NHS

I'm sure that if we wait ling enough, you will tell us.
BTW, my experiences are miles away fro Leicester.

Kitty's are not.

What has that got to do with anything Dj? Seems a bit personal! Obviously, the NHS is in a mess and needs sorting out - but how?

As we're in anecdotal mood, my personal experience of the NHS over the last five years is that it's got much worse. I have number of chronic conditions and have seen the level of primary care plummet. Clinical Commissioning Groups, the internal market and outsourcing to the cheapest provider and have been a disaster.

GadTea You referred to your own experience of care wherever it is that you live. It seems that you are fortunate. Many people are not. For instance, In some areas people have to be virtually blind with cataracts before they will be operated on. Because you spoke particularly of your own favourable situation, I can see why durhamjen made the comment she did - it's not all about you, or me, or those that are doing OK - it's about the many people who are struggling to get access to health care.

The people who keep saying something needs to be done, and that might include privatisation or some sort of health insurance, have overlooked the fact that in 2014 the results of a reputable piece of research carried out in 2011 found the NHS to be the best out of 11 countries, in terms of cost, efficiency and access to healthcare. Switzerland came second, Sweden third and the US last. Following nearly 6 years of Conservative cuts and other de-stabilising factors such as a top-down re-organisation that even the Conservatives admit was a failure, the NHS is in chaos and many hospitals are now expected to be closed. This was what Labour warned of before the 2010 election - because we had seen it before when the Conservatives were last in power. It has been widely reported that an even smaller percentage of money is now being spent on the NHS, as compared with other developed countries. It is no wonder that the system is failing.

I think people are entitled to comment on the NHS based on their own experience, given that everyone else seems to have an axe to grind. The press by and large blames everything that goes wrong on the NHS without any acknowledgement that it might be due to something such as human error or incompetence that might occur in any system. Solutions that might involve the private sector are shot down not on their merits but because they would erode the purity of the NHS concept, even though private/public partnership mixes, including an insurance element, work well in other countries.

My own family's recent experience is that the NHS works very well, at GP, A&E, and in- and out-patient levels, but that it does suffer from management, not clinical or nursing, incompetence. It also suffers from financial constraints due not least to its own success: people are living longer than was envisaged when it was set up and lots of treatments to keep us alive are very expensive. And extra funding is hard to come by; one poster suggested that its allocation should go up from 7% to 10% (not sure of what: GDP? HMRC's tax take?), but did not say where the extra 3% should come from: defence, social security, education?

I don't pretend to have solutions, but I don't see why posters should be shot down for saying that the NHS works for them; personal experience is part of the mix.

If the government got its act together about tax fraud, that would solve the problem.

www.opendemocracy.net/ournhs/carol-ackroyd/nhs-managers-are-being-forced-to-lie-to-public

I'm sure some of you will not believe this, either.

" Of course the NHS could save money by ending the market in healthcare and stripping out the costs of lawyers, accountants and others whose job is simply to run the market. This would save an estimated between £4.5bn to £10bn a year if not more. But that’s something central government - both Labour and Tory – has repeatedly refused to look at."

Corbyn would do it if he was PM. Unfortunately by 2020, there will only be a rump of a HS left.

grumppa, Maybe you would like to give some examples of 'management incompetence'. Durhamjen has just highlighted some examples which have resulted from the current government's reforms. One of my sisters was an NHS manager until redundancy and could give you a list of inefficient practice (not incompetncy), most of which have resulted from government 'reforms'.

Extra funding needs to come from tax.

Excellent link from OpenDemocracy, dj. Unfortunately, some people are so blinkered that they don't even want to find out what's going on.

Good post grumppa.

Yes excellent post Grumpa. I am convinced that management efficiency can provide the financial improvements that are essential if we do not wish to increase the tax bill to fund it.

So many of our posters are quoting third or fourth hand information, often from sources that have an axe to grind.
It used to be "heard it in the pub, so it must be true" nowadays it's "seen it on the internet, so it must be true". Anyone can post unsubstantiated rubbish about any subject they like on a web page, it's the modern day soap box. Yes, there are some good factual sources, but I'm sure for every one of those there are a dozen crap ones. I will find and read those I consider well informed and ignore the rest. I will not read links, just because someone thinks I should.

Again, a lot of hot air about "incompetence" but no actual facts. Our medical and care staff - in the hospitals, surgeries, people's homes and in residential settings - are working themselves into the ground, with reduced numbers of staff - and people focus on incompetence.

Yes, there is bound to be some incompetence - as there is in any large organisation. You only have to read the consumer letters written to newspapers to see examples that. But why the public services alone should be singled out as being especially incompetent I don't know.

