NHS Rant

[koolpc]

Def 2nd going private for the consultation at the very least. Hope she gets seen soon mate. No way she should be suffering like that. NHS can be a right pain. I been waiting over 6 months to see the chronic pain management department.

 

[Jumper118]

Almost every private sector employee in Britain would disagree with the assessment that private sector managers are good...

I didn't say they were good. The ones that get bad results get fired. That is all.

 

[SexyGreyFox]

A great example of Managers in the NHS can be seen in the building I work in that contains lots of little departments so I'll break it down:

There are 3 Managers with 1 staff member each
There are 3 Managers with 2 staff members each
There are 2 Managers with 3 staff members each

and so on .....

 

[Jumper118]

A great example of Managers in the NHS can be seen in the building I work in that contains lots of little departments so I'll break it down:

There are 3 Managers with 1 staff member each
There are 3 Managers with 2 staff members each
There are 2 Managers with 3 staff members each

and so on .....

lol. that is awful. sounds like 7 managers too many

 

[SexyGreyFox]

lol. that is awful. sounds like 7 managers too many

Funnily enough the department who Ace will be getting in touch with has the most Staff to Manager ratio with 1 Manager for 9 staff.
I have a Head of department, Deputy Head of department and 6 colleagues, to be honest those two Heads are needed.

 

[Mercenary Keyboard Warrior]

I will give you a great example. Food. Food industry is private nobody massively overcharges for food very few people go hungry and food is plentiful and cheap.

Now I know you don't know what your on about, this is the industry I work in.

Your statement is completely flawed. Most of the food industry charges what it can get away with. (As does all private industry basically)

There are products that have massive margins because people perceive a greater benefit, and others than are low. yet some of the best profit earning brands are poor value for money compared to own labels.

 

[LeeUK]

Yeah the NHS are a joke.

Let's get it privatised double quick.

 

[Monkeynut]

Yeah the NHS are a joke.

Let's get it privatised double quick.

Daniel Hannan is on it: https://www.thetimes.co.uk/article/let-american-firms-run-hospitals-urges-free-trade-group-5rxxd9tb8

 

[shadow_boxer]

Off topic but.

...There is however a tide of people leaving the profession, going overseas or locuming rather than progressing with training because frankly life as a doctor sucks a large part of the time. We had strikes last year, contracts imposed, working hours protection stripped away. The NHS doesn’t value its staff now, let alone potential staff.

This. Of my 5 best mates from medshool who graduated around 10 years ago.

1. Left NHS. Work privately as a radiologist.
2. 10 years later still in training to be a cardiologist.
3. Moved after 3 years to New Zealand
4. Left the profession completely.
5. GP doing routine and locum work.

Quite sad on reflection but I don't blame people for leaving or making the best for themselves. I certainly rarely feel valued. As a "trainee" particularly, merely a commodity to be exploited by detatched rota coordinators with little understanding of job or training process. My wife and I are seriously considering moving to Canada to practice in the future.

 

[Raumarik]

A great example of Managers in the NHS can be seen in the building I work in that contains lots of little departments so I'll break it down:

There are 3 Managers with 1 staff member each
There are 3 Managers with 2 staff members each
There are 2 Managers with 3 staff members each

and so on .....

Entirely depends on pay grades. There are managers where I work on £20K and some on £55K.

"Manager" doesn't really mean anything in the NHS, you can line manage without having that in your job title anyway.

 

[Jumper118]

Now I know you don't know what your on about, this is the industry I work in.

Your statement is completely flawed. Most of the food industry charges what it can get away with. (As does all private industry basically)

There are products that have massive margins because people perceive a greater benefit, and others than are low. yet some of the best profit earning brands are poor value for money compared to own labels.

It doesn't matter. You are getting caught up on the profit is bad, but it isn't. Profit creates capital to invest in new projects and if everyone can afford food it doesn't matter that the profit margins are massive. Its always been better than state run food programs.

You may know how the food industry works, but you clearly fail to grasp basic economics.

In fact if the NHS is so amazing and cheaper than private industry, why don't they make it so people can pay less tax, but not receive health care from the NHS. Then we would see how cheap it really was.

 

[Jumper118]

Yeah the NHS are a joke.

Let's get it privatised double quick.

The NHS itself must not be privatised. It must be torn down completely otherwise you end up with the same mess as the trains are in.

