Is the NHS sustainable in its current form?

[Highland Mule]

I did not see the post, why would I decline to answer if I knew the question?

Whole-body CT scans aren't routinely done but certainly they do give you a dose so they would not want to be doing them repeatedly and there would be a tiny but quantifiable risk to having that dose, hence why a radiologist would need justification for doing one.

MRI scans as you say don't give a radioactive dose but they aren't keen to do people who are pregnant (lack of evidence I guess) and aren't keen on people with any kind of metallic implant- there is a kind of heating effect involved.

The biggest bone of contention is in the contrast agents used. There is a small outcry over them being used in the USA but that's probably just America for you.

Not a problem - was no dig intended - you must just have missed it before.

Seems that a CT gives 10-30mSv of dose (typical), which would give an increase of around a tenth of a percent in one’s likelihood of early cancer death - up from ~30% to ~30.1%.

 

[ollie989898]

I don't know why but the forum seems to give up alerting me to many many new posts so they get forgotten about, it's almost like it can't keep up with replies or something?


I would think the dose from any kind of angiogram or interventional work relying on x ray would give a bigger dose purely due to the period of time during which you are exposed- they use a low(er) level of x ray intensity (usually of the abdomen or thorax) for significant periods of time and then use a more intense dose periodically to 'sharpen' the image they are seeing- all in real time. By comparison a chest x ray or CT scan is done within minutes.

Some of the radioactive tracers they use in cardiac stress tests etc would give a pretty significant dose as well, I guess these all have to be weighed up against the risk from not conducting the procedure?

From what I have seen they are quite rigorous about recording doses and there are limits to how long the clock can tick before the radiographers get nervous.

 

[Deutzdx3]

It’s a dinosaur that needs up dating. Trouble is there are plenty of militant lifers that don’t want it to change as it’ll mean they have to actually do some work. Lots of money wasted needlessly, they are still running in some areas on windows 2000 and some still have fax machines. It needs to remain in public hands but be run like bupa or equivalent to stop the needless waste of funds. IMO.

 

[caveman]

I did not see the post, why would I decline to answer if I knew the question?

Whole-body CT scans aren't routinely done but certainly they do give you a dose so they would not want to be doing them repeatedly and there would be a tiny but quantifiable risk to having that dose, hence why a radiologist would need justification for doing one.

MRI scans as you say don't give a radioactive dose but they aren't keen to do people who are pregnant (lack of evidence I guess) and aren't keen on people with any kind of metallic implant- there is a kind of heating effect involved.

The biggest bone of contention is in the contrast agents used. There is a small outcry over them being used in the USA but that's probably just America for you.

Was booked in for MRI scan. Attended and was asked if I had any metal bits fitted. Replied that the only metal entering my body had been years ago, when using an angle grinder without goggles, which I had attended A&E to have "picked out".
Scan was denied and had to go have head/eyes X rayed, so I got another dose of radiation anyways.
Didn't see any results and have not been reinvited for a scan.
It was mentioned, that if there was any metal left in my eye, it could possibly be ripped out by the magnetism.

 

[Mek]

Just in case anyone missed it.

https://www.facebook.com/video.php?v=465483967409181

 

[wrenbird]

Since Ollie declined to answer, I've done my own digging. A CT scan can give a decent radiation dose - of a level that you wouldn't want un-necessarily (well above the legal limit for radiation workers), but an MRI scan doesn't give any radiation dose.

The dose levels from CT would certainly give a strong reason why one shouldn't get one "just in case", and hence would explain the need to see a doctor before.

I spent 10 hours Monday night/Tuesday morning in A&E after falling down steps outside made slippery by all the rain. I bashed the back of my head,knocking myself out just briefly, but the worst pain was in my back and ribs on my left-hand side.
The junior doctor I (eventually) saw wanted to send me for a CT scan on my head,chest and abdomen. While I was in x-ray dept waiting to go in for the scan, the senior doctor from A&E appeared,he had come up from A&E to find me to examine me himself as he was concerned that the scan on my head might be unnecessary.
After examining me he came to the conclusion that,yes I had mild concussion and a bump on my head,but in his opinion it was better not to have scan on my head, but I should have the scan on my chest and abdomen. This was done quite promptly,but then had to wait 6 hours for the result to come back to A&E. At least waiting all that time meant that they could keep an eye on me to make sure nothing changed regarding the bump on the head.
As others have said the staff do their best in what is often trying circumstances ( A&E overnight is not somewhere I would want to work ),but there does seem to be many things that could be improved.
The first thing happened when I was admitted was a nurse took my obs and also took blood. Less than half an hour later, another nurse appeared to take blood. My partner told him that that had already been done, nurse said they would go and check,came back,there was no record of first lot being taken,had to do it again.
This seems to be a regular problem, not just in A&E. Over the last few years there have been several occasions when I have had to have various tests and procedures repeated because the results from the initial test have disappeared into the ether somewhere never to be seen again.

