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Old 12th January 2023, 07:15 AM   #1
Nessie
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The slow collapse of the NHS.

We all know the UK's beloved NHS is collapsing, which is often represented with huge queues of ambulances outside A&E, but this, I mean, FFS, how bad is this

https://www.dailyrecord.co.uk/news/p...-kyiv-28938543

Raised in the Scottish parliament and remember, NHS spending is higher in Scotland due to devolved powers and the problems are not as bad as they are in E&W.

A Ukrainian lady, living under the refugee scheme in Scotland, flew back to Ukraine to see her old GP, as she could get an appointment about her hormonal thyroid condition with him, faster than she could get to see a GP in Scotland.
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Old 12th January 2023, 07:44 AM   #2
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ummmm... not to sound callous, but how much of a refugee is a refugee who has the resources to fly back at will like that, and has a home base available at short notice like that, complete with good doctors and all?

(not to downplay the ukraine thing in the least, but, i mean, refugee, and this, something doesn't ...well i don't know)
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Old 12th January 2023, 07:50 AM   #3
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Originally Posted by Chanakya View Post
ummmm... not to sound callous, but how much of a refugee is a refugee who has the resources to fly back at will like that, and has a home base available at short notice like that, complete with good doctors and all?

(not to downplay the ukraine thing in the least, but, i mean, refugee, and this, something doesn't ...well i don't know)
I did not know only poor people can be refugees. Do the rich women have to stay? Are they at less risk of death?

But that is very much not the point. The point is that in the UK we are getting used to seeing images of queues of ambulances and the BBC's number 1 headline this morning was

https://www.bbc.co.uk/news/health-64243044

"Ambulance bosses have apologised to the family of a man who died after he had a heart attack but no ambulance came."

The state of the NHS pops up on various other threads, but posts get lost, so this is purely about that subject and how it is collapsing around us.
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Old 12th January 2023, 07:54 AM   #4
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Originally Posted by Nessie View Post
I did not know only poor people can be refugees. Do the rich women have to stay? Are they at less risk of death?

Nah, obviously these aren't refugees on account of the economics of it, but the war thing.

Just, the fact of being a refugee on the one hand, and on the other hand having access to resources as well as, importantly, a home base complete with all sorts of conveniences that many of the citizens where you've taken refuge don't have access to, sounds just a wee bit incongruous.

Not to criticize her, or her having been granted refuge, but only to comment on this ...curious thing, as it appeared to me at first read.


Quote:
But that is very much not the point. The point is that in the UK we are getting used to seeing images of queues of ambulances and the BBC's number 1 headline this morning was

https://www.bbc.co.uk/news/health-64243044

"Ambulance bosses have apologised to the family of a man who died after he had a heart attack but no ambulance came."

The state of the NHS pops up on various other threads, but posts get lost, so this is purely about that subject and how it is collapsing around us.

Agreed, not the point of your thread. Not to deflect any more from what you're actually trying to discuss there.
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Old 12th January 2023, 08:08 AM   #5
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I have seen a bit more about what happened.

https://twitter.com/scotlibdems/stat...19849661022210

The 22 year old found it harder to get a GPs appointment in Scotland, than back in war torn Ukraine.
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Old 12th January 2023, 08:21 AM   #6
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How do you define failure and success for the NHS?

If the appetite isn't there to spend more money on the NHS, but the services paid for with the limited money is efficient, but there are long waits because of insufficient money, is that failure or success?
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Old 12th January 2023, 08:27 AM   #7
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Originally Posted by BobTheCoward View Post
How do you define failure and success for the NHS?

If the appetite isn't there to spend more money on the NHS, but the services paid for with the limited money is efficient, but there are long waits because of insufficient money, is that failure or success?
Long waits in a health care system is normally the sign of a failure.
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Old 12th January 2023, 08:39 AM   #8
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Originally Posted by Nessie View Post
Long waits in a health care system is normally the sign of a failure.
That doesn't make sense.

If we agree to budget 100 dollars for a birthday party, and you show up to the party and it feels like a 200 dollar party, that is a success. The fact it doesn't have the same things as a 1000 dollar party doesn't mean it.failed.

