Those prospects are not very good I fear
NHS prospects : Those prospects are not... - Atrial Fibrillati...
NHS prospects
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MiniMeGreen
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It has taken 13 years of serious neglect to put it in that state. Every public facility that was ever privatised was first run into the ground. So if people seriously want an NHS then they better start listening to the people who invented it, not those who just pay lip service. There’s my Sunday rant. I find it good for the heart ❤️
It’s a juggernaut which is sadly stuttering to a halt. It simply cannot now do what it set out to do in 1948. It’s needed an overhaul for decades but no politician has been willing/able to grasp the metal. A 5-year parliamentary term isn’t enough to solve anything, so the safe political option has been to keep pouring money in and kicking the can down the road.
From the US I can say a lifetime career in politics is t enough time either because ours just keep kicking the financial can down the road also. It’s disgusting that nothing gets done and tax payers shoulder the burden. Rant over.
Trouble is, they are NOT pouring money in at a rate to keep up with inflation, ageing society and advanced medicine or inflation. It is seriously underfunded per head compared to counties with better health care like France, Germany and the Nordic countries
It is true it is funded at a slightly lower level of GDP vs Germany & France but not by a significant amount per capita and still ahead of many comparable European countries. Money may be part of the solution, but is it the sole answer? In 2022, the US had the highest spend per capita amongst OECD countries, but it also topped the league for avoidable deaths. The UK came second.
We are doubtless blessed with the NHS. But we shouldn’t be blind to its limitations and failings. Honest analysis, debate and reform is the best way forward to ensure its viability in the long term.
There was a recent study carried out by the Kings Fund on the NHS’s current status which I believe makes for measured and thoughtful reading.
kingsfund.org.uk/press/pres...
If you are interested, BBC Briefing Room podcast had an episode about the NHS which was v interesting and surprisingly they said it is well run from an admin side. You might want to have a listen.I shall read that report, thank you for the link
Thanks Jajarunner. I listened with interest & noted there was a Kings Fund representative on the panel. The Kings Fund report I linked to did indeed highlight admin as a positive performance area - but I can’t get excited by that if our avoidable deaths are the second highest amongst OECD countries. The conversation was based around what can be done as a short-term fix which is important, but a long-term strategy is even more key. We can analyse why we are where we are, but what do we do to make things better going forward? Why does there seem to be no appetite for reform?
Finally, Amanda Pritchard. The invisible CEO of NHS England, being paid £250k+ of taxpayers money and whose job description is to ‘improve health and ensure high quality care for all”. In the private sector, she would be answering questions as to why her company isn’t delivering for its customers. What’s her strategy going forward to improve patient outcomes and to manage her £181 billion per annum pot of Government (taxpayers) money as efficiently as possible? Radio silence.
Nice work if you can get it 😱🙄
Just read it, very interesting. Thanks
This short Guardian article is likely to be accurate. Unfortunately the poorest amongst are becoming increasingly less likely to obtain access to services, treatment and care in a timely manner. I fear that this trend is likely to accelerate.
It didn't take long for some truly worrisome numbers to surface theguardian.com/society/202...
Whereas the concept of an NHS way have been feasible back in the 40s, it’s not a structure that is workable in the 21st century. It’s no coincidence that no other nation has, or intends to adopt this model. The idea that the NHS is, or has ever been the envy of the world is baseless. It’s time that the NHS ceases to be a political football and politicians work together to design a healthcare system that works for its customers and funders - that’s us. Stop tinkering at the edges and start again. I don’t believe any party can sufficiently fund an NHS that the population expect, without over taxing and damaging the economy that’s actually required to fund it. It’s a downward spiral. Look at what works best in other countries and design a system around that. The most effective seems to be a combination of private and social enterprise providing the healthcare paid for by social insurance. We could do a lot worse (and are) than to follow the German example.
Alas, as a country we can’t even construct a railway without the project being massively late, over budget and highly politicised by competing and self serving interests. At the end of the day, it will be those of us who cannot afford to opt out who will be the worst affected.
The problem is that healthcare can only get more expensive as more and more issues/ailments/diseases are looked after. Compare the reach of the NHS when it was founded with now. Cancer testing and treatment, IVF, many many areas of improvement. Ultimately it needs to be paid for. In the US it's likely paid by your company, so you get less money in your pocket.I agree the German system is a good one because they have not been afraid to tax at a rate that actually pays for the service (approx twice our personal and employer NI payments) rather than scrimping and enforcing 'efficiences' like we do)
Omniscenti1, what you say in your first sentence is obvious to everyone, and Speed makes some excellent points. But politicians turn blind eyes to the problem. We have an increasingly ageing population with their (our) associated illnesses. Though I self-funded my heart op in July (had I not, I MIGHT be having it at an NHS hospital around now), I must have cost the NHS a great deal this year, with half-a-dozen scans, followed by consultations. And I suspect that the monthly bill for my repeat prescriptions doesn't fall far short of £80.
