# Is the NHS beyond repair?



## Amity Island

Is the NHS beyond repair? | The Spectator
					

Another week, another warning that the NHS has reached crisis point. A cross-party group of MPs today published a report detailing the extent to which the health service and social care sector in England is understaffed – and found that it is facing the worst staffing crisis in its history...




					www.spectator.co.uk


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## Drummer

I often turn on BBC Radio 4 and come across an interview with some poor person who has lived for decades with a serious condition which GPs and hospitals have denied exists, was a figment of their imagination, they looked up on the internet, was down to hypochondria, hysterics, attention seeking - even trying to seduce the doctor.
A couple of weeks ago on a Wednesday there was a poor woman who was in her 50s before being diagnosed with hyperflexible joints and autism. She was so beaten down by the combination of the two conditions and the relentless  abuse from people who should have been providing care - so yes - the NHS has been doing more harm than good to a lot of people for a very long time.


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## EmmaL76

Drummer said:


> I often turn on BBC Radio 4 and come across an interview with some poor person who has lived for decades with a serious condition which GPs and hospitals have denied exists, was a figment of their imagination, they looked up on the internet, was down to hypochondria, hysterics, attention seeking - even trying to seduce the doctor.
> A couple of weeks ago on a Wednesday there was a poor woman who was in her 50s before being diagnosed with hyperflexible joints and autism. She was so beaten down by the combination of the two conditions and the relentless  abuse from people who should have been providing care - so yes - the NHS has been doing more harm than good to a lot of people for a very long time.


My eldest daughter has extreme hyper mobility in almost every joint. Apart from a couple of weeks physio she’s had no help at all with it.


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## Bruce Stephens

From 



__ https://twitter.com/i/web/status/1551877444126253056 we under resource the NHS compared with at least come comparator countries. (I don't think they should include the US which is an obvious outlier.)

Data's from https://www.bmj.com/content/367/bmj.l6326

Just as interesting (I think) is comparing us with the OECD and EU averages. It looks (from the graph he gives in 2/10) like our spending is within spitting distance of the average OECD and EU averages, and yet (from the BMJ article) we have many fewer GPs, doctors, nurses, hospital beds, and we train fewer doctors, nurses, etc. (I'm not suggesting we ought to aspire to spend just the average of the OECD or EU: we're surely wealthier than that. It just seems odd that we seem to be doing so poorly given that we seem to be spending at about that average.)


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## Rob Oldfield

Bruce Stephens said:


> From
> 
> 
> 
> __ https://twitter.com/i/web/status/1551877444126253056 we under resource the NHS compared with at least come comparator countries. (I don't think they should include the US which is an obvious outlier.)
> 
> Data's from https://www.bmj.com/content/367/bmj.l6326
> 
> Just as interesting (I think) is comparing us with the OECD and EU averages. It looks (from the graph he gives in 2/10) like our spending is within spitting distance of the average OECD and EU averages, and yet (from the BMJ article) we have many fewer GPs, doctors, nurses, hospital beds, and we train fewer doctors, nurses, etc. (I'm not suggesting we ought to aspire to spend just the average of the OECD or EU: we're surely wealthier than that. It just seems odd that we seem to be doing so poorly given that we seem to be spending at about that average.)



One of the key things there is how much 'NHS spending' is actually going to the private sector.  The 'VIP lanes' for Covid equipment showed just how crooked that could be.

Pretty much impossible to get a 100% accurate picture but this has a lot of information: 









						How much public health spending goes to the private sector? - Full Fact
					

Depending on how you count it the figure could be anywhere between 7% and 26% of spending by the Department of Health and Social Care and NHS England.




					fullfact.org


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## Rob Oldfield

Amazon's latest move into health care.  If we don't fight for the NHS, we're going to lose it.



			NPR Cookie Consent and Choices


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## novonord

EmmaL76 said:


> My eldest daughter has extreme hyper mobility in almost every joint. Apart from a couple of weeks physio she’s had no help at all with it.


should exclude Ehlers Danlos, can be very difficult and elusive to diagnose -hypermobility is a sign...though usually accompanied by other features.


