View Full Version : NHS Neglect! A-G-A-I-N
M Swanson
07-Feb-13, 09:40
Yet again, we have a harrowing report on hospital neglect of old patients in Stafford, but it's likely to be elsewhere! I know this firsthand, because I work, five days a week, feeding and helping poor souls, to try and improve their quality of life. Despite the vast sum of money which is poured into the NHS, the standards are falling, although in all honesty, geriatrics has never been a high priority, since I trained decades ago. I don't know what's to be done about it, but the abuse has got to stop. All the money in the world won't buy caring and the right staff and management.
We all have to get old. Perhaps, we need to be more hands-on?
http://www.google.co.uk/#q=stafford+nhs+in+the+independent&hl=en&tbo=u&source=univ&tbm=nws&sa=X&ei=cWYTUaXVKoWc0QWEkoHgDg&sqi=2&ved=0CC0QqAI&bav=on.2,or.r_gc.r_pw.r_qf.&bvm=bv.42080656,d.d2k&fp=ffbd20575db1c5e7&biw=1333&bih=657
It was a pritty disgusting report that was released the other day and I think there is more to come. I have worked for the NHS several times and both my parent work in the health service as a result I have always been going into hospitals pritty much all my life. The biggest change I have seen over the years is in nursing staff. The profession used to focus on the care, comfort, rehabilitation and wellbeing of the patiant. Now they treat patiants like part of a production line and not as real people, staff are driven by targets on how fast a patiant can get home. I think this has got something to do with nursing becoming an academic profession rather than the vocational profession it once was.
The biggest change I have seen over the years is in nursing staff. The profession used to focus on the care, comfort, rehabilitation and wellbeing of the patiant. Now they treat patiants like part of a production line and not as real people, staff are driven by targets on how fast a patiant can get home. I think this has got something to do with nursing becoming an academic profession rather than the vocational profession it once was.
IMHO the words highlighted in red are wrong so wrong.Those should be changed to management.Nursing staff on the whole are busting their guts every time I have been in the hospital as a patient trying to do their damnedest for the patients given the restrictions they are working in.Management are the ones who seem to have lost all vision of patient care due to their focus on targets and how much it costs to keep a patient in a second longer than needed.Nursing to many is still a passion but to management huh they need to take a few weeks back on the ground floor for a reality check as far as I can see !!
IMHO the words highlighted in red are wrong so wrong.Those should be changed to management.Nursing staff on the whole are busting their guts every time I have been in the hospital as a patient trying to do their damnedest for the patients given the restrictions they are working in.Management are the ones who seem to have lost all vision of patient care due to their focus on targets and how much it costs to keep a patient in a second longer than needed.Nursing to many is still a passion but to management huh they need to take a few weeks back on the ground floor for a reality check as far as I can see !!
Thats a good point. My comment was about what i physically see in the hosptials and the changes in nursing practice is the biggest thing I have seen. That is due not just because of managers but politicians too and yes some of it down to the attitude of the staff themselves.
There is not one answer. The culture of the NHS has to change and that can only be driven by the politicians and the control they have over priorities and targets. The intellectualising of the profession has excluded many who have the right attributes but the wrong academic ability. The proliferation of 'managers' sometimes at the expense of clinical staff needs to change and the privatisation of the NHS must stop. There is no one taking responsibility for anything as is evident by the lack of responsibility shown by the trust involved. The whole care of the elderly and vulnerable is shocking and terrifies the life out of me. We need to look to other countries to see how they run their health service and take the best of that and the best of ours and start from the beginning. Lets see if westminster has the guts to do that....
Yes it is shocking and a disgrace that no one at the top has been charged, sacked etc. Lets us remember though that this is the English NHS. I am not saying that it could not happen here in Scotland but the 2 organisation are now different. England, Wales, NI & Scotland now have their own NHS and are run in different ways.
Yes it is shocking and a disgrace that no one at the top has been charged, sacked etc. Lets us remember though that this is the English NHS. I am not saying that it could not happen here in Scotland but the 2 organisation are now different. England, Wales, NI & Scotland now have their own NHS and are run in different ways.
