One of the greatest achievements that Britain has ever achieved, should be a source of great pride.

It costs what it costs. We pay for plenty of pointless wars and bail out greedy banks, NHS is chicken feed in comparison. Look abroad to northern Europe who have great healthcare, they pay higher taxes. You get what you pay for .

I believe that I know the NHS inside out and a bit more.

The one that most talk about exists in fantasy land promoted with the 'best in the world phrase'

Best in the world my ar..se...Why then is it that we come low down in just about every European league table that measures health outcomes?..usually on a par with Estonia!

Standards of basic care in our hospitals has deteriorated...hospitals not following basic hygiene and cleanliness procedures, nurses 'too posh to wash'

Go on any ward and see patients unattended in their time of need, call bells unanswered, meal plates put down and removed uneaten for patients too ill to eat without help, beds without consultant names above them, nursing staff who cannot be identified by rank or qualifications..same applies to the non white coated doctor, difficult to spot.

Try and discuss your medical condition and treatment and that of a relative to see how difficult it is.

See how many times you are told 'your father is not actually my patient' so I dont know' or similar when approaching a ward nurse.

Perhaps worst of all poor outcomes for just about all the major illnesses compared to Europe.

lets look at Primary Care..your GP and others

GPs who earn over 100K, many towards the 150K per year...many of those now work a four day week and without out of hours.

I bet you have not worked out how little of a working week your GP spends in face to face consultations...try it...you will be surprised!

Tick box medicine with high rewarding often ridiculous targets has changed General Practice dramatically.

Doctors in General Practice now spend their time planning how to cherry pick and achieve the most financially rewarding targets at the expense of other heath care needs...In short we now have a breed of get rich quick doctors who have never worked past 6pm in a primary care setting and of course never on a Sunday...oh!..not on a Saturday either!!

Now we have promises that cannot be delivered ..7 days a week Primary Care...impossible! in the present set up...It shows how little the politicians understand about how it actually works....Same with promising 7 days hospital care without an impossible amount of money and reorganisation...again complete lack of understanding of the set up.

Lets just promise it, especially a week or two before an election..can we do it?..no way!...If anyone asks blame the economy or coalition partner but keep promising!

I wont even discuss the care of the elderly and dementia sufferers which is nothing short of disgusting..maybe on another thread.

Of course with the above outline, I have made some generalisations and there are some fantastic people working in our health service from doctor to cleaner but the system makes it impossible for them to deliver the great service we talk about but do not deliver..we talk the talk but certainly dont walk the walk.

Can it be fixed?...........Maybe another thread but it wont be fixed by plucking things out of the sky like 24 hour appointments for over 75.....why exactly?..at what consequence?...why not 73?...I mean who thinks up these things.

A midwife for every mum!...what does that mean?...how will it be achieved?....Any midwife will answer the last question for you....It wont!

The NHS has achieved some great things under difficult cir***stances but 'best in the world?'.....I should coco!

-- Edited by Kempo on Sunday 12th of April 2015 08:39:51 AM

I agree that the issue Is culture and that culture is materialism. The philosophy that has taken over in hospitals is an extension of the square mile. Corporate thinking and behaviour equals demoralised staff.
T
When nurses and doctors are motivated it is due to legitimate professional Control over their philosophy of care. The government and society prefer automatic regulation above the skill and philosophy of medicine and care.

 

In the 80's there was a growing recognition of the need for skill and holistic philosophies, but they were drowned by targets, payment by results and IT systems that corralled professionals and made them the *****es of a managerial system  - non sympathetic, non aligned, autocratic and punishnent/blame culture - that has drawn the blood from the marrow of every inspired moment. 

 

What we have now is a closed shop of fear and indifference driven by greed and status and too many careerists that have no heart for care.

 

It is a shameful buisness at times. Too many good people have been silenced by the system and it continues to this day.

-- Edited by ian on Sunday 12th of April 2015 10:10:36 AM

I am by my nature a cynic and a pessimist sickly but it does seem that we agree on the deteriorating standards and that's from two people who have worked within the system for a good few years.