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## novonord

NHS a sacred cow, consumes 20% of government spending, a crisis brewing in General Practice, no easy solution to the waiting list problems either in the Hospital service, must become a whole lot more efficient and markedly too many staff in some areas and far too few in others, pension problems forcing many GPs and Hospital doctors out early.
Discouraging smoking further, cutting down population intake of salt and fizz and tackling the obesity crisis might help as diabetes consumes over 10% of the budget, mainly through complications.


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## nonethewiser

Of course it's at crisis point, but beyond repair don't be silly.


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## EmmaL76

She’s 


novonord said:


> should exclude Ehlers Danlos, can be very difficult and elusive to diagnose -hypermobility is a sign...though usually accompanied by other features.


This was a consideration at the beginning, she does have issues will collagen and her skin is fairly stretchy but not enough for ED. As she’s aged she has kinda fused together a bit, and she’s stopped her contortionist party tricks so I haven’t had to pop her shoulders back in quite some time. She doesn’t seem to be in as much pain as when she was younger, but the cysts behind effected joints can be quite painful. ED I heard was passed down from parents, no ED in the family but quite a bit of double jointed. I’m pretty bendy but nothing like her… bless her


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## novonord

EmmaL76 said:


> She’s
> 
> This was a consideration at the beginning, she does have issues will collagen and her skin is fairly stretchy but not enough for ED. As she’s aged she has kinda fused together a bit, and she’s stopped her contortionist party tricks so I haven’t had to pop her shoulders back in quite some time. She doesn’t seem to be in as much pain as when she was younger, but the cysts behind effected joints can be quite painful. ED I heard was passed down from parents, no ED in the family but quite a bit of double jointed. I’m pretty bendy but nothing like her… bless her


good, glad that this seems to have been excluded by developments...


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## Dave_Z1a

Beyond repair, yes in my opinion. Its a failed model designed years ago and there is no point throwing heaps of money at it year after year, it needs total restructure, plenty of other systems world wide that do better job, cheaper and have better outcomes for patients, e.g. Australia. Trouble is, like the blob its a sacred cow in this country, political dynamite, no government has the courage to sort it out. It makes me cross when politicians utter the tired old phrase "the best health system in the world" utter tosh, it isn't by a long chalk, I have had better treatment in Papua New Guinea,  obvious really when we can't even get people to hospital in a timely manor these days plus I lost both my mother and father following chronic and appalling mismanagement and misdiagnosis in hospital, tried medical negligence proceedings against them but even the lawyers had to give up in the end, the establishment, i.e, the blob, just closes ranks. Its an out of control monolithic organisation which does have some star players doing a great job but they are heavily outnumbered.


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## mikeyB

I presume this thread refers to NHS England, which has been starved of money since 2010. NHS Scotland is far from perfect, but it isn’t in the state of NHS England because it is more efficiently run. There are no queues of Ambulances carrying patients waiting for admission to A&E at any Hospital in Scotland. There are no Hospital Trusts, with their attached bureaucrats on mega salaries. All hospitals are connected by an IT system that works, so if you are admitted to a hospital as an emergency in an an area outside your own, they can access your medical history without even asking you.

And @Dave_Z1a is right - NHS England does need reorganisation. Imitate NHS Scotland. It’s cheaper, despite paying their nurses more than they get in England. Doctors too. Because they don’t have to pay all these bureaucrats that litter NHS England.


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## Bruce Stephens

Nice chart (for NHS England):


__ https://twitter.com/i/web/status/1552690714617815040


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## mikeyB

Presumably as the government is advising the NHS to claim damages against the companies, those fines will go into government funds. And no doubt the NHS will have to pay for any legal costs incurred doing it. Madness.


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## john e

Tories have never supported public health care, they are the problem, hence creeping privatisation, money to be made


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## john e

Amity Island said:


> It certainly appears that way. I think the 3 months to save the nhs is either a call to do something to save the nhs or a warning that that's it for the nhs. What will take its place? A hybrid part private for those who work/have income part free for everyone who can't pay towards their care?


