It has taken a little over 10 years and Tory cuts to push the NHS from the top to second from the bottom of risk nation health care.

growstuff

Baggs

Thank you.

This system does not sound very cost-effective from a tax-payers point of view.

But that's the system which was imposed by the Conservative government with the Health and Social Care Act 2012. Providers and users don't have any choice.

Thanks. Yes. So where was the BMA? Why weren't they making a stink?

Well said, gsm. Let's hope it's high on the list of the next government.

Thanks Baggs. I think it would take a very long time and there would be considerable resistance from within the NHS with each senior manager having his own little empire to defend.
During my working life I purchased a number of redundant hospital sites for developers and I saw the increasing complexity and bureaucracy at close quarters. The seller was usually the Secretary of State for Health but I saw the treacle his solicitor had to wade through in order to get instructions from the relevant Trust or whatever. A law unto themselves, each of them.

But the issue isn’t with management - that is just your constant hobby horse.

The Kings Fund say it is

FUNDING CUTS

Germanshepherdsmum

Thanks Baggs. I think it would take a very long time and there would be considerable resistance from within the NHS with each senior manager having his own little empire to defend.
During my working life I purchased a number of redundant hospital sites for developers and I saw the increasing complexity and bureaucracy at close quarters. The seller was usually the Secretary of State for Health but I saw the treacle his solicitor had to wade through in order to get instructions from the relevant Trust or whatever. A law unto themselves, each of them.

Sorry to have to be blunt, but you have no idea what you’re talking about. The NHS is constantly reorganised, and senior managers have little security of tenure. At hospital and community level the vast majority of managers are clinicians who care deeply about the services they manage, but lack of staff and funding and unachievable targets set by government makes their jobs impossible. Calling them little empires is demeaning, it’s no different for them than it was for you in your little legal firm, and you wouldn’t like it if somebody who hadn’t a clue but had a tangential involvement in one specialist area came in and told you how to run your business.

Casdon

Germanshepherdsmum

growstuff

Germanshepherdsmum

growstuff

Germanshepherdsmum

I agree eazybee. The sort of managers we have in the NHS are good at wasting money. Since my days in local government I have referred to what I witnessed as a public sector mentality’ based on the way people I worked with, at all levels, functioned. Entering the private sector was like a baptism of fire.

In what way?

Being accountable to real people with high expectations rather than other departments with low expectations. Getting through the work no matter how long that took (for no extra payment). Not letting it build up to unmanageable levels (which I never did but colleagues thought entirely acceptable). Far greater demands in every way than I ever experienced in the public sector.

How could the NHS prevent work from building up to unmanageable levels, if people keep getting ill?

Who do you think NHS staff are accountable to, if not real people?

You asked what I meant by a baptism of fire. I answered.

However my personal experience of what I called public sector mentality can be applied elsewhere. Maybe one good ex-private sector manager could do the work of two mediocre managers, at no extra cost. One level of management within the NHS is accountable to the next and so on. Being directly accountable to the client who is paying your fees is rather different.

It’s errant nonsense to suggest that managers in the private sector are in any way more competent than (equivalent level but much lower paid) managers in the public sector. They work within different constraints. They have different values. They don’t work harder. They get more perks and none of the brickbats.
Only somebody who hasn’t worked in the public sector ever or for over 25 years and who has no real knowledge but plenty of opinions makes such ignorant comments. Do you have any concept of how deeply insulting you have been?

It is interesting really, because my experience in the public sector is that when people came in from the private sector to (patronisingly) try and tell us how to do things, they saw what complex, demanding circumstances we were working in and soon ran away again.

Germanshepherdsmum

Thanks Baggs. I think it would take a very long time and there would be considerable resistance from within the NHS with each senior manager having his own little empire to defend.
During my working life I purchased a number of redundant hospital sites for developers and I saw the increasing complexity and bureaucracy at close quarters. The seller was usually the Secretary of State for Health but I saw the treacle his solicitor had to wade through in order to get instructions from the relevant Trust or whatever. A law unto themselves, each of them.

