Do you want to discuss boring politics? (169 Viewers)

[duffer]

It's the same myth the Tories have been trotting out forever, that it is possible to resolve decades of chronic underinvestment in the NHS, with reform. (See also council funding, education, etc. etc.)

No government in the last twenty years has been able to do it, it's a fiction.

 

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[shmmeee]

because they’re getting a shit service

up until the pandemic it wasn’t markedly different to a majority of the last Labour government, actually higher than a lot of the time (i appreciate they did a lot to improve it which took time, but I also believe the changes in GP contracts is part of the reason we have such a mess when it comes to A&E now)

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If people want to blindly follow the nhs is great it just needs more cash then that’s their call. I’ve said before I’ve known people work with the NHS pre Tory government and the bureaucracy and unwillingness to accept and deliver change was around then. I presume the culture hasn’t changed much

ps whatever happens it needs cross party buy in as the countries health is far too important to play party politics

There’s definite changes that can be made. My GF works in the NHS and could give you a list a mile long of issues.

The problem is the NHS, like education, has suffered from repeated government “reforms” and people are wary of another.

I’m not sure if Streeting is playing the “reform” card purposefully to let anyone think it’s what they want it to be. But the very word itself is tainted, like “efficiency savings”. Really to gain trust it needs to be specific policies. But most of the things that are needed will involve some level of funding and like everything else Labour is saying right now once that convo comes up they run a mile.

 

[Sky Blue Pete]

What's he not wrong about?

The nhs could spend whatever money it is provided.
Some areas of the nhs work in a 20th century way. IT for instance is like many civil service departments caught up in the past

 

[fernandopartridge]

The NHS problems are a bit like the problems experienced by the population - just because the rate of inflation is now a bit lower does mean I am suddenly better off.

 

[shmmeee]

The nhs could spend whatever money it is provided.
Some areas of the nhs work in a 20th century way. IT for instance is like many civil service departments caught up in the past

You aren’t going to get a new IT system for £0 tho

 

[fernandopartridge]

The nhs could spend whatever money it is provided.
Some areas of the nhs work in a 20th century way. IT for instance is like many civil service departments caught up in the past

Have you got an example Pete?

 

[fernandopartridge]

You aren’t going to get a new IT system for £0 tho

People working in the NHS don't want a new IT system though, it's not where the problem is. The problems are more basic than that - they have got very old kit that is just not fit to work with the cloud hosted EPRs etc they are trying to use. It's a bit like playing the newer versions of Champ Manager on an old PC.

The networking infrastructure is inconsistent, for example many GP practices have got a tiny bit of bandwidth which they are trying to use to perform remote video triage etc over.

You get politicians like Wes and the Tories waffling on about AI and great tech advances. NO, sort the basics out first otherwise widespread AI etc is a complete pipe dream.

 

[Sky Blue Pete]

Have you got an example Pete?

Mental health provision would be one - we could never spend enough

 

[Como]

The NHS has had many problems for as long as I can remember. if it is so wonderful a system why has no EU country copied it?

Anyway it it does not really matter it is unreformable and nothing of consequence is going to change.

 

[shmmeee]

People working in the NHS don't want a new IT system though, it's not where the problem is. The problems are more basic than that - they have got very old kit that is just not fit to work with the cloud hosted EPRs etc they are trying to use. It's a bit like playing the newer versions of Champ Manager on an old PC.

The networking infrastructure is inconsistent, for example many GP practices have got a tiny bit of bandwidth which they are trying to use to perform remote video triage etc over.

You get politicians like Wes and the Tories waffling on about AI and great tech advances. NO, sort the basics out first otherwise widespread AI etc is a complete pipe dream.

I’m classing hardware and infra in as IT here really. Data analysis comes at the top of a pyramid with infra at the base. There will be low hanging fruit but if what we want is a data driven efficient system it won’t come for free is the point.

 

[shmmeee]

The NHS has had many problems for as long as I can remember. if it is so wonderful a system why has no EU country copied it?

