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BARKINGMAD
3rd Apr 2018, 08:16
Our former minister who wasted three thousand million pounds on a much-vilified and destructive "reorganisation" of our health service is now a passionate advocate of spending more on cancer diagnosis and IT services.

This Damascene conversion follows his diagnosis of cancer and treatment by the same Health Service he helped propel into it's current state of crisis.

Is there a connection between these events? Discuss.

Gertrude the Wombat
3rd Apr 2018, 11:25
Personal experience can drive political action. The reason I put 600 new bike parking spaces into Cambridge city centre was not unconnected with my frustration at never being able to find anywhere to park my bike.

Fitter2
3rd Apr 2018, 12:57
I understand that the NHS needs more money (although I doubt that it can ever have enough to do everything that could be done for everyone who needs, or wants, it. But why does every discussion centre around 'cuts' when every figure shows it steadily increases in real (inflation adjusted) terms?
http://i64.tinypic.com/2s8pbwx.jpg

charliegolf
3rd Apr 2018, 13:14
I understand that the NHS needs more money (although I doubt that it can ever have enough to do everything that could be done for everyone who needs, or wants, it. But why does every discussion centre around 'cuts' when every figure shows it steadily increases in real (inflation adjusted) terms?
http://i64.tinypic.com/2s8pbwx.jpg

If a 78 year old woman has to wait for 15 hours for an ambulance after breaking her femur outside her sister's home, there is not enough in the ambulance pot. Saying (as they always do), "This government has increased spending by...", doesn't cut it. We need 'enough' in the system. Your graph shows an increase that isn't 'enough'.

CG

G-CPTN
3rd Apr 2018, 13:30
If a 78 year old woman has to wait for 15 hours for an ambulance after breaking her femur outside her sister's home, there is not enough in the ambulance pot.

Not necessarily - AIUI, many ambulances get 'hung up' waiting to unload their patients - instead of being released to go back on the waiting to respond rota.

Highway1
3rd Apr 2018, 13:31
If a 78 year old woman has to wait for 15 hours for an ambulance after breaking her femur outside her sister's home, there is not enough in the ambulance pot. Saying (as they always do), "This government has increased spending by...", doesn't cut it. We need 'enough' in the system. Your graph shows an increase that isn't 'enough'.

CG

But NHS inflation runs at a higher level than the general inflation in the economy - so if you keep trying to blindly meet that 'demand' you end up (eventually) with the NHS consuming the entire economic output of the country.

Given the unlimited demand for the NHS will any increase be 'enough'?

whale1776
3rd Apr 2018, 14:52
If a 78 year old woman has to wait for 15 hours for an ambulance after breaking her femur outside her sister's home, there is not enough in the ambulance pot. Saying (as they always do), "This government has increased spending by...", doesn't cut it. We need 'enough' in the system. Your graph shows an increase that isn't 'enough'.

CG

So how much is Ďenough?í

charliegolf
3rd Apr 2018, 14:53
Put another way... is there another first world country that takes 15 hours to get a woman with a broken femur to hospital? (Noted about ambulances getting hung up, but they don't put people in first responder cars, so they aren't hung up at A&E. They didn't send one of those either.)

But NHS inflation runs at a higher level than the general inflation in the economy - so if you keep trying to blindly meet that 'demand' you end up (eventually) with the NHS consuming the entire economic output of the country.


Start with A&E. Work from there- vsi people get saved/have their severe pain eased. Then stick a few billion into old people's nursing care- bingo, beds galore. Now the A&E blockers can be admitted.

CG

Fitter2
3rd Apr 2018, 15:21
I fully agree that some priorities seem to be unbalanced, but describing 'not enough money' as a cut seems to me to be intellectually dishonest.

The problem starts with all politicians knowing that to admit openly there never will be funding to do all that is possible is a political suicide note. We need an open and honest debate about what should be the NHS priorities; and whether patients who need treatment caused by their own actions (and how to identify who falls into that category) should self fund, or at least contribute more.

funfly
3rd Apr 2018, 15:32
The NHS has always been a problem to politicians and however much money is thrown at it, it will remain so. Increasing population, increasing elderly population, more medical treatments, the difficulties go on. The added difficulty being the intransigence of the people involved throughout the monster and the power of the GPs. This within a massive bureaucratic enterprise is the kiss of .....
Some countries manage it far better than we do, often at greater expense to the population. It would need a brave and enlightened politician to provide the answer.

VP959
3rd Apr 2018, 15:41
I fully agree that some priorities seem to be unbalanced, but describing 'not enough money' as a cut seems to me to be intellectually dishonest.

The problem starts with all politicians knowing that to admit openly there never will be funding to do all that is possible is a political suicide note. We need an open and honest debate about what should be the NHS priorities; and whether patients who need treatment caused by their own actions (and how to identify who falls into that category) should self fund, or at least contribute more.

Spot on. Those who deliberately abuse their health and ignore the many warnings about well-proven health risks (and I don't include all the fake health risks that get talked about a lot) should drop down the priority list, and it should be made clear to them that their first priority is to look after their own health, and only when they are unable to do that should the NHS intervene.

