What is the root cause of overcrowded hospitals?

[Goweresque]

You can have Norway's healthcare when you pay Norway's taxes. I'm all in favour, are you?

Yes please!

Norway spends 10.5% of its GDP on healthcare, the UK spends 10.2%. (Figures from World Atlas here: https://knoema.com/atlas/United-Kingdom/Health-expenditure-as-a-share-of-GDP and here: https://knoema.com/atlas/Norway/Health-expenditure-as-a-share-of-GDP) So for a slight extra payment of tax (around £20bn over what the NHS gets now) we can have a super duper Norwegian style healthcare system can we? You really really sure about that? The Health and Social Care levy is just about to give the NHS another £12bn per year, do you really think thats going to get it close to Norwegian standards? Or will it p*ss it all up the wall and we'll hardly notice any difference?

The truth is that the UK spends pretty much the same as all other European countries on healthcare, more than some, less than others. And its performance on that budget is appalling. Giving the NHS more money will never solve the problem. We've tried that idea to death. Its the structure thats all wrong. Why do you think not one country in the world has copied it, apart from Singapore, who being pretty smart abandoned the model soon after because they realised how crap it was. Everywhere else in the world (apart from the US, which as we all know is 'special') manages to have a healthcare system that both operates efficiently and doesn't allow the poorest to die on the streets. Why can we not learn from them? The main reason we can't is the vested interests of the 1.5m people who work for the NHS, thats the real reason. They don't want change, and won't allow it, regardless of how sh*t the service the NHS gives to the public as a result. The UK public are being held to ransom by the workforce of the NHS and it should not be allowed.

 

[ollie989898]

Yes please!

Norway spends 10.5% of its GDP on healthcare, the UK spends 10.2%. (Figures from World Atlas here: https://knoema.com/atlas/United-Kingdom/Health-expenditure-as-a-share-of-GDP and here: https://knoema.com/atlas/Norway/Health-expenditure-as-a-share-of-GDP) So for a slight extra payment of tax (around £20bn over what the NHS gets now) we can have a super duper Norwegian style healthcare system can we? You really really sure about that? The Health and Social Care levy is just about to give the NHS another £12bn per year, do you really think thats going to get it close to Norwegian standards? Or will it p*ss it all up the wall and we'll hardly notice any difference?

The truth is that the UK spends pretty much the same as all other European countries on healthcare, more than some, less than others. And its performance on that budget is appalling. Giving the NHS more money will never solve the problem. We've tried that idea to death. Its the structure thats all wrong. Why do you think not one country in the world has copied it, apart from Singapore, who being pretty smart abandoned the model soon after because they realised how crap it was. Everywhere else in the world (apart from the US, which as we all know is 'special') manages to have a healthcare system that both operates efficiently and doesn't allow the poorest to die on the streets. Why can we not learn from them? The main reason we can't is the vested interests of the 1.5m people who work for the NHS, thats the real reason. They don't want change, and won't allow it, regardless of how sh*t the service the NHS gives to the public as a result. The UK public are being held to ransom by the workforce of the NHS and it should not be allowed.

I don't think the spending on healthcare in Norway is any greater, but their spending on social care and the remainder of their services probably will be. What are their levels of homelessness, child poverty and drug addiction like? What is their prison and police service like? What is their education and childcare budget like?

 

[JCMaloney]

I'm never quite sure how NHS is organised.

Seems fairly simple up here, but sounds more complicted south of the border. Is a NHS trust the same thing as a regional health board here?

Yes and no! Thanks @ollie989898
Its a complex old beast - there are Trusts and there are Foundation Trusts which was the "Gold Standard".
Trusts were originally set up to avoid paying business rates - the high Court threw that out.

Best explanation I could find is on Wiki: https://en.wikipedia.org/wiki/NHS_trust

Our Trust was created by pulling together 3 hospitals and some ancillary units (cottage hospitals if you like).
The three hospitals have their own specialties.
Of course we are always changing, just recently all childrens services moved to a new build unit on a different site.
The plan is that the other 2 sites will also change and become more specialised with a mix of new build, repurposing and selling off spare land and some old houses we owned.
And we have 1 (recently extended but now overflowing) A&E for around 1 million local folk, the nearest Major trauma is QMC in Notts or Birmingham.

