We are watching the demise of the NHS with our eyes wide open.

Anybody who works in any public service will recognise that the waste is quite shocking. My sister worked for the NHS procurement dept and found that you could run down to the Supermarket to get toilet rolls cheaper than the NHS was paying. I found the same in Education and my boys work in the Fire Service alongside the Police where they see similar problems. When the Government ask for cutbacks, more often than not it is easier to slash costs by getting rid of staff rather than looking at where the waste is. Well run private, profitable businesses do not allow this. That is not to say I want these services to be privatised, I don't but I do want them really looked at to see where changes could be made. Deloittes always take the easy option as far as I can see and their high fees for doing a useless job are certainly not warranted.

I've never worked for the NHS, but I did have experience of having to rely on it a few years back and it made me think of some ways that its running could be improved, and I'd be interested to know what people with more experience and knowledge than me think of it.

Although its not popular to say so right now, I don't think there are enough managers . There seems to be so much waste and the way that things are run just looks like it needs a good shake up. Not by people on huge salaries, but by people who can actually run things on a day to day basis and make them work better than they currently are working.

I'm not criticising the medical staff at all, definitely not, but their expertise is not in running a business or project management or in developing good processes.

Is it just me?

I’m sure we can all be sideline managers quoting what is or is not wrong with the running of the NHS.

But that is not IMO the issue.

The issue is whether the U.K. wants to continue with a NATIONAL Health Service or whether the preference is private health.

That is existential issue before us - not whether what we have us run properly.

Well, that went well.

Positive contributions and questions not allowed.

Whitewavemark2 I don’t think it’s in any doubt that the British public want the continuation of the NHS, every survey confirms that is the case, so it’s not an existential issue.

The real problem is that the public is too gullible. To take the point made by Alegrias1, employing more NHS managers would undoubtedly improve service provision, but can you think of a more publicly vilified group of people - and ironically a great many of them are clinician managers, so know what they are doing better than any government could - but they are just pawns in the game, desperately trying to make things better in exceptionally difficult circumstances. It’s the government and the media always looking for somebody to blame that causes a lot of the problems- and there are plenty of people, including on Gransnet who believe what they are told or they have observed in a particular circumstance or position, without any further investigation into the facts.
The resourcing is the biggest problem. You only have to look at all the performance indicators at the end of the last Labour Government to see what a massive difference to service quality correct funding makes, all the rest is smoke and mirrors.

But you see that is my point.

This populist government undoubtedly wishes to privatise health in the U.K.

In order to do so they will continue to find fault with the service and their ire is directed towards the staff. As we have seen recently with the doctors.
What I am trying to say is don’t join in with their game of rubbishing the NHS.

Don’t you think that the pandemic has seriously scuppered any serious plan they may have had to privatise anything but very peripheral elements within this parliament though Whitewavemark2, public approval for the NHS is so high despite all the attempts to rubbish it? If they do try we will have the interesting scenario of Scotland and Wales remaining fully NHS, but not England.

Not so sure Casdon. Something which really concerns me is the number of privatised e-consult services. People are so desperate to see a GP, they're willing to pay a relatively small amount to see a private GP. These services are cherry picking their patients, so the normal GP service loses funding and is left with the expensive, "difficult" cases.

As I've mentioned on another thread, I can't get a GP appointment, even though I'm in permanent pain, am finding it increasingly difficult to walk and probably need to see a cardiologist about the blood vessels in my legs. I can't afford private healthcare, but I have a good friend who could afford it and has offered to pay. It would go against all my principles to accept, but I am seriously tempted and am still in two minds. If I do accept, I would be jumping the queue. Despite the shortage of doctors, it would appear there's no shortage if people are willing to pay and that can't be right.

Unfortunately, I fear that's what the future will hold. The NHS will remain free at the point of delivery, but it won't be delivering much. Even now, when I log on to Patient Access, there's a list of private services available in my area and I can imagine that people will be driven to use them as a result of frustration with what's available.

I can’t see the e-consult GP service replacing GP surgeries growstuff, as they can’t examine patients, and giving out private prescriptions will be very litigious, so they would only deal with very minor issues (maybe those people actually didn’t need to see a GP for). I’m sorry you have struggled to see your own GP, I’d be inclined to complain formally to the practice manager? You’re right about patients seeking private treatment jumping the queue, and people do use them because they are desperate to be treated, but that’s not a new phenomenon, and the majority of private doctors at consultant level work in the NHS as well. If they didn’t they wouldn’t be able to get you into the NHS system quickly. I’m probably speaking out of turn though because I’m in Wales, and possibly the system is different in England already.

Just going to leave this here

Costs certainly need to be reduced - I don’t understand why managers don’t negotiate better deals for drugs, for instance. The A&E unit where my dd currently works won’t prescribe paracetamol except in extreme circumstances because it costs the department £9 for a box of 16 tablets, the same ones you or I could buy for 35p in Tesco. That’s madness.

Casdon The number of them is already growing and more people are using them. They won't see people like me because I'd be too expensive and have chronic conditions, so they'll cherry pick the "cheap" patients they can make a profit from. I know a number of people who use them already.

Casdon The Practice Managers are part of the problem. I'm even a member of the patient feedback group.

Yes, I think the system probably is different in Wales. There is an increasing number of private GP services and e-consult services available round here. Along with private podiatrists and physios, they're mushrooming.

SueDonim

Costs certainly need to be reduced - I don’t understand why managers don’t negotiate better deals for drugs, for instance. The A&E unit where my dd currently works won’t prescribe paracetamol except in extreme circumstances because it costs the department £9 for a box of 16 tablets, the same ones you or I could buy for 35p in Tesco. That’s madness.

