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.

2022/2023 158 billion fund8ng. Compare this to 474.1 billion in 2021, for Germany. So even more now, but can't find figures. We need dedicated social health insurance, , even the King's Fund have moved this.
Can the NHS learn from Germany Health system
bbc.co.uk
From personal and family experiences in that country, I would say yes.

Callistemon21

Are nurse practitioners diagnosticians?
Are they being used instead of GPs to deal with matters outside their experience?

We seem to have an impasse at our surgery with a nurse practitioner who cannot or will not refer a problem to a doctor or Consultant and a receptionist who says the only options are to go privately or wait for another six weeks to see a GP.

Nurse practitioners, and Advanced nurse practitioners both those I worked with, and in my surgery are very well qualified, they have to be to be able to practice, and on more than one occasion have checked with a Dr as necessary. They are prescibers in their own right . So complain to your practice manager in the first instance, or change surgeries,because otherwise nothing will change.

the cost of the NHS includes the staggering amounts paid to people for PPE, much of which was totally useless. Tories use a lot of private companies who expect a profit, NHS workers didn't. I cannot get an NHS dentist, my old one stopped NHS work cos they didn't like the contract, now I have to travel 30 miles for a new service & its provided by BUPA, but the cost to the state is probably more than the NHS, I am lucky I can travel, not everyone can.

The NHS is full of people who are really committed to helping others regardless of their ability to pay and that is a really special vocation & benefits us all. Like myself when I was a nurse, my rewards came from the good I did for people, not money & its a shame to loose that, except I think Labour will return to that long term, just like they set up the NHS in the 1st place.

hallgreenmiss

In real terms funding was cut from £3.5bn in 2015-16 to just over £3bn in 2020-21.

Where on earth do you get that figure from? The NHS gets a lot more money than that - its over 150 billion!

Whitewavemark2

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

The Kings Fund say it is

FUNDING CUTS

What funding cuts? The NHS was protected from austerity, and in recent years has had a ton of money poured into it - whilst still providing a worse and worse service. Its not money that is the issue here - it needs massive reform but neither Conservatives nor Labour will bite the bullet and do it.

Callistemon I think if I were in your situation, I'd ask for an appointment with the practice manager and explain your concerns. It sounds as though you have a nurse practitioner who's maybe a bit of a control freak.

We have one like that in my practice and I hate seeing her. However, another one has been appointed and she's been brilliant. As a result of my diabetic review, I had my medication adjusted, was referred to an NHS podiatrist, to a GP to review my pain relief and for a Doppler scan. Another nurse did the Doppler scan and has referred me back to a GP. That's all been within 3 weeks, so it's possible for them to act quickly.

Callistemon21

Are nurse practitioners diagnosticians?
Are they being used instead of GPs to deal with matters outside their experience?

We seem to have an impasse at our surgery with a nurse practitioner who cannot or will not refer a problem to a doctor or Consultant and a receptionist who says the only options are to go privately or wait for another six weeks to see a GP.

Nurse practitioners are able to diagnose, but only within their specific area of expertise - e.g.wound management, continence, diabetes, or whatever specialist area they have been trained in. They should not diagnose other conditions, but refer on to a doctor if a condition falls outside their own training.

Whitewavemark2

grantanow that is so right.

I thought Stella's contribution was very interesting. What a good idea to mention when you retired from (or when you were last employed in) the job or industry you are commentating on. It all help us form an opinion.

Expertise not experience

Are nurse practitioners diagnosticians?
Are they being used instead of GPs to deal with matters outside their experience?

We seem to have an impasse at our surgery with a nurse practitioner who cannot or will not refer a problem to a doctor or Consultant and a receptionist who says the only options are to go privately or wait for another six weeks to see a GP.

