Save the NHS!

[Minstadave]

Ummm

At the moment students partially pay their training with tuition and nhs picks up the rest but if you force students to take on the NHS' cost of training by loan which is repayable through income if they seek private work or void if they do a certain so many years within the NHS, you guarantee the people the NHS pay for will dot heir time or pay back what they owe.

Takes a cost of teh NHS and uses it against people who wish to get trained but not work for the NHS.

I don't think keeping the doctors who leave the NHS after training in the UK is really going to be a solution to the much larger problem which is working in an NHS that is:

a) overwhelmed
b) a monopoly employer prepared to thoroughly screw its employees
c) relegated it's employees to endless shift work and mindless bureaucracy

It'd be nice to make people feel valued and not just holding back an endless tide rather than fine or tie them into contracts.

 

[Avenged7Fold]

It does c because of a. If everyone did their time or paid their way, it would not be anywhere near as overwhelmed and we wouldn't have to pay the huge premiums involved in filling the rota gaps with agency workers.

Also i am not talking about doctors leaving the UK i mean ALL UK trained doctors pay their cost the NHS covers through either a % of their private work or time done in the NHS. Too many doctors going private are causing an overwhelmed NHS and are wasting investment spent in training them. Obviously the growing population and increase in elderly people are a big reason why its overwhelmed but we cant just cull them.

 

[StriderX]

It does c because of a. If everyone did their time or paid their way, it would not be anywhere near as overwhelmed and we wouldn't have to pay the huge premiums involved in filling the rota gaps with agency workers.

Also i am not talking about doctors leaving the UK i mean ALL UK trained doctors pay their cost the NHS covers through either a % of their private work or time done in the NHS. Too many doctors going private are causing an overwhelmed NHS and are wasting investment spent in training them. Obviously the growing population and increase in elderly people are a big reason why its overwhelmed but we cant just cull them.

Well we can cull them by just ignoring the NHS has problems, the Westminsterfudge will win the day.

 

[Minstadave]

Also i am not talking about doctors leaving the UK i mean ALL UK trained doctors pay their cost the NHS covers through either a % of their private work or time done in the NHS. Too many doctors going private are causing an overwhelmed NHS and are wasting investment spent in training them. Obviously the growing population and increase in elderly people are a big reason why its overwhelmed but we cant just cull them.

I am no expert on private work but I can't imagine doctors doing private work either solely or on top of their NHS work have much to do at all with the NHS being overwhelmed. Just as doctors leaving the UK aren't the major problem.

The key areas overwhelmed currently in the NHS are ED, adult acute medicine, adult and paeds ITU. None of which have any significant levels of private work going on.

It's nice to trot out that doctors are greedy and wracking up hundreds of thousands whilst the NHS crumbles but it's not true. The big money in private medicine is im surgery, anaesthetics and radiology - these aren't the key areas that are crumbling.

The problem is much simpler:

An aging population
Everyone expects immediate appointments and quick fixes
Chronic underinvestment in hospitals, staff training and recruitment, community care etc
PFI bills crippling trusts
Chronic fear of raising taxes to appropriately fund the NHS compared with other European nations

Like the Xmas period for instance, huge demand but social care is down to a skeleton crew due to forced unpaid leave to save money, so discharges are delayed.

The Tory press can trot out articles all day about greedy GPs, greedy locums, lazy patients etc but that's not the real problem.

 

[The_Abyss]

Many over 65s are still earning.

There might be many who are still earning but if that is the case then they're earning virtually nothing. From the latest ONS household disposable income report (https://www.ons.gov.uk/peoplepopula...leincomeandinequality/financialyearending2016 )

 

[Tefal]

If your replying to my post:

To guarantee they end up in the NHS but still give them the freedom to work elsewhere if they pay the money back. If we offer fully funded courses on the condition they HAVE to stay in the NHS, we would have people shouting about NHS management abusing their contracted workers who have no choice but to stay. The NHS would come under fire and ew people would want to train as doctors.

You need to give people the option to not work for the NHS while giving incentive to do their time.

What had that got to do with saying uk students could apply to fully self fund thier course like forigen stidents do?

 

[c1tro]

The NHS will die with this government. Be prepared to pay for everything (aka new American health model) starting from social and non-emergency care and finally emergency care.

 

[Orionaut]

The problem is much simpler:

An aging population
Everyone expects immediate appointments and quick fixes
Chronic underinvestment in hospitals, staff training and recruitment, community care etc
PFI bills crippling trusts
Chronic fear of raising taxes to appropriately fund the NHS compared with other European nations
.

The problem that the NHS faces is that everybody expects it to do everything

70 years ago, it was possible to do this relatively inexpensively since the range of treatments was limited and not particularly costly.

Nowadays things are rather different.

Perhaps we need to think more carefully about what people should expect from the NHS.

Should cancer patients expect to receive treatments that might cost £1000/day so they can survive another 2-3 months?

Should we be introducing a charging scheme for people who suffer reckless avoidable self inflicted injuries (The Drunk Tank model)?

If we were starting with a blank sheet and trying to work out what the NHS should or should not provide and how much we should spend on it as a proportion of GDP. What would we want to provide and spend?

 

[jonneymendoza]

The problem that the NHS faces is that everybody expects it to do everything

70 years ago, it was possible to do this relatively inexpensively since the range of treatments was limited and not particularly costly.

Nowadays things are rather different.

Perhaps we need to think more carefully about what people should expect from the NHS.

Should cancer patients expect to receive treatments that might cost £1000/day so they can survive another 2-3 months?

Should we be introducing a charging scheme for people who suffer reckless avoidable self inflicted injuries (The Drunk Tank model)?