I'm all for less managers and more nurses and doctors. BUT... it is the front line staff that have the regular contact with patients. If anyone is responsible for their neglect or even abuse.........
Scrap the NHS as is and start again.
tonkatojo
07-Feb-13, 15:57
Scrap the NHS as is and start again.
Are you part time "bupa" salesman Phill, for all it's many faults politicians have jiggered it for decades instead of listening and taking heed.
Are you part time "bupa" salesman Phill, for all it's many faults politicians have jiggered it for decades instead of listening and taking heed.It's the decades of jiggering that is part of the problem, and the management culture. It has been jiggered past recoverable with institutionalised incompetent management looking to keep a tidy retirement pot.
tonkatojo
07-Feb-13, 16:13
It's the decades of jiggering that is part of the problem, and the management culture. It has been jiggered past recoverable with institutionalised incompetent management looking to keep a tidy retirement pot.
Aye agreed, but going the private route is not a good idea either partly or fully,free at the point of need should be maintained, but cut out all the health tourism and the like, with a return to origin policy or valid credit debit card and a bupa application form with it. Mind I do not agree with private health full stop so the latter is wishful thinking by me.
No, private business is not the answer for the delivery of a health service. However it does need an element of business / commercial management, in its current form the NHS just hemorrhages money as many managers have no real grasp of balancing cash flow, they just know how to dispose of a budget.
billmoseley
07-Feb-13, 21:50
maybe the health service needs dividing into 2. emergency and medical treatment free to all. then another part for cosmetic and non life threatening pay for by some sort of compulsory insurance. ( he says putting his head on the block). The nhs is fantastic and works great but it is a bottom least pit when it comes to money.
....All the money in the world won't buy caring and the right staff and management.....
True.... But.... The lack of money may contribute significantly to the lack of caring & the wrong staff....
Of course lack of care is not unique to the NHS, we've seen the worse examples of neglect in the private sector, especially in elderly care over the years.
IMHO the words highlighted in red are wrong so wrong.Those should be changed to management.Nursing staff on the whole are busting their guts every time I have been in the hospital as a patient trying to do their damnedest for the patients given the restrictions they are working in.Management are the ones who seem to have lost all vision of patient care due to their focus on targets and how much it costs to keep a patient in a second longer than needed.Nursing to many is still a passion but to management huh they need to take a few weeks back on the ground floor for a reality check as far as I can see !!
Yep...agree completely. Been in hospital a few times over my lifetime since the 1960s...as have members of my family..and you know something, the problem isn't with the staff per se....but the whole way the UK has gone since the 1970s. When you have more mangers, earning silly money in proportion to the numbers of doctors and nurses....what care do managers provide to the punter? ; when meeting targets is the imperative which forms the basis of everything a Health Authority has to focus on, and patient considerations have no legal weight.....why would anyone think that, if governments don't give a toss, anyone working in the Health Service will do what they don't have to, miss their targets and then get kicked up the bum by the managers passing on their government arse-kicking?
Why would anyone with an ounce of commonsense believe that transforming nursing into a career with prospects, with the need for qualifications up to degree level, would not completely remove those who once went into nursing as a calling to nurse patients, and not as a method of becoming a nurse manager once they had been trained in basic nursing, during a working shift by actual working nurses with patients to see to, dozens of forms to complete etc.....as if those working nurses had nothing else to do in life but babysit the theoretically qualified nurses who wouldn't know a bedpan if it louped up and bit them. (OK, so I'm exaggerating a bit with the last, but not that much.)
maybe the health service needs dividing into 2. emergency and medical treatment free to all. then another part for cosmetic and non life threatening pay for by some sort of compulsory insurance. ( he says putting his head on the block). The nhs is fantastic and works great but it is a bottom least pit when it comes to money.
Agree.,,,,,,been saying on forums for years that the NHS was intended as a health benefit from cradle to grave.......not for elective procedures which make people feel better in themselves but are not essential for maintaining either health or life.