Daniel Hannan is on it: https://www.thetimes.co.uk/article/let-american-firms-run-hospitals-urges-free-trade-group-5rxxd9tb8

Yes the American system is crap too. Already said. There is too much regulation which stops new business starting up.

Obama actually put loads of charity hospitals out of business because they were not able to meet the regulations on their budgets, meaning ironically, thousands of poor people using charity health care now don't have any. He basically just moved a bunch of people using charity health care off charity and onto government paid for health care. Adding a middle man and raising the costs overall for Americans.

 

[neviditelny]

but the main reason for this is PALS > Complaints > Clinical Negligence
Solicitors Experts look for the tiniest things that may or may not have been done so staff have to be on the ball with their paperwork.
It was only a couple of years ago when I was having my own operation that I realised a whole department had been setup called PreAMS because of potential mistakes that could be made where in the old days it was: Your operation is on November 6th 1985.

Yes, paperwork is important but if I compare for example with my ward the nurses generally only get to deal with the patient's when they give them medication, otherwise most of the time they will be filling in care plans and documentation in regards of the patients which they have hardly seen or dealt with.
As an example, when we have a patient being admitted to my ward, we have a 30-odd pages document with assessments that needs to be done with each patient. And to add to that, my ward have 32 beds, and we quite often have a turnover of 10-15 patients a day (sometimes even more).

 

[neviditelny]

When people complain about management what do they mean?

Ward managers? Account Managers? Heads of Service? Commissioners? Regulators?

Many of these roles are needed to help operations run smoothely or reduce variation in care received regionally or try to prevent departments from overspending.

Perhaps if there were fewer top down reorganisations, managers could get on with the job they want to do rather than having to deal with restructures.

For me the management goes from the Ward Managers (the Senior Sisters/Charge Nurses) to Matron and Divisional Managers etc. People tend to go upwards in the hierarchy very quick but also tend to lack a lot in knowledge, experience and how to actually manage and lead people. There is a shocking lack of knowledge and understanding of how to actually work and deal with people (both patients and the own staff).

 

[stockhausen]

A great example of Managers in the NHS can be seen in the building I work in that contains lots of little departments so I'll break it down:

There are 3 Managers with 1 staff member each
There are 3 Managers with 2 staff members each
There are 2 Managers with 3 staff members each

and so on .....

The modern curse of status - ‘Everybody has won, and all must have prizes.’

 

[Mercenary Keyboard Warrior]

It doesn't matter. You are getting caught up on the profit is bad, but it isn't. Profit creates capital to invest in new projects and if everyone can afford food it doesn't matter that the profit margins are massive. Its always been better than state run food programs.

You may know how the food industry works, but you clearly fail to grasp basic economics.

In fact if the NHS is so amazing and cheaper than private industry, why don't they make it so people can pay less tax, but not receive health care from the NHS. Then we would see how cheap it really was.

I am not getting caught up at all, its quite funny because if yo uknew me you would understand how iditoic and/or uninformed you are.
Just for reference i my almost 30 years at work I have always worked for international/global businesses, most of that time (bar 6 years as a systems accountant/manager in fin services).
I studied economics to A level, then some specifically business focussed for my proffessional qualification (accountancy).
I was in my 30s when I was FD in a FTSE company.

My last job prior to when I moved to food (high tech end), was working in a global pharma company. So yeah I have a bit more of a clue on how business works, both in general and also in pharma.

Just for reference, most of the time when sitting around at board level the term profit isn't really used, profit is a result of doing the other things right. Its normally far more along the lines of margins (gross/ net etc), margin improvement, sales growth, cost control as far as financials. But thats (unless the business is strugling) normal vastly outweighed by others things such as employee engagement, competitor activity etc

One last item you should consider before any more inane points, healthcare has very high barriers to entry. Its a really highly regulated industry. Going back to my time in pharma, when we changed practically anything it was regulated, even the plastic bottles some IV was supplied in. These high barriers to entry make it harder for competitors to enter, the natural functioning of competition is supressed by this.

 

[Vern1961]

NHS can be very good or very bad. While the biggest problem is getting past the GP or GP receptionist, even a referral does not guarantee prompt treatment. In the case of my MMN, I spent nearly 4 years being told I had carpal tunnel, nothing they could do, wear a wrist support etc. Even my appointment with the neurologist he was going to discharge me back to the GP and it was only when the nerve conduction study came back got recalled to be told what condition I actually had.

