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[Varche]

I for one am not surprised that the NHS is in crisis. I am deeply sorry that it isn't performing as it should.

This current A and E crisis - that is the right word for it is a culmination of factors.

Can you see a GP when you are ill in the UK? Yes but in a few days time when you have navigated the 8.30 call hurdle.
Hospital beds full of old people who statistically ten years ago would have been dead by now. Why are they there ? Social services has been cut to the bone by successive governments despite there being an ever bigger need.

How can a poor country like Spain be able to offer next day and often same day appointments through an efficient one number serves a whole province service/Internet booking? How can they offer hospital procedures much quicker than the Uk which let us not forget is a very rich country?

What has changed since we were young? Then when you needed to see a doctor you rang the surgery and got an appointment the same day. If you were too ill to attend the surgery, a doctor would come to you at home. If you needed a doctor at two in the morning or any time Saturday or Sunday, one would be there for you.

Varche's solution. Well for a start I would make greater use of Chemists for minor ailments. They get paid a fantastic amount of taxpayers money even if they only make ONE prescription a year. Then I would bring doctors into line with industry. One day closed in the week and one open at weekend (normal pay). NHS. I would get them to do a cost of failure anaysis. There is loads of waste. Just think missed appointments for one. I would also bring in charging . That would encourage people to attend their appointment. In fact maybe £300 (like other countries) toward the cost of an operation. On the same tack £10 for a doctors consultation too. I would charge for IVF and other cosmetic procedures. It isn't a right to have children but it is important to try and maintain the health and wellbeing of existing humans. I know that the NHS is supposed to be free but something has to give. Maybe some tiers of managers could go.10% more with 10% less like Private industry does every year.


Will it happen? No because for some unfathomable reason the NHS is a sacred cow and is now going to get tossed around like a political football. .Beggar, I did say it wouldn't be political.

[aaronjb]

£300 for an op?  Assuming that includes diagnostic procedures I'd have elected to carry on sh.. pooping blood & blood clots rather than pay that to have a camera stuffed up there which (so far) has ultimately told me nothing is wrong (except the obvious that there's clearly no medical cause for… hmm!)

Or I'd have gone private and paid my £100 excess

[Field Marshal Dr. Opti]

£300 for an op?  Assuming that includes diagnostic procedures I'd have elected to carry on sh.. pooping blood & blood clots rather than pay that to have a camera stuffed up there which (so far) has ultimately told me nothing is wrong (except the obvious that there's clearly no medical cause for… hmm!)

Or I'd have gone private and paid my £100 excess

Some people ( Tory politicians?) are more than happy to pay to have 'foreign implements'  shoved up their arse.

However...that is another thread.

[Field Marshal Dr. Opti]

Charging £10 for missed appointments may help to concentrate the mind.

[Terbs]

Well, it does not take much thinking about the basic causes......

Bigger population....living longer, immigration, etc
Closing A and E units
Increasing managers/white collar staff
Closing Hospitals and closing wards
Reducing Nursing staff over the years

All the above are contributory factors. Obviously, idiots that go to A&E for stupid reasons don't help.
I would have thought that any sensible person could work out, for example, closing the A&E and Maternity departments from my two closest hospitals and putting them to Stoke Mandeville does not help SM with their
capabilities. I expect some hospitals in other areas have been dumped on Stoke Mandeville too

[omega3000]

Dont forget the Bi££ions we give to the EU every year and people are living longer , more and more families are taking in their own parents due to care home costs so its not that 
Should be a charge for drunks wasting A&E time as well 

[Kevin Wood]

I'm not so sure it's as bad as the media make out, TBH (apart from all the waste).

My doctor's surgery irritate me because they won't allow me to book non-urgent visits to my GP in advance. If I phone them, they insist on giving me an appointment later that day or next day, when there's insufficient notice to arrange work commitments around it.

Pharmacies are taking an increasing workload from the NHS. My local chemist has offered me NHS flu jabs while I've been collecting prescriptions the last couple of winters, saving an appointment at the surgery, and they can now carry out reviews for certain conditions, again, saving an appointment at the surgery.

I agree that those who are no-shows at surgeries, or present for time-wasting reasons, should pay a penalty. It should be free at the point of use to those who don't waste resources, however.

Both of my parents have had episodes requiring surgery in the last 3 months. In my Dad's case it was not life threatening but completely debilitating. He was operated on the day after presenting himself at casualty. In my Mum's case it was potentially cancer (but thankfully didn't turn out that way) and she got various scans, a biopsy then straight into Guy's for a major operation within a couple of weeks.

I don't doubt that some are failed by the NHS, but I've yet to personally experience care that could be improved in any way, TBH.

It does come at an enormous cost, of course, and, like most things in the public sector, the government risk a huge revolt if they dare to try to make it more efficient.

[Terbs]

It is enormous cost, and not trying to be political, and continuing emd's post, our taxes/monies are being spent wrongly.
Overseas aid, HS2, etc are other projects that should be second after getting our own house in order. There are many other areas where home should come first, but it always falls on deaf ears.

As regards the 'living longer' I would be interested to know what the death rates are today for all ages

[Sir Tigger KC]

This A & E crisis that the media is getting all worked up about is all about targets.

