NHS - in crisis ?

[unclebulgaria67]

The question is whether the NHS is in crisis ?

 

According to media reports i have seen during the last few weeks, there are the following problems.

 

- non urgent operations are being cancelled with long waits for some procedures. People are being offered quick private treatment at the same NHS Hospitals if they pay the full private rate as a cash payment.

 

- there are thousands of elderly and disabled in Hospital beds who cannot go home, because of lack of social care and no funds to carry out adaptions to peoples homes.

 

- people are waiting 3 weeks or more to get appointments with GPs

 

- there are large numbers of people being refused new drug treatments by NICE on the basis of cost, even though the drugs are licensed.

 

- the Tory party promise to cap care home costs will not be introduced before the next election.

 

Meanwhile it has been revealed that redundancies due to NHS reforms have cost £2 billion, with many re-employed by other parts of the NHS. Government claim money has been saved.

[fletch70]

The NHS is definitely in crisis . G.P's no longer have time to treat the patient just the symptoms , the ambulance service is broken .

G.Ps will not prescribe things that can be bought without prescription-even for those patients who can not afford the cost

 

Not really sure what we need to do apart from the obvious-remove the government

 

All the evidence shows that until the wealth divide is conquered the health divide will remain , so increase wages, make companies pay the going rate, do not let them rely on state handouts to subsidise their profits .

That may start the move from a national sickness service to a national health service which will benefit every part of the country

[p3t3r]

A lot of blame is being directed toward NHS doctors, latest is the #iminworkjeremy

More and more nurses and doctors are taking to twitter and facebook sharing their disgust against the NHS.

 

Government now wants doctors / consultants to work weekends. Would someone work say, in a shop for less than £3 an hour? Because that is what the government expects consultants to work for at the weekend. This consultants letter has gone facebook viral with around 25,000 shares at moment.

 

There is no point in some doctors or consultants working weekends. The other cogs of the hospital such as phlebotomist, porter, radiologist, all these other cogs that are needed are not working.

 

The NHS is in a terrible mess with blame being directed at NHS workers. Most NHS workers go above and beyond their duty as an employee yet are being blamed by the government for a failing NHS.

 

I suspect the government want to privatise the NHS and are running it down in every way possible. They want the NHS to fail so that it would make it easier to privatise. The NHS is being setup to fail.

[Nystagmite]

G.Ps will not prescribe things that can be bought without prescription-even for those patients who can not afford the cost

I don't get the issue with this. It costs the NHS far more, from what I remember.

 

I've recently moved and trying to get an appointment is difficult. I actually had the receptionist stand there and tell me that what I had wasn't an emergency. It was. But it wasn't serious enough to warrant a visit to A&E. Unfortuantely, I didn't have the patient leaflet with me which tells me I need to be seen ASAP if I had that symptom. (dehydration, despite drinking some 4 litres of water per day) She reluctantly gave me an appointment the next day.

 

Thankfully, previous GP surgery wasn't as bad - asked for emergency appointment and got asked what the issue was. I then got asked something (in short, had a horrible reaction to medication and urgently needed something else) and was given an appointment that afternoon.

[fletch70]

I don't get the issue with this. It costs the NHS far more, from what I remember.

 

 

The problem with this is that some of these drugs are quite expensive to buy for example Buscopan.

I was recently refused an ambulance even after the out of hours Doctor told me to call one, they said it wasn't life threatening, as it happened only a perforated appendix

 

I found that the hospitals were working 24 hours, radiology, porters etc. Registrars were there just not enough of them, mind you first hospital was part of the Leicester Trust where they cover all three hospitals and the other was the QE in Birmingham which is a major trauma centre.

 

Throwing money at the NHS is not the way to cure the health problems , education, removing people from poverty and providing opportunities for the poorest in society . The Black report may be old but it is still valid just as the Acheson report is. Shaw (2005) also agrees

 

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[unclebulgaria67]

I suppose the UK is fortunate to have the NHS, when you see people having to sell the family home in the US to pay for Hospital bills, because they did not have healthcare insurance.

 

The problem is that the population of the UK has increased, but the funding has not kept up. Also there is a crisis in terms of food and alcohol abuse. People don't have healthy diets, because good food can be more expensive. Diabetes costs the NHS billions. Alcohol related problems also cost the NHS billions.

