The New Cabinet

Walk in Centres were a great idea [we've used them several times] but they are closing down in many areas. I'm sure they took a lot of pressure of A&E departments and doctors surgeries. Chemists seem to be offering more and more services although they're not cheap [I saw an add for mole checking the other day] and I've often had bad advice from pharmacists. Eye tests should be free again as they are such a good health check. Good nutrition should be taught in schools [maybe it is ?].Companies that provide medication for dispensing doctors should automatically provide the cheapest generic [again,that might be happening now].We should all be responsible for our own health, but at the same time help should be there when needed. I don't know what the answer is though. I read once the Japan has a 'ministry of forward planning department'; I've often felt that we don't think ahead in this country.

I agree Anya - turn NI into NHSI and separate it completely. As we both agree on 'a long term NHS plan' (can we start a call for such a thing) that is a lovely start to the week .

Thank you for the details MargaretX. The more we can know and compare the better.

Sounds very well organised MargaretX. I agree with others that this constant fire fighting and damage limitation approach to and by NHS should be replaced by a good, very long term strategy not one that lurches from election to election.

I support a national health service,sick people should be treated whether they can afford to pay or not.
Many in the UK now pay for private health care,yet also pay NI and taxes which are used for an NHS which they do not use.I don,t think many of those would be happy to see a rise in taxes .
Certain uses should be chargeable i.e. Friday night drunks.

Someone has previously mentioned the price of agency nurses and lack of training for our own.I signed a petition a few weeks ago as bursaries for our trainee nurses are under threat.We need more career nurses of our own with fair pay.
We also need to crack down on the fees paid to NHS hospital locums.
Before posting this,I have found various websites advertising tax saving services to NHS locums,boasting up to £25,000 p.a. tax SAVING.....more than lots of people earn.
I think many people would be willing to pay slightly more tax to improve the NHS,after they have seen the NHS put their own house in order.
I first looked into this when I had an unsatisfactory appointment with a locum consultant 4 years ago.
I was given a further appointment with a full time consultant who was astonished that I was not told I have cataracts,let alone,no opinion at all on the actual problem under investigation.
The agency www.click4locums.co.uk has a list of hourly rates,but they are not the highest.

I don't support the argument about people who pay for private healthcare not wanting to pay higher taxes. Yes, they do use the NHS when it suits them. They use A and E and emergency services. I believe even David Cameron's last child was born in an NHS maternity unit, because the baby was early.

We need to face up to the real problem, which is that the NHS is a victim of its own success and people are living longer, not blaming drunks and locums.

The reason agency nurses and locums are used is because hospitals have budget constraints and aren't allowed to employ enough full-time staff.

But Granny2016 without the NHS there would be no doctors in private medicine. Anyone who uses private healthcare benefits from the NHS hospitals that train staff. They do use the NHS, just don't join the waiting lists for operations and appointments. I am not saying private medicine is wrong only that the people using it owe a debt to the NHS as well. Private medicine also sets limits to the amount of treatment someone is entitled to, when the money runs out good old NHS steps in.

'The reason agency nurses and locums are used is because hospitals have budget constraints and aren't allowed to employ enough full-time staff'..I didn't realise that dd. .

No, Tegan, you should be angry at it, not sad. It's government policy.

Thousands of permanent posts have been axed, so when somebody's ill or on holiday or there are more patients than expected, locums have to be employed. There are also some specialisms, where it's not possible to fill vacancies quickly enough, because there are shortages.

The PAC has given them until December to come up with figures for staffing a 27/7 NHS. What happens between now and then?
More locums?

@ Daphnedill,I don,t blame drunks for the state of the NHS,but they are a nuisance and do clutter up A&E.A bill might sober them up a bit,and allow staff to look after those who need attention.
I take it that you don,t live in one of our major cities where Friday and Saturday evenings are one long pub crawl and people are flat out on the pavements!
Our hospital,which is a large teaching one,informed me that locums can be employed from 1 day to 6 months.

@Trisher,I believe that NHS doctors are paid very well in the private sector,but you are correct,they are trained by the NHS ,also they do use NHS facilities for private work.
My daughter was very ill some years ago and was given a 6 to 8 weeks wait for investigative X-rays. I asked the hospital when she could have a private X -ray
and was told the following day !!
I then asked to book that appointment for my daughter,but on the NHS.
After consideration by the department manager,she was given the appointment ,the results took a few days and her 6 months of treatment began.

Though I disapprove of private care impacting on NHS patients,I do not blame anyone who choses it.

I don't live in a big city, but I DO live near one of the biggest teaching hospitals in the country. I spent a couple of hours in A & E two weeks ago with my son, who dislocated his knee cap on a Saturday evening. A & E wasn't full of drunks.