I respectfully disagree, the German system isn't as good as it may seem from the outside. It's definitely a two class medicine while people with private insurance are clearly preferred because considerably higher bills are covered for exactly the same thing. However, that's not the main problem. That's the endless bureaucracy and the so called "Fallpauschalesystem" i.e. a priori defined maximum payment per any defined diagnosis and procedure. This system obviously doesn't animate anyone to do more as there is no incentive in it. One of the saddest examples is the jokingly low price of a consultation by any physician while this is one of the most important part if it should go right thereafter. This is one of the reasons while there were regionally big clusters of various unnecessary but well paid procedures. Some of those scandals do surface occasionally.
To both MiniMeGreen and Taviterry. I can't say I disagree with either of you. There is an intrinsic battle between two system resulting in dissatisfaction, almost built in. Limits on healthcare payments have here killed off NHS dentistry, and often private providers will benefit from cherry picking parts of provision (lots of NHS tests and then procedures done by Bupa) and I've benefitted as a patient myself like this.Ultimately however the NHS is cash strapped, and there is no political will on either side to actually provide the right amount of funding to pay for it.
Well said. We need to stop pretending and find a solution. We have a growing population, who are living longer, with more complex (expensive) illnesses. Wearing blinkers & thinking the NHS can continue as it is is doing everyone a disservice. The content of those articles constitutes a national emergency and it’s a disgrace we don’t have a cross-party committee working on a long-term solution as a top priority.
Healthcare should not be free for the wealthy. Indeed, the wealthy should support free healthcare for lower income earners. Like it is in Australia.
Good theory, doesn't work. Look on countries who inherited the medicine for all paid by all like Czechia and Slovakia former Czechoslovakia under the Russian thumb. Nothing works as it should, waiting lists comparable to NHS and nicely developing bakshish system for everything. Private practices are just restarting once again.
Both a Polish friend and a Ukrainian one, both resident in England opted to return home for better treatment there, for which they paid relatively small amounts of money. The latter did so before the current war, when she had a few tests before coming back to the UK. The former returned home permanently when Covid struck, a key factor being better care for her autistic child. On the other hand, I knew a Spanish woman who split her time between London, the Canary Islands and the States who aimed to have a free STI check-up whenever she was here.
Ennasti- That’s how it works in the UK. The top 10% wealthiest pay something like > 80% of all personal taxes. On top of that, they also often pay for their families own healthcare and schooling. The question is should they pay even more and if so, being the mobile type, will they chuck in the towel and move abroad taking their tax payments, spend and businesses with them? There is a limit to how much the remaining tax payers can fund a health service, especially if it is inefficient and provides the best available treatment for all, irrespective of cost.
It’s also a very small step from working from home to working from abroad….
I don’t think we should give up hope for the nhs, but change is needed from the top down.
As an ex employee in a clinical setting ( rehab mental health) it saddens me greatly that I personally and the rest of the mdt could no longer offer our patients the best treatment plan but ultimately the cheapest. Patient’s discharged before they were ready and to unsuitable accommodation, sometimes with disastrous results. Re-admission numbers soaring due to early discharge and insufficient care packages. Pressure on A&E department were patients in crisis present, which isn’t an appropriate place for them and whilst dealing with this staff are not able to perform the primary task that A&E should be for.
All these things cost the nhs more in the long run but make the books a little more acceptable in that financial year.
Silly things need to change as well, like every time there’s a new trust logo or chair all headed paper is meant to be destroyed. Not even used as scrap. X that by every trust in the uk.
Stress levels among staff are at an all time high and morale at an all time low.
Sorry for the rant.
All very true and the symptoms of a failing system that is unsustainable. The answer though surely is not to keep throwing good money after bad but a complete rethink. Politicians need to look for the long term solution instead of scoring political points.
And here we are, just electing the best politicians seems so unbelievably difficult. Not everybody can see through some of them in time especially given the constant numbing propaganda.
That’s probably because we have no ‘best politicians’. They’re all as bad as each other - a careerist bunch of middle-management non-entities, totally void of vision or passion.
I do know some people which I hold in high esteem in different countries. The huge problem now is however, that some of them are giving up because of personal frightening threats to them. I've heard of someone giving up saying that it has become impossible to do a good job without becoming corrupt.
That makes me very pessimistic about our prospects as a humanity. My feeling is that history is going to repeat itself soon to the worse. Sorry for that.
Yes , I believe that The Guardian is responsible for most of the numbing propoganda
Yes indeed. The politics of the last decade have taken us further than ever towards a two-tier system. NHS dentistry has forced our family into paying. It's not good at all and what saddens me most is that the nation sits back and cares not a jot for those who are suffering because of it.
What has allowed the government to get away with it can surely only be a combination of apathy, that illness requiring the NHS is too infrequent to stir up a mass of people into action, plus there's enough money in sufficient people's banks to allow the private system to flourish.
