed to crumble (literally) and very little was invested in building new hospital facilities. Many hospitals were still struggling along in Victorian buildings They inherited a huge problem.
Next time you go to hospital would you like to be on a long "nightingale" ward with 2 rows of beds and a leaking ceiling?
Would you like your grandchildren to go to a school that is cold, draughty and damp?
The investment that was made at this time means that NHS facilities are much more fit for purpose and most schools have been brought up to a much better standard, or their building replaced. In retrospect it was a mistake to use PFI for some projects. But feckless expenditure on schools and hospitals. Of course it wasn't.

Before the Blair government we had schools and hospitals that had been left to crumble. I remember buildings with buckets to catch the water coming in from holes in ceilings. PFI was used in an attempt to provide buildings that were both fit for purpose and treat the consumer with the respect to which they're entitled.

It's a familiar scene, tory governments that neglect or demolish public service followed by a Labour government that has to spend to rebuild. The current round of cuts can't be dismissed when asking why A and E is being 'over used'.

I have a feeling that the local government correspondent for the Guardian would agree with you, Iam and Jess.

JessM yes it is good to have fit for purpose buildings, however any judicious person will tell you, if you can't afford the repayments don't buy on HP. Services are being cut in these state of Art establishments which renders them not fit for purpose, this because the repayments are obscene. Eg. 68 million to build a hospital. Total repayment 770 million. If that was a Wonga loan Watchdog would be featuring it on TV and parliament would discuss.

Yes, completely wrong, Joelsnan. However, the government should have funded the schools and hospitals itself. We needed them as the Tories had let them run down.
The first thing they did in the coalition was to stop the building schools for the future scheme. Now there are not enough school places up to 2020.

After the banking crisis, money was printed, using QE, to support the banks. If it had been used for building houses, schools and hospitals, we would not be in the mess we are in.

nhap.org/slack-attitudes-and-bed-blocking-lord-carter-of-coles-is-avoiding-the-nhs-real-and-very-urgent-issues/

www.pulsetoday.co.uk/views/letters/mr-cameron-the-nhs-is-not-safe-in-your-hands/20031064.article

The best letter I've seen yet about the NHS and what is happening to GPs.
Signed by over 150 GPs in less than two days.

GPs held a special conference last week, and they supported the idea of mass resignation if Cameron and Hunt do not do something to improve the NHS.

And for their next trick...?
The government are selling off a publicly owned plasma company, that supplies plasma to NHS to an American company. Not great when you think that we will lose control of the supply chain for this essential blood product.
www.independent.co.uk/news/uk/politics/is-there-no-limit-to-what-this-government-will-privatise-uk-plasma-supplier-sold-to-us-private-8718029.html

In my own opinion we have just as many issues with the NHS in Scotland, as anyone else.
Where I live there was a GP shortage, one practice had to close their lists. I am having IMMENSE issues with my hospital, which unfortunately I cannot discuss on a public forum.

The Scottish Govt. insists on this fantasy of free prescriptions and free personal care for the elderly, great in theory but FREE still has to be paid for. We have an ageing population, not to mention our overseas visitors(one of the reasons I am voting to come out of the E.U. among others) who are all entitled to free prescriptions/treatment, this to me is unsustainable. Things have to be paid for. I am not saying the ageing population do not deserve these things, the people like our elderly who defended our country and have paid into our system deserve the care. There are too many taking out of the system, who have never paid in and I include our own non working population in this.I mean the won't work brigade, not the can't work. There is the question of all the jobs that have been lost too, but that is another discussion.

Near to me there are about 80 flats being built, all the folk who move there will be entitled to treatment from the two Health Centres in my own immediate district. The Health Centres are bursting at the seams.

Re PFI hospitals, the one we have is not big enough and it is in a major city , where they closed umpteen smaller hospitals to fit into this one. Folk are chucked out after operations as soon as they can walk.

I think the abuse of the NHS and the waste is unacceptable. I had reason to attend hospital before Christmas, on the wall it stated 163 people did not turn up for appointments, why is this allowed to go on? Bad enough a doctor's time wasted, but this was a consultant's clinic. No wonder people cannot get seen.

If I didn't attend my dentist, she can bill me. This should be done with the timewasters who do not turn up AND who do not let the appropriate person know so that the unused appointment could go to someone else. Why no one in government addresses these issues I do not know, but politicians are not accepting that the NHS up and down the country is broken. My own cynical reasoning being that in Scotland, in particular, we have an election looming and certain parties do not want to be seen as the big bad wolf, and this is the same reason they will not increase the Council Tax, while Councils are tearing their hair out with the lack of money for local facilities.

An article from The Scotsman

www.scotsman.com/news/mothers-health-at-risk-in-rush-to-get-them-out-of-hospital-1-4023173

Our hospital here in Southend had a 'black hole of £10,000,000. So they brought in some clever dick to tell them where they are going wrong, at a cost of £789,000 for one year. Now the black hole is bigger but they won't say by how much.

www.theguardian.com/society/2016/feb/07/barts-london-hospital-trust-biggest-overspend-nhs-history

It will be interesting to see what happens at Barts. If it was a private hospital it would have closed and the NHS would have had to take over.

Cher, the problem with both Scotland and Wales is that most of their money comes from the government in London in the block grant. They then have to decide on priorities in sharing it out. They are finding out in England that cuts to social care and councils impact on the NHS.
What else do you think Scotland should do with the money it gets?