It's bad enough, cost-wise to the tax-payer, that we appear to do bowing down before pharmaceutical companies who come up with drugs, because that is what they do to make profits, and then come up medical names for problems, persuading the medical fraternity (mostly the psychiatric lot) they will cure problems which never existed before the pharm companies invented them. I was born in 1947, have been painfully shy for my whole life..but coped well enough to marry, have kids, get a good education and hold down a fairly responsible job....today, I'd have Social Anxiety Disorder/Social Phobia and be pumped full of unnecessary, and expensive, drugs.
The world is going to hell...in a hand-basket.....and we are paying to gold plate the bliddy thing!
All the money in the world won't buy caring and the right staff and management
True.... But.... The lack of money may contribute significantly to the lack of caring & the wrong staff....
If properly allocated and a sensible view taken on staffing, a better allocation of funding could increase the numbers of Nurses, reduce the nurse to patient ratio and allow them more time to simply nurse rather than 'deliver' a care plan to a maximum number of patients.
....today, I'd have Social Anxiety Disorder/Social Phobia and be pumped full of unnecessary, and expensive, drugs.Really? Or in a better ran system you may get access to some counseling that may help with any anxiety. Less cost but meeting patient needs.
In it's current form there is an institutional legacy of pish poor management coupled with a historic watch and wait approach to medicine, 'We've always done it this way' is one mantra, this then leads to a complete hatchet job of private sector 'modernisation' to 'streamline' & 'modernise' which we know means wholesale cuts because no one is able to adapt.
Best bet, start again.
M Swanson
08-Feb-13, 10:16
I agree with Phil on this one. I think the best way forward is to scrap the present system and start again.
There are several good points raised in the thread and I'll pick up on a couple, if I may. The first is regarding cosmetic surgery, which is reported to be costing the NHS millions a year. Take for example, my friend's wife in London. When in her 70's, she chose to pay privately for an £8K tummy tuck. There were complications and she was admitted to hospital for corrective surgery. She was there for three weeks and it's left her needing to have other procedures, for the rest of her life. All this costs a fortune and for what? Private clinics are springing up everywhere, so it must be big business.
Health tourism also costs the NHS millions of pounds, but there's nothing new about this. I was first made aware of it, in London, in the 70's. It was a very well organised business, offering attractive packages to overseas patients. If you want an International Health Service then fine, but no point complaining if, or when the NHS collapses under the weight.
I'd like to see the old system of State Enrolled nurses return. These nurses were not able to reach the required level of education to aim higher, but they were, in my experience, the backbone of the health service we provided then. None were more competent at hands-on care and the system would have ground to a halt without them. Every ward had a cleaner, who was also a vital member of staff. They would often take up the slack when needed.
Just a few ideas to add to the pot. :cool:
We need to be careful with the issue of elective and perceived cosmetic surgery as this quickly drifts to the like of smokers not getting cancer treatment, Sunday league footballers not getting their broken legs fixed etc. These are very minor cost issues in the scheme of things but the source of 'smoke & mirrors' diversions from some if our favourite newspapers.
Health tourism is an issue but not one that the NHS can easily tackle, more joined up work is required with a better staffed Border Force and some review (repatriation) of our EU commitments. But again the costs here are tiny in comparison but would no doubt make the front page of future bog paper.
… Now they treat patiants like part of a production line and not as real people, staff are driven by targets on how fast a patiant can get home. I think this has got something to do with nursing becoming an academic profession rather than the vocational profession it once was.
No, it has nothing to do with the nursing staff. They are doing the absolute best they can with the extremely limited funding from central government. It's all to do with lack of beds and pressure from government via management to send 'bedblockers' home.
cptdodger
08-Feb-13, 13:30
I have been in and out of hospitals since 2007 (mainly Ninewells, Dundee and Caithness General, Wick) for a multitude of horrendous procedures. The last one I was in two minds whether or not to report the surgeon for assault ! However, I cannot fault the nurses in either hospital, they literally held my hand through these procedures. The care and understanding and support was second to none. You can teach anyone to become a nurse (academically speaking) but you can't teach compassion. I have always said, nursing is a vocation not a job. And it is not a job I could do.
How do you get the message through that we (you) might be old and vulnerable some day. I do believe that is where some of the answers lie when it comes treating the eldery. If nurses docors all carers could see through the eyes of the people they are looking after things I am sure things would start to cahnge.
