Junior Doctors strike

That depends entirely on your personal interpretation of other people’s right to understand what a doctor is telling them about their condition Primrose53. I disagree with your interpretation, because casual and lay interpreters cannot and do not convey medical information in the same way that clinical interpreters, who have received several years specialist training do.

Wyllow3

Why?

Because £60 million could be better spent on far more important things in hospitals. I have met people from the UK who have been to hospitals abroad having taken ill or had accidents and the only translators have been unpaid volunteers. Often there is no translation service at all.

One GP I know from a Zoom meeting planning for MH services in the future works in a very deprived area. There are the resources set up in her area to refer to a special form of community centre which offer friendly chats, as well as medical (advanced nurse) offers - for example people needing easy exercise as well a the values of warmth and company.

I think more like that would help, but it's a shame it cant work round the clock.

Yes, I agree very much with your last sentence and it is a reality.

People lie, Wyllow, exaggerate symptoms or refuse to tell triage staff what they are; they threaten legal action (I know my rights!) or to involve MP’s. They’ll turn up on the door demanding attention, or they tell staff ‘I know where you live’

There are very few sanctions that can be taken against them, even if they throw them off the list, often the surgery is told they must accept them back again.

A lot of GP/A&E problems are not health issues, they’re social matters, poor housing, relationship breakdowns, loneliness, lack of community and so on.

Thank you, Wyllow, I will pass that info on to my friend,

icanhandthemback that example is very troubling. Yes ENT is very crowded and backlogs, but I honestly can't understand why needing to repeat makes it a no no. I'd try and get GP refer elsewhere. the NHS Patient Care Guide says GPs can refer patients to specialists outside their local area for a second opinion, often facilitated by a patient's right to choose their hospital or consultant.
"While second opinions are not a strict legal right, GPs generally respect this request"

In general the NHS better organised could do a lot more than it does, but there is still the issue not just of a large group of people getting older - us - with conditions that develop, but also that as we get more and more successful treatments for severe conditions that now can be treated that were not before, and generally take some time and bed space...I have not got any easy answers for this

I'm shocked at the examples of going to the surgery for those sort of reasons SueDonim.

How on earth do they get through the triage system?

Someone ringing first thing with these sort of problems in my surgery, the receptionist would pass it onto the triage doc:

But you would get a text back pretty pronto suggesting you go to the chemist or some basic advice/get advised it they want to be seen to go to the GP drop in centre in town where they would have to wait but be seen.

This, unless of course they have a chronic history where a sudden heavy cold is significant.

We do have a certain culture where people don't look after themselves health wise sadly. This is of course understandable and understood for some.

The internet has something to answer for - people google and find the worst possible explanation.

OTOH there are some infections like Meningitis which have a very rapid onset and you have to know how to spot the symptoms, it's not easy.

How are things with your son, now, Primrose? This must be a very worrying time for you.

Absolutely agree about people taking personal responsibility. I've been shocked at times by friends, from NHS, expecting a pill for everything and knowingly continuing to drink to great excess, eat rubbish and smoke heavily.

Personal responsibility also plays a part in upholding the NHS. I don’t think this will apply to Gransnetters who I reckon are a pretty savvy lot, but my trainee-GP daughter sees so many people who really don’t need a doctor. A visit to the chemist or even just the supermarket to buy paracetamol or some E45 cream etc would be enough to remedy their woes.

She sees people who demand a same-day appointment because they’ve woken up with the start of a cold, or they have a stye or decide their ingrowing toenail needs treatment at 3am. It’s not an occasional event, she sees similar patients every single day.

She also has opinions about the organisation of the NHS, of course. She says it’s broken.

I'm finding some of the newer measures taken excellent. Take cataract treatment now - people used to have to wait a year of more, now it's going to a specialist clinic.

This may be a step forward for one area but services are quietly being removed so people are not getting the treatments they need to help them live healthy lives. For example, a friend of mine has a problem with their breathing which can be corrected by a small operation. The problem interferes with their sleep so they are suffering chronic fatigue as they never get proper sleep. This cannot be resolved by a C-PAP machine. The consultant has agreed to refer for the op but explained that he will get refused because the NHS is no longer doing these operations as it might be something that needs to be repeated in the future. So this person can't work because of the fatigue and this will cost the country in benefits but at least it won't cost the NHS!

Yes indeed Maremia. It might well be quite common.
Taking my thoughts further, might it be useful to study countries with high satisfaction levels for healthcare? We could look where such services are going right rather than focus on where we're going wrong. I'm not sure which countries these would be though. Different funding mechanisms should be studied too. Just because it's always what we've been doing doesn't actually mean it's a good way, just a familiar one. We'd need a government with imagination and the bravery to make changes if they're found to be in our best interests.