Anyway it it does not really matter it is unreformable and nothing of consequence is going to change.

So we should harmonise all social policy with the EU? Didn’t expect that take from you.

 

[shmmeee]

Mental health provision would be one - we could never spend enough

Like obesity it’s something where the NHS picks up the tab for other policy failures. Same as behaviour in schools. IMO it’s caused where you straddle public and private responsibility. We don’t want to take policy action to say change what people eat or how they exercise/move around, or limit say social media, or any other drivers of poor physical and mental health. But we still want to stop people completely fucking themselves up so catch them at crisis point.

Like people say about taxes, we’ve got a US approach to personal liberty with a European social support network. We seem to suffer a lot from being neither a social democratic communitarian Northern European country nor a hyper efficient, I’m alright jack, individualistic libertarian country like the US.

 

[Sky Blue Pete]

Like obesity it’s something where the NHS picks up the tab for other policy failures. Same as behaviour in schools. IMO it’s caused where you straddle public and private responsibility. We don’t want to take policy action to say change what people eat or how they exercise/move around, or limit say social media, or any other drivers of poor physical and mental health. But we still want to stop people completely fucking themselves up so catch them at crisis point.

Like people say about taxes, we’ve got a US approach to personal liberty with a European social support network. We seem to suffer a lot from being neither a social democratic communitarian Northern European country nor a hyper efficient, I’m alright jack, individualistic libertarian country like the US.

Yep agreed but I think we are aligned politically

 

[skybluetony176]

The NHS has had many problems for as long as I can remember. if it is so wonderful a system why has no EU country copied it?

Anyway it it does not really matter it is unreformable and nothing of consequence is going to change.

Most countries in the EU have a universal healthcare system. The real question is why aren’t we copying them, especially true of the Scandinavian countries. Take Denmark for instance. Its universal healthcare system is so effective that only about 1% of hospital beds there are private, compared to about 9% in the UK. We’ve lost over half our hospital beds in the last 3 decades and seen big rises in people turning to private healthcare in some way.

 

[wingy]

Mental health provision would be one - we could never spend enough

Stop stressing out in the first place I'd say to that?

 

[CCFCSteve]

Something rather large and health related happened in 2019 that added a huge amount of costs to be fair.

Exactly and it’s only since then that satisfaction ratings have dropped markedly ?!*

This isn’t a defence of the Tories (the initial fuck up by Grayling I think - no surprise - is what’s tainted the word ‘reform’) but more of a point that things need changing as well as investment/cash. That’s why I mention cross party buy in

Better social care overflows for elderly patients to stop bed blocking (why not have something attached to large hospitals ?), immediate brief GP oversight on people coming to A&E are just a couple off the top of my head, not mention better systems/processes - I’ve mentioned the shambles in A&E from personal experience


*I know that wasn’t your point but it works both ways yet people are happy to ignore it when argument suits

 

[fernandopartridge]

Like obesity it’s something where the NHS picks up the tab for other policy failures. Same as behaviour in schools. IMO it’s caused where you straddle public and private responsibility. We don’t want to take policy action to say change what people eat or how they exercise/move around, or limit say social media, or any other drivers of poor physical and mental health. But we still want to stop people completely fucking themselves up so catch them at crisis point.

Like people say about taxes, we’ve got a US approach to personal liberty with a European social support network. We seem to suffer a lot from being neither a social democratic communitarian Northern European country nor a hyper efficient, I’m alright jack, individualistic libertarian country like the US.

I think personal attitudes in the UK are in reality much closer to northern European ones it's just got a rabid right wing media that likes to try and encourage something more American (when it suits).

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[clint van damme]

Most countries in the EU have a universal healthcare system. The real question is why aren’t we copying them, especially true of the Scandinavian countries. Take Denmark for instance. Its universal healthcare system is so effective that only about 1% of hospital beds there are private, compared to about 9% in the UK. We’ve lost over half our hospital beds in the last 3 decades and seen big rises in people turning to private healthcare in some way.