It's only the degree of the failings that we seem to differ which is a great shame.

The major benefit over say the USA is that it is available to all and free at point of delivery.
Maybe because of this we have to accept poorer quality...if this is so then we should be told and not conned.

I agree fully with your point re business management style not working yet it's something the Torys in particular will commit to for ever.

The NHS doesn't sell cornflakes so don't manage it as if it does.

It gives stuff away and maybe therein lies the basic problem maybe not..it's difficult to say the least.

Changes can be made although some would be unpalatable to the public.

I would scrap the GP set up which favours only GPs and a dying breed of older patients who insist on their personal doctor...It doesn't work in modern times and is too costly.

We need primary care centres in each town and then costs will drop dramatically although obviously upfront money to finance the change would be needed and would be significant.

GPs would revolt as would the public but brave decisions are needed.

Management costs, building costs and running costs would die decimated.
From a Primary Care Centre a seven day a week service could be delivered, I have no doubts and the costs would be less than in the present system.

If you want to choose your doctor then get your wallet out but if you want the NHS to treat you then you have to give up the personal family doctor nonsense....it's a nice want but we cannot afford to provide it...that's the reality.

I am poacher turned gamekeeper...the present Primary Care system benefits mainly the carers not the cared for.

 

-- Edited by Kempo on Sunday 12th of April 2015 10:22:17 AM

Having seen the very top of care, I can say 'physically' wow - when my wife was at deaths door, if they hadn't been so good & fast acting she wouldn't be as good as what she is today. I was that moved by the dedication of those people in intensive care (and obviously her neuro surgeon who was called out of bed at an ungodly hour) that 12 months after I actually didn't mind sitting in A&E for 3 hours to have my rolled ankle seen to. However despite all this, when it came to seeing someone to look after the mental aspect of her recovery, i.e. best practise & advice in bringing her round to reality from her injured head / morphine induced reset she was in - nobody. In fact it was to the point of appalling.

To your post Kempo, I would agree its a mess, resources wasted by a labour government hell bent on producing management, and management to watch the managers, people who spend all day justifying that their job is needed in a hospital when they don't ever make anyone feel better!

I think the shortage of nurses & doctors etc is purely down to the environment they have to work in. You would have to be one special individual to work in the pressure cooker of an A&E, its not an attractive job to have purely down to the working conditions. Get it so its an attractive proposition and our country can produce enough of its own without foreign intervention

I lecture in simulation to nurses and paramedics and a lot of this covers patient safety and clinical risk. The modern health system in the western world is not focussed on either of these things, it is focussed on producion,to move as fast as possible with as little cost as possible. Production pressure leads to errors, people are asked to work faster with a more a complex workload will inevitably stuff up. We are not making cars we are treating individuals individual needs, one size does not fit all. To top it off there is a culture of bulllying within the management system and reluctance to address issues of risk and safety. As they say they bury thier mistakes.
I agree with Kempo about the need for primary care centers which will be more efficient and effective. Most importantly is a change in atitude from governments and managers, we need to own our failings and they need to be transparant and not hidden. putting the individual and their needs first.
OK rant over. :)

I've never had but first class service from the nhs. Was very ill 10 years ago and had to spend six months in and out of hospital. On the other hand my wifes friend was made redundant from the hospital recieved over 20k then got set on three weeks later in the next office. This happened to all five in the office. Two didn't return. Now I see where the money goes. Good and bad.

I see the GPs' trade union have now produced a survey showing how hard done by they feel!

They ought to try some of their patients' jobs!.

General Practice does indeed have a number of stresses but so do many jobs....the truth is GPs are highly paid 100K plus, have as many weeks holiday as they choose[yes its true before anyone questions this fact], fantastic pension, many do a four day week, no out of hours responsibility, no weekends.

The job is much easier now than in the past and much better paid.

Of course many GPs are thinking of early retirement as I did and thats because the pay has been so high for years and the pension is so good allowing them to retire early..something that most of you I guess would not be able to do even if you disliked the job.