NHS winter crisis looms

My grandparents died before I was born. One of my grandfathers died before the NHS and because he could not afford medication.
We do and did pay for our own NHS care as well as that of parents, grandparents if alive, and children and anyone who needs it. The assumption is that most people will not. That's why it is/was such a good system.

In the meantime, Hunt is in China doing deals with the Chinese to take over even more of it.

Blah blah blah! You didn't pay for your own NHS care. You paid for your parents and grandparents, who possibly didn't live as long as you will and didn't cost so much. People weren't expected to live so long after retirement when the cease paying for medical care.

What does the fact that your parents and grandparents fought in wars have to do with anything?

Facts facts facts.

PS. Somebody on another forum once told that story about stationery.

I have mentioned this before... I was a voluntary worker in a local City hospital. The NHS was under the influence of a Labour government and had been for some years. One day, I was asked to take delivery of hospital stationery and show the driver to stock cupboards. I was amazed at the size of the stock cupboards and even more amazed that there was positively no room to take more stock. I asked the driver to take it back... which he said he would but it was part of monthly stock that was paid for and contracted to be delivered whether needed or not.

And as for the ageing population. We, and our parents and grandparents, paid into this ever since 1948. Even some years later when I knew the value of money, I remember my family had to pay weekly to be on a Doctor's panel. I am the only member of my family who needed hospital treatment for an operation that would cost £3,500 in Turkey in an American hospital using the same equipment as the NHS at a cost of £15k.

As for "a dip in baby boomers", I grew up in the shadow of parents and grandparents who had fought for this country and other relatives who had lost their lives in two world wars. I remember that children were the future, and Commonwealth governments encouraged large families.

Having had to use a taxi in an emergency nearly 15 years ago, a middle aged Asian taxi driver from a Commonwealth country said to me that he was happy to be in this country. His younger brother had needed a lung removed and the operation was free as was other medical treatment that was needed. So, is someone on GNet discriminating against indigenous peoples of the UK who require medical treatment in old age?

www.networks.nhs.uk/editors-blog/towards-a-merry-christmas

The government hasn't stopped dismantling the NHS over Christmas.

nhaspace.com/2016/12/24/christmas-message-from-the-national-health-action-party/

Yes, Jess.
The NHS would be in an even more dire state if it wasn't for all these other groups, hospices, Macmillan, Marie Curie, Lifespan, etc., as well as all the individual charities set up to fund various treatments.
We have a lot to be grateful for.

Macmillan nurses are a similar category. They may provide care in homes or in hospitals sometimes. My friend had a Macmillan team working on his oncology ward.

I said it depends on where you live. We fund raise for the hospice, but not hospice at home. I suppose it depends on how it was set up.

So why are we always fundraising for our local hospice at home?


I've just looked it up - it gets a minimum amount of funding from the government, the rest is by fundraising locally.

That's why it's done through continuing healthcare. Anyone who is likely to die within the next 6 months can get funding for it, through the NHS or social services. I know this because my husband used it, and it was organised through the GP surgery and the hospital. We had quite a shock when we got home from hospital after his surgery, and had a phone call from the hospice about it. The hospice is a charity, but hospice at home isn't. It can be very confusing.

Hospice groups who care for people in their homes are charities I think; ours does use a room at the local NHS hospital as a base but they would not do the normal care work which people may require on discharge from hospital; they are there to provide care for cancer patients and terminally ill patients.

Hospice at Home is organised by your GP. It can be a charity, or not-for-profit organisation, or run by the council, depending on where you live.

Do you remember how earlier in the year, Jeremy Hunt called junior doctors all sorts of names for going on strike and having elective surgery postponed?
He's asked hospitals to cancel elective surgery himself in order to allow for the winter crisis. So it's okay for him to cancel operations but not the junior doctors. Strange, that.

We have Sue Ryder homes here ( they are certainly a charity.)

Macmillan is a charity, as are most (all?) hospices.

Round here, hospice at home is a charity. Similar to Macmillan. Was that NHS?

When my husband was dying of cancer, we had hospice at home carers coming to see him four times a day. They used to tell me they were there for me as well as him, so if there was anything they could help me with, they would. They used to make 30 minute calls instead of fifteen minute ones.
They still had to phone up and say when they were leaving to go on to the next home.
I can't imagine that happening now. It's all about finance, isn't it?