If the NHS budget is insufficient for short lines, then what is the problem?
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Old 12th January 2023, 08:46 AM   #9
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Originally Posted by BobTheCoward View Post
That doesn't make sense.

If we agree to budget 100 dollars for a birthday party, and you show up to the party and it feels like a 200 dollar party, that is a success. The fact it doesn't have the same things as a 1000 dollar party doesn't mean it.failed.

If the NHS budget is insufficient for short lines, then what is the problem?
Most people who are ill, want to get better quicker. The time to get better under the NHS is getting longer and longer. That is a bad thing.
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Old 12th January 2023, 09:32 AM   #10
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Originally Posted by Nessie View Post
Most people who are ill, want to get better quicker. The time to get better under the NHS is getting longer and longer. That is a bad thing.
Should it be getting shorter and shorter? Can it? If not, is it a bad thing?

If the budget isn't going to be sufficient to pay for efficient services, and people don't want it bigger, then isn't whatever the number of services rendered the right number?
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Old 12th January 2023, 10:38 AM   #11
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Originally Posted by BobTheCoward View Post
Should it be getting shorter and shorter? Can it? If not, is it a bad thing?

If the budget isn't going to be sufficient to pay for efficient services, and people don't want it bigger, then isn't whatever the number of services rendered the right number?
The issue at the moment, is that due to the cost of living crisis, many people, even if they wanted to, could not cope with a rise in NI. No one in the UK is happy with what is happening with A&E, even people who have private health care, as no private health care operator has an A&E provision.

There are private GPs, as there are dentists, indeed, most dentists are private and GPs may head the same way. Or, you could go to Ukraine.
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Old 12th January 2023, 11:00 AM   #12
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Haha, this may sound like thread-bobbing, that exchange up there; but it isn't really, when you think about it.

Why's your NHS in such dire straits? Is it some rot within the NHS itself, ineffectual management of it? Or is it just the funding? (I'd go with funding, but then I don't really know, I'd be guessing.)

If it is the funding, then why isn't NHS getting enough money? Can't your economy afford to plough any more into it, given your troubles with Brexit and the Covid and the shrinking economy and the war now and everything? If you simply can't afford it, then there's nothing that can be done, really, not even if dead bodies start heaping up as a result; or at least, not until things get better, in economic terms. Or is it simply some political something-or-the-other? In which case people taking to the streets, agitating and screaming, and if that fails then voting governments in and out on this focused plank, might be the change you're looking for.
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Old 12th January 2023, 11:04 AM   #13
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Originally Posted by Nessie View Post
I have seen a bit more about what happened.

https://twitter.com/scotlibdems/stat...19849661022210

The 22 year old found it harder to get a GPs appointment in Scotland, than back in war torn Ukraine.
Sounds like she has the means to go private, might have been easier for her to jump into a private clinic here. How long was the actual wait?
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Old 12th January 2023, 11:08 AM   #14
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Originally Posted by RolandRat View Post
Sounds like she has the means to go private, might have been easier for her to jump into a private clinic here. How long was the actual wait?
Yeah it doesn't really pass the sniff test - a one off private GP visit will cost around 50.
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Old 12th January 2023, 11:12 AM   #15
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Originally Posted by Chanakya View Post
Haha, this may sound like thread-bobbing, that exchange up there; but it isn't really, when you think about it.

Why's your NHS in such dire straits? Is it some rot within the NHS itself, ineffectual management of it? Or is it just the funding? (I'd go with funding, but then I don't really know, I'd be guessing.)

If it is the funding, then why isn't NHS getting enough money? Can't your economy afford to plough any more into it, given your troubles with Brexit and the Covid and the shrinking economy and the war now and everything? If you simply can't afford it, then there's nothing that can be done, really, not even if dead bodies start heaping up as a result; or at least, not until things get better, in economic terms. Or is it simply some political something-or-the-other? In which case people taking to the streets, agitating and screaming, and if that fails then voting governments in and out on this focused plank, might be the change you're looking for.
See many of my posts in UK politics thread, a recent one in the thread about health insurance. If you really want I can re-hash all of that.

The short answer is political decisions taken predominantly by one political party, who have long been ideologically opposed to the NHS. Do I need to spell out which party that is? Or to add that a another political party aided and abetted them around 2010?