We get a bit busy!
Our specialties then reach a further 2-3 million patients across the UK.

 

[Muck Spreader]

Yes please!

Norway spends 10.5% of its GDP on healthcare, the UK spends 10.2%. (Figures from World Atlas here: https://knoema.com/atlas/United-Kingdom/Health-expenditure-as-a-share-of-GDP and here: https://knoema.com/atlas/Norway/Health-expenditure-as-a-share-of-GDP) So for a slight extra payment of tax (around £20bn over what the NHS gets now) we can have a super duper Norwegian style healthcare system can we? You really really sure about that? The Health and Social Care levy is just about to give the NHS another £12bn per year, do you really think thats going to get it close to Norwegian standards? Or will it p*ss it all up the wall and we'll hardly notice any difference?

The truth is that the UK spends pretty much the same as all other European countries on healthcare, more than some, less than others. And its performance on that budget is appalling. Giving the NHS more money will never solve the problem. We've tried that idea to death. Its the structure thats all wrong. Why do you think not one country in the world has copied it, apart from Singapore, who being pretty smart abandoned the model soon after because they realised how crap it was. Everywhere else in the world (apart from the US, which as we all know is 'special') manages to have a healthcare system that both operates efficiently and doesn't allow the poorest to die on the streets. Why can we not learn from them? The main reason we can't is the vested interests of the 1.5m people who work for the NHS, thats the real reason. They don't want change, and won't allow it, regardless of how sh*t the service the NHS gives to the public as a result. The UK public are being held to ransom by the workforce of the NHS and it should not be allowed.

Healthcare spending per capita in Norway approximately 50% higher than the UK. A GDP comparison is really irrelevant due to the wealth and size differential.

 

[Charlie Gill]

An underfunded NHS?

Lack of willing applicants for Dr and Nurses jobs?

NHS mismanagements?


Or what?

The photo in the toast thread of ambulances queuing up, can not be made to be normal!

Sick people. No sick people; no queues, no overcrowding.

 

[ollie989898]

I'm not so sure how acute staffing shortages are. I remember an article stating that there were about 40,000 nursing vacancies at any one time, but then 30,000 people are given a place in nurse training each year in the UK. There are, from memory, around 8000 medical (i.e. doctor) vacancies but then we are now entering 9000+ students into medical school each year, previously the figures were creeping up slowly from 7500 or so for while to 8000+.

So lets say you are adding 30,000 qualified nurses to the system each July and another 8000 qualified doctors.

The biggest issue is that there are areas that are less attractive and shiny to new graduates. For no reason I can understand, emergency medicine, general practice and psychiatry are not that popular with new graduates. Similarly, you can imagine that a newly minted junior doctor is gonna be keen as mustard to live and work in London and the like because you've a life to lead. Suddenly the prospect of working in a GP practice for the rest of your life in the middle of the Mendips isn't so shiny and attractive. Similarly, psychiatry gets a bit of bad press and stigma leading to people discounting it before they even approach graduation.

On the other hand, there is no end of people wanting to chase max-facs, neurosurgery, TnO, etc etc and be a consultant surgeon. It's all the glitz and glam, isn't it? Be a hot shot surgeon, living the dream.

 

[wanton dwarf]

My experience and the rest of the family has had a very poor experience of the NHS.

The latest one is where my brother was feeling tired, had been for years. On & off to the Doctors. Turns out he has Hemochromotosis - too much Iron in his blood.

Having got the NHS app, he's been able to see that it's as clear as day that too high Iron levels were in his blood tests for years. This can lead to Cancer of the Liver and general degredation of the body. Because this is a DNA condition, the rest of the family is in process of checking ourselves.

Mother was saying she had a similar experience where it ended up the Doctor stating she had a condition which was on her blood test some years ago .. of course my mother never got to see the results.

We've had similar experiences with Cancer treatment, Gall Stones (Father had an emergency operation), I was left to endure Gall Stones for 5 years on drugs (Which I found out later potentially lead to Dementia) - Gall stones are potentially life threatening, as my father found out. The worst is, it's day surgery. Five years of drugs and an emergency operation & weeks of treatment (Nil by mouth) instead of day surgery ?