I spent the whole of my working life as a nurse manager 1st under Salmon reform then a Nurse Practitioner in Gp surgery .My daughter is an advanced nurse pactitioner in a GP surgery
The answer to the problems are complex
Patients demand and expect more so we have to look at ourselves.
Not enough doctors and nurses being trained and those that are being undervalued in many ways
Too many reforms since Salmon was introduced resulting in extra costs in the re organisations and staff moral low
The problems do not result from one government it has been there and not addressed through several political governments who all frightened of addressing the issues
As you say its aim was to saves lives but it has become so advanced in treating so many more illnesses and mental health demands have increased in so many ways
So we all have some responsibilty !!

13 years of Tory cuts has brought our wonderful NHS to its knees. Shame on them

Nicenanny3

Too many managers and top brass pen pushers. I used to be a nurse, appointments given to very old people one year in advance obviously half of them never turned up, either dead or appointments forgotten about, they couldn't do anything else for them, why not just sign them off. Food waste, make patients pay for their own food. Private patients seeing NHS consultants on NHS clinics. Prescriptions given for paracetamol and over the counter drugs, make the patient pay for these.

But the King's Fund says that the NHS has fewer managers than other systems.

Change the booking system. I know I have a mammogram in June 2024 and a Dexa scan in August 2024, but I won't be sent the actual date until much nearer the time and I have to confirm them.

I wouldn't actually buy the food the hospital offers, if my recent experience is typical.

How much would it cost to collect the money for paracetamol, give a receipt and then have it audited? How much would it save anyway?

Anniel

Growstuff,

Specific instance YES!!!! PFI has cost the NHS dearly. Go back to the brave new world of Tony Blair whose bright idea was to build hospitals by getting very large and ricih contractors to bukud so many new hospitals. Great idea but they not only cost huge amounts of money but entailed the hospitals getting ALL maintenance carried out by the same contractors who charge ridiculous amounts of money for that service. Also I clearly recall a series where a top economics brain of a man had a series looking at waste in the NHS. Operating theatres left inoperable because the top admin brass in hospitals could not organise a pee up in a brewery. Both political parties have thrown money at the health service with poor outcomes. If It is all so wonderful why is it that no other country in the world has copied the NHS model. Look at the EU ( so loved by many on GRANSNET) and find one country that has the same model health service as us? In Eire you pay to see your GP, in France you pay personally but claim back, Maybe other grans who live in France and Spain and other places can explain. I live in a country were we pay to see the doctor and for tests, Not a large amount but ALL pay. I do know that the UK citizens pay for the NHS happily but it is extremely poorly managed. It took me three emails last week to make the Diabetic Eye Test Centre at the Royal Free understand that I would not be attending my appt because I am not at home and I have had laser surgery on both eyes so I have no problem. All well meaning but I go through this charade often. Junior doctors and the BMA should be ashamed. The JD does not earn much for a couple of years but after that they are reasonably well paid. I have lots of experience with Consultants and none of them are poor. Sure, the Conservatives have not done well with the NHS. We all know that soon Labour will be in power, but WWM2 you blame only the Tories and never the long years under Blair. You would think only the Tories were responsible for everything wrong in UK but some of us can see blame in a wider context, I do wish you were an MP because your zeal for putting things right is commendable!

I agree PFI was a financial disaster for the NHS but it was not initiated by Mr Blair. PFI was invented by the previous Tory government and he continued it. At the time it was self-evident to anyone thinking about it for ten seconds that using private finance would be more expensive than using money raised by taxation (because no interest is paid on it). But taxation is so politicised that no government likes to be seen to collect tax. PFI kept the costs off the balance sheet.

In real terms funding was cut from £3.5bn in 2015-16 to just over £3bn in 2020-21.

Too many managers and top brass pen pushers. I used to be a nurse, appointments given to very old people one year in advance obviously half of them never turned up, either dead or appointments forgotten about, they couldn't do anything else for them, why not just sign them off. Food waste, make patients pay for their own food. Private patients seeing NHS consultants on NHS clinics. Prescriptions given for paracetamol and over the counter drugs, make the patient pay for these.