M Swanson
09-Feb-13, 08:57
The first principle of nursing was that the treatment and care of the patient was the highest priority. Nothing came above that and it was drilled into us from day one of our training. Whilst most, I believe, still observe that, some who would be better employed elsewhere, do not. This applies equally to private care and NHS services. It is a real problem and to ignore it, is to ensure that nothing will change and as with the Stafford hospital neglect will continue. It may be only one of several areas of major concern, but it does exist, imo. Nurses are not all "angels" and never have been. Although this can be applied to all other professions, the consequences, as we have witnessed recently, can be catastrophic.
In my day, Matron reigned supreme. Her word was law and she never compromised standards .... her authority was absolute. She was highly trained and experienced in the running of the hospital. We never had all the managers prevalent today, who know nothing of what the position requires. The only other person of note was the Principle Medical Officer and together they assumed total responsibility for the provision of care. I could never imagine, anyone in such a position, failing so badly and yet being rewarded with a golden handshake, upon resignation as happens now. How ludicrous that we now have more administrators than patients.
I'm hoping Stafford is the wake-up call that we so badly need. People are dying from neglect. How did we ever let it get to this?
oh dear I am afraid that I am going to tangle two threads here but I am not doing it out of mischief but because I think it is a valid point so apologies.
M Swanson you ask how did we ever let it get to this. Well its been getting to this for the last thirty years. There are several key issues. Firstly the Thatcher years began to create a culture where profit was more important than people. The privatisation of the nationalised industries and the diminishing of Public services really began here. I know that there is a whole thread devoted to the glorious "Margaret Hilda" but under her leadership the application of profit seeking to public services diminished their ability and their desire to provide a service to the people using them. The unemployment of the 80s helped to drive the me me me culture that pervaded the 90s and I think had led to the complete lack of empathy and compassion we find in our society today. Latterly the demonisation and villification of the sick, disabled and vulnerable haa continued to dehumanise individuals. . Disastrous policies from New Labour over PFI shackled many NHS Trusts to massive costs. The desire for central government to manage this, continually improve that, drive down this and slash that has helped to reduce staffing levels to the bone on the clinical side of things whilst increasing managers and administrators. The intellectualising of Nursing may have contributed to this although i am loathe to say that nurses shouldnt be academically qualified to degree standard but i think there should be levels underneath that which allow those without academic qualifications to enter the profession and focus on the less clinical caring that is so important.
To blame the nurses on the wards is to misunderstand the way that a culture within an organisation impacts on its staff. If they are working in a culture where patient care is of little importance, where they are told off for sitting chatting to a patient, where they are expected to work 12 hour shifts and if they dont get their lunch at the time they should they dont get it at all, where their toilet breaks are monitored and where they are not allowed to stand and chat or even catch their breath, then patient care WILL come secondary. If all the meetings they attend are about cuts, time management, processes, savings, efficiencies then patient care will slip down the agenda and become less and less important until it is the least important of all.
Despite this there is individual responsibility and it is unforgiveable that anyone, never mind a nurse, the tea lady, the cleaner, the myriad of people that traipse backwards and forwards on a ward during the day left people without water, stinking in their own urine crying with pain and misery and did nothing about it. But then maybe we are back to what I said earlier, the lack of compassion and empathy in today's society - which perhaps is the true legacy of the Thatcher years.
M Swanson
09-Feb-13, 14:33
Squidge wrote:-
'Despite this there is individual responsibility and it is unforgiveable that anyone, never mind a nurse, the tea lady, the cleaner, the myriad of people that traipse backwards and forwards on a ward during the day left people without water, stinking in their own urine crying with pain and misery and did nothing about it. But then maybe we are back to what I said earlier, the lack of compassion and empathy in today's society - which perhaps is the true legacy of the Thatcher years.'
I suppose it was inevitable that politics would enter the discussion, which I must say, I tried to steer clear of, because I wanted my posts to be about my own training and experiences, when applied to the harrowing abuse of some vulnerable patients today, but I fully accept that politics has contributed so much to this awful state of affairs.