Pretty sure some of the Consultants are a major problem. Some have very big egos and don't give a toss about people. The worst experience I had was in Nottingham getting an endoscope with stomach samples, the guy deliberately put the endoscope in twice and rip peices of my stomach out whilst being very harsh and vindictive - for no reason I could fathom. The nurses even appologised for the tw@ts behaviour. Looking back, the chap could have done with beating within an inch of his life IMHO. Another Consultant in Leicester seemed not to like me having read about the procedure and possible side effects - I think he was the one that decided to punish me for 5 years with a potential exploding Gall Badder. Of course my GP just let it happen - took my parents to kick me up the ass and get treatment from another hospital.

Finally fixed at a Cottage Hospital in Leicester.

Not impressed to the extent I want to see significant change based on outcomes - way too much politics and ego trips.

 

[little_p]

Yes please!

Norway spends 10.5% of its GDP on healthcare, the UK spends 10.2%. (Figures from World Atlas here: https://knoema.com/atlas/United-Kingdom/Health-expenditure-as-a-share-of-GDP and here: https://knoema.com/atlas/Norway/Health-expenditure-as-a-share-of-GDP) So for a slight extra payment of tax (around £20bn over what the NHS gets now) we can have a super duper Norwegian style healthcare system can we? You really really sure about that? The Health and Social Care levy is just about to give the NHS another £12bn per year, do you really think thats going to get it close to Norwegian standards? Or will it p*ss it all up the wall and we'll hardly notice any difference?

The truth is that the UK spends pretty much the same as all other European countries on healthcare, more than some, less than others. And its performance on that budget is appalling. Giving the NHS more money will never solve the problem. We've tried that idea to death. Its the structure thats all wrong. Why do you think not one country in the world has copied it, apart from Singapore, who being pretty smart abandoned the model soon after because they realised how crap it was. Everywhere else in the world (apart from the US, which as we all know is 'special') manages to have a healthcare system that both operates efficiently and doesn't allow the poorest to die on the streets. Why can we not learn from them? The main reason we can't is the vested interests of the 1.5m people who work for the NHS, thats the real reason. They don't want change, and won't allow it, regardless of how sh*t the service the NHS gives to the public as a result. The UK public are being held to ransom by the workforce of the NHS and it should not be allowed.

What ALL 1.5m people that work in the NHS don't want to change? And won't allow it?
Care to expand as to the reasons why?

 

[ollie989898]

Yes and no! Thanks @ollie989898
Its a complex old beast - there are Trusts and there are Foundation Trusts which was the "Gold Standard".
Trusts were originally set up to avoid paying business rates - the high Court threw that out.

Best explanation I could find is on Wiki: https://en.wikipedia.org/wiki/NHS_trust

Our Trust was created by pulling together 3 hospitals and some ancillary units (cottage hospitals if you like).
The three hospitals have their own specialties.
Of course we are always changing, just recently all childrens services moved to a new build unit on a different site.
The plan is that the other 2 sites will also change and become more specialised with a mix of new build, repurposing and selling off spare land and some old houses we owned.
And we have 1 (recently extended but now overflowing) A&E for around 1 million local folk, the nearest Major trauma is QMC in Notts or Birmingham.

We get a bit busy!
Our specialties then reach a further 2-3 million patients across the UK.

This diagram gives some perspective of the overall structure of the healthcare system.

 

[teslacoils]

Viagra on prescription.
Childhood ADHD explosion.
Gender reassignment.

But try and get an NHS dental appointment in Lincolnshire ......2 and a half years to get my children a routine checkup.

Emergency fixing stuff and preventative medicine f**ked but plenty of dosh for the frilly stuff.

Face facts - old people die and they're better off dying at home. Do the basics well. Charge folk for the rest.

 

[Highland Mule]

This diagram gives some perspective of the overall structure of the healthcare system.

View attachment 1041905

Only for England though - presumably Wales and NI are different, as I know Scotland is.

 

[ollie989898]

Viagra on prescription.
Childhood ADHD explosion.
Gender reassignment.

But try and get an NHS dental appointment in Lincolnshire ......2 and a half years to get my children a routine checkup.

Emergency fixing stuff and preventative medicine f**ked but plenty of dosh for the frilly stuff.

Face facts - old people die and they're better off dying at home. Do the basics well. Charge folk for the rest.

I think the government might be way ahead of you.

Let's look at viagra (sildenafil) a minute. Strangely enough, GPs are only allowed to prescribe this if the patient meets the right criteria, for example, people suffering with diabetes or recovering from pelvic surgery or prostate problems.