 

Why does the government not try to educate people more on healthy diets and exercise ? Bring back lessons in schools on basic food skills and nutrition. Increase the amount of PE time required each week. Reintroduce TV public service broadcasts on health issues. Encourage greater participation in sports.

 

Government could also increase VAT on unhealthy sugar laden foods and somehow use it to subsidise healthy foods. Perhaps government can work with the food industry to find the best way to increase healthy food consumption.

[fletch70]

I do agree with a lot of that but it is also the time to create the healthy meals, the money to buy the ingredients and of course the ability to get these ingredients.

 

There is no community anymore, no support . It has been a long time coming and maybe it has gone too far to come back

[tobyjugg2]

People don't have healthy diets, because good food can be more expensive. Diabetes costs the NHS billions. Alcohol related problems also cost the NHS billions.

 

Why does the government not try to educate people more on healthy diets and exercise ? Bring back lessons in schools on basic food skills and nutrition. Increase the amount of PE time required each week. Reintroduce TV public service broadcasts on health issues. Encourage greater participation in sports.

 

In many regards government health warning simply can't do enough - take smoking.

I believe parental example is lacking - or should that be that BAD parental example is rife?

[unclebulgaria67]

In many regards government health warning simply can't do enough - take smoking.

I believe parental example is lacking - or should that be that BAD parental example is rife?

 

Parents are important, as they set examples. If parents smoke, then perhaps children more likely to smoke.

 

Most conditions that cost the NHS a lot of money are inherited in genes. Of course the way someone lives their life will affect this. For example diabetes can run in families and if people consume too much sugar or don't exercise enough, they may suffer from it or it can be made worse.

 

Some people believe that if you want to know how you are likely to die, that checking family history is the biggest indicator. In my family, my Dad died from exactly the same issues as his Dad. My Mum died from the same issue as her Dad. Also the age death occurred was similar.

 

According to human biology experts, humans were only originally designed to live about 40 years. But as time has gone by, environment has changed, diets have improved and medical advances has been found. Go back 200 years, people would have worked in tough physical places, lived in poor cold housing and not had proper access to healthcare. Within the next 50 years it is quite possible that humans could live to an average of 100. Scientists may start to manufacture replacement body parts, so when you need a new heart, liver, kidneys etc, you have an operation. They may find ways to stop the body rejecting new organs. This is likely to be very expensive and an NHS offering free treatment to aid most people living to 100 and beyond, would be a massive draw for people to come to the UK.

 

The NHS is in crisis now and will remain so. There will never be enough invested to satisfy demand. There is a political choice. One party wants to increase private involvement and does not mind people paying cash to jump the queue in NHS hospitals. Another party would increase taxes if necessary to pay for the NHS and would only use private to add extra capacity to meet targets for operations. Remember in the past, the Tories allowed patients to wait 2 years or more for operations. Under Labour the NHS paid for private operations if the NHS could not meet target timescales.

[tobyjugg2]

There is a political choice. One party wants to increase private involvement and does not mind people paying cash to jump the queue in NHS hospitals.

 

There are private hospitals to cater for that. Its my view that the NHS should not do that - else it is little more than a publicly subsidised service for the wealthy.

[fletch70]

I think it is a very dangerous game to start playing-the blame game . There are lots of factors why people eat a poor diet , smoke, drink to excess, take drugs . Some of them are personal choice, some of them less so. I would hate to live on some of the estates I saw when I was working, little access to public transport, the only local shop being expensive and full of snacks and chocolate . If you are living on one of these estates with say 2 young children and no transport I think I would have an unhealthy lifestyle and if the only 'me' time I got was either popping outside for a ciggie or going to the pub I would be probably be drinking and smoking.

I doubt that many of us on here are in the lower levels of the socio economic scales and can not imagine the pressures they are under , fighting to survive.