But what needs to be said, is that despite any changes MH made, the Labour governnment had years to overturn privatisation, yet they didn't. In fact, one of the first new pieces of legislation they made, was passed in 1997 which stipulated that in any private finance initiative scheme, that went broke, the debt would be picked up by the Secretary of State for Health! This was much further than MH went. Hmmmmmm ! It was Blair who converted NHS Trusts into Independent Foundation Trusts, including private treatment centres paid for by public funds. This most definitely is one of the true legacies of Blair and the Labour Party.
I would like to see a return to the days when the first requirements of nurses, was their compassion and willingness to work hard to provide the very best treatment possible. They should also have the right to be heard when they feel the care has slipped below an acceptable level. Too much emphasis is put on achieving higher qualifications, instead of valuing the terrific work done by those, who may not be so academically bright, but whose talent lies in dealing, compassionately with people in need. There wasn't a finer group of nurses, than the SEN's, imo. We should weed out the lazy, uncaring, bad eggs! Every profession has some, (as the recent report on Stafford testifies), but there is no harsher consequence for indifference, than the death of poor folks, whose only crime is getting old.
Please don't think I'm living in the past. I may be old, but I'm still very much hands-on today. Perhaps if more of us who don't wear the uniform, took a little of our time to help out with feeding, or in any other way, we could help effect the changes so needed. I am never backwards about coming forwards, trust me! :D As I've said .... you can't buy caring, but we can expose the lack of it. If not, we'll get what we deserve!
I you sure she wasn't Margaret Hitler?
Unfortunately trying to talk about NHS failings without discussing politics is like trying to make an omelette without breaking eggs. You cant! I do agree with you M Swanson, the Labour party had disastrous policies too. The meddling year on year on year and the drive for profits has led to where we are now.
If nurses docors all carers could see through the eyes of the people they are looking after things I am sure things would start to cahnge.That may be a small part of the problem but the bigger one I believe, is the staff to patient ratio.
It's tick box care based on the minimum cost to the maximum deliverable according to some vague time management review. A nurse can change X beds, take X pulses, deliver X tablets and do XY & Z in a shift. There is no time for compassion, no time to comfort patients or speak with relatives, there is no capacity for the unforseen or ability to absorb being a member of staff down.
M Swanson
10-Feb-13, 11:04
That may be a small part of the problem but the bigger one I believe, is the staff to patient ratio.
It's tick box care based on the minimum cost to the maximum deliverable according to some vague time management review. A nurse can change X beds, take X pulses, deliver X tablets and do XY & Z in a shift. There is no time for compassion, no time to comfort patients or speak with relatives, there is no capacity for the unforseen or ability to absorb being a member of staff down.
I believe it may be a bigger part of the problem than you think it is Phil. This changed attitude to caring, begins at the top, with executives and administrators receiving huge salaries in a field for which they have possess no expertise, to the nursing and domestic staff. I know it must be variable, but in my own area, there are two large hospitals and their staff to patient ratio is extremely good. It was so very different in my day and yet the length of time patients spent in our care was much longer. In a way, this was preferable, because it gave us a much better opportunity to get to know them and their specific needs, although I appreciate that nobody likes to stay longer than is absolutely necessary. I would rather have a staff of three of us, looking after 40+ patients, who were dedicated to their work, than a dozen with a couldn't care less attitude.
Then, the importance of hygiene was instilled in all of us. How shocking it was, when I first encountered a ward sign, instructing the patient to ask their doctor to clean their hands before examining them! Unbelievable! We were taught to scrub our hands, up to the elbow, between attending to patients and afterwards to disinfect lockers and the bed areas. It was second nature to us. I know I've made several references to the smaller details of the problems so prevalent today, but they all add to the general picture.
We found time for compassion Phil and I believe the time and opportunities are still there for today's hospital carers. It's different with Care Homes, because the recruits tend to be young and the vast majority don't last long. Their workload is far greater and generally has a much worse staff to patient ratio.
Then, the importance of hygiene was instilled in all of us. How shocking it was, when I first encountered a ward sign, instructing the patient to ask their doctor to clean their hands before examining them! Unbelievable! We were taught to scrub our hands, up to the elbow, between attending to patients and afterwards to disinfect lockers and the bed areas. It was second nature to us. I know I've made several references to the smaller details of the problems so prevalent today, but they all add to the general picture. .