The NHS has been a political football, subject to wildly inconsistent, contradictory and pretty ******* useless decision-making from our political class as far as anyone in my family can remember (unlike Sunak, I do actually come from a NHS family).
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Old 12th January 2023, 11:24 AM   #16
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Originally Posted by Carrot Flower King View Post
See many of my posts in UK politics thread, a recent one in the thread about health insurance. If you really want I can re-hash all of that.

I don't really need details, an approximate answer will do fine. Which you've already provided here, thanks.


Quote:
The short answer is political decisions taken predominantly by one political party, who have long been ideologically opposed to the NHS. Do I need to spell out which party that is? Or to add that a another political party aided and abetted them around 2010?

The NHS has been a political football, subject to wildly inconsistent, contradictory and pretty ******* useless decision-making from our political class as far as anyone in my family can remember (unlike Sunak, I do actually come from a NHS family).

I didn't actually know that, don't follow UK politics in much detail. That the Conservatives are "ideologically opposed to the NHS". Why would they be? Do they want UK to go the private healthcare route?

If it's merely (or largely) politics, then I suppose enough outrage generated and demonstrated over this is what should make a difference. You're a democracy after all.

---

Rishi Sunak does keep saying he's from an NHS family. His father I think? (Or maybe his mother, I forget which.) Isn't that true, then?

eta: Okay, ran a quick google-check. Apparently his father was in NHS. And he's got a brother who's a doctor, although it doesn't say there if he's part of NHS.

link: https://metro.co.uk/2022/08/02/meet-...nues-17100119/

Last edited by Chanakya; 12th January 2023 at 11:27 AM.
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Old 12th January 2023, 11:57 AM   #17
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Question

Originally Posted by Carrot Flower King View Post
See many of my posts in UK politics thread, a recent one in the thread about health insurance. If you really want I can re-hash all of that.

The short answer is political decisions taken predominantly by one political party, who have long been ideologically opposed to the NHS. Do I need to spell out which party that is? Or to add that a another political party aided and abetted them around 2010?

The NHS has been a political football, subject to wildly inconsistent, contradictory and pretty ******* useless decision-making from our political class as far as anyone in my family can remember (unlike Sunak, I do actually come from a NHS family).
Wait, are thry just kneecapping budget and savings measures, or did they implement other policies?
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Old 12th January 2023, 12:17 PM   #18
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Originally Posted by Chanakya View Post
I don't really need details, an approximate answer will do fine. Which you've already provided here, thanks.





I didn't actually know that, don't follow UK politics in much detail. That the Conservatives are "ideologically opposed to the NHS". Why would they be? Do they want UK to go the private healthcare route?

If it's merely (or largely) politics, then I suppose enough outrage generated and demonstrated over this is what should make a difference. You're a democracy after all.

---

Rishi Sunak does keep saying he's from an NHS family. His father I think? (Or maybe his mother, I forget which.) Isn't that true, then?

eta: Okay, ran a quick google-check. Apparently his father was in NHS. And he's got a brother who's a doctor, although it doesn't say there if he's part of NHS.

link: https://metro.co.uk/2022/08/02/meet-...nues-17100119/
Sunak's made the claim, as you note, on a number of occasions: his dad was a GP, so a private contractor to the NHS; his mum a pharmacist running her own business in part supplyinf services to the NHS. I contrast with me, as I was a nurse, my sister was a nurse, my wife worked in NHS admin, my bro-in-law was a NHS manager, our parents were physios in the NHS (mother was dual qualified, so a nurse also) my mum's cousin (who was most helpful to both me and my sister in making career decisions) was also a nurse and that generation goes back to the early 50s in NHS employ.

Re the Tories: at least 2 former Tory Secretaries of State for health, i.e. the top politician, have written books extolling the virtues of private healthcare (Andrew Lansley and Jeremy Hunt). One of them is now Chancellor of the Exchequer. And then there is the small matter of their record in office...

