The New Cabinet

Jane, the government has always said that the NHS is ring-fenced. However you look at it, giving it £8 million while asking it to save £22 million is not ring-fencing.

www.health.org.uk/sites/default/files/Spending-Review-Nuffield-Health-Kings-Fund-December-2015_spending_review_what_does_it_mean_for_health_and_social_care.pdf

Figures here, Jess.

Which post, Anya? Note she didn't call me silly, just the post, whichever one that is.

I know further funding is unlikely to be available. I was just thinking in writing I suppose. Having worked in NHS I can see that its possible to work differently to achieve better results but this is the face of increased expectation and new expensive treatments being developed all the time. I'd hate to have to be the Health minister. Its a really tough situation all round and we're all actual or potential patients.

Why is dj's post silly?

Well not a cat's chance in hell of getting more funding Jane10. During the election campaign I remember Cameron (in the only TV debate his minders allowed him to appear in) saying that he was kindly "giving" the NHS an extra £8billion over the next 5 years. In the next throwaway remark he mentioned that the NHS is also going to have to make £22billion "efficiency savings" This at a time when the NHS was already stretched with demand growing quite fast due to our ageing population. Unfortunately none of the other party leaders pointed out this amounted to a £14 billion cut in funding. Health economists are agreed that the NHS has been starved of the funds it needs just to maintain status quo, since the 2010 election.
So why suddenly start saying they need to provide a gold plated 24/7 service in all departments at this point?

DJ what a silly post.

Message deleted by Gransnet. Here's a link to our Talk Guidelines.

www.taxresearch.org.uk/Blog/2016/07/15/rsa-animate-economics-is-for-everyone/

Do you think Hammond has seen this?

I would certainly not expect it to be 'cost neutral'! Good care costs money. If 7 day working could be implemented (obviously with increased staffing to run all the shifts) then waiting lists would be reduced. Only snag being trying to do it with insufficient funding. Och?

Well if we must have the shopping analogy, there are unlikely to be any senior managers, certainly no office staff and very few checkout people available in the middle of the night. Exactly in fact the situation that happens in our hospitals already. If you were to suggest to Tescos that they should provide exactly the same staffing at all times of the day and night they would laugh out loud and tell you it wasn't financially viable.

Jayh, hope your foot is okay. Presumably your husband will be doing lots of extra jobs around the house to make up for it.

I do not want my hospital to be compared to Tesco.
However, lately, I have noticed that some supermarkets are changing their hours so they are not open 24/7. Tesco's was one of them.
In fact, Tesco was never open 24/7 because it has always been illegal to open for a full Sunday. Should Tesco workers get a better deal than the NHS?

Hunt wants his version of 24/7 without any extra expense. The phrase is cost neutral. It is not possible. He thought just tinkering with overtime rates would solve the problem. It will not. He is just spreading the same number of staff over more days.

I'm with Anya on this one. Hospital premises are expensive to run. There's no reason not to use all the clinic space, theatres etc on a 7 day basis. Main problem is that this would require current staffing to be spread too thinly. More staff in possibly different mix required?

Anya, I am very well aware how hospital shift work operates. A full service CANNOT operate at weekends without reducing the cover during the week or employing extra staff. This has nothing to do with the days individuals are expected to work, but the MAXIMUM number of hours they can work safely. You really don't seem to grasp the issues, so it probably is pointless to continue the discussion.

I should have added that they do shift work as routine.

No DD that is not the issue. Hospital staff are not contacted to work Monday - Friday 9.00- 5.00 and they know this when making a career choice - a very lucrative career choice might I add.

But as I've just posted, there's no point in continuing a discussion where we can't agree on the need let alone the resolution ; we'd just end up batting the problem back and forth and getting nowhere.

Anya, Getting enough staff to commit to weekends is NOT the problem. The problem is finding enough staff to work at weekends on top of a full working week on weekdays.

Why do routine appointments and procedures including operations NEED to take place at weekends?

I can see you don't think there's an issue with weekends Jess so no point in continuing this discussion.

I saw that interview JessM! I'm glad I didn't see it before the referendum! Arrogance and dereliction of duty comes to mind!!!

So why is Hunt not solving " the problem" by giving hospitals more money to provide an extended cover? Not sure where you are getting the idea from Anya that there is a current problem with cover, in areas that need cover. Obviously it would be nice to have an out patients appointment any time you fancy- but that would cost a lot of money. Someone will know the answer to this: Is it common for private hospitals and consultants to offer full service for minor surgery and outpatients at weekends?
If the seriously wanted to change the system they would have needed to do some careful analysis of the problem in consultation with the experts who actually run hospitals and the patients. Not rush into a battle with junior hospital doctors!
This was one of Cameron's blithe promises during an election campaign that he did not expect to win. He was good at blithe promises: greenest government ever, meeting a target for immigration, not having a top down health service re-organisation and a small matter of a referendum that is threatening to throw our government into chaos. To name but a few.
Did anyone else see the Nick Robinson clip of him interviewing Cameron before the 2015 election and asking him "What is Plan B if you lose the referendum." To which the inspired answer was "Plan B is to have a referendum".

Hospitals have always been open for business 7 days a week...why would you think otherwise but getting enough staff to commit to weekends has become the problem.

Of course the hospital trusts need to employ sufficient staff to cover weekends. Doctors are not being asked to cover every weekend but to commit to a certain number.

But...but...presumably shops employed extra staff when Sunday opening became the norm and they made extra profit. Most of the small shops in my town don't open on Sundays and the reason they give is that it wouldn't be commercially viable.

If a hospital employs X number of staff to cover five days and is then told that it has to spread the same number of staff over seven days, weekdays are going to be understaffed.