 

Something to think about, the countries with the smallest wealth divide also have the smallest health divide i.e life expectancy etc of the lowest levels to the highest levels

 

Health inequalities are directly related to social inequalities so if we want to save the NHS we need to address social inequalities

[tobyjugg2]

It seems to me that no bus services, and shops full of junk is more driven by the people choosing to not use buses and to buy crap rather than the reverse, and it is undoubtedly true that a 'downward' accelerating spiral is 'easier' than creating and maintaining an upward moving one where buses are used (hence funded) and healthy food is bought (hence sold).

 

Making the right personal choices is seldom simple or easy, but that they should be made is essential.

[citizenB]

I think it is a very dangerous game to start playing-the blame game . There are lots of factors why people eat a poor diet , smoke, drink to excess, take drugs . Some of them are personal choice, some of them less so. I would hate to live on some of the estates I saw when I was working, little access to public transport, the only local shop being expensive and full of snacks and chocolate . If you are living on one of these estates with say 2 young children and no transport I think I would have an unhealthy lifestyle and if the only 'me' time I got was either popping outside for a ciggie or going to the pub I would be probably be drinking and smoking.

I doubt that many of us on here are in the lower levels of the socio economic scales and can not imagine the pressures they are under , fighting to survive.

 

Something to think about, the countries with the smallest wealth divide also have the smallest health divide i.e life expectancy etc of the lowest levels to the highest levels

 

Health inequalities are directly related to social inequalities so if we want to save the NHS we need to address social inequalities

 

I am not quite sure what you are saying here, Fletch ?

 

Living on an estate with 2 kids and no car, so you are forced to smoke, drink and eat unhealthy foods ? Rubbish.

 

It is cheaper to purchase mince meat and make a shepherds pie or some braising steak and make a stew than to take the kids down to the local chippy or other food takeaway joint ?

 

If they can afford to smoke and drink, then they can afford to buy the makings of a meal and make it.

 

My mother used to take 4 children on the bus with her when she went shopping - Only Dad worked at that time, so there was very little money coming into the home. My parents didn't purchase a TV until I was 16 and we didn't even have a landline, let alone a mobile phone for everyone in the family. However, there was always a proper meal on the table every evening.

 

The NHS has quite simply been abused by the very people it was set up to help.

 

A&E departments full of drunks or accidents caused by drink driving over the weekends.

 

When the labour Government was in, it raised the salaries of GPs quite considerably (and rightly so) however they then had their contracts changed whereby they didn't have to do out hours of cover. So locums were hired in at extra cost.

 

Expensive IT systems which either don't work or don't have the operators.

 

Hiring in expensive Agency workers rather than keeping a bank of retired nurses who might only want a few hours of work a month.

 

People who cant be bothered to keep their appointments at Surgeries or Out patients.

 

Hospital tourism

 

Targets and top heavy administration hasn't helped finances.

 

In my local village store, which is across the road from a Grammar school, I queue behind the school children spending up to £20.00 a time on sweets and pastries. Some of these youngsters are truly obese but none of them are from down and out estates, their parents drive them to school rather than let them walk a few 100 yards, or in the case of the 6th form, they drive themselves. It is my understanding that the school has home economics and a full sports programme. So it is sheer laziness that they are likely to be the next heart attack victim or diabetic !

[unclebulgaria67]

Agree that good home cooked meals can be cheap. It is buying convenience and takeaways foods that make it expensive.

 

Plus there is home delivery offered by supermarkets to most parts of the country.

[fletch70]

Well, where do I start in response to all that

Supermarket deliveries, well yes but you need IT access , and a bank account that comes with a debit card. On top of that you need to spend a minimum amount to get delivery and even more to get cheap delivery.

Let's face it, buses are expensive , or at least are if you are on a low income. In Birmingham it's £4.20 for a return , where I live its £2 for a single journey of about 1 1/2 miles all these things add up. I have a coop over the road but it is considerably more expensive than the big supermarkets but they are difficult to get to

 

Why should we be blaming people on a low income for smoking and drinking but saying it's ok for those on a higher income.

 

Citizen B , while I do agree with some of what you say the extent of it is not as great as the DM would have anyone believe . The thing is as well, you say that it's cheap to buy mince, well yes the economy mince is cheaper but also full of saturated fats and god knows what else, the drive to make profits has reduced the quality of foods. In any event it is often cheaper, especially for one or two people to buy the cheap ready meals from a supermarket than to cook a meal -there is also the question of low pay so that in many cases particularly a single parent will work long hours and may not have the time or energy to slave over a stove when they get home from work.