ETA It must be remembered that the Tories, and their previous enablers the Orange Book Lib Dems, are right wing, "free"-markets-above-all, "small state" ideologues, heavily in thrall to the myth of consumer choice in everything. So there is nothing about something like the NHS they ever liked. That and it was a Labour Party invention, building on work done by some Liberals. Our politics has always been very tribal.

About us being a "democracy"...Depends how you want to define it. Our "first past the post" system and the, errrrrrr, interesting ways parliamentary constituencies are decided upon gives us governments which frequently have large parliamentary majorities based on a minority of the popular vote, let alone the whole electorate. I have hardly ever voted for someone who became our MP and even less for a subsequent government, all because I have lived in places with a built-in majority for otherparties (NB my voting record is very mixed, but never Tory).

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Old 12th January 2023, 03:00 PM   #19
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As an American, I don't understand this. Most Brits rely on the NHS for most of their health care. When Boris Johnson almost died of covid, he was treated (successfully) in an NHS hospital. Why isn't it political suicide for a UK politician to fail to support, or even want to cut, the NHS? I would think that would go over like "I'm gonna take all your guns!" in the U.S.
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Old 12th January 2023, 03:21 PM   #20
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Originally Posted by Nessie View Post
The issue at the moment, is that due to the cost of living crisis, many people, even if they wanted to, could not cope with a rise in NI. No one in the UK is happy with what is happening with A&E, even people who have private health care, as no private health care operator has an A&E provision.

There are private GPs, as there are dentists, indeed, most dentists are private and GPs may head the same way. Or, you could go to Ukraine.
NI (national insurance) has nothing to do with the NHS and never has. NI paid for unemployment, sick pay, and pensions. The NHS was always funded from general taxation.
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Old 12th January 2023, 03:31 PM   #21
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Originally Posted by Chanakya View Post
Haha, this may sound like thread-bobbing, that exchange up there; but it isn't really, when you think about it.

Why's your NHS in such dire straits? Is it some rot within the NHS itself, ineffectual management of it? Or is it just the funding? (I'd go with funding, but then I don't really know, I'd be guessing.)

If it is the funding, then why isn't NHS getting enough money? Can't your economy afford to plough any more into it, given your troubles with Brexit and the Covid and the shrinking economy and the war now and everything? If you simply can't afford it, then there's nothing that can be done, really, not even if dead bodies start heaping up as a result; or at least, not until things get better, in economic terms. Or is it simply some political something-or-the-other? In which case people taking to the streets, agitating and screaming, and if that fails then voting governments in and out on this focused plank, might be the change you're looking for.
The main reason at present is because of a surge in admissions due to a combination of flu and covid. On a background of failure in social care. It is not really the NHS that is failing, it is social care. Many of the patients I look after are elderly, living alone, with dementia. They have deteriorated over the last two years. They get covid or flu not badly, but they take to their beds and get dehydrated or fall and can't get up. They came to hospital, they don't really need the sort of acute care* the NHS is good at delivering, but they need a prolonged period of rehab or a care home. They need a welfare and financial guardian appointed, this can take months, unfortunately they cannot leave hospital until a guardian is appointed who can agree to their going to a care home. So we have wards full of elderly frail patients we cannot just send home because they would just die. This means we have no beds to admit new patients to. So we treat sick patients in corridors whilst frail elderly with no acute medical problem occupy acute beds.

The present crisis is an acute crisis of respiratory infections that will resolve and a chronic crisis that is a social care crisis that won't. The fix needed is social care not the NHS. These elderly frail people should be detected earlier and their admissions with an acute social crisis prevented.

*Also that I am trained to deliver; we need more geriatric doctors and beds, my skills are in critically ill patients.