I am hoping a change in government will see things change. It did once before.
Steve
It doesn’t matter who is driving if the vehicle is fundamentally flawed. Gordon Brown chucked a whole load of money at the NHS in the early naughties and other than giving staff big pay rises it made proportionally very small difference to outcomes. I’m yet to be convinced that any party has a magic wand to wave at the NHS.
I’m pretty much on your side to be frank and hold no hope out regarding other political parties - but the reality is different if the figures are to be believed concerning doctors and nurses training places and waiting list times.
Steve
Hopefully your last sentence will become reality.
Atlee introduced charges for Dentistry and sight problems, in 1951. The recent banding of charges, means I pay less than I used to for annual /biannual examinations.
Yes - opticians seem to have faired better under the NHS. I think it’s utterly negligent of the government to have forced people into private dentistry as has happened in so many parts of the country.
Steve
Go to Canada, Australia, USA, and Ireland, all countries with a shortage of dentists. There's an international shortage of dentists.
I didn’t know that. I wonder why? I imagine many retired during the pandemic years as happened in other professions. But that’s not the direct cause of the problem within NHS dentistry, surely?
Steve
We also have a significantly lower number of dentists / 1000 people compared with any EU country and the rest of Europe as well as Canada, Australia and the USA.
Steve
It's simply not a popular occupation, so fewer people are entering the profession. Having been involved in it, I have met a number of dentists who wish they had chosen another profession. If your saw the state of oral hygiene some people present with (even after careful instruction from a hygienist), you wouldn't want to be a dentist either !
I can well imagine but the same must apply to many medical specialties I imagine.
The lack of NHS dentists is a failure of planning and interest, I would argue, since other countries do manage to train far more and our private system seems to be flourishing.
Steve
Private dentistry has been the choice by UK practitioners for years. One English dentist who came to work for my boss, told us several amusing things - among them when he was a Registrar at a NHS London hospital, they had a walk in clinic from 9 am until 1pm - if someone arrived at 12.55pm, they received the '3 P's treatment', which was - Penicillin, Paracetamol and Piss off'. Later when he worked in general practice, his employer would decide whether to attend to the patient under the NHS or treat him/her as a private patient , according to the car they arrived in - he would watch from his surgery window,. He was caught out one day when a man arrived in a brand new Bentley, was given first class treatment, but it turned out he was the chauffeur ! This was nearly 40 years ago !
Unfortunately you have to pay to read the Guardian online so I can't see it
They must have changed the policy then. It used to be that you could read with ads. They also doubled the inscription price this year. I'm sorry.
I take it you are in Germany??....And the Guardian is hardly an unbiased British newspaper. The NHS is not great at present, but there would be a massive backlash in the UK if any government tried to fully privatise care. Its free at the point of use, and I spent 40 years working in the UK system...What we don't see in the UK are people being bankrupted due to them not being able to afford healthcare bills, as is common in the USA....No. its not perfect but its valued by the majority
Unfortunately fear of that ‘massive backlash’ is what’s stifled open and honest debate amongst politicians for years. To either stay free or to follow the US system and go fully private is not a binary option.
Unfortunately what IS and has already happened is privatisation of the NHS by stealth. Just talk to anyone who actually works in it. This website is a good source of relevant information and articles, which include The Guardian
What the NHS will be reduced to, in my opinion, is Emergency Trauma Care and acute care. Unfortunately the people who will suffer most are those with chronic conditions as private health care does not cover monitoring people with chronic conditions and we all know about the waits to see an EP - unless you are acutely ill when you would go through A&E.
When one takes a pet to the vet with a developing long term illness the vet often starts with 'what does it eat?'
When GP's learn how to ask that AND know the answers to what 99% of what most chronic metabolic illness sufferers will list, then the pressure on the NHS might just start to be resolved.
What I do think has been shown to be successful in educating and encouraging people to change their eating to improve health is to engage in GP led health education programmes a series of group meetings with specialists which my previous GP surgery attempted - I think 6 people signed up out of about 20,000 patients. So sad. That is why GPs are looking to private ways such as private practice, podcasts, writing etc but the only way they can do that is work part-time and have sponsors who will want their pound of flesh.
Unfortunately every single person needs testing to see exactly which foods are ‘healthy’ for them. Currently the only way of doing that which also has ongoing guidance that I know is the Zoe Health Programme. I learned so much from that and the research they are doing is showing that the more compliant follower are with their personal recommendations, the more successful they are at transforming their health, improving fitness and losing weight.
You can learn a huge amount though just following them and listening to their podcasts.
The one positive thing that government could do is to legislate on ultra processed foods but would they? Course not because big companies lobbying ensure that doesn’t happen.
I also think the statin siren call is still fully embedded in the general medicine fraternity. Health programs seem to still shy away from embracing older more natural ways of eating.
Now 'climate change' has sneaked it's way into general medicine and the big scare against meat is gaining traction.
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