I was concerned last year when I went to Raigmore hospital to visit someone and there was no soap in the toilet. OK, these things run out and have to be replaced. So I informed the duty staff. The following two days showed no improvememnt, there was no soap in the same toilet. The duty nurse informed me that the private cleaning firm was poor at taking intervention actions like this and was off for the weekend anyway. It should be just a matter of going to a cupboard and getting a new bottle, no but that is too costly for the NHS :roll:. An example of how privatisation is not working in the NHS.
We found time for compassion Phil and I believe the time and opportunities are still there for today's hospital carers.So why are we constantly hearing about the 'frontline' pressure and how everyone is ran off their feet and not enough staff to cope? Just bone idle lazy gits?
M Swanson
10-Feb-13, 15:07
That's for you to research, Phill. All I can write about is my own area hospitals, Stafford and a few others. The wards are where the caring takes place and I've witnessed, many times, the kind of couldn't care less attitude of a nurse, who serves a meal that's outside the reach of the patient. How long does it take to do the job properly? I've lost count of the times I've been assigned a number of patient's to assist with eating and the number of additional ones I've added to my list. If I hadn't, the untouched plates would have been hastily removed, without a second thought. How long does it take to run round with a tray of glasses and jug of quash to offer everyone? We always devoted at least two hours, out of our 12 hour shift, to concentrate exclusively on feeding and changing patients, so they were well-fed and comfortable. It was a priority and we worked as a team, for the maximum benefit of the vulnerable. If we were short of staff, then Sister rolled up her sleeves and pitched in too! People are dying of starvation. How can the staff be oblivious to the suffering? How can you not know that Mrs Brown needs changing? Or Mr Smith is wasting away? Or Miss Jones is dehydrated. I don't know if the negligence can be attributed to "bone idle lazy gits." But I do know there are some who just don't care. Gratitude can blind us to flaws in nursing standards. The Stafford Hospital should be a wake-up call for us all.
macadamia
10-Feb-13, 15:34
Can't help noticing that there is a tendency still to blame Margaret Hilda for nearly everything that's gone wrong with UK plc, and is STILL going wrong, since the 1980s, many years after she left the political scene. An innocent question - at what stage will the posturings of all politicians be prohibited from the casual use of the "Thatcher" 'get out of gaol' card? are we going to have to endure many more decades of the blinkered stubbornness which makes people vote along tribal rather than political lines? Are people ever going to give up thinking of themselves just as victims, and becoming more proactive in improving their outlook on life?
M Swanson
10-Feb-13, 15:59
Brilliant post, thanks Macadamia. Your way ensures that things can change. The old route dictates that things will never change.
I've never felt a "victim," in my life, that I can ever remember. I don't like this label ...... it's only worn by those who like to shift responsibilities and consequences elsewhere. The lady's not for excuses! :)
You may not have ever felt like a victim and Macademia may say that "Are people ever going to give up thinking of themselves just as victims, and becoming more proactive in improving their outlook on life?" Those poor people in Stafford WERE victims - and I uae that word in its truest sense and without the sneer that accompanies it in both the previous posts. There is an argument that we have NEVER paid enough National Insurance and so the NHS has been under resourced most of its life. However the Thatcher Government and their policies of privatisation set us on a road to where we are today ably assisted by successive gvernments and their desire to put profits before people. Margaret Thatcher is not to blame for the deaths of those people in Stafford but her policies and her governments contributed to the system which led to their deaths. If you cant see that then it is You who are blinkered and likely to repeat the mistakes of the past...... as we seem to be doing again and again.
M Swanson
11-Feb-13, 00:18
No, I can never remember thinking of myself as a victim, like, as Mac says, is so prevalent today. And what's more, I'm very glad I haven't. I couldn't have achieved half of what I have done, if I'd have fallen into that particular trap. The only one responsible for, and accepting the consequences of, anything that's happened in my life is ............. me. I've never had time to waste looking for others to blame, or excuses not to shape my own destiny. To liken that to Stafford patients is ludicrous. They are vulnerable people who need all the help we can give them. I've never been in that position ......... yet, but I could very well be, just like all of us. It's why I work hard to try and involve others to make even a small effort to change the dreadful abuse. Nobody has sneered anywhere on this thread. Least of all me, but you know that don't you!