 

[Cripper]

The NHS is treating the world. When I regularly visited someone in a long stay ward the immigrants I met who could speak English were nice people with chronic conditions who said it was a much better service than what they had at home. There were seven people on the ward 3 from England, 1 Poland, 1 Cyprus, 1 China and one from sub continent who did not speak English. With mass uncontrolled immigration you can’t plan for the future as you don’t know how many people you will have to treat. Importing medical staff from poor countries is immoral and in some cases they are not trained to the same standard. Properly run countries like Japan seem to be able to manage the oldest population in the world without importing huge numbers of people. People would pay for treatment directly. Most people already pay for dentists and opticians. You have to have insurance for your car so why not your body. It will happen when the next recession comes and the welfare state cannot be paid for. Personal and government borrowing at low interest rates is a pyramid scheme that will collapse soon.

 

[Henarar]

https://m.facebook.com/story.php?story_fbid=10158067048120625&id=531305624

 

[capfits]

'Misery' for A&E patients facing record-long waits

Patients are waiting hours on trolleys as a beds shortage causes backlogs in emergency departments.

www.bbc.co.uk

 

[Danllan]

The NHS is treating the world. When I regularly visited someone in a long stay ward the immigrants I met who could speak English were nice people with chronic conditions who said it was a much better service than what they had at home. There were seven people on the ward 3 from England, 1 Poland, 1 Cyprus, 1 China and one from sub continent who did not speak English. With mass uncontrolled immigration you can’t plan for the future as you don’t know how many people you will have to treat. Importing medical staff from poor countries is immoral and in some cases they are not trained to the same standard. Properly run countries like Japan seem to be able to manage the oldest population in the world without importing huge numbers of people. People would pay for treatment directly. Most people already pay for dentists and opticians. You have to have insurance for your car so why not your body. It will happen when the next recession comes and the welfare state cannot be paid for. Personal and government borrowing at low interest rates is a pyramid scheme that will collapse soon.

While I agree with the general sentiment of your post, you are not entirely accurate in what you have written. Japan imports nurses and carers from S. Korea, Malaysia, Indonesia and S. America.

 

[dave6470]

The the wastage of money in the NHS is unbelievable
My gran lived with me for years and had a bed supplied one of those hospital ones that lift up and down sadly she had to move into a home it took the health service 7 months to come and lift the bed and when they did the driver told me it was going to put in a skip as all the beds of that make didn't pass a new health and safety directive
All that was wrong was a small bracket that wasn't needed 2 mins wood have removed it
No they had to be scrapped
Also there's still over £3000 of drugs may brother was on for his cancer treatment that where never opened can't take them back crazy

 

[Old McDonald]

'Misery' for A&E patients facing record-long waits

Patients are waiting hours on trolleys as a beds shortage causes backlogs in emergency departments.

www.bbc.co.uk

I have a niece who is a nurse and was on A&E Christmas Eve. She said there were over 100 children brought in during her shift (plus adults) and apparently extremely few of the children had anything wrong with them, and she said none serious. The common sypmptom was that they had vomitted at some stage. Excitement, eaten too much rubbish? The NHS, or any other business, cannot function if there is more work than the staff can do. It would not matter how much more money is given, how many new hospitals are built, the unnecessary A&E visits would soon swamp them too.

 

[rob1]

its the snowflakes running off to A&E for a runny nose or a scratch, last time I went about five years ago for a bit of metal in my eye(yes I was wearing goggles at the time) there was a lad of about 18 there complaining that his asthma was bad, he was walking around and tlking quite happily and showed no signs of having difficulty breathing, and having been asthmatic since thre I know when someone is in trouble, he had his mum, sister and at least one other person with him, it looked ike they were on a jolly day out

 

[fudge]

The reality in this area is that A&E and the ambulance service is swamped not by worried parents but pissheads and junkies who need scraping off the streets seemingly every weekend. Time for booze to be thrice the price and drugs to be legalised and taxed IMO.

 

[Danllan]

The reality in this area is that A&E and the ambulance service is swamped not by worried parents but pissheads and junkies who need scraping off the streets seemingly every weekend. Time for booze to be thrice the price and drugs to be legalised and taxed IMO.

I agree with decriminalising and taxing / raising duty on drugs, but I think that there has to be a personal penalty for irresponsible use of the emergency services too. Your benefits decrease or you pay an extra penny on income tax or, most obviously, if you need treatment for something self-inflicted, you pay the bill.

 

[Highland Mule]

I agree with decriminalising and taxing / raising duty on drugs, but I think that there has to be a personal penalty for irresponsible use of the emergency services too. Your benefits decrease or you pay an extra penny on income tax or, most obviously, if you need treatment for something self-inflicted, you pay the bill.

I can see that last one keeping your lawyer mates in business for a few years - self harm due to mental illness isn’t really self harm, is it? Liver damage due to alcoholism as a result of psychiatric issues - I wouldn’t like to say.