Locums can be employed for long periods, because vacancies can't be filled and because there is no budget for full-time staff due to uncertainty and cuts. It can work out cheaper for the NHS, because they don't have on costs such as NI and pension contributions nor do they have to pay redundancy pay, if they have to make cuts. My daughter shares a flat with three medics. One was a locum for four months after being made redundant as a result of cuts.

By the way, you should be grateful your cataract wasn't dealt with by these people...

www.theguardian.com/society/2014/oct/23/family-investigation-cataract-surgery-private-vanguard

Private isn't always best and the NHS ended up picking up the pieces of the botched operations.

My cataracts haven,t been treated Dapnedill,I have been told to wait until they worsen.
I do very detailed work for my income so am in no hurry as I dread it not working.
A friend had hers done on the NHS,one eye is worse and the other is perfect vision which she finds very frustrating.

I did read your link.....not good at all.

No, it's not good. Private providers also employ locums. With commissioning of services to outsourced providers, quality of care is unlikely to improve and there is even less likely there will be continuity of care.

The real issue is that over 40% of the NHS budget is spent on the over 65s. When the NHS was founded in 1948 average male life expectancy was only just over 65, so about half of all males died before they retired.

Infant mortality was 34 per 1000 (it's now 5 per 1000). That's an amazing improvement, but some of those babies will have disabilities or conditions requiring lifelong care, which is expensive.

No private provider is going to pick up work with difficult births, the disabled or diseases of the elderly, because it's not profitable. If we want a truly first class health service, we have to pay for it. That means raising taxes or charging people for visits. I'm not in favour of charging for visits, because I know that I, for one, would put off seeing my GP if I found something worrying until it was maybe too late.

What system does Southern Ireland have? I seem to remember friends having to pay a small amount to see a Dr.

You can only have a private provider is he doesn't pick and choose. The government has to make a law about it

When there are more of them then the work will be spread out
6 weeks for an XRAY! impossible. The staff levels sound to be dangerously low.

Other countries can do it. I had a tiny inflamed gland on my back. It got worse when I was in Austria in a mountain village. The GP told me to get onto the couch, lay on my stomach, and he cut it open and removed it, bound it up and sent me back to our holiday flat where I lay down and recovered. I went three times in all that week, and it healed well no antibiotics.

In 1000 metres high he can't send patients anywhere except by helicopter so he did it all. Another patient told me he set broken bones in the ski season. Fantastic.
It cost me nothing as in the EU there is an agreement.

To be honest the NHS is too large it is unmanageable. It should be divided up.

But, Margaret, that's how private outsourcing works in the UK and what the government is encouraging. The NHS 'commissions' services for ambulance services, mental health, radiography, out of hours care, etc. Sometimes the NHS wins the contracts; sometimes private providers step in, but they're only interested in the acute, profitable work. The NHS picks up the cinderella services. Commissioning administrators cost over £2billion, which could go to patient care.

The NHS IS divided up into smaller regions, each with its own managers, policies and procedures. It hasn't operated as a national giant for years.

Sorry to say this again, but the real problem is money. The latest year for which comparable data seems to be available is 2013. Germany spent $4819 per capita, the UK spent $3235. Imagine what the UK could do with over fifty per cent extra funding!

PS. My son had his knee Xrayed the day he dislocated it and again at the end of last week. He's starting physio next week - all on the NHS.

@Tegan

It costs 100 Euro to go to A & E with a doctor referral in Eire. There are also charges for GP visits and ambulances.

Apparently nearly half of Irish citizens have private health insurance.

Yes in S Ireland you do have to pay to see a doctor and, I think pay for all your prescriptions. Because it is so rural people have to travel very long distances to see consultants or get hospital treatment.

When my daughter was travelling round Eire for a few months, she flew home for medical treatment, then flew back. Even though she had a EHIC and would have been entitled to free treatment, she found the service incredibly slow and inefficient. It was quicker to fly back to the UK.

Apparently, some people have a medical card which entitles them to free or subsidised treatment. If you don't have private health insurance, it's expensive and waiting lists are long. The Irish spend more per capita than the UK does.

fullfact.org/health/spending-english-nhs/

Can anyone make sense of this? It's no wonder those in charge of CCG finance have problems.

See Leadsom has been reported as the worse most useless minister ever by civil servants who previously worked with her. The farmers must be concerned. Whose going to fight their corner? She believes in total free market economics. Idiot woman.

Do they have a table, whitewave? I did not think that anyone could be worse than IDS.

I think the poin t with Leadsom is that she is so useless that in fac t she is totally ineffectual.
She wasn't sure if climate change was real but was sure that God existed and one that disapproved of gay marriage.