I've already highlighted the contribution made by Blair & Co., which far outstrips anything Margaret Hilda did, but you always make scant reference to that. But really what matters, is that we stop playing the blame game and address the dire situation patients find themselves in today. And your banging on about resources, suggests that you do not accept one of the main reasons the abuse happens. Money will never eradicate the cruel treatment. As I've said before, you can't buy caring. So there!
I must admit that I have only skim-read this thread, but I feel grateful that we have the NHS. It's not perfect by a long shot, but it sure beats what we would get in many other parts of the world. It's a great service when you consider the alternatives, and for a fairly young and healthy person like myself it is more a safety net than anything else: one that I consider very secure.
Personally, if the NHS in Scotland were looking for a little income "relief", they should perhaps consider charging certain folk for prescriptions. I seldom need medication and I earn a comfortable enough living. I can afford to pay £5-6 or so for my prescriptions, so that someone who needs medicine on a regular basis doesn't have to. I really wouldn't mind, and I felt a little bad the last time I was prescribed medication when I walked away from the pharmacy without paying for it.
I know I pay tax like everyone else, but the NHS is a real balancing act. I don't mind weighing the balance in favour of those less fortunate in terms of income, health or both.
Oh the saintly, the strong and the righteous - how they love to pat themselves on The back!!!! lets just paraphrase what I did say. Those poor people at stafford were victims of the worst of the society we have allowed to develop over the last 30 odd years which began during the governments of Margaret Thatcher and continued through the Labour years to where we are today with nothing being learnt.
The drive for Profits before people, under resourced clinical staff, over resourced managers, ill thought out PFIs which landed NHS trusts with debts they will never repay, lack of resources as they are diverted to private companies, the drive to academic excellence at the expense of caring and empathy and the mantra that public = bad and Private = good. All these have led us to where we are now which is plenty hospitals doing their absolute utmost to provide excellent care but others where some utterly catastrophic failures have occurred where the things I have mentioned above end up overtaking anything good or worthwhile.
The answer is to look at all of the above and go back to putting people before money. I doubt the political will is there to do that though.
macadamia
11-Feb-13, 09:24
Sorry Squidge - all of this didn't start with Mrs. Thatcher - there are some horrifying tales of brutal management, wage cuts, and extreme poor conditions throughout the so called glory days of the Industrial Revolution and beyond. Remember Coal bosses screwing the workers with compliant government in the background? Kids up chimneys and child labour at pittance rates? Pensions a waste of time (if they existed) because of hard, grinding work which wore men and women out before they could pick it up: and no welfare state to support those who didn't work. Men standing in crowds on the off chance of a day's casual work. Diphtheria, smallpox, polio, TB, rickets, unsanitary conditions, murderous smog, and the genuine howls of the hungry. Please do not wave the sword of comparative poverty today as opposed to the real poverty of yesterday. Yes, we could do better. Yes, some fall between the cracks. But don't for one moment pretend that over the last fifty years, life hasn't got better for most people - not just the bloated plutocrats and the silver spoon brigade! And let's not kid ourselves - better and instant communications reveal much more quickly and accurately those "pockets of resistance" such as crap hospitals and government departments. More sins of commission and omission are being discovered sooner and more effectively than ever before. I remain hopeful, and positive about all our futures.
cptdodger
11-Feb-13, 10:37
Aye agreed, but going the private route is not a good idea either partly or fully,free at the point of need should be maintained, but cut out all the health tourism and the like, with a return to origin policy or valid credit debit card and a bupa application form with it. Mind I do not agree with private health full stop so the latter is wishful thinking by me.
About twenty years ago now I was having terrible problems with my health, (I wont go into all the gory details!) every month I was in terrible pain which caused me to either be physically sick or in some instances pass out with the pain. For over six months I was going back and forward to the GP for tests, then he referred me to the local hospital, when I went there, they were just going to carry out identical tests, which at that point showed nothing, so I left. I was actually beginning to question my sanity! My now ex husband had Bupa which covered him and myself, so I went back to the GP and got referred to a private hospital.