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Old 12th January 2023, 04:15 PM   #22
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Originally Posted by Planigale View Post
....
So we have wards full of elderly frail patients we cannot just send home because they would just die. This means we have no beds to admit new patients to. So we treat sick patients in corridors whilst frail elderly with no acute medical problem occupy acute beds.
....
Does the UK have intermediate facilities other than hospitals to deliver that kind of supportive care? Or home care providers? It sounds like a U.S. "assisted living" home might be more appropriate. Maybe the NHS could take over hotels and equip them to provide basic, non-urgent care on a temporary basis.
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Old 12th January 2023, 07:46 PM   #23
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Originally Posted by Planigale View Post
The main reason at present is because of a surge in admissions due to a combination of flu and covid. On a background of failure in social care. It is not really the NHS that is failing, it is social care. Many of the patients I look after are elderly, living alone, with dementia. They have deteriorated over the last two years. They get covid or flu not badly, but they take to their beds and get dehydrated or fall and can't get up. They came to hospital, they don't really need the sort of acute care* the NHS is good at delivering, but they need a prolonged period of rehab or a care home. They need a welfare and financial guardian appointed, this can take months, unfortunately they cannot leave hospital until a guardian is appointed who can agree to their going to a care home. So we have wards full of elderly frail patients we cannot just send home because they would just die. This means we have no beds to admit new patients to. So we treat sick patients in corridors whilst frail elderly with no acute medical problem occupy acute beds.

The present crisis is an acute crisis of respiratory infections that will resolve and a chronic crisis that is a social care crisis that won't. The fix needed is social care not the NHS. These elderly frail people should be detected earlier and their admissions with an acute social crisis prevented.

*Also that I am trained to deliver; we need more geriatric doctors and beds, my skills are in critically ill patients.

That's a very interesting insight!

Not that that argues against Carrot Flower King's analysis; it's probably that as well as this, not either-or.

And why isn't social care, of the specific kind you discuss, better set up? Sounds like a money thing again, and policy preference for private care, again going by CFK's analysis.

But again, that's a very insightful nuance you've argued there.

I suppose it's a question of political will somehow not coalescing around people's real needs and wants, despite how in theory it should in a democracy. Probably because of tribalism, as CFK suggests, when it comes to voting; and maybe points to the opposition's failure to properly organize and mobilize around these issues. UK isn't the only democracy to be plagued by political failure after all, lots of places have it worse than you do in fact.
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Old 13th January 2023, 12:27 AM   #24
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Originally Posted by Chanakya View Post
That's a very interesting insight!

Not that that argues against Carrot Flower King's analysis; it's probably that as well as this, not either-or.

And why isn't social care, of the specific kind you discuss, better set up? Sounds like a money thing again, and policy preference for private care, again going by CFK's analysis.

But again, that's a very insightful nuance you've argued there.

I suppose it's a question of political will somehow not coalescing around people's real needs and wants, despite how in theory it should in a democracy. Probably because of tribalism, as CFK suggests, when it comes to voting; and maybe points to the opposition's failure to properly organize and mobilize around these issues. UK isn't the only democracy to be plagued by political failure after all, lots of places have it worse than you do in fact.
Yes the social care thing is probably financial to a large extent. Social services / social care is essentially a local authority responsibility whilst the NHS is national government. The money paid to care homes by local authorities is low, probably below cost. Many people need to top up to get the care home they want / need. People delivering social care tend to be on minimal wage. So there is a shortage of carers. There used to be many long stay dementia beds within the NHS, they have been closed with a move to community care. Carrot Flower King probably knows more about this than I do.

Currently insurance for social care when you get elderly is probably more useful than private health insurance. There are lots of politics around the extent to which elderly people should contribute to their care, in particular whether when they go into care they should sell their house to fund care or whether wealth should remain within the family.
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Old 13th January 2023, 01:30 AM   #25
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Originally Posted by Chanakya View Post
Haha, this may sound like thread-bobbing, that exchange up there; but it isn't really, when you think about it.

Why's your NHS in such dire straits? Is it some rot within the NHS itself, ineffectual management of it? Or is it just the funding? (I'd go with funding, but then I don't really know, I'd be guessing.)

If it is the funding, then why isn't NHS getting enough money? Can't your economy afford to plough any more into it, given your troubles with Brexit and the Covid and the shrinking economy and the war now and everything? If you simply can't afford it, then there's nothing that can be done, really, not even if dead bodies start heaping up as a result; or at least, not until things get better, in economic terms. Or is it simply some political something-or-the-other? In which case people taking to the streets, agitating and screaming, and if that fails then voting governments in and out on this focused plank, might be the change you're looking for.
Successive Tory government have underfunded the NHS, to shoe in more private medicine and their preferred insurance system.