If we were starting with a blank sheet and trying to work out what the NHS should or should not provide and how much we should spend on it as a proportion of GDP. What would we want to provide and spend?

just privatise everything. **** it. we should pay

 

[fez]

The problem that the NHS faces is that everybody expects it to do everything

70 years ago, it was possible to do this relatively inexpensively since the range of treatments was limited and not particularly costly.

Nowadays things are rather different.

Perhaps we need to think more carefully about what people should expect from the NHS.

Should cancer patients expect to receive treatments that might cost £1000/day so they can survive another 2-3 months?

Should we be introducing a charging scheme for people who suffer reckless avoidable self inflicted injuries (The Drunk Tank model)?

If we were starting with a blank sheet and trying to work out what the NHS should or should not provide and how much we should spend on it as a proportion of GDP. What would we want to provide and spend?

This is what people don't seem to understand. The NHS is a massive black hole for money and we could spend twice what we do now and the actual general level of service wouldn't increase that much.

The population is ageing, people are living much longer with more severe health conditions than ever before and we have access to much better, more expensive medicine than ever.

Consider the situation 50 years ago:

Medical care was much more simple.

The range of drugs available was tiny in comparison.

Bureaucracy, health and safety and testing wasn't a big part of healthcare. Now we have ***** suing the NHS because something went wrong.

People died roughly 10 years younger than they do now

Peoples general health was better due to a more active lifestyle

People with a lot of medical issues simply died of them instead of being kept alive through complex and expensive medical treatment.

People didn't abuse the NHS like they do now whilst complaining that the government is the ones crippling it.

This is basically the schools argument on a different topic. The people who are ******* over the NHS and the education system are almost entirely the people who use it.

The NHS will eventually change to be an critical care system that will not offer the massive scope of treatment it does currently and it will be our own fault.

 

[Minstadave]

I'm not sure the NHS as it is at the moment is the massive money pit people write it off as. Our spending on health is lower than many developed nations and that's with all the crappy PFI initiatives we are stuck with.

If anything a US style system is a bigger black hole for cash - just individuals cash.

There is a clear issue with rising costs of treatment, but all healthcare systems face that.

 

[Dis86]

I'm not sure the NHS as it is at the moment is the massive money pit people write it off as. Our spending on health is lower than many developed nations and that's with all the crappy PFI initiatives we are stuck with.

If anything a US style system is a bigger black hole for cash - just individuals cash.

There is a clear issue with rising costs of treatment, but all healthcare systems face that.

The IT side of it definitely is. Found a nice new...scam for want of a better word being used by some surgeries.

 

[c1tro]

The NHS will eventually change to be an critical care system that will not offer the massive scope of treatment it does currently and it will be our own fault.

This is also my opinion. Once this has happened it will need a rebooting of the whole political/social system to re-establish free health and education as the majority of the population will realize what they've lost.

 

[jonessa]

The IT side of it definitely is. Found a nice new...scam for want of a better word being used by some surgeries.

Pray tell.

I'm intrigued.

 

[Terminal_Boy]

Has there ever been a taxpayer funder IT project that wasn't an utter omnishambles?

 

[Dis86]

Pray tell.

I'm intrigued.

Basically gp surgery has an IT budget which is paid for by the NHS. They pay this entire budget to a third party company to manage their IT for them. This agreement has some terms in it that will likely never ever be needed. An excessive number of callouts for example.
At the end of the annual term the surgery goes to the NHS and requests a larger budget as they spent all of theirs. The NHS obliges.
The gp surgery then contacts the IT company and gets a partial refund for any clauses that were not met.
This refund becomes profit for some individuals.
the new annual budget is wholly given to the IT company. Rinse.
Repeat.

 

[hurfdurf]

 

[Orionaut]

And what is actually the point of treating incurable lung cancer?? :/

If you have to cook meth to pay for a couple of extra months of life, It is clearly nonsense to try to treat it really!

Nobody lives for ever, expecting a sate funded health system to spend hundreds of thousands of pounds (Potentially, in some cases) so that a dying person can spend an extra couple of months dying is insane.

(Same also works at the other end of the spectrum)

And yes, I do know what I am talking about.

My Dad died of Colon Cancer, an old Girl friend died of Ovarian Cancer. I see no justification whatsoever in the state funding £1000/day treatments so that they could have spent an extra couple of months doing so.

When your number is up it is up!

(I am all for screening and early intervention, that is a different thing altogether, but once you have a metastatic cancer you are ****ed and except in the most exceptional cases the outcome is pretty predictable. 6-9 months on the outside. Use the time to come to terms with it and help your family to cope with your inevitable loss.)

 

[Dis86]

And what is actually the point of treating incurable lung cancer?? :/

If you have to cook meth to pay for a couple of extra months of life, It is clearly nonsense to try to treat it really!

Nobody lives for ever, expecting a sate funded health system to spend hundreds of thousands of pounds (Potentially, in some cases) so that a dying person can spend an extra couple of months dying is insane.

(Same also works at the other end of the spectrum)

And yes, I do know what I am talking about.

My Dad died of Colon Cancer, an old Girl friend died of Ovarian Cancer. I see no justification whatsoever in the state funding £1000/day treatments so that they could have spent an extra couple of months doing so.

When your number is up it is up!

(I am all for screening and early intervention, that is a different thing altogether, but once you have a metastatic cancer you are ****ed and except in the most exceptional cases the outcome is pretty predictable. 6-9 months on the outside. Use the time to come to terms with it and help your family to cope with your inevitable loss.)

You're looking at it the wrong way. It's not so they can send extra time dying. It's to spend extra time living

 

[Orionaut]

You're looking at it the wrong way. It's not so they can send extra time dying. It's to spend extra time living

If you have actually watched Loved people dying under these sorts of circumstances, you might have a different opinion.

(And it is still a rotten use of resources, I would rather the NHS spent the money on Teeth and Feet)