In England 95% of A&E admissions have to be seen within 4 hours, but at my local A&E (Dorset County Hospital, Dorchester) something like 94.6% were seen within 4 hours during December, so it is classed as failing or in crisis! Really? 

Maybe the 5.4% who had to wait longer than 4 hours, were those who could or should have waited to see their GP later in the day or even the following day!   

Maybe Triage Nurses should have the power to send people away with instructions to make an appointment with their GP!    I bet that would help things along somewhat!   

Also the statistics are much worse in Wales where 83.8% got seen within 4 hours during November.  So why aren't the BBC and Labour getting in a lather about those figures?  Maybe it might have something to do with the fact that the Welsh NHS is run by the Labour Welsh Government!     Ooops! 

[Kevin Wood]

This A & E crisis that the media is getting all worked up about is all about targets.

In England 95% of A&E admissions have to be seen within 4 hours, but at my local A&E (Dorset County Hospital, Dorchester) something like 94.6% were seen within 4 hours during December, so it is classed as failing or in crisis! Really? 

Maybe the 5.4% who had to wait longer than 4 hours, were those who could or should have waited to see their GP later in the day or even the following day!   

Maybe Triage Nurses should have the power to send people away with instructions to make an appointment with their GP!    I bet that would help things along somewhat!   

Yes, this might well be part of the problem. As soon as you have targets, they distort the motivations of the staff away from pure clinical need. Once someone is in the "system", the clock starts ticking and they need to be "seen" within 4 hours, and telling them to sling their hook and stop being so silly doesn't register as "seen" so a worthy patient gets to lie on a bed in a corridor until they can think of something to prescribe to the time waster.

Besides, it's a busy time of year, as we're all told. If the system was meeting its' targets at all times, busy included, there's be unacceptable wastage at slack times of the year.

Not that I'm an expert in hospitals, but I've seen reliance on metrics over common sense @rse up plenty of other systems.

[The Sheriff]

To those of you who blame immigrants for the problems in the NHS. I agree, to a point but, unfortunately, if we sent them all home there wouldn't be any doctors at all. 

[Varche]

This A & E crisis that the media is getting all worked up about is all about targets.

In England 95% of A&E admissions have to be seen within 4 hours, but at my local A&E (Dorset County Hospital, Dorchester) something like 94.6% were seen within 4 hours during December, so it is classed as failing or in crisis! Really? 

Maybe the 5.4% who had to wait longer than 4 hours, were those who could or should have waited to see their GP later in the day or even the following day!   

Maybe Triage Nurses should have the power to send people away with instructions to make an appointment with their GP!    I bet that would help things along somewhat!   

Waiting up to four hours at A and E to be seen? I think that is outrageous. I would expect to be seen within minutes of arriving with a genuine problem not my tattoo hurts. I only have two experiences thank goodness of A and E in Spain. Both those were waiting time of less than five minutes AND I suspect someone eyeballed the incomers to drop what they were doing.

You have to have targets otherwise it cannot be managed. maybe the targets need refining.

I like the Triage on your bike idea for non A and E cases.

Another thing that should be charged is drunks with a double charge for violent drunks. I would have separate units for them (in the old days they were called police cells) and they would be funded by a tax on drinks companies.

I currently have an aunt in law in hospital waiting for care(4 times a day) to be available so she can go home. 15 weeks of which the bed blocking might be 8 or 9.

[TheBoy]

The money UK plc pay on overseas aid and EU membership etc would make the square root of sod all difference.

2 problems affect the NHS - inefficiency and the way society use A&E instead of GPs (I accept GPs (or rather the bloody receptionists) do make it difficult, as Kevin Wood says, they are only interested on targets).

[Taxi_Driver]

This A & E crisis that the media is getting all worked up about is all about targets.

In England 95% of A&E admissions have to be seen within 4 hours, but at my local A&E (Dorset County Hospital, Dorchester) something like 94.6% were seen within 4 hours during December, so it is classed as failing or in crisis! Really? 

Maybe the 5.4% who had to wait longer than 4 hours, were those who could or should have waited to see their GP later in the day or even the following day!   

Maybe Triage Nurses should have the power to send people away with instructions to make an appointment with their GP!    I bet that would help things along somewhat!   

Also the statistics are much worse in Wales where 83.8% got seen within 4 hours during November.  So why aren't the BBC and Labour getting in a lather about those figures?  Maybe it might have something to do with the fact that the Welsh NHS is run by the Labour Welsh Government!     Ooops! 

Really! I had to visit Dorchester A&E a few years ago, to have a dressing changed on my hand...l got seen to in 10mins!!!

[Field Marshal Dr. Opti]

The money UK plc pay on overseas aid and EU membership etc would make the square root of sod all difference.

2 problems affect the NHS - inefficiency and the way society use A&E instead of GPs (I accept GPs (or rather the bloody receptionists) do make it difficult, as Kevin Wood says, they are only interested on targets).

When I book an appointment they always ask what the problem is.

I always reply. I'll discuss that with the doctor thanks, not you.

Most of these women  seem to be 'enjoying' the menopause. I'm not about to trust them with ahem...ahem.....delicate medical details. Discreet they are not.