I had the first appointment on the Monday, by the Wednesday I was in having a laparoscopy, which showed the problem, the following Monday, I had the operation to resolve the issue (which thank goodness it did).
While I understand what you are saying about private health care tonkatojo, it was a last resort for me. If it had'nt been for that, I highly doubt I could have gone on much longer suffering that pain. And I certainly would not want to get to a point whereas private medicine was our only option as in America. All I can say is it helped me when I really needed it.
My dad was admitted to hospital as an emergency on Boxing day. He was given his own room, he had lots of tests including MRI scan and others. He had a lovely meal on New Years Eve. He was looked after brilliantly and he is 77. It turned out to be a reaction to some medication he had for high blood pressure but the staff made absolutely sure it was nothing else. He lives in France and was in a hospital in a small town. It cost him nothing. He came out looking like he had been on holiday... My poor mum and sister however were exhausted!!!! Maybe we need to look to other countries in Europe to see how they do it. Whenever alternatives are suggested it seems to be the US that is suggested as the alternative. Maybe its time to change that.
There is a legacy in the NHS by clinicians to watch & wait, backed up by outdated management. It appears t be the cheapest option. Do a few tests and wait, then maybe some more and wait again.
All the while huge amounts of cash are being wasted by 'managers' who have either come from nursing / clinician staff but without actual management ability i.e. based on length of service. Or completely outside public service management who don't have a clue about healthcare but can piss a good budget up the wall like the others.
Add to that a lot of empire building and serving their own pension pots, the waste is horrific.
But those hospitals that are more proactive and operate on a more modern management & clinical system can treat people quickly and efficiently, often it is about pushing through change but people don't like change, unions don't like change ("We've always done it this way!"). So rather than an organic modernisation we have pillar to post cuts and privatisation to 'streamline' services.
It's now so screwed up and stuck with a legacy of incompetence I do think the best option is a ground up re-start.
tonkatojo
11-Feb-13, 12:42
[QUOTE=cptdodger;1007152]About twenty years ago now I was having terrible problems with my health, (I wont go into all the gory details!) every month I was in terrible pain which caused me to either be physically sick or in some instances pass out with the pain. For over six months I was going back and forward to the GP for tests, then he referred me to the local hospital, when I went there, they were just going to carry out identical tests, which at that point showed nothing, so I left. I was actually beginning to question my sanity! My now ex husband had Bupa which covered him and myself, so I went back to the GP and got referred to a private hospital.
I had the first appointment on the Monday, by the Wednesday I was in having a laparoscopy, which showed the problem, the following Monday, I had the operation to resolve the issue (which thank goodness it did).
While I understand what you are saying about private health care tonkatojo, it was a last resort for me. If it had'nt been for that, I highly doubt I could have gone on much longer suffering that pain. And I certainly would not want to get to a point whereas private medicine was our only option as in America. All I can say is it helped me when I really needed it.[/QUO
It is good you got sorted, but my point is if there were no private facilities they would be put on the NHS, I cannot say for certain but most operations done in the "private" health are done not by private doctors but NHS ones on the side, now if the "private" was not available the doctors would have more time for NHS patients and beds in NHS would not be set aside for private income. When these NHS beds are used for "private" use do they employ extra nurses and suplies for them or are the normal staff used, I know which I think are. Do bupa hospitals have their own doctors trained by them or nursing staff ?.
My opinion is there should be no private health in the UK as it takes from the NHS and those who cannot afford health insurances suffer as they are further down the lists, but the cry will be, richer more well off can afford to pay to jump the queue, well pay the NHS to do them so all can benefit from the extra income not the moonlighting personel as is now and perhaps the waiting times in hospitals will come down and the extra income will buy the new equipment for all to use not the chosen few. Just my opinion.
cptdodger
11-Feb-13, 13:05
Honestly, I do agree with what you are saying. In my case the consultant I had was private and not part of the NHS in any way, but, I cant answer for the rest of the medical staff there (http://www.bmihealthcare.co.uk/fawkham). And back then we would not have been able