I get what you're saying Aveline. Make new plans, discuss new 'routes'. Then develop the ones that will work.
I have a possibly 'horrid' answer to your question about in 70 years.
Assisted dying might be well established by then.

Why?

£60million is being earmarked for translators in the NHS. That is truly shocking.

Of course the current situation of an ageing population and an explosion of new treatments could not be predicted back in the late 40s. Seventy years on from now where will we be? We'll still have older people, joints will still wear out and cataracts form. Or probably will. However, AI will have caused huge improvements in aspects of care in other illnesses, diseases and conditions. What planning needs to be done right now to try to predict and intelligently plan for the future of NHS? We can't continue to be constrained by the 'its aye been' thinking.

Maremia

Just a wee irrelevant moan coming up,
'Why, as a country, did we let things get so bad?'

Its a fair moan. the long period of conservative government has a heck of a lot to answer for.

Amongst other things, letting the situation arise where Resident Doctors pay so much for training then can't move up the food chain with a job. What a mess. What a waste. How crazy. They have to pay back the training money, without proper career prospects, and we are deprived of those doctors.

this was actually the reason I supported the strike. I am unsure about the pay issue, but the waste, the pointlessness of this, is truly significant going forward.

I'm finding some of the newer measures taken excellent. Take cataract treatment now - people used to have to wait a year of more, now it's going to a specialist clinic.
I've just been refereed via a new scheme, to an advanced optician for a series of eye problems. It's called The Community Eye Service and the place is within an 8/10 min drive or taxi. What a relief.

I was blue lighted in mid January to A and E and had only 4 hours to wait before I was taken to a bed on a ward because my oxygen levels were dangerously low.
I think provision is patchy. And departments vary. ENT in one area is good, in others, not good.

Good things are being done, despite all.

The new local arrangements in my city are working out as in grouping practices, but we do have a very good practice manager and lead GP who takes advantage of any opportunities. MH is probably the one they cannot deliver on consistently, but it was always the Cinderella service. We don't have enough beds locally in my big city and they are farmed out at great expense, which makes it difficult for visitors. 16 beds for over 65's (excluding dementia which is separate) for the whole city.

Is it back to the deficiencies in 'Social Care', which was the first promise broken by the Tories, when they swept to power last time?

It was also created on the premise that the vast majority of those able to work would be doing so Vintagewhine, and there would be sufficient tax contributions to fund it.

Aveline

Casdon I * know* it's a fantasy!! The whole NHS started as someone's blue sky thinking. If we can imagine what we actually need we can start planning how to get it. Otherwise we're left in the current situation.
In an obvious suggestion, why not open all the old convalescent and cottage hospitals to discharge the current bed blocking patients? That should clear things up. Again, all that's missing is the money and the will.

What my blue sky thinking would tell me is that what is required are more surgical, orthopaedic, and surgical specialty beds with all the back up, in general hospitals, because that is the safest place for surgical procedures. Community hospitals with outpatient and minor treatment facilities and rehabilitation beds for older people already exist, in Wales at least. What we are short of are beds for people with both dementia and medical issues who awaiting assessment prior to placement. People awaiting long term care packages should not be in hospital at all, so key to my plans would be Local Authority managed interim facilities.

The blue sky thinking that created the NHS thought free universal health care would result in a healthier population that needed less treatment. It didn't predict the increase in people living longer lives with comorbidities, the increase in treatments and expensive medical interventions, the need to provide increased social care when women entered and stayed in the workforce etc etc. I think if it had we would not have had a free at point of access service.

Casdon I * know* it's a fantasy!! The whole NHS started as someone's blue sky thinking. If we can imagine what we actually need we can start planning how to get it. Otherwise we're left in the current situation.
In an obvious suggestion, why not open all the old convalescent and cottage hospitals to discharge the current bed blocking patients? That should clear things up. Again, all that's missing is the money and the will.

Just a wee irrelevant moan coming up,
'Why, as a country, did we let things get so bad?'

I was in A&E after a fall and a head injury - after 5 hours, I saw the maxilo facial folks who pinned my teeth, and even though not their job steristripped my lip and eyebrow and cleaned me up. I then spent another 4 hours sat in a draughty dark corridor while waiting for a doctor, alongside a frail elderly lady in a wheelchair who had been there for 8 hours with nothing to eat or drink (my DH got her a cuppa, and had a go at an auxiliary nurse to chase up her wait, a very grumpy doc arrived about 3/4 hour later complaining about having been called out) By this time DH was getting poorly as he had nothing to eat (diabetic) so we went home, where he ate and sat up all night to make sure I was OK, then called the GP out in the morning. And that was a fast track. Chap sitting next to us had been waiting 10 hours for just a stitch in a deep hand cut, so he could drive 100 miles home. You can imagine what he thought of our A&E