I know some will argue that being obese is a disease, and that in a tiny number of cases it may well be, but the majority of people that are obese are so because of their own poor diet choices, and it has been proven that it doesn't cost more to eat healthily than it does to live on junk food, so any argument that it's linked to poverty really doesn't stand up. Poor diet is, much of the time, a personal choice, like smoking or taking drugs, or drinking.

Treating everyone who is obese, a smoker, drug abuser or heavy drinker as if they have a disease seems to me to be just the wrong approach. Some may have an underlying predilection to over-eat, smoke, take drugs or drink, but they will be a small minority. Filtering out those with a genuine medical reason for being like this from those that don't, and then giving priority to treating those with the medical condition, would go a long way to fixing many of the problems, I'm sure.

In case this sounds a bit drastic, I was a heavy smoker and fairly heavy drinker. When the risks to my health were brought home to me following an annual medical when I was 34 years old, and I was given a pretty stern lecture on just how short my life could be if I carried on smoking and drinking to that extent, I stopped smoking and massively cut down on my alcohol intake. I lost weight, found exercise easier and more enjoyable, and my quality of life improved. I suspect that I've probably saved the NHS a fair bit over the 30 odd years since, just as a consequence of that stark warning all those years ago.

Icare9
3rd Apr 2018, 16:12
... but drug users, alcoholics, smokers and the generally obese AREN'T wanting to do anything other than continue doing what they do.

They need to be "helped" to a better life style that the common sense of the rest of the population guide them to do.

Just how you can persuade people who don't want to change what they do, or to stop them falling back into those habits is the challenge and quite frankly, only those told the brutal truth may change. So do you simply let people self destruct as it were?

Pontius Navigator
3rd Apr 2018, 16:22
On bed blocking, I bed blocked for over 4 hours when last discharged. At 10am I was cleared to go home, dressed and packed. Left the ward at 1pm to go to the restaurant for lunch and back by 2. Shortly after the pharmacy sent my meds to the ward.

Multiplied up and you have a significant waste of bed space. If I could have got my meds sooner, or gone to an external pharmacy, my bed would have been available sooner.

charliegolf
3rd Apr 2018, 16:39
Fitter, point of order- I don't think it was me who mentioned cuts was it? I'm on a bit of a rant too- my (family's) experience with the NHS of late has been crap. Maybe time's up?

CG

DType
3rd Apr 2018, 16:56
I never really understood how boob implants qualified for NHS supply and retrofit, but maybe as a mere man I should not say nothing on such a subject.

Rail Engineer
3rd Apr 2018, 20:29
Put another way... is there another first world country that takes 15 hours to get a woman with a broken femur to hospital? (Noted about ambulances getting hung up, but they don't put people in first responder cars, so they aren't hung up at A&E. They didn't send one of those either.)Money has very little to do with Ambulance provision. Ambulance provision is completely wasted by people calling who very clearly do not need one, and other forms of timewasters and scrotes who view ambulances as a free taxi service to Hospital. Incredible resources are also tied up waiting for admission to hospital, thus removing the Ambulance from availability for many hours in some cases.


I recall a programme recently when a person trapped in a car had to wait all night for an emergency ambulance because of demands from people who clearly did not need one but were prioritised.


The UK desperately needs to (a) deal swiftly and painfully with timewasters and others who abuse the ambulance service, (b) give notice to regular callers demanding an ambulance that they will no longer be sent one, and (c) start using common-sense to reject what are clearly unnecessary or inappropriate demands for ambulances, e.g. I have a toothache, am drunk, etc, etc.


Finally the legal system needs to deal without mercy against those who abuse and assault Ambulance staff and who vandalise and steal from them whilst the staff are on a call.

BehindBlueEyes
3rd Apr 2018, 20:53
I never really understood how boob implants qualified for NHS supply and retrofit, but maybe as a mere man I should not say nothing on such a subject.

Or infertility either; not exactly a life threatening condition - bet thatíll open a whole new can of worms! Not when weíve got existing humans beings dying because NICE canít release or afford the cost of drugs.

Contentious too, but Iíve had cause to visit A&E several times over the years with family members. Not on a Friday or Saturday night, but afternoon/early evening. The place was quiet. We waited and waited and waited. A couple of staff wandered through, had a chat (hopefully work related) No one seemed to be called. A maximum of two, maybe three other patients were also sitting with us. There was no urgency to attend to any of us. To be fair, there was no profuse amounts of blood spreading across the floor or no agonising screaming but in another other business, itís always considered appropriate not to keep the customer waiting, and if you have to, at least tell them why. It wasnít busy, there was no emergency, which clearly should take priority but hardly rushed off their feet.

DType
3rd Apr 2018, 21:13
Infertility?
Rushing in where angels fear to tread, lesbian couples tend to be infertile, but the NHS solves that one too!!!
Conclusion:- I must be a dinosaur.

Gertrude the Wombat
3rd Apr 2018, 21:47
I never really understood how boob implants qualified for NHS supply
Maybe you've never had breast cancer?