In contrast once the treatment started the unit was second to none. Helpful nursing staff, pleasant surroundings and everything done to put you at ease. Just as well, as theres no cure only treatment to ease the symptoms, which will be ongoing until the end of my days or the NHS no longer fund it.

MMF is not a life threatening condition but it is potentially life changing with gradual loss of motor function and nerve damage. The prospects would have been far better and less expensive to treat if it had been identified several years ago rather than misdiagnosed or dismissed as RSI.

 

[chrcoluk]

There is all sorts of issues, the latest one to anger me?

I have been trying to get a late day appointment for the past 2 weeks, my GP currently has 6 permanent doctors, yet according to the receptionists only 4 appointments after 4.30pm are available for the next 4 weeks.

The surgery is open till 6pm and these are 10 minute slots, so whats happened to the other 116 or so slots? These are not appointments booked up, they simply stated there is only 4 available to book and the slots are no longer available as policy, one receptionist was about to give me a reason but then stopped early sentence like she was not allowed to say.

Access to healthcare seems to be getting very hard in my area, I think its highly variable per region tho as different regions are at different stress points. A postcode lottery so to speak.

My last referral was done via a private GP, he told me the NHS GPs are under tremendous pressure to hold people back to save money.

It doesn't matter. You are getting caught up on the profit is bad, but it isn't. Profit creates capital to invest in new projects and if everyone can afford food it doesn't matter that the profit margins are massive. Its always been better than state run food programs.

You may know how the food industry works, but you clearly fail to grasp basic economics.

In fact if the NHS is so amazing and cheaper than private industry, why don't they make it so people can pay less tax, but not receive health care from the NHS. Then we would see how cheap it really was.

I dont quite agree.

A for profit organisation always needs extra money to generate the profit, in addition shareholders tend to want profit growth year on year so the demand for profit is always growing. Profit could be compared to "waste" in state entities.

So the question is if the waste in NHS is more than the combined waste in a private healthcare and the profit making, if it isnt then a state funded NHS is better value for money.

I havent a clue as to exact reasons for the NHS problems.

But some reasonable assumptions are.

1 - Per adult head, our NHS is underfunded vs other top EU countries such as france and germany.
2 - Some staff seem to have a lot of clout in terms of their terms of employment, favourable hours and pay, my local hospital has been paying doctors to cover a&e over £70 an hour. That is clearly a ridiculous situation been abused by doctors, pure greed. It got so bad, several times a&e was left unmanned as managers had massive restrictions on authorising the doctors to work due to out of control costs, including the last time I went a&e.
3 - bad management of resources, so often I see nurses standing around chatting to each other or look like they struggling to stay busy, as well as admin staff, but doctors the opposite, when I left a consultants room after an appointment there was a queue of 3 staff waiting at the door for him, at a time he was 90 mins behind on appointments. So some resources clearly need shifting from nurse and admin staff manning levels to doctors. This massive shortage ironically is probably why problem #2 exists as the doctors know they in so much demand.

Healthcare is been compromised, high quality drugs no longer get prescribed, people have to either make do with less effective alternatives which can drastically reduce quality of life or even cause death, or no alternative at all. Doctors make assumptions that are dangerous like mistaking cancer for a minor infection, probably because the latter is cheaper.

There is doctors at my hospital which can barely speak english.

If the system was privatised, I can see some of these problems been dealt with especially #2. But I also feel overall funding would drop so problem #1 would get worse. Of course my private GP appointments have generally been productive, but I am paying a big wad of cash for those appointments.

A general observation based on the treatment given to me, my frends, family and what I read in the news, is that the NHS always value preserving life over maintaining quality of life. So if e.g. a condition doesnt have an immediate risk of killing you but is crippling you, then that would be lower priority than keeping someone in the last minutes of their life alive. Which is why so often people get brushed away, but then when the problem becomes real serious the NHS suddenly acts like it gives a crap. Also the 999 service is generally quite good as thats dealing with people in very grave situations. Its always going to be controversial on what people think is a better use of resources, so much of the NHS money is used to prolong life of the elderly probably at the expense of the working age who need treatment. For sure ideally there would be no choice to make and no compromise anywhere, but there is compromises currently been made.