Kamiso

Calendargirl

I’m amazed so many students want to go to medical school.

Junior doctors striking because their pay is only £14 per hour or similar. And subsequently leaving the profession in droves.

Does that not put these prospective doctors off? Why do they think it will be any different when they qualify?

Too many are trained and qualify in the uk then take off elsewhere without having to repay the cost of their training. They should either stay for an equal amount of time it took to train or pay back the cost.

There was always huge amounts of waste in the NHS when I worked in it with absolutely no comeback at all. The opinion of the public facing staff is of no interest to management who see no point in rocking the boat that overpays them.

The Consultants who could insist on change’s won’t because they make a lot of money from people forced to go private.

Since paying GPs a much higher salary they have attracted too many who want high salaries but as little access to patients as possible. As for my surgery putting out a message that the reception staff have undertaken a two week course and must now be regarded as safe to make decisions regarding who needs to see a doctor. If I had been unlucky enough to get through to the surgery after two hours of trying, I would be dead. Thankfully the person on 111 sent for an ambulance immediately.

You do realise medical students pay for their own training. Working as medical students, observing then later on clinical practice, for these hours worked, yes worked, they do not get paid. So if you want a guaranteed length of service following their initial training, then yes the country should pay for them to become Dr's,the we can ask them to pay monies back.

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SueDoku

Anyone who thinks that privatisation is the answer - watch the 10-part series called 'Health Before the NHS' that's being shown on BBC4 at 11.30pm starting next Tuesday (in other words, hidden away). Then see what you think...

I don't think many are advocating privatisation, rather more funding from the govt. It's the way in which that could happen is under discussion.

Grantanow

We never talk about a 'private sector mentality' but it could well include the kind of managerial incompetence that leads to environmental disasters (like sewage in rivers, the consequences of mining), the wrongful prosecution of subpostmasters for fictitious frauds, audit failings and tolerating a climate of harassment leading to public criticism.

Sometimes it's incompetence but often it's pure greed as with the dividends paid to shareholders over the years, especially the water companies.

The treatment of the sub postmasters was appalling and I hope that they get very good compensation although in some instances that would be of no help whatsoever.

Audit failures are often caused because the firms don't want to lose their larger clients and there fore might not have been as stringent in their tests as they should have been. There used to be rules concerning the size of a client to the practice as a whole. They should still be in place but whether anyone takes any notice is another matter. It's over 40 years since I worked on audits but there may be some one on here with more recent experience.

Kamiso What kind of waste?

If you knew you were seriously ill, why didn't you phone for an ambulance in the first place?

In just over a week's time it will be the 75th birthday of the NHS. I was five at the time and remember nothing of its birth but I do remember my parents talking about this miracle that meant they no longer had to worry about how they could pay if they needed medical care. Many families had to decide beween which family members they could afford to have treated. It's unthinkable that families could soon be facing that situation again.
It makes me weep to see the NHS gradually slipping away. Blame can be laid in many quarters and over many decades but the long years of austerity have certainly hammered the nails into the coffin. The pandemic is an easy target but in truth the NHS was already weakened and we were very ill-prepared for it. Somewhere along the NHS's journey we took our eye off the ball - didn't realise that the population was growing, as was life expectancy. More funding was needed and the vexed question of a fair taxation system to fund it was sidelined and continues to be so.

Anyone who thinks that privatisation is the answer - watch the 10-part series called 'Health Before the NHS' that's being shown on BBC4 at 11.30pm starting next Tuesday (in other words, hidden away). Then see what you think...

maddyone

^It would be helpful if you could make suggestions for improvement…..^

Why? Do you think anyone in government or the NHS gives a toss what improvements are suggested on Gransnet? Who would it be helpful to?

Probably not. There's not much point moaning about "management" either. In fact, let's all shut up and put up with it all.

It would be helpful if you could make suggestions for improvement…..

Why? Do you think anyone in government or the NHS gives a toss what improvements are suggested on Gransnet? Who would it be helpful to?