NHS crisis

[cruiser2]

The "excuse", if you can call it that, from the DoH is that patients do not stay in long to recover after operations so fewer beds are needed.
Yet there are more operations being carried out and the population has increased.
Accountants are trying to save money, but bed blocking is only increasing costs.

[Suff]

The "excuse", if you can call it that, from the DoH is that patients do not stay in long to recover after operations so fewer beds are needed.
Yet there are more operations being carried out and the population has increased.
Accountants are trying to save money, but bed blocking is only increasing costs.

Not quite so simple.

Finance is trying to balance a ballooning cost with a slowly growing budget whilst political pressure insist that totally elective procedures are mandatory and can't be dropped.

Whilst, at the same time permanent staff restrictions force engagement of cripplingly expensive contract resources...

When you wind up in this mess it is easier to reduce beds and hospitals than to simply say NO.

[Workingman]

... at the same time permanent staff restrictions force engagement of cripplingly expensive contract resources...

And there is a perfect example of the senseless inefficiency many of us complain about. Combine that with an internal market of 450 Trusts and 850 not-for-profit organisations all jostling for position and you have the perfect recipe for the current problems.

Even if all the Trust managements were not useless, and there is plenty of evidence that many of them are, they do not have the clout to make meaningful representations to their political masters. If a few of them combine over their similar concerns they still have little power. It is not like the old days when there were a dozen or so Regional Health Authorities each covering many hospitals and services. It only took a few of them working in unison to draw in others and put real national pressure on the government. Devolution has also diminished that ability.

[medsec222]

Each hospital had a hospital secretary, a matron, and a physician superintendent. These were linked with other local hospitals in the area under the umbrella of a group management. There was a central national department which negotiated prices for everything. Each hospital ordered equipment and supplies from the central department. I remember in those days there was usually a surplus in the budget at the end of March, and this was the time when extras such as replacement carpets, desks, etc were ordered which could be allocated to the various wards and departments that needed them the most.

[Suff]

True but then came the truly massive costs of MRI infrastructure and other life saving machines.

NHS managers, unable to understand the concept of what needed to be done with their budgets, did not accept the position by companies, who had organised to allow hospitals to spread payments over two budgets. Not only did they escrow the money paid by the hospitals, they took the interest earned off the remainder of the payment in the second year.

NHS budgets have to be spent by year end of they lose the money and their budget is slashed the next year because they had a surplus.

What did the particular Scottish hospital do in this case? Refused to split the payment, blew all the money they had saved in the current budget on total non essentials. Then bought the hardware, fully, out of the next years budget, at the start. Going millions over budget in that budget year as they ran out of money by the Autumn.

This is the level of quality and skill our NHS directorate bring to our health service. They even ignore the finance departments recommendations on how to finance their equipment...

Sadly it does not beggar belief...

[medsec222]

It is so different now Suff to what it was. In those days a case of need had to be made for large costly items. I seem to remember that everything was scrutinised and put out to tender. Independent Trusts managing their own budgets seemed a good idea at the time, but now I am not so sure. In any case, other dynamics have come into play which have a huge impact on NHS budgets, not least the large increase in numbers using the NHS and the movement of vital NHS staff to other parts of the world, including consultants.