NHS

[cromwell]

One of MrsC's uncles was taken to hospital last night, we think it's food poisoning. Long story short, he goes to casualty in Pinderfields. It's jam packed. Eventually he gets looked at. He's so weak they put him on a drip. But there is no bed available in Wakefield. No bed available in Pontefract. So they send him to Dewsbury.

OK, he's being looked after which is good. But the old hospitals at Wakefield and Pontefract have been demolished and replaced with PFI Hospitals. All modern and jazzy - Pinderfields looks like an airport terminal - but fewer beds. When they were being built people warned about this, saying that at a time when the population was obviously going through the roof it was complete lunacy to build a smaller hospital. And, being PFI hospitals, the cost of running them is ruinous.

Why can't the people in authority plan anything properly? Why did we get it right in the old days and wrong now?

It's the same in the village. The village surgery was built in the 1970's. Since then the village has at least tripled in size. Is the surgery any bigger? No. In fact the number of patients per doctor is shortly going to be just under 3,000 - way over NHS guidelines.

I get so mad about this. You live here, work and pay your tax here but when you really need something you've paid into all your life you might not get it when you need it.

Rant over!

[Kaz]

Shocking and bound to get worse, I believe the tories are considering selling the NHS off to the Yanks

I hope Mrs C's uncle recovers soon xxx

[cromwell]

Thanks Kaz. I'm sure he will, but you do wish things could go smoother sometimes. I suppose the fact that it was Saturday night with all the drunks and idiots out would have filled casualty up.

[Suff]

I took Mrs S into the Urgence at the local hospital here at 8am, it was empty, in fact it was so empty that there was no-one at the desk and we had to ring for someone to attend.

Mrs S was scanned within two hours (the doctor didn't come down till 9am). They analysed the results and within an hour had decided to send her to Limoges.

I was following but my car has an intermittent fuel fault which means I can't overtake like a maniac and I can't do over 75mph, when it's bad. The ambulance took off like a bat out of hell (no sirens or lights just FAST) and I lost it.

So I wound up in the main university hospital in Limoges around 2pm. There were 6 people waiting in Urgence. I had to faff around for a bit because they'd sent her to the maternity hospital as all gynecological cases are sent there and their computers are not linked even though it is also a Uni hospital and on the same campus.

So I went to Urgence at the Mere et Lenfents. Empty. But at least someone on the desk who could guide me.

I went to the ward and was pointed to the room. Where I sat with Mrs S for 5 hours, moving myself when anyone needed past to get at the IV tree or the machines pumping drugs into her.

Mrs S went into surgery at 8pm, 12 hours after she had first entered A&E and she'd already been scanned twice, seen the surgeon and the anaesthetist. I left and came back at 22:45 and waited till Mrs S came out of recovery at 23:45.

Not once did anyone say to me that there were visiting hours or that I should go somewhere else to wait. In fact they offered me refreshment.

When Mrs S was in, she mentioned about the crippling wait times in A&E in the UK. They told her that because people have to pay the top up on their medical (France only pays 70% and they take insurance for the other 30%), people go to their doctor first and hospital second. In fact people don't go to hospital or the doctor if they feel bad, they wait and see if it really IS bad.

What is happening in the UK is that free and unlimited access to the NHS and unmanaged access to A&E means people abuse it. Because they abuse it, they block places for others who really need it.

The PFI initiative and slightly smaller hospitals was supposed to go hand in hand with bigger and better doctors surgeries and practises and 7 day junior doctor (less than 10 years service), support.

What happened? GP's saw a windfall in money and sucked it into the practises and didn't grow them or expand the buildings. Junior doctors went on strike because they can make more money on overtime than they can in a 7 day rota, even with the extra money they were being given and hospitals have been left without the beds and the staff to take up the fall out.

Don't even begin to get me started on the NHS, if the staff of the NHS were given their way we would suck up 200% of the current budget and give you 10% better service.

On top of that uncontrolled immigration from the EU, even for tax paying hard working families, cripples the existing services. Edinburgh, in 2 years, saw a 10% rise in population (50,000 people), mainly from eastern Europe. There is no way in hell that the medical services can cope with that increase in demand in that short a time frame.

Chances of the UK adopting a French style system? None. Germany? Has an even better health service. The catch? It's even more private than the French and the Germans all sign up for health insurance.

The very biggest problem with the NHS? In a pay per use scenario, the money you pay goes to the health service. In a government funded heal service, the money you pay for taxes goes into a great big pot and the politicians get to argue about who gets how much of it.

Were I in government I would campaign on segregating taxes for both health and pensions. All other taxes for the rest of the "stuff". Should the cost of pensions and healthcare rise, then the segregated taxation would also rise, impacting everyone equally. In a tax give-away scenario, the segregated taxes would be ringfenced. Want to cut taxes, no HS2, no Heathrow 3rd runway BUT, NHS and Pensions get funded properly.

