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[Sir Tigger KC]

There's been lots in the news recently about the NHS in a crisis this winter, with fleets of ambulances parked up waiting to unload patients, people on trolleys in corridors, and 50,000 cancelled operations!    So why does the NHS seem to struggle every winter? 

A lack of cash?  Badly managed?  Not big enough for the population?  People presenting at A&E when they could wait to see their GP?  Tories?  People getting sicker?  Aging population?  Stupid people calling an ambulance for a stubbed toe etc? 

Or all of the above? 

[78bex]

My neighbour is an NHS manager & she`s as mad as box of frogs 

Her boss must be equally as barking for her employing her & his boss must be ..............

The cull needs to start very soon from the top down &  anyone entering A&E need breatherlysing first  & if found to be drunk get heavily fined & poked with a stick

[Steve B]

NHS is for the low life in this present governments eyes....That means all of us on this forum,and everyone who is not in there gang

[Migv6 le Frog Fan]

That's utter bollix. Do some research as to what happened to the NHS under the last Labour Govt.

Population increasing by almost half a million a year,People living longer with the associated health problems that brings, its very badly managed indeed,Far too many non medical people on big salaries on the gravy train, people using the NHS for all sorts of things it isn't intended for, but they have minds trained by socialists - i.e. the state can and should solve any problem we think we have.

I read a story today about a surgeon who took early retirement because "the last straw was that a 25 year old, with a second class  sociology degree, from a second class university, rearranged my patient schedule from the clinically important list I had drawn up, to a list which better met the hospital targets he had come up with".

This is the legacy of Tony and his cronies which has wrecked much of this country, including the NHS, or the IHS as it bcame under them.
The mess is too big to sort out imo. The whole thing needs to start again from scratch, with all vested interests, apart from patients, banned from having any input.
I cannot accept the NHS is short staffed (around 1.5 million I believe) or short of funds (around £130 billionI believe !!).
Its easy to just say, put more money in to fix it, but the problems are much more deeply imbedded than that.
The last Labour Govt. more than doubled the NHS budget and made everything much worse.

[Fraggles Rock]

That's utter bollix. Do some research as to what happened to the NHS under the last Labour Govt.

Population increasing by almost half a million a year,People living longer with the associated health problems that brings, its very badly managed indeed,Far too many non medical people on big salaries on the gravy train, people using the NHS for all sorts of things it isn't intended for, but they have minds trained by socialists - i.e. the state can and should solve any problem we think we have.

I read a story today about a surgeon who took early retirement because "the last straw was that a 25 year old, with a second class  sociology degree, from a second class university, rearranged my patient schedule from the clinically important list I had drawn up, to a list which better met the hospital targets he had come up with".

This is the legacy of Tony and his cronies which has wrecked much of this country, including the NHS, or the IHS as it bcame under them.
The mess is too big to sort out imo. The whole thing needs to start again from scratch, with all vested interests, apart from patients, banned from having any input.
I cannot accept the NHS is short staffed (around 1.5 million I believe) or short of funds (around £130 billionI believe !!).
Its easy to just say, put more money in to fix it, but the problems are much more deeply imbedded than that.
The last Labour Govt. more than doubled the NHS budget and made everything much worse.

This is precisely why one of Donalds first, and most important so far, jobs was to undo Obamacare... socialist schemes cost EVERYONE dearly... in this case, personal health insurance premiums practically doubled overnight

[Mister Rog]

That's utter bollix. Do some research as to what happened to the NHS under the last Labour Govt.

Population increasing by almost half a million a year,People living longer with the associated health problems that brings, its very badly managed indeed,Far too many non medical people on big salaries on the gravy train, people using the NHS for all sorts of things it isn't intended for, but they have minds trained by socialists - i.e. the state can and should solve any problem we think we have.

I read a story today about a surgeon who took early retirement because "the last straw was that a 25 year old, with a second class  sociology degree, from a second class university, rearranged my patient schedule from the clinically important list I had drawn up, to a list which better met the hospital targets he had come up with".

This is the legacy of Tony and his cronies which has wrecked much of this country, including the NHS, or the IHS as it bcame under them.
The mess is too big to sort out imo. The whole thing needs to start again from scratch, with all vested interests, apart from patients, banned from having any input.
I cannot accept the NHS is short staffed (around 1.5 million I believe) or short of funds (around £130 billionI believe !!).
Its easy to just say, put more money in to fix it, but the problems are much more deeply imbedded than that.
The last Labour Govt. more than doubled the NHS budget and made everything much worse.

I totally agree with all of that and more.

Until a few years ago I sold medical equipment. The amount of cash the NHS wastes is absolutely staggering. The problem is that it has become a political hot potato and any attempt to change things results in a torrent of criticism. I think Hunt is a t***, but in fairness anyone in his job would get just as much stick.