That doesn't have anything to do with the operational efficiency of the NHS.

Baggs

growstuff

Baggs

Thank you.

This system does not sound very cost-effective from a tax-payers point of view.

But that's the system which was imposed by the Conservative government with the Health and Social Care Act 2012. Providers and users don't have any choice.

Thanks. Yes. So where was the BMA? Why weren't they making a stink?

They did, but people were deceived.

But it does affect operational efficiency growstuff. So many different bodies running what used to be run by one. The times I go to collect my prescription from the gp’s dispensary these days and find that not everything is available not because of supply problems but because of the way the NHS has organised deliveries - I trust the frustrated and long-suffering pharmacist not to be lying.

Casdon

Germanshepherdsmum

Thanks Baggs. I think it would take a very long time and there would be considerable resistance from within the NHS with each senior manager having his own little empire to defend.
During my working life I purchased a number of redundant hospital sites for developers and I saw the increasing complexity and bureaucracy at close quarters. The seller was usually the Secretary of State for Health but I saw the treacle his solicitor had to wade through in order to get instructions from the relevant Trust or whatever. A law unto themselves, each of them.

Sorry to have to be blunt, but you have no idea what you’re talking about. The NHS is constantly reorganised, and senior managers have little security of tenure. At hospital and community level the vast majority of managers are clinicians who care deeply about the services they manage, but lack of staff and funding and unachievable targets set by government makes their jobs impossible. Calling them little empires is demeaning, it’s no different for them than it was for you in your little legal firm, and you wouldn’t like it if somebody who hadn’t a clue but had a tangential involvement in one specialist area came in and told you how to run your business.

Yes

Germanshepherdsmum

But it does affect operational efficiency growstuff. So many different bodies running what used to be run by one. The times I go to collect my prescription from the gp’s dispensary these days and find that not everything is available not because of supply problems but because of the way the NHS has organised deliveries - I trust the frustrated and long-suffering pharmacist not to be lying.

We are told that it is a supply issue - the pharmacist has never said it is the way deliveries are organised - ever.

In fact there was never a supply issue until - you can guess.

Germanshepherdsmum

But it does affect operational efficiency growstuff. So many different bodies running what used to be run by one. The times I go to collect my prescription from the gp’s dispensary these days and find that not everything is available not because of supply problems but because of the way the NHS has organised deliveries - I trust the frustrated and long-suffering pharmacist not to be lying.

But that's nothing to do with the problem you described nor the Health and Social Care Act. It's to do with supply problems, which are caused by a number of different factors outside the NHS' control. The NHS doesn't organise deliveries to pharmacies.

The problem I described is indicative of the increasing bureaucracy caused by reorganisations within the NHS. It is nothing to do with supply problems, as I said. The NHS certainly does organise deliveries to gp pharmacies - which is what I mentioned most specifically to make it clear I’m not talking about Boots and other independent pharmacies. Read my post again.

Since Labour came to power with Attlee in 1945 we have had 30 years of Labour rule and 78 of Tory rule. 5 Labour PMs and 11 Tory.

Does this not suggest that one party is more to blame than the other for the constant re-organisations that have gone on in the NHS?

I moved into education from working in the NHS in 2002. The shortcomings of the management were evident even then. In my experience it was at best inefficient, (I’m being diplomatic here) I was frequently left with the impression that the left hand had no idea what the right hand was doing when it came to management with problems caused for those working with patients and the patients themselves. This was long before the present government came into office and was one of the issues that influenced my decision to move on.

Yes, this was a long time ago but speaking with my son and daughter in law, both working in the NHS, it seems that very little has changed.

I’m surprised at the willingness of some to blame all the ills of the NHS on the government whilst absolving the management of all responsibility. There is room for both to up their game considerably.

Germanshepherdsmum

The problem I described is indicative of the increasing bureaucracy caused by reorganisations within the NHS. It is nothing to do with supply problems, as I said. The NHS certainly does organise deliveries to gp pharmacies - which is what I mentioned most specifically to make it clear I’m not talking about Boots and other independent pharmacies. Read my post again.