And even the insurance based systems that some countries in the Europe do have are a million miles away from the American style one which is what the tories are driving at when they talk about reform.

What Streetings plan is I'm not sure.

 

[Ian1779]

What Streetings plan is I'm not sure.

For him to get personally rich off the back of his idea.

Check out who donates him money if you want to know where his ‘interests’ lie

 

[CCFCSteve]

For him to get personally rich off the back of his idea.

I just don’t see that Ian. I’ve looked into his background which is pretty interesting and whilst I don’t have much faith in politicians across the board, I don’t think that should be the automatic response when he or anyone else talks about NHS reform/improvement

 

[shmmeee]

I think personal attitudes in the UK are in reality much closer to northern European ones it's just got a rabid right wing media that likes to try and encourage something more American (when it suits).

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On social support definitely. I think we’re more enterprising than the Europeans though. There’s a middle ground there that’s uniquely British somewhere. We just need to be comfortable with it and what it means. Sugar tax and banning smoking is probably fine, cookie banners and banning straight /bendy/whateverthememewas bananas less so.

 

[wingy]

On social support definitely. I think we’re more enterprising than the Europeans though. There’s a middle ground there that’s uniquely British somewhere. We just need to be comfortable with it and what it means. Sugar tax and banning smoking is probably fine, cookie banners and banning straight /bendy/whateverthememewas bananas less so.

Good fags should get cheaper then?

 

[shmmeee]

Good fags should get cheaper then?

We should probably just stop smoking wingy. Let’s be honest.

 

[Ian1779]

I just don’t see that Ian. I’ve looked into his background which is pretty interesting and whilst I don’t have much faith in politicians across the board, I don’t think that should be the automatic response when he or anyone else talks about NHS reform/improvement

Of course you don’t Steve, and it’s not an automatic response. There are people on here that have a better understanding of the issues NHS has, and I’d trust their judgment and that of other people who work in it over an odious little scrote like Streeting.

Meanwhile, he continues to take money from people involved in private healthcare…

 

[fernandopartridge]

NHS England put in place the 'increasing capacity framework' two years ago. This framework is to make arrangements so that the NHS is able to easily buy in from the private sector extra capacity to help with the elective waiting list.

Increasing Capacity Framework - Provider List

Increasing Capacity Framework

increasingcapacityframework.co.uk

Further to that, the procurement laws governing healthcare contracts have just changed so that any provider capable of providing particular type of services can be awarded a contract without competition.

Wes' great plan for involving the private sector in the NHS has already been delivered by the Tories, does he do any research at all?

 

[fernandopartridge]

Oh, and the private sector is paid exactly the same tariff for an elective procedure that an NHS Trust is. This reform then means that the government pays the same but the surplus (if there is one) goes to shareholders whomever and wherever they may be, rather than being recycled within an NHS Trust to spend on the much larger general service provision they bring.

 

[chiefdave]

NHS England put in place the 'increasing capacity framework' two years ago. This framework is to make arrangements so that the NHS is able to easily buy in from the private sector extra capacity to help with the elective waiting list.

Looks like that's the subject of tonights Panorama

Spire Healthcare: Death of NHS-funded private patient raises safety concerns

BBC Panorama investigates patient safety at a major private provider used by the NHS.

www.bbc.co.uk

 

[fernandopartridge]

It's almost as if there is an inherent practical efficiency of having one NHS Trust with multiple specialisms under one roof.

 

[CCFCSteve]

Oh, and the private sector is paid exactly the same tariff for an elective procedure that an NHS Trust is. This reform then means that the government pays the same but the surplus (if there is one) goes to shareholders whomever and wherever they may be, rather than being recycled within an NHS Trust to spend on the much larger general service provision they bring.