One of the biggest issues that almost everyone keeps quiet about are the PFI deals started by the Tories but really used extensively under Labour. We all like our shiny new hospitals, paid for by private money, but with terms that almost make Wonga look good !

The Blair/Brown years introduced a whole new culture to the NHS, one of targets/metrics and managers who did great Powerpoint presentations and were very good at "corporate speak". This culture still thrives and is impossible to change, as they say " turkeys don't vote for Christmas".

In addition the workload on the NHS has increased enormously, along with the population, and for many A&E is the first port of call for almost any ailment.

Grrrr I could really go on a rant here . . . 

[Sir Tigger KC]

Grrrr I could really go on a rant here . . . 

Go on then Rog! 

[2boxerdogs]

SWMBO & myself both worked within the NHS I left in 1989 & she left in 1987 we could both see where it was heading , they put "educated idiots" in charge with little or no people skills decimate experienced staff in order to save money & then seem amazed when the system flounders.

[Varche]

Good luck with rebuilding/reforming (call it what you will). It isnt a car you can SORN and fix at your leisure.

One start would be education. The BBC should carry advert/programmes on how to proceed with simple ailments. Plus chemists who already receive handsome amounts of your money should be a more prmary point of contact,referring to GP as appropriate. Why not have more half doctors? ( our parents were all half doctors and knew how to treat bee stings, colds, flu, flesh wounds). Charge for missed appointments, charge for first consultations.

It needs a cross party branch and root reform. Fat chance of that happening.

As we all live longer and with chronic conditions something has to be done. Same with care for the elderly. The sticking plaster of raising rates by 5% or whatever is not enough. Fail to address that and the hospitals will be clogged up more with bed blockers. That is an area hatdoes need hige amounts more of cash or a huge change in care funding i.e. the problem ndividual is bled dry till the state takes over.

[Marks DTM Calib]

When I had my little coming together with a saw a few years ago, I had to attend A&E in order to get the skin joined back together over the exposed bone as it was cleaer that Duck tape would not achieve the same means (and it was considered).

When you sit and observe what is going on around you for four hours its clear why A&E is in a mess, sights I observed (but were not limited to) included:

A University student who had cut her finger, after three hours she was asked to raise her hand as a nurse applied a sticking plaster and sent her on her way.

Two drunks, brought in by ambulance, one left of his won accord after two hours and the second kept throwing up in the bin (she was in a real state).

Numerous drug addicts

One guy in his twenties with stomach cramps, after a few hours he disappeared, then came back and declared he had crimped a length and felt much better.

Another guy was of foreign decent and waited around for 4 hours so he could get free Paracetamol.

There were plenty of others to which probably accounted for around half of the people there.....all time wasters and all have to be seen, assessed, then treated.

[Sir Tigger KC]

I'm convinced that one of Labours greatest opps ups with the NHS, was when Patricia Hewitt the then Health Secretary 'renegotiated' the GP's contracts.  Gave them a pay rise and removed the obligation to provide a 24 hour service! 

So now it's almost impossible to see a Doctor outside office hours and it's damn hard to see one within the Monday - Friday 9 to 5 window for that matter as well!    Try phoning your local surgery to make a non urgent appointment for next Tuesday afternoon for example, and you'll get told to phone before 8am on the day.  When you do that you invariably get told there are no appointments available, but if it's not urgent they might be able fit you in next year! 

So where do people go when they've got a runny nose?    A&E!  Who'd have thought it?   

[Kevin Wood]

The thing is, we accept that the M6 will be carnage at 4:30 on a Friday afternoon, or that McDonalds won't exactly offer "fast food" when a footy match has just kicked out, yet here we are, the week after the Christmas binge when everybody has been over-doing it and too busy scarfing mince pies and sherry to attend to their healthcare, it's the start of the flu season, the darkest time of the year on the roads, the coldest and the most depressing time of year to boot.

Suddenly it's a "crisis" because the hospitals are a bit busy.

Surely that just demonstrates that the system is working at its capacity, as does any optimally resourced system at busy times. I'm sure we could have a system where everybody gets seen within 5 minutes at all times, but that would entail paying hospitals to sit idle at most other times of the year. We wouldn't stomach the taxes to pay for that, though, just as we wouldn't pay for another half a dozen lanes on the M6 so it never gets busy.

I don't doubt that the NHS could be more efficient, but that's another issue. Until I hear reports of people losing their lives due to the "crisis", then it's not one, IMHO.

[Viral_Jim]

This is precisely why one of Donalds first, and most important so far, jobs was to undo Obamacare... socialist schemes cost EVERYONE dearly... in this case, personal health insurance premiums practically doubled overnight

That is just plain wrong. Data shows that the USA's incredibly efficient capitalist system, has spent more per capita than our socialist system, every year since about 1960.