When Labour get into power, NHS funding shoots up.
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Old 13th January 2023, 01:36 AM   #26
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Originally Posted by Bob001 View Post
As an American, I don't understand this. Most Brits rely on the NHS for most of their health care. When Boris Johnson almost died of covid, he was treated (successfully) in an NHS hospital. Why isn't it political suicide for a UK politician to fail to support, or even want to cut, the NHS? I would think that would go over like "I'm gonna take all your guns!" in the U.S.
The Tories were caught out by Brexit, which lost a lot of NHS workers and then the pandemic, which showed that their level of resourcing and funding was not enough to cope with a disaster. The Tories then wasted billions on test & trace and dodgy PPE and now declare there is no money left.

The Labour lead over the Tories is now huge and what has happened to the NHS is a major cause of that.
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Old 13th January 2023, 01:40 AM   #27
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Originally Posted by Planigale View Post
The main reason at present is because of a surge in admissions due to a combination of flu and covid. On a background of failure in social care. It is not really the NHS that is failing, it is social care. Many of the patients I look after are elderly, living alone, with dementia...
I work in home care and many of my clients are elderly, living alone and have dementia. It is almost daily that we go to the home of a hospital discharge, to find they have not been discharged, which wastes a visit. Many carers are faced with gaps between visits, because there are not enough people to fill the shift.

That is the fault of the hospital's administration of discharges, as home care has capacity that is not used or is wasted.
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Old 13th January 2023, 01:42 AM   #28
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Originally Posted by Planigale View Post
...People delivering social care tend to be on minimal wage. So there is a shortage of carers...
There used to be lots of carers from EU countries, usually eastern European. Now there are virtually none.
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Old 13th January 2023, 02:24 AM   #29
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Originally Posted by Nessie View Post
There used to be lots of carers from EU countries, usually eastern European. Now there are virtually none.
Absolutely, and the Social Care system is facing many of the same challenges that the NHS does.

As ever, it's never one single thing that causes these problems, it's the buildup of many different factors all having a cumulative effect. I am by no means an expert here, but worked in social care for about a decade (on the administration side) and saw quite a shift even in that relatively short time.

Over time, people have become slightly less likely to live with, and be cared for by, family in their old age. Increasing expectations of a quality in later life and improved medical care has led to an aging population, the staffing of social care has been heavily imapacted by Brexit, and the costs to Local Authorities are increasing.

That's not to say it can't be sorted out, but it's just another item on a long list of things that need to be a long-term priority in a political system that is inherently short-sighted.
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Old 13th January 2023, 04:10 AM   #30
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Lots of adverts around here for carers, often at the minimum wage level, 9.50 per hour or just over. Someone can earn 15 an hour as a domestic cleaner working 9 to 4, and folk wonder why the vacancies are going unfilled. As a society we have decided that care work is a minimum wage position. People earn more stacking shelves.
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Old 13th January 2023, 04:37 AM   #31
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Originally Posted by Darat View Post
Lots of adverts around here for carers, often at the minimum wage level, 9.50 per hour or just over. Someone can earn 15 an hour as a domestic cleaner working 9 to 4, and folk wonder why the vacancies are going unfilled. As a society we have decided that care work is a minimum wage position. People earn more stacking shelves.
It is worth checking out what newly qualified nurses and doctors actually start on: hint less than 15 per hour, which helps explain some of the current dissatisfaction over pay.
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Old 13th January 2023, 06:27 AM   #32
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Originally Posted by Nessie View Post
The Tories were caught out by Brexit, which lost a lot of NHS workers and then the pandemic, which showed that their level of resourcing and funding was not enough to cope with a disaster. The Tories then wasted billions on test & trace and dodgy PPE and now declare there is no money left.

The Labour lead over the Tories is now huge and what has happened to the NHS is a major cause of that.

In which case I hope "Labour" wins come next election, whenever that might be. Ordinarily I wouldn't care one way or the other who might win and who might govern over there, why would I after all; but this callous neglect of such an important service, and what's more one that's already in place, that's insupportable. This misguided policy directly results in unnecessary suffering, deaths even in some cases. So that, even if what happens in your island is none of my business, but I'd still welcome this current lot getting booted out in favor of the pro-NHS-funding party, your "Labour".