There has only been one previous post that mentioned "incompetence", and the word was used twice. That doesn't seem to warrant the "lot of hot air" statement.

I have mentioned "inefficiency", that is by no means incompetence and I have never suggested such.. Efficiency can be improved as technology etc advances to allow systems to become more efficient and as management techniques improve.

I do have first hand experience of the care sector as I worked as a carer for 6 years prior to retiring.

The Kings Fund has just published some figures which might help to settle some debate, particularly relating to A&E.
The A&E standard is 4 hrs. 95% of patients discharged or treated within that time.
2015/16 it failed to met this in every single month except July.
Q. Has the A%E number of patients increased?
Up to about 2010 the figure remained steady at about 14million.
By 2014/5 there had been an increase to 22.3million. Most of these were represented by less serious issues. But the extra pressure is largely from older folk and other emergencies.
13% of patients are discharged without an treatment.
35% just need guidance.
Q. Lack of GP appointments. 85% get a timely appointment down from 88% in 2010. There has therefore been no significant deterioration.
The removal of GP out of hours responsibility is not significant. Most people end up in A&E in working hours.

2014/5 356000 more admissions than in 2010. This has a clear knock on effect on waiting times due to waiting for hospital beds.
2014/5 A&E were operating at 85% bed occupancy rate, which means they will struggle to deal with demand.

Delays in discharge
Known as delays in transfer of care. This was stable until 2014/5. The delays increased by 33%. Proportion attributed to social care rose by 31% reflecting the LA budgetary cuts which were highly significant. Especially so in recent years.

Staff shortages.
50% of year 3/4 registrars resign. The Kings fund stated that there is a limit to the workload that the staff should be e pelted to undertake.

Funding.

No actual increase since 2009/10
All increase to 2020 will be mostly swallowed by inflation.
17% decrease in social care budget.
Since 2009 hospitals have been getting busier, but it has not increased at the rate of population increase. Older folk attribute most of all to increase.

Read a couple of articles this morning that were saying even management effficiency is hard to improve on without cuts to A&E and/or specialist units such as urology and rheumatology (e.g. that not every hospital will be able to continue providing these). The. trouble seems to be two-fold: we spend less of our GDP on our health service than comparable countries, and the rate of increase in the number of patients (partly because of the ageing population) has gone up quite dramatically.

It seems a lot of NHS hospitals in England (articles were only talking about England, though the nearest A&E to me in Scotland closed down a couple of years ago) are very much in deficit.

From these figures then I think we can deduce that funding is the biggest source of the problems experienced by the NHS. Funding particularly in social care. To cut the budget just at the time when our generation was coming onstream seems highly significant, and to deny that it has any effect is not facing the facts.

Our choice then is to either increase spending or degrade the NHS.

Yes, except that it doesn't feel like our choice even though "we" (enough of us anyhow) voted for the current government. We've only got ourselves to blame. That old saying strikes again: people get the government they deserve.

I think we just have to grin and bear it for the next few years. ??

Perhaps we should have a question on the referendum slip asking if an extra 5pence on NI or income tax should be levied to go specifically to the NHS.

Another significant fact is that Hospital beds have decreased by 51% since the 1990s. This is not as bad as it sounds as change in the way we treated the mentally ill etc meant fewer beds were required. However, I suspect that it was tempting to cut a tad more than necessary when the accountants were looking at the budget.

Not only will we have lost those beds but also the capacity to increase if necessary.

If all you go on is first hand experience of the NHS, you do not see what is happening over all
Maybe not, but perhaps it does give insight into a more complex situation than some entrenched opinions would have us believe.

Like grumppa I believe that "first hand experience" whether working in the NHS or being served by it plays an invaluable part in forming one's own opinion and is perfectly valid.
If we were only to go by the media, we would get a broad brush view , with varying degrees of accuracy and informed comment, depending on the source.
Yet again, personal discussion is being shot down in flames if it dares to veer from the received wisdom of the OP.
To ask "why are you bothering with this thread at all?" is hardly designed to encourage balanced discussion. .

Undoubtedly day to day experience colours our views about all sorts of experiences, and it is perfectly valid to bring it into a general but subjective discussion.
However, surely we must all agree that one cannot run an institution like the NHS or anything else on personal experience.
Objectivity and evidence can be the only key to any problem.

Informed opinion in the media is certainly important in considering ones owns views.
But when it comes to "letters" I am very sceptical, complainers always (IMO) make more noise that those that are satisfied.
I have some close friends that complain about the local GP and hospital services. They also complain about the post office, shops, postwoman, dustmen (sorry,dust persons), foreigners, garages, broadband supplier (they have tried most of them), their neighbours, probably us, ete etc, and these are only the one I can remember recently, you get the picture.