Also since the abolishment of PCT's I feel the NHS has no public accountability, the complaints procedure since that got removed is a joke.

In this thread I haven't even spoken about the mental state of my wife either, she is so low at the moment that it is affecting everything, she is not coping mentally at all. I wanted to keep the thread just on track for the hospitals inability at manage her direct problem.

Her GP is helping her manage the mental state she is in at the moment, but she isn't in the best of places - quite understandable too. She doesn't get more than 60 mins uninterrupted sleep ever, because the pain wakes her up constantly. She is napping on/off during the day due to lack of proper sleep, but short naps do not do what a proper 7-8 hours sleep does. This is also affecting her mental well being.

But this is just a byproduct of the underlying primary issue, that is her condition.

You have my sympathy 100%, I have personal experience of what can happen when an initial problem is left untreated, it then causes other problems like dominoes falling down, e.g. a lack of sleep can severely harm a human, she cannot sleep because of pain, which in turn has likely caused other issues and the prolonged period of pain and lack of treatment has affected her mentally. The NHS has increased its own costs of treating your wife by failing to treat her early at the onset of illness. It may be years for your wife to return to normality as the result of all this.

I can sympathise with that. I had gallstones when I was in my early 20s. Given that I was fit, had spot on cholesterol there was obviously no logical reason for me to have them they weren't diagnosed. For 12 months my gp tried me on various meds and painkillers which did nothing. It was only at this point i finally had an ultrasound scan which confirmed what the problem was. For 18 months I never slept through a single night due to the pain. I was genuinely losing my marbles. Nothing took away the pain. I was making myself sick, sitting on the toilet for hours, avoiding food, doing anything I could to try and just alleviate the pain even slightly.

In the end I crawled in to A and E on my hands and knees coughing up blood.
They initially refused to operate saying something needed to be scheduled through my GP and then a referral and that I had to go home. I refused to leave. They called security. The security guards refused to move me as they could clearly see how ill I was with one of them actually saying "he's in A and E, this is where he needs to be otherwise what's the point of the place?".
I passed out at some point after that. Woke up the next morning without a gallbladder as it had ruptured.
The surgeon that operated on me apologised on behalf the the NHS pointing out it should never have gotten to that stage.

excellent from the security staff, I hope they didnt get fired for what they did.

I will give you a great example. Food. Food industry is private nobody massively overcharges for food very few people go hungry and food is plentiful and cheap.

I wouldnt consider food cheap, there is a lot of people with malnutrition and we have food banks as evidence people are struggling to afford to buy food.

As an example 10 years ago I could buy 4 Cornish pasties for a £1, now they nearer a £1 each.
Sometimes the price inflation isnt crazy but instead the food amount is reduced so they reduce the weight of the food you buy in the packaging.

Food has most definitely got way more expensive despite competition in the market.

Gas and electric also has competition and has out of control cost increases, competition is by no means a guarantee prices will be restrained.

 

[Rifte]

I live in India at the moment and have for the previous three years.

I have, however, been a regular tourist to the country for a number of years and on the back of this in about 2010 I decided to get to utilize the Indian medical system.

Wealth is nothing without your health and you can get treated for pretty much anything the same day for a fraction of the cost of going private in the UK.

Its a sad state of affairs when a middle class Indian national has access to a better medical system than a western country.

My mother needed a knee replacement a number of years ago, the NHS had an approximate waiting time of 18 months to two years at the time. For the total cost of around 2 grand, my mother had a return ticket to India, booked into a five star hospital and the knee replacement completed in a matter of 24 hours of landing in the country.

 

[Minstadave]

2 - Some staff seem to have a lot of clout in terms of their terms of employment, favourable hours and pay, my local hospital has been paying doctors to cover a&e over £70 an hour. That is clearly a ridiculous situation been abused by doctors, pure greed. It got so bad, several times a&e was left unmanned as managers had massive restrictions on authorising the doctors to work due to out of control costs, including the last time I went a&e.

I find this interesting. How much is the hourly rate for a lawyer or even a plumber?

A&E in particular pays a lot for staff because it’s awful work, antisocial shifts and there is a nationwide shortage of staff.

This is despite regional trusts banding together to try and cap locum costs and aggressive efforts by government to drive down costs of out of hours working.

Why is it wrong for doctors to know their worth?

Pay will only go one way if privatised.