(How completely insane that people should vote for these guys despite their misguided policy on healthcare. But then again, you guys did vote for Brexit as well, didn't you. And in any case, shooting themselves in the foot is what polities do, you're hardly alone in that.)
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Old 13th January 2023, 06:29 AM   #33
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Originally Posted by Darat View Post
Lots of adverts around here for carers, often at the minimum wage level, 9.50 per hour or just over. Someone can earn 15 an hour as a domestic cleaner working 9 to 4, and folk wonder why the vacancies are going unfilled. As a society we have decided that care work is a minimum wage position. People earn more stacking shelves.
Are carers government employees?
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Old 13th January 2023, 07:16 AM   #34
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Originally Posted by Darat View Post
Lots of adverts around here for carers, often at the minimum wage level, 9.50 per hour or just over. Someone can earn 15 an hour as a domestic cleaner working 9 to 4, and folk wonder why the vacancies are going unfilled. As a society we have decided that care work is a minimum wage position. People earn more stacking shelves.
A care visit is about 25, for an hour and all the care jobs where I am, start at 10.50 an hour, rising to 15 and a relative who was a senior social work manager thinks it is likely that 25 is split 50/50 carer/business.
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Old 13th January 2023, 07:20 AM   #35
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Originally Posted by BobTheCoward View Post
Are carers government employees?
Care is split between the NHS and local authorities, often as social health care partnerships and the private sector.

My care job is a social care partnership part local authority, part NHS, as we help to stop bed blocking. The funding is roughly a third local authority, third NHS and a third from the client (though some get that funding from benefits).
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Old 13th January 2023, 07:31 AM   #36
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I guess to get back to a question earlier.

What are problems with the NHS that are not ultimately problems of money.
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Old 13th January 2023, 08:02 AM   #37
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Originally Posted by BobTheCoward View Post
I guess to get back to a question earlier.

What are problems with the NHS that are not ultimately problems of money.
The backdoor privatisation.
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Old 13th January 2023, 08:05 AM   #38
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Originally Posted by BobTheCoward View Post
I guess to get back to a question earlier.

What are problems with the NHS that are not ultimately problems of money.
Very little. It is the single largest employer in the UK, so it obviously has inefficiencies and staffing problems inherent in any large bureaucracy, public service. It is also, again like many organisations, reluctant to admit it is at fault and it spends millions every year fighting off complaints and hushing up scandals.
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Old 13th January 2023, 10:41 AM   #39
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Originally Posted by Chanakya View Post
In which case I hope "Labour" wins come next election, whenever that might be. Ordinarily I wouldn't care one way or the other who might win and who might govern over there, why would I after all; but this callous neglect of such an important service, and what's more one that's already in place, that's insupportable. This misguided policy directly results in unnecessary suffering, deaths even in some cases. So that, even if what happens in your island is none of my business, but I'd still welcome this current lot getting booted out in favor of the pro-NHS-funding party, your "Labour".

(How completely insane that people should vote for these guys despite their misguided policy on healthcare. But then again, you guys did vote for Brexit as well, didn't you. And in any case, shooting themselves in the foot is what polities do, you're hardly alone in that.)
Problem is current Labour policy (since 1997) is: "We'll do the same as the Tories, but won't laugh so maniacally while doing it."
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Old 13th January 2023, 10:50 AM   #40
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Originally Posted by BobTheCoward View Post
I guess to get back to a question earlier.

What are problems with the NHS that are not ultimately problems of money.
Decades of political interference (as recounted in various other threads here), constant "reform" with no evaluation of efficacy before the next "reform" is enforced (as recounted in various other threads), a long history of poor management with aims conflicting with the delivery of good clinical care (as recounted in various other threads here), the introduction of an internal market (ditto), deliberate decisions to cut clinical training numbers (ditto), deliberate decisions to remove senior clinical staff (ditto), deliberate decsions made to cut other services and leaving NHS to pick up the pieces (ditto), deliberate decisions taken to allow buildings to fall into disrepair, a long history of under-staffing...

I won't mention the fallout from PFI, as that could be seen as money, but there are some big problems there which would require a whole other set of discussions.
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