I agree, but I'm really talking about people not in care homes. The situation used to be that vulnerable and elderly people stayed in their own homes and were looked after by the district nursing team, the GP and input from the council (eg meals on wheels) and the voluntary sector.

If a person needed a higher level of care, they could be admitted to a medical ward (which weren't that great), a care home or an acute hospital, if necessary. District/community nurses had the expertise to know which would be most appropriate. People with money have always had the option to go to a better quality care/nursing home.

The problem is that the options are no longer there. It's now either 'no care' or 'acute care'. That's a bit simplistic, but not far off the reality. For example, lots of elderly people have leg ulcers due to poor circulation. A community nurse could treat ulcers at home, but often ulcers are neglected and the patients end up in hospital. In extreme cases, this leads to sepsis and/or amputation. Good community care could avoid the problem in the first place.

There are various estimates of how much avoidable hospital admissions cost the NHS. I don't know what the exact figure is, but it's almost certainly in the billions. Whatever the figure is, the claims of health tourism and people 'wasting' A&E time pale into insignificance.

It's all about saving money in the short term and costing in the long term - not forgetting the experience of people in the last few years of their lives.

There's also the extra whammy of Osborne blithely increasing the minimum wage without accounting for the fact that this would put up the cost of care - without making any more money available to pay for the increased salaries. Shocking that carers are on minimum wage, but that is often the reality. Consequence is care homes closing. Leading to knock on effect...

Exactly! These days a community nurse might be used by a council to assess a patient's needs for care, but is much less likely to be involved in actually doing the caring or managing the team doing the caring.

District nurses were a national treasure. I used to lecture on a course where experienced nurses used to do the Diploma.
When MIL was alive I used to fret because the carers obviously were not medically trained to spot any worrying symptoms. Like the time her legs swelled like sausages and she kept this fact to herself for a couple of days. However carers used to help her wash every morning... It was caused by a worsening of heart failure and required a week or so in hospital to get meds adjusted...
There were several occasions when her dear and wonderful friend, a practice nurse, spotted something and called the doctor.

It's both.

One of my sisters was a team manager for a large team of district nurses (NHS). The whole service was transferred to social services (council run), who then outsourced it to private companies. My sister and about a hundred qualified staff were made redundant. Some of them were re-employed (on lower rates of pay and insecure contracts), but much of the work is now being done by carers without medical qualifications.

The clients now get a couple of short visits a day (if they're lucky) and are often admitted to hospital to be on the safe side. When the service was run by the NHS, district nurses could assess patients and deliver treatment if necessary. Carers can't do that and there is virtually no district nursing team left.

Therefore, people are admitted to hospital, sometimes just for observation, and hospitals won't discharge them if there isn't 24/7 care available at home.

In addition, community hospitals with low dependency beds have been shut down, so there is no 'half way house', so people end up blocking beds in acute wards. Admittedly, some of the geriatric and medical wards were a bit grim and people wanted to get home as soon as possible, but the option isn't there now, so people are either discharged too early (often requiring readmitting) or they stay in an acute hospital, sometimes miles away from relatives and friends.

Isn't it more that they are admitted because they are acutely ill but then can't get discharged because the "care package" is not in place, or is not adequate, or there is no suitable non-acute-hospital facility for them to go to? I dont think they admit many people to hospital these days who are not acutely ill?

This thread seems to have drifted somewhat. The problem with winter is that too many people are admitted to acute hospitals, who would be better off staying at home or in a community setting, but the resources aren't there. These services aren't funded by the NHS but local councils, who are themselves facing savage cuts.

The description of a job creation scheme is just about right Jess the French do love their bits of paper and everyone having. 'Dossier'. However the system does seem to work well enough. It is only in the last few years - about ten or so - that the Health service has given everyone a card (a credit card type) and you do need to have it with you all the time in case of medical emergency.

We also pay means tested contributions called National Insurance, although there's a cap so the wealthiest pay a lower percentage. Pensioners don't pay anything and I wouldn't mind betting that at some stage reduced NI for pensioners will be brought in, although it will be politically difficult - maybe when/if the Conservatives have a huge majority.