Waste is only a miniscule part of the problem.

I agree about many of the recent points raised today.

The NHS can be extremely inefficient and wastage is huge. I am positive that millions could be saved were proper protocols set in place.

I know NHS Managers are vilified and they are necessary however I don't feel some of them are negotiating hard enough and of course we all pay for this inefficiency. If your example, Sue Donim is accurate we all ought be rioting in the streets!

In my area I know of two private GP services and as was said above, they cherry pick the easiest cases, forwarding anything tricky up and onwards, having no need of a follow-through process, constant monitoring etc. These, incidentally, are face-to-face appointments.

I know of a family who use this service all the time.... whenever a child has a sniffle. Off to the private GP where they are offered antibiotics. It makes me very cross as we could soon have an even bigger antibiotic problem than we do already..

Whitewavemark2, I am sure you are right, we are v.e.r.y slowly being drawn into privitisation (think NHS dental, optical care and so much more practically all gone).

If we were to eventually go down the American route we are lost. A huge amount of their health care spending is on administration (insurance companies) and their outcomes, despite spending twice as much as we do per capita are poorer.

I have only been on one protest march but would be prepared to do much more to show that we must keep the NHS. Whoever is in power, it needs funding and above all more staff.

I can feel my blood pressure rising.....

growstuff

Casdon The Practice Managers are part of the problem. I'm even a member of the patient feedback group.

I don’t know what the current practice manager is like at our surgery but previous ones have been useless. They took one on and she was then off sick for two years and intermittently thereafter.

Fadingrose

Just going to leave this here

And your point is what Fading Rose?

Evidence to the Select Committee

Lord Sedwill and Professor Dame Sally Davies both argued that although the NHS responded well, there was a need to scale back radically usual activity because of the norm for the NHS to run “hot”. For example, Dame Sally told us: Everyone in the room was used to and aware of the fact that the NHS runs, as I call it, hot in the winter […] because of winter infections, particularly with a bad seasonal flu, and can almost fall over […] [If] you look at Europe, we are in the bottom half dozen for number of doctors per head of population, number of hospital beds per head of population and number of ITU beds per head of population. We clearly had a less resilient system.

Later, the point is made that the NHS had been significantly underfunded for a number of years.

A system which is run at full stretch (i.e running hot) most of the time doesn't have the capacity to absorb extra heavy demands made on it. The fact that other specialities, and their patients, have had to suffer is a direct result of running a system with no spare capacity. Have a look at Candelle's post of 18.15 yesterday and perhaps you can tell us how the poorly funded NHS could possibly take extra in one area without cutting back in others.

I don't suppose the situation does my blood pressure much good either Candelle.

I know of three experienced, good GPs in this area, who have left the NHS to set up a private practice. One of them was my regular GP for years and he was brilliant, but I could only see him now if I pay.

It makes me spit when people who seem to have no issues don't seem to believe the problems some of us are having. It does seem there's a postcode lottery. I read an article recently, which claimed that some areas have twice the number of GPs per head as others. I live in the bottom third, but not the worst.

I’ve just returned from an EU country. I was ill during my stay. I was seen immediately at the emergency medical centre in a mountain village. Five minute check in, details of my illness taken. Straight in to see the doctor. 45 minute exam/discuss my health. Covid test. No charge. Five prescription items e24 total charge.

Sago

UrmstonGran An excellent post?????

Which one Sago? I post so many.
???

GagaJo

How many hours do you think is reasonable for a GP to work Kali? We UK teachers work 60+ and I can assure you THAT isn't reasonable.

You misread what I am saying. The Government calculations are done for what THEY consider to be full-time and a full patient list of 1500 minimum.

For the same practice size, the practice OH worked at has gone from 5 full time and 1 part-time- to 11 part-time. It is completely different.

And yes, I remember the old days when Junior doctors for several years worked 140 hrs a week- and agreed no-one wants to go back to those days. It nearly killed my OH, and it did kill several of his colleagues. As GPs they also worked nights and week-ends on a 1 in 4 rota, as well as full-time on top. So I know.

But this is what the Government has based number required predictions. And yes, it is wrong, for sure.

I well remember Agenda for Change Urmstongran and the numbers on the cheques I was signing for locum GPS who refused a salaried job because being a locum paid much more.

it is NOT underfunded, money is wasted through-out the service. The waste in the GP surgery I work at has to be seen to be believed. Patients make appointment then don't turn up, ask for referrals and don't make or keep the appointment. Get sent for scans/MRI/Xrays and don't turn up, get given blood test forms and don't have the blood test. Don't do their annual diabetic urine/blood check, don't come in for asthma or diabetic reviews, don't come in for smears. The HOURS I waste phoning/texting and still they seem to have no interest in their own health until they get a runny nose then abuse me because they can't talk to the doctor.

The NHS has been seriously underfunded for at least the last thirty years by successive governments.
Why else have we reached a situation where midwives are doing thirteen hour shifts? They have even had their study bursaries taken away, so have to get a loan.
Those working in care homes have been told to leave if they won't accept the jab for a virus that no scientist anywhere in the world can isolate or prove it exists.
So 100,000 care workers will leave next month, probably to work in the NHS, where they are allowed to work without being jabbed.
For comparison, while I was living in France, 75% of my health insurance was paid by the government. My 25% of it, covered by private insurance, cost me 95 Euros a month.
The NHS is being deliberately run down to be replaced by private health provision. That is reality.