 

I didn't say anyone was forced to smoke or drink, what I said was that maybe it is their only coping mechanism-some people have the luxury of taking their dog for a walk to get fresh air and exercise and some downtime -not everyone can.

 

These thoughts aren't just mine , The Black report (1980) which the tories tried to bury, The Acheson report says essentially the same.

 

Then there are things such as gender and ethnicity which have a significant impact, women have, statistically less access to healthcare, the North still has less access to the best healthcare, children of ethnic minorities are less likely to be referred to a consultant than their white counterpart.

 

I could write pages on this but for now will leave it

[tobyjugg2]

where I live its £2 for a single journey of about 1 1/2 miles

 

Walk? I do despite being fortunate and having a car.

4 birds with one stone:

Exercise, fresh air, cost saving and get the shopping done all at the same time.

(That is for small 'essentials' shops of course)

 

Why should we be blaming people on a low income for smoking and drinking but saying it's ok for those on a higher income.

 

I dont see anyone doing that

 

 

The thing is as well, you say that it's cheap to buy mince, well yes the economy mince is cheaper but also full of saturated fats and god knows what else, the drive to make profits has reduced the quality of foods.

 

In any event it is often cheaper, especially for one or two people to buy the cheap ready meals from a supermarket than to cook a meal

 

-there is also the question of low pay so that in many cases particularly a single parent will work long hours and may not have the time or energy to slave over a stove when they get home from work.

 

1. The cheap mince would still better and cheaper than the ready meals

 

2. No they aren't - the cost of one very budget pinger meal would buy 3 tins of baked beans and a loaf of wholemeal bread with change. and the beans on toast would be a better meal. (just a simple example)

 

3. Convenience over health and budget is exactly the issue.

[MrHat]

To answer the original question:

 

No the NHS is not in crisis

 

Or

 

Yes....but it has always been in crisis (or at least for decades) and this is because of fundamental flaws

 

I would also point out that 'in crisis' seems to me to be a disproportionate term used to create sensation and pursue political goals and therefore, not very helpful

[Conniff]

I will second that MrHat and the bit

According to media reports ....

The media 'always' sensationalises everything, I wouldn't believe a word of it.

[tobyjugg2]

Yes....but it has always been in crisis (or at least for decades) and this is because of fundamental flaws

MrHat,

Would you care to expand on that to clarify your reasoning.

I wouldn't agree that the NHS is fundamentally flawed in fact, quite the opposite, but I do think that there are issues impacting the NHS, not least of which

* General health of the populace

* Targets set - some of which mean targets are chased at the cost of effective service (missing some very valid targets is defining that it is in crisis)

* A number of things related to lifestyle like cosmetic surgery being performed on the NHS

... and a number of related such like issues

 

but I see these as political and social issues which are being imposed on the NHS, not fundamental flaws in the NHS

[fletch70]

Toby

Please tell me where you can but three tins of beans and a loaf of wholemeal bread for 69p which is the cost of Asda smart price Lasagne . Also FYI baked beans are full of sugar and salt.

 

I was giving an example of bus prices, as it happens I frequently walk or use my ike to get into town but what about people who have disabilities or are older and less able . Asda is about 3 miles away and would be two bus journeys, yes you could possibly walk there but returning with heavy shopping . It is very easy to to pass judgement and tell people what to do that was exactly what Virginia Bottomley did in the health of the Nation.

 

I would suggest that most of us on here are lucky enough not to be in that position but we seem to live in a blame culture

[tobyjugg2]

Toby

Please tell me where you can but three tins of beans and a loaf of wholemeal bread for 69p which is the cost of Asda smart price Lasagne . Also FYI baked beans are full of sugar and salt.

 

I must admit to ignoring the £1 or below microwave meals as not being worthy of being called food. That is not intended as a facetious remark and I have tried some of them.

 

I considered microwave meals only start being worth even considering at £1.50, and even those are mainly starch and fat.

Aldi beans are 24p and wholemeal bread 38p a loaf when I went on friday.