 

[rob1]

I can see that last one keeping your lawyer mates in business for a few years - self harm due to mental illness isn’t really self harm, is it? Liver damage due to alcoholism as a result of psychiatric issues - I wouldn’t like to say.

The trouble is with lots of young kids the mental issues are brought on by drug use, calling for the legalisation of canabis is the road to problems, I know two kids in my extended family who have had serious mental issues after using it, and a mid 20's lad near us committed suicide last week after using it for a fair number of years

 

[fudge]

I can see that last one keeping your lawyer mates in business for a few years - self harm due to mental illness isn’t really self harm, is it? Liver damage due to alcoholism as a result of psychiatric issues - I wouldn’t like to say.

Completely agree. Addiction is a mental illness in itself. Any human thinking human being would share @rob1 concern at problems it brings. However under charging for alcohol and the criminalisation of drug use isn’t tackling the problem. The reality is drugs including alcohol are freely available and their over use damages us all not just the user. The idea that a penny on income tax would cure an addiction is obvious bollox IMO.

 

[Chasingmytail]

The issue these days is people wake up in the morning have an aliment and are attuned to seeing what is it. Instead of leaving it a few days, popping a pain pill and taking a rest the population are insisting that a Dr checks them out and gives them something (around an antiboitic). I see this all the time and those with children seem to be worse. This isnt sustainable at all. I want to see the GP about minor things (say repeat prescription that they wont do without seeing me), Checking on bloods etc etc you spend 2 days on the phone trying to get through. Its not urgent then sitting in the waiting room 1hr. This could be sorted into a smoother system I dont want to be taking up precious time of a GP for this.

One area could be GPs doing minor checks in pharmacies - weekly pop ups for queries/coughs colds etc.
Def more phone calls in my surgery now if you want same day you have to ask the dr to call back I guess the majority are not urgent. This could be implemented further.
Drs should do weight, body check particularly on serial visitors - they have to tell people how it is, Your overweight, you are drinking excessively you are unfit and if it continues its going down on your notes so an future insurance claims etc. I think GPs fanny around they have to tell people how it is and if an obese child comes in then the parent needs to be told.
My Sister in law pops to the dr every few week with aliments - found a spot, my left leg is aching, had a headache last week, The Dr is not there for casual visits like this. These could be chatted about in a pharmacy.
The cost of the visit could be put on a poster. Reminding those people that seem to be on a constant loop perhaps again these people need to be taken aside to see if there is anxiety issues or perhaps could be better seeing a nurse.

Why anyone wants to become a GP now cant fathom it out.

Some people need to be reminded if they dont so any exercise, sat on arse all day, in front of a screen, no fresh air, no stretching etc of course they are going to have poor posture which is going to give you issues.

The biggest problem is the 'Free service' everyone wants to get better straight away with a pill straight away but dont want to seek alternatives. Or even pay 40 squid to see someone tomorrow to sort out the back ache. The GP gives endless advice on pain killers but none on stretching, seeking help themselves. Patient then returns week after week.

 

[Danllan]

I can see that last one keeping your lawyer mates in business for a few years - self harm due to mental illness isn’t really self harm, is it? Liver damage due to alcoholism as a result of psychiatric issues - I wouldn’t like to say.

See below...

Completely agree. Addiction is a mental illness in itself. Any human thinking human being would share @rob1 concern at problems it brings. However under charging for alcohol and the criminalisation of drug use isn’t tackling the problem. The reality is drugs including alcohol are freely available and their over use damages us all not just the user. The idea that a penny on income tax would cure an addiction is obvious bollox IMO.

There are always 'grey' areas; there are also black and white ones. It is possible, more or less, to argue the toss about nigh on everything, every action, every decision, and that is done far too often. It is clear that there needs to be a significant change away from the status quo, decriminalisation and the controlled production and supply of drugs is an obvious start. Recognising that, for some, addiction is a genuine condition is another, but so it recognising that for a large majority of the Friday night drunks there is no get-out via addiction as an excuse.

Personal responsibility is, manifestly, a good thing. My suggestion of an increase in an individual's tax contribution was one of principle, it was not made with reference to those diagnosed with an addiction. That written, there is a real chance that over-diagnosis, meaning diagnosing something as a 'medical' (i.e. psychiatric) condition which most would regard as nothing more than bad behaviour could / will go too far. This is done by categorising an ever-increasing number of human faults as 'medical conditions', when they can readily be overcome by the application of a bit of responsible thought, which the vast majority have the ability to do, whether or not they exercise it.

The 'excuse' of a medical diagnosis / condition was rather fashionable in defence teams a decade or so ago, and has persisted with the recognition that some people have, by nature, a medically demonstrable shorter 'fuse' etc.. But it doesn't wash, fortunately the current jurisprudence - and resulting ratios - still place, in fact stress, the importance of personal control and responsibility in all nearly all cases.