Yes, it does have to do with supply problems, whatever your friendly pharmacist claims.

I'm suprised that the NHS was top of any list 10 years ago,
where can I find this information?
In 2004 I had to take my mother to Queen Alexander hospital in Portsmouth where she lived and was appalled at the wait and the poor state of the place, 3rd world sprang to mind.
I'm not wanting to turn this into a France 'is better than' comment but the comparison was stark. I don't think the general public knew how far behind it had slipped even then.

I know about supply problems growstuff. One of my medications is not easy to obtain. That has not been the problem. Why you know better than I and my gp’s pharmacist I don’t know, unless you think I’m stupid and he’s lying,

growstuff

Germanshepherdsmum

The problem I described is indicative of the increasing bureaucracy caused by reorganisations within the NHS. It is nothing to do with supply problems, as I said. The NHS certainly does organise deliveries to gp pharmacies - which is what I mentioned most specifically to make it clear I’m not talking about Boots and other independent pharmacies. Read my post again.

Yes, it does have to do with supply problems, whatever your friendly pharmacist claims.

You are correct*growstuff*.
dispensingdoctor.org/wp-content/uploads/2021/10/DDA_GUIDE_2022-25_WEB-COMPLETE.pdf
Page 45 refers.
The only exception I’m aware of is for vaccines.

So you know more about my particular medicines than I or my pharmacist? I don’t think so. I’m fully aware of supply problems - this is not the case here.

Currently being discussed on Ch4 News.

Germanshepherdsmum

So you know more about my particular medicines than I or my pharmacist? I don’t think so. I’m fully aware of supply problems - this is not the case here.

I’m only showing what the regulations say Germanshepherdsmum. If the supply of your medication is an exception then that will put an extra burden on a hospital dispensary I presume. As there are major recruitment issues in hospital pharmacy and inadequate staffing allocations due to lack of government funding then you are at the sharp end of seeing the effect of NHS cuts affecting patients for yourself.

Casdon

Germanshepherdsmum

So you know more about my particular medicines than I or my pharmacist? I don’t think so. I’m fully aware of supply problems - this is not the case here.

I’m only showing what the regulations say Germanshepherdsmum. If the supply of your medication is an exception then that will put an extra burden on a hospital dispensary I presume. As there are major recruitment issues in hospital pharmacy and inadequate staffing allocations due to lack of government funding then you are at the sharp end of seeing the effect of NHS cuts affecting patients for yourself.

It's a GP pharmacy attached to a practice.

The "NHS" does not supply them with medications directly. They have to order medications from a wholesaler.

I am no longer a dispensing patient because I live within a mile of an independent pharmacy, but when I was, I used to have one drug on a repeat prescription which was hardly ever available with the rest. I had a long conversation with the pharmacist about supply. All the GPs in the area were supplied by a hub and the pharmacist had to put in orders.

In any case, this has nothing to do with commissioning.

growstuff

Casdon

Germanshepherdsmum

So you know more about my particular medicines than I or my pharmacist? I don’t think so. I’m fully aware of supply problems - this is not the case here.

I’m only showing what the regulations say Germanshepherdsmum. If the supply of your medication is an exception then that will put an extra burden on a hospital dispensary I presume. As there are major recruitment issues in hospital pharmacy and inadequate staffing allocations due to lack of government funding then you are at the sharp end of seeing the effect of NHS cuts affecting patients for yourself.

It's a GP pharmacy attached to a practice.

The "NHS" does not supply them with medications directly. They have to order medications from a wholesaler.

I am no longer a dispensing patient because I live within a mile of an independent pharmacy, but when I was, I used to have one drug on a repeat prescription which was hardly ever available with the rest. I had a long conversation with the pharmacist about supply. All the GPs in the area were supplied by a hub and the pharmacist had to put in orders.

I think there may be rare exceptions for specific drugs (controlled) which may only be supplied for one or two patients in a rural practice growstuff. The drug would be cross-charged in that event.