If they’re paid the same tariff then I don’t think there can be too many complaints. I can’t imagine they’d be much in the way of surplus as consultants charge more for operating privately. Agree that I thought this type of thing was already in place, just not well utilised. I hope he’s got more in his locker than just this though

 

[skybluetony176]

If they’re paid the same tariff then I don’t think there can be too many complaints. I can’t imagine they’d be much in the way of surplus as consultants charge more for operating privately. Agree that I thought this type of thing was already in place, just not well utilised. I hope he’s got more in his locker than just this though

In my experience private consultants are the same consultants you would see under the NHS. I needed an urgent referral to the urologist a couple of years ago, urgent meant about 6 weeks so I went private and saw a urologist the next day. I needed a high quality ultrasound but the Meriden centre didn’t have one so he referred me back to the NHS for the ultrasound, thankfully that was only about a 10 day wait. I got the ultrasound done and it went to a NHS urologist although the sonographer could confirm it was nothing to worry about I still needed a follow up appointment. The follow up appointment came through at Walsgrave and saw the same urologist I saw at the Meriden clinic next door. Basically I jumped the queue for £650. It begs the question though that if consultants can earn more money doing the same work for private clinics as they do for the NHS why not just pay them the same as the private clinics pay them in the first place? Given private clinics get the same tariff when doing NHS work, just cut out the middle man.

 

[fernandopartridge]

If they’re paid the same tariff then I don’t think there can be too many complaints. I can’t imagine they’d be much in the way of surplus as consultants charge more for operating privately. Agree that I thought this type of thing was already in place, just not well utilised. I hope he’s got more in his locker than just this though

Of course there is a surplus, these private entities wouldn't agree a contract for work with no margin in it. The consultant's charge will be no greater than the actual cost of employing a consultant in an NHS Trust taking into account on-costs etc.

 

[shmmeee]

In my experience private consultants are the same consultants you would see under the NHS. I needed an urgent referral to the urologist a couple of years ago, urgent meant about 6 weeks so I went private and saw a urologist the next day. I needed a high quality ultrasound but the Meriden centre didn’t have one so he referred me back to the NHS for the ultrasound, thankfully that was only about a 10 day wait. I got the ultrasound done and it went to a NHS urologist although the sonographer could confirm it was nothing to worry about I still needed a follow up appointment. The follow up appointment came through at Walsgrave and saw the same urologist I saw at the Meriden clinic next door. Basically I jumped the queue for £650. It begs the question though that if consultants can earn more money doing the same work for private clinics as they do for the NHS why not just pay them the same as the private clinics pay them in the first place? Given private clinics get the same tariff when doing NHS work, just cut out the middle man.

Because private healthcare is only profitable if you can refuse the expensive cases and cherry pick the profitable ones.

 

[CCFCSteve]

Of course there is a surplus, these private entities wouldn't agree a contract for work with no margin in it. The consultant's charge will be no greater than the actual cost of employing a consultant in an NHS Trust taking into account on-costs etc.

I meant a meaningful surplus. Of course they’re making a profit but I’m assuming Trusts have calculated the approximate actual costs previously so if private are receiving the same then it’s not like there’s massive profiteering going on

Ps it’s a bit bizarre trusts are making a surplus to start with

 

[Como]

Most of my involvement with medical care has been visits to Chemists and they have all been privatised.

You want a new Hospital who will build it, not the NHS.

NHS does not manufacture ambulances.

I seem to remember that when the NHS started part of the deal was that Doctors maintained their independence.

The one thing hopefully we can all agree on is that it is very badly run, how do we change that?

 

[fernandopartridge]

Most of my involvement with medical care has been visits to Chemists and they have all been privatised.

You want a new Hospital who will build it, not the NHS.

NHS does not manufacture ambulances.

I seem to remember that when the NHS started part of the deal was that Doctors maintained their independence.

The one thing hopefully we can all agree on is that it is very badly run, how do we change that?

Colleague has just been involved in a new major trauma centre in Greater Manchester, the NHS organised the building and equipping of that actually

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