Anyone know what the NHS prescription charge is right now? Best part of a tenner, isn't it?

Cost of 4 100mg tablets of sildenafil is £1.36.

And as much as gender dysphoria or reassignment is in the news, only a few select providers for this service exist.

 

[ollie989898]

Only for England though - presumably Wales and NI are different, as I know Scotland is.

I should think so. They must be different and so they are different. Quelle suprise.

 

[nivilla1982]

 

[JCMaloney]

This made me chuckle.....

 

[kiwi pom]

Yes and no! Thanks @ollie989898
Its a complex old beast - there are Trusts and there are Foundation Trusts which was the "Gold Standard".
Trusts were originally set up to avoid paying business rates - the high Court threw that out.

Best explanation I could find is on Wiki: https://en.wikipedia.org/wiki/NHS_trust

Our Trust was created by pulling together 3 hospitals and some ancillary units (cottage hospitals if you like).
The three hospitals have their own specialties.
Of course we are always changing, just recently all childrens services moved to a new build unit on a different site.
The plan is that the other 2 sites will also change and become more specialised with a mix of new build, repurposing and selling off spare land and some old houses we owned.
And we have 1 (recently extended but now overflowing) A&E for around 1 million local folk, the nearest Major trauma is QMC in Notts or Birmingham.

We get a bit busy!
Our specialties then reach a further 2-3 million patients across the UK.

Is that the problem, you're always changing? New boss comes in and everything's blown yup regardless of whether it was working or not, which means more reshuffling and extra expense. Get halfway through the re structure and that boss has fecked off for whatever reason and round we go again.
Too many in offices and not enough people doing the actual work?

Perhaps its not the hospital side that's the problem though, more that people struggle to see a doctor or dentist, on time and get good outcomes, so they end up in A&E?

 

[little_p]

Is that the problem, you're always changing? New boss comes in and everything's blown yup regardless of whether it was working or not, which means more reshuffling and extra expense. Get halfway through the re structure and that boss has fecked off for whatever reason and round we go again.

It happens in lots of organisations, not just the NHS. I've heard people call it the '7 year cycle'. The overarching though process usually lurch's between 'we could get more efficiencies from going large' to 'we are too big and slow, we need to split up'.
But the big vs small change always consists of something new. Usually the fad which is going on at that time. A decade or two it was 'out-sourcing', when that didn't work it was all about 'bringing in-house'. The current thing is 'collaboratively working'.
Around the 3-4 year mark the boss usually fecks off. The smart ones realise that you should be moving up and on every few years and most importantly before the blame can be pinned on them.

 

[JCMaloney]

Is that the problem, you're always changing? New boss comes in and everything's blown yup regardless of whether it was working or not, which means more reshuffling and extra expense. Get halfway through the re structure and that boss has fecked off for whatever reason and round we go again.
Too many in offices and not enough people doing the actual work?

Perhaps its not the hospital side that's the problem though, more that people struggle to see a doctor or dentist, on time and get good outcomes, so they end up in A&E?

That is about it.
For example, when I worked in Procurement, we got a new Director.
Her CV was freely available and she rarely stayed anywhere more than 2 or 3 years.
She arrived with a raft of ideas that were akin to running around lobbing hand grenades into the room everywhere she went.
3 years later most of her "projects" were incomplete and she was gone....

Then apply that from the top down - Health Secretary, Trust CEO`s, Corporate Directors, Managers etc its constant flux.

Only 7 years to go.

 

[le bon paysan]

Tonight’s Panorama exposes the way the NHS has been infiltrated by mega USA health company, Centene, running surgeries for profit.
@robs1
This is who fishy Rishi was meeting in California.

 

[DrWazzock]

That is about it.
For example, when I worked in Procurement, we got a new Director.
Her CV was freely available and she rarely stayed anywhere more than 2 or 3 years.
She arrived with a raft of ideas that were akin to running around lobbing hand grenades into the room everywhere she went.
3 years later most of her "projects" were incomplete and she was gone....

Then apply that from the top down - Health Secretary, Trust CEO`s, Corporate Directors, Managers etc its constant flux.

Only 7 years to go.

Sounds just like DEFRA. BPS nicely bedded in so let’s scrap it and start all over again.