A big issue facing the NHS at the moment is the cuts made to social care. Since 2009/10 total spending has fallen 13.5% (more in real terms) while the number of people over 65 grew 18% and those over 85 grew 17%. Consequently you have elderly people who aren't getting the care that they need (or, haven't saved enough to look after themselves in old age, if you turn it on its head).

So these people get ill and end up in the only place that an ambulance will take them. Then, once the hospital has sorted them out, they often can't be discharged as there is nowhere for them to go where they will get the level of care that they need. As the hospital owes them a duty of care, they can't just kick them to the curb.

I experienced this first hand last year when my dad went into hospital. He was on a ward of 8, 3 of whom had nothing medically wrong with them, but there was no-one in place to take care of them (one needed to be in a home, two needed health visitors) so they just stayed on the ward for the entire two weeks my dad was in, and were still there after he came out.

So now it's almost impossible to see a Doctor outside office hours and it's damn hard to see one within the Monday - Friday 9 to 5 window for that matter as well!    Try phoning your local surgery to make a non urgent appointment for next Tuesday afternoon for example, and you'll get told to phone before 8am on the day.  When you do that you invariably get told there are no appointments available, but if it's not urgent they might be able fit you in next year! 

I very much like our local GP's system, you call up in a morning, they assess you over the phone, either give you an appointment of tell you to buzz off to the pharmacy. Funnily enough, when I had a rash, fever and had just got off a plane from china, I didn't have to wait "we can see you in 30mins, but if you start to feel worse come immediately".

Under the system most GP's operate, I'd have been another one in A&E (as it turned out I had cellulitis and needed treatment reasonably urgently) who could have avoided being there.

[Varche]

This is precisely why one of Donalds first, and most important so far, jobs was to undo Obamacare... socialist schemes cost EVERYONE dearly... in this case, personal health insurance premiums practically doubled overnight

That is just plain wrong. Data shows that the USA's incredibly efficient capitalist system, has spent more per capita than our socialist system, every year since about 1960.

A big issue facing the NHS at the moment is the cuts made to social care. Since 2009/10 total spending has fallen 13.5% (more in real terms) while the number of people over 65 grew 18% and those over 85 grew 17%. Consequently you have elderly people who aren't getting the care that they need (or, haven't saved enough to look after themselves in old age, if you turn it on its head).

So these people get ill and end up in the only place that an ambulance will take them. Then, once the hospital has sorted them out, they often can't be discharged as there is nowhere for them to go where they will get the level of care that they need. As the hospital owes them a duty of care, they can't just kick them to the curb.

I experienced this first hand last year when my dad went into hospital. He was on a ward of 8, 3 of whom had nothing medically wrong with them, but there was no-one in place to take care of them (one needed to be in a home, two needed health visitors) so they just stayed on the ward for the entire two weeks my dad was in, and were still there after he came out.

So now it's almost impossible to see a Doctor outside office hours and it's damn hard to see one within the Monday - Friday 9 to 5 window for that matter as well!    Try phoning your local surgery to make a non urgent appointment for next Tuesday afternoon for example, and you'll get told to phone before 8am on the day.  When you do that you invariably get told there are no appointments available, but if it's not urgent they might be able fit you in next year! 

I very much like our local GP's system, you call up in a morning, they assess you over the phone, either give you an appointment of tell you to buzz off to the pharmacy. Funnily enough, when I had a rash, fever and had just got off a plane from china, I didn't have to wait "we can see you in 30mins, but if you start to feel worse come immediately".

Under the system most GP's operate, I'd have been another one in A&E (as it turned out I had cellulitis and needed treatment reasonably urgently) who could have avoided being there.

That is the point I alluded to earlier. We have plenty of first hand experience of that. An aunt in law was twice in a Scottish hospital for three months while they failed to get care sorted. All the cost of failure mounts up. Blocked bed, admin, and care, friends wasting money and time visiting when they could have been doing their normal visits to her at her home and attending to small errands. The list is enormous and solely because there isn't the resource for care at home

[STEMO]

The social care issue is not limited to the NHS. It goes right through the education system as well. Teachers now have to watch out for signs of physical abuse, sexual abuse, female genital mutilation, child sexual exploitation, mental health issues blah, blah, blah. But, when suspicions are reported to social care, they don’t have the staff or resources to do anything about it, so it goes on.
To take Albs point about the surgeon, a lot of the old school, experienced social workers left their posts in the noughties because they were basically burned out. Now we have a large group of willing, but inexperienced workers who are totally overwhelmed by the sheer volume of cases.
This kind of thing isn’t seasonal either, it is constant, unbearable pressure.