Who knows, but what ever it is it will not be good for the NHS or us


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## void

People are being softened up to want to get rid of it

It's ideological for those in power. The NHS was founded on socialist principles for the health of the nation. It delivers the best value per pound spent than any other system, and they want to get rid of it.  So it's being underfunded, and has been for over a decade. Look up "starve the beast".

As a person with a chronic disease needing periodic testing and medication, i'm terrified for the future. There's no way I'd be able to pay retail price for insulin and appointments, and I doubt very much I'd be able to get insurance as it'd fall under "pre-existing condition"


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## nonethewiser

Amity Island said:


> How can doctors work privately when they aren't dealing with their NHS patients first?



Good guess would be money.


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## mikeyB

There is one thing that is never mentioned in the NHS England's crisis - Brexit. The NHS in England has lost thousands of nurses and doctors who simply couldn't afford to pay for all the bureaucracy and charges to remain in the country. That has led to the 120,000 vacancies in NHS England. And all the waiting list - well past 6 million, including me, is due to that. 

Now the government is raiding the commonwealth, advertising nurses from those countries to get to to England with free visas. Never mind what that does to the state of the health services in those countries. That action has come to the notice of several charities, and to United Nations.


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## void

Amity Island said:


> A story today in telegraph, g.p refusing to attend a death, instead insisted widow do this via a video call.
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> Doctor tells widow to film body on Zoom call for death note
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> Woman was told doctors ‘don’t come out any more’ and asked to hold phone camera to the deceased’s body
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> www.telegraph.co.uk


I kind of doubt their veracity given that publication's political position.


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## Abi

I am afraid I do believe it's veracity. As a GP myself fortuantely working in a well staffed practice  without having to deal with 100s of patient interactions a day. In some practices it is not unusual for two GPs to deal with a list of 100 or more patients in an afternoon-so literally no time to go out and verify a death. In my practice GP will ( or we are soon recruiting a paramedic who might dosome of this work)- if in hours- and if OOH then sometimes OOH doc or paramedic. I would throw in the towel if I felt cornered into asking a patient to video their deceased loved one. There should not even be  a need. A lay person can legally verify a death if they feel confident to do so- so  in this case no need and totally undignified to ask them to do so. If they are not confidant to- or at any rate I believe as a mark on compassion and respect- a trained person (not necessarily GP but nurse or paramedic) should do so...
I think that people really need to sit down and decide which health service ( Germany, Netherlands whatever) we should copy. Because I agree that the NHS ain't functioning. The right hand does not know what the left hand is doing and people end up doing other people's jobs badly instead of being able to get on with their own for which they are experienced and trained. Hospitals doing social care very badly so that patients not discharged and ambulances can not off load- so elderly left on floor for 12 hours with broken hip- or GP surgery clogged up because ambulance cannot attend patient with  cardiac chest pain for hours ( and afraid of fallout should they patient die and they are less experienced and equipped to managed a heart attack than the hospital). GPs trying to deal with patients with significant mental ilness when  mental health services can be almost non existent-so no other choice than to advised patient to attend A and E- hardly a suitable place for a patient who is feeling suicidal or in acute distress or agitation to sit for hours). GPs dealing with social problem because of lack of social care, or worsening clinical problems due to long waiting lists, so other patients who have problems who could be GP managed- end up cogging up A and E...


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## void

@Abi the problems you describe will be used by tories to gut the NHS.
Social care is not an NHS problem, or IMO should not be. Bed blocking is a problem of social care. The whole social care thing for the elderly needs to be fixed by someone who has empathy, is practical and who understands the issues fully.

I agree with the gist of what you say and defer to your experience as a GP. Mental health has been underfunded for a long while (i think it's the cinderella of medical treatment), and the brexit thing has made matters very much worse. I think the right hand not knowing what the left hand is doing is a consequence of the NHS being treated like a political football, of the "internal market"and every change within it backwards or forwards costing energy in the form of money.

The NHS is the last large thing that looks socialist to a tory, and the way they have of getting rid of it is to make it useless and then going "see?" to make people vote for it to be dismantled.

Going back to the article, it seems to be a singular error on the GPs part, consequential to covid. That should not be a "see?" and unsurprising it's in the publication it's in.


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