Of course that would never happen and it's unlikely, given a real view of the costs, that people would even vote for it...

So we live with the mess and have a postcode lottery.

[Workingman]

The BBC does a fantastic job of criticising the NHS at every opportunity, so it does not need any help from us and our personal comparisons. I have recently had an issue, but that is me, one patient versus one doctor, and it is resolved. That does not reflect in any way on the NHS, per se.

In general terms the NHS is the finest health system ever invented. It works for over 90% of us all of the time - each day, every day. We should never, ever, forget that. We should also thank our lucky stars for the nurses, doctors, radiologists, physiotherapists, pharmacists and all the other medical staff who do their very best to help us in our times of need.

Where we can, and must, complain is with the funding and management of this brilliant institution. Those complaints should be targeted from the top down; from politicians through senior managers and even departmental managers. There are too many of them and they are inherently inefficient. They are the ones who through 'group think' and focus groups impose the systems the medical staff have to work to. They are the ones who gave us PFI, who close hospitals and A&E departments, who broke up perfectly working unitary authorities into Trusts for every medical service imaginable - blame them.

The modern NHS urgently needs a lean and mean management system and one that listens to, and takes note of, what its medical teams are telling it. It needs to be removed from politics and it needs its funds ring-fenced. However, it also needs to have its remit clearly defined. There are too many areas where it butts up against, and even duplicates, services offered by other agencies, such as social care.

We already have the world's best medical services, but with a little help they could be so much better.

[medsec222]

Couldn't agree more Frank. Very well said. My husband is a patient at the moment and everyone from clerical staff, nursing staff, doctors, and the district nurses have been wonderful. What would we do without them. I dread to think.

[Suff]

We already have the world's best medical services, but with a little help they could be so much better.

From one perspective, yes.

But what benchmark do you use to compare it with?

[Workingman]

It depends on the benchmarks.

If we dig down into medical procedures then, of course, we are not the best in the world in every one - nowhere is.

But when it comes down to providing *free at point of contact* emergency care to anyone in need, regardless of class, caste, social status, wealth or nationality, nowhere else comes close. And I am not talking about *incidents* where multiple nationalities are involved - such as a terror attack, I am talking about individuals who need immediate care due to their own specific complications.

I have been hospitalised in the US, Canada, France, Germany, Yugoslavia and Mexico and though the medical care was excellent the paperwork and insurance claims made me even more ill.

[Kaz]

Worth fighting for, isn't it Frank?

[Suff]

It would be Kaz if you didn't have multiple family members who have died under NHS care because, for the want of a better expression, lack of the ability to deliver.

Two to cancer because they faffed for MONTHS before even beginning treatment. Three from "overwhelming Sepsis" that they did not have a trace of before going into hospital. That last one is particularly bad.

I know several cancer sufferers here in France who are survivors because and ONLY because, they were into treatment the DAY it was discovered. Yes the NHS has some absolutely excellent treatment, but you need to be in the right place at the right time to get it. If you are not, then you are out of luck.

Personally I know far too much about both the financing and the politics of that financing within the NHS to believe that the current situation can be resolved short of total destruction of the NHS and the replacement with a better system.

You only have to look at how other countries are putting massive amounts of money into detection and prevention, only putting people into end of the line care when it is absolutely unavoidable, to realise that the NHS, through lack of ability of any original thought or even to take on other's original thought, is spending 3 times as much money on end of the line procedures than it would on preventing many of these procedures early.

My view is that the NHS is as good as it is because OF the quality of SOME of the people there. Many, to be truthful. However if the NHS were correctly reformed and reconstituted, it could provide everyone what they need and not just some of the people. If people need to take a small top up insurance to cover a portion of their care (given that the DSS would top up everyone who could not), to get a far better performance for everyone, surely that is better than the underperforming black hole money sink we have today?

The NHS is a millstone round the neck of the UK. There is NO free care at the point of use, anywhere else in the world, precisely because it Does Not Work. The only way the NHS is going to reform is if it faces catastrophic change and the loss of the majority of the people who are demanding that nothing changes.

Junior Doctors? Personally I'd have given them all 5 years notice and started the recruitment process from abroad. If they accepted the terms, then the notice would be rescinded, if they did not, then they had 5 years to find a job in private practise or outside of the UK. Strike and that notice would be reduced by 1 year for each year in which they were on strike.

My recruitment of doctors from outside the UK would include a mandatory quality English test too, including understanding several regional English accents.

If we want a health service which ensures the "health" of the people in the UK then we need to structure it so that it does. Because, otherwise, we'll only be extending poor quality of life where the person does not already possess excellent health.