 

Check the contents and you will find less salt, sugar and fat and far more fibre and protein in that 24p tin of beans compared to even the 'better' £1.50 microwave meals.

 

So even when comparing with the 69p pinger you reference (God forbid), the 24p tin of beans is healthier, cheaper and no more effort. With 4 slices of wholemeal toast from your loaf - even better and still cheaper - and enough for 2.

 

Thats where I was coming from fletch.

 

 

and its NOT about blame, its about taking responsibility for your and your children's health and choices.

[fletch70]

Going back to the NHS , it is and has been fundamentally flawed since its inception.

Quality healthcare for all free at the point of delivery

 

Well the first problem was that the government at the time caved into Consultants who could then only work a minimum number of hours in the NHS so that removes the free for all bit

Secondly , and this is still true, prior to the NHS the best Doctors were in general based where they could make most money so that was in the south or the more affluent area . The geographic problems are still there, the best hospitals , and the centres of excellence are based in cities -example, Glenfield in Leicester, QE in Birmingham, Christies in manchester . People have to travel miles to get treatment at these centres, bad enough if you have a car or a support network to take you but if that's not there what difference could that make. people from South Cheshire travel to Christies , sometimes on a daily basis for courses of Chemo and radiotherapy , the travel will have the greatest effect on the poorest

[tobyjugg2]

Quality healthcare for all free at the point of delivery

I completely fail to see where that is an inherent flaw

 

Well the first problem was that the government at the time caved into Consultants who could then only work a minimum number of hours in the NHS so that removes the free for all bit

 

Not entirely sure of your point there, but on te positive side it ensured that people worked for the NHS who were a known item and not just someone who wanted something for occasional stints in the NHS

I think any downside of that is more in the NHS at the moment due to outsourcing and SOME agency staff.

Many agency staff are excellent and would be valued members of the NHS if there were jobs in the NHS to be had.

 

Secondly , and this is still true, prior to the NHS the best Doctors were in general based where they could make most money so that was in the south or the more affluent area . The geographic problems are still there, the best hospitals , and the centres of excellence are based in cities -example, Glenfield in Leicester, QE in Birmingham, Christies in manchester . People have to travel miles to get treatment at these centres, bad enough if you have a car or a support network to take you but if that's not there what difference could that make. people from South Cheshire travel to Christies , sometimes on a daily basis for courses of Chemo and radiotherapy , the travel will have the greatest effect on the poorest

 

It would be excellent if we could have every facility needed on every street corner, or even at every GP surgery, but that is simply impossible.

How many multiples of our nations current entire turnover would be needed for that.

Some illnesses are very rare, and much as it would be desireable to give individual care to everyone wherever they are, even in the rarest of issues,

Quality healthcare for all free at the point of delivery

is the only realistic option. Unless you could define some other approach which would be practicable?

[fletch70]

The aim of the NHS when it was set up was quality healthcare for all, free at the point of delivery

 

the points I mentioned about consultants only working part time

the best Dr's been where the money was and/or the big teaching hospitals

 

Both these points mean that quality for all was not happening, it is still the same-hence the NHS is in crisis

 

The hospitals I mentioned do not treat rare illnesses, Christies is a major Cancer hospital , I know of three people from a small village in south Cheshire that have made these journeys to manchester and there are many more that I have heard of but do not/did not know. Glenfield in leicester is a centre of excellence for cardiac surgery again not exactly a rare illness

 

Leicester Royal infirmary is the Cancer unit for miles around, people have to travel over an hour to this hospital for treatment

 

Centralisation of key treatment centres is a problem

 

The idea behind the NHS was that it would improve the health of the nation and as such there would be less need for it, that didn't exactly work

[tobyjugg2]

I think that you are missing the 'point of entry' qualifier, which although undesirable is necessary.

 

Quality healthcare does not necessarily mean the highest paid consultants, and in many ways is contrary (one 'top' consultant employed as apposed to 3 very capable ones?)

Also the sheer cost and size of the required equipment and support mechanisms.

 

Even an unlimited budget would not give care for every situation in every town.

 

That there should be more centres like those you describe I agree with fully fletch, as I am sure do those in the NHS, but the realities of funding and political will define otherwise