Fitter2
3rd Apr 2018, 21:53
Fitter, point of order- I don't think it was me who mentioned cuts was it? I'm on a bit of a rant too- my (family's) experience with the NHS of late has been crap. Maybe time's up?
CG
Hi CG. Not you, it was Lansley himself who (having presided as minister at one of the periods of smallest inflation adjusted increases in NHS spending) cited NHS 'cuts'.

It is also the mantra of the Labour party, who left the economy in such a hole that ability to make substantial increases is challenging. They also never provided the NHS with 'enough' money.

The provision of medical services in all their forms is a major problem, and political rhetoric does nothing towards finding solutions.

DType
3rd Apr 2018, 22:09
GtW
Too true, but I THINK the majority of implants are for enhancement, not restoration. But as I said, I don't know nothing (because of my gender).

Gertrude the Wombat
3rd Apr 2018, 22:16
I THINK the majority of implants are for enhancement, not restoration.
... and some of those may be judged cheaper than the alternative of mental health treatment, and a lot cheaper than the alternative of no treatment at all.

Note that I carefully said "some" and "may" - I don't have the detailed numbers any more than you do. But I do have experience of making public policy decisions, and things are rarely as simple as the media (including, sadly, the BBC these days) dumb them down to be.

Mac the Knife
4th Apr 2018, 22:15
"I never really understood how boob implants qualified for NHS supply"

Future plastic surgeons have to learn on someone (under supervision).

Mac

abgd
4th Apr 2018, 22:48
GtW
Too true, but I THINK the majority of implants are for enhancement, not restoration. But as I said, I don't know nothing (because of my gender).

I think you're wrong:

https://www.nhs.uk/conditions/cosmetic-treatments/is-cosmetic-surgery-available-on-the-nhs/

abgd
4th Apr 2018, 23:02
[QUOTE=VP959;10106187
In case this sounds a bit drastic, I was a heavy smoker and fairly heavy drinker. When the risks to my health were brought home to me following an annual medical when I was 34 years old, and I was given a pretty stern lecture on just how short my life could be if I carried on smoking and drinking to that extent, I stopped smoking and massively cut down on my alcohol intake. I lost weight, found exercise easier and more enjoyable, and my quality of life improved. I suspect that I've probably saved the NHS a fair bit over the 30 odd years since, just as a consequence of that stark warning all those years ago.[/QUOTE]

Well done. Unfortunately you haven't given up your flying habit which could be equally bad for your health.

A few years ago I calculated that hang-gliding was, on average, likely to cut off as many years of my life as smoking would. If you or I were to be injured in a crash, why should the NHS pay for our care but not for a smoker's bypass operation? Perhaps it should actually give us a rebate.

The real problem for the NHS is the people who stay healthy. If you die at 55 from a massive heart attack this will cost the NHS perhaps £1000. If you are a teetotal vegan half-marathon runner who lives to 105 and needs bilateral hip and knee replacements, a cataract operation, three prostate operations, twenty years of treatment for hypothyroidism, forty years of statins, 55 years of effective treatment for high blood pressure, twenty years of being monitored on Warfarin, 10 years in a nursing home and 3 years in a dementia care home... that's what will cost the NHS (and social services) money.

abgd
4th Apr 2018, 23:14
But NHS inflation runs at a higher level than the general inflation in the economy - so if you keep trying to blindly meet that 'demand' you end up (eventually) with the NHS consuming the entire economic output of the country.

Given the unlimited demand for the NHS will any increase be 'enough'?

Regard Ariel Sharon: he had a stroke and was kept in a vegetative state for 8 years at a cost of about 4 million dollars. I often wonder what proportion of the population we could do that for if we were to try hard enough.

Even worse, what proportion of people who might otherwise die, might we be able to keep in a state of perpetual living-death? I'm fairly sure we could consume the entire national GDP one way or another without much effort.

That said, there is more and more healthcare that is genuinely useful as well. But we could save stupendous sums just by cutting down on the cruel and unusual punishments, without picking on the smokers and aviation addicts.

Fairdealfrank
5th Apr 2018, 01:41
Andrew Lansley.
Our former minister who wasted three thousand million pounds on a much-vilified and destructive "reorganisation" of our health service is now a passionate advocate of spending more on cancer diagnosis and IT services.

This Damascene conversion follows his diagnosis of cancer and treatment by the same Health Service he helped propel into it's current state of crisis.

Is there a connection between these events? Discuss.


Might the word be "karma"?


As for the NHS financial crisis: stop wasting money

Private jet
7th Apr 2018, 12:17
All I know is that whenever there is a Conservative government at the helm things go downhill for the NHS. What the exact reasons for this are I don't know. I suspect it could be as simple as ideology. They just don't like it, so are, possibly even subconciously, being unsupportive, and not just finance wise.
One thing I do know is that the daily flight from Islamabad into Manchester is known locally there as the "MRI express" That is not MRI as in scanner, but MRI as in Manchester Royal Infirmary. The next day many of the pax are queuing up at A & E or registering with local (Pakistani of course) GP's. They can do these things because they are staying with relatives and use their residential addresses. The NHS needs to cease being the IHS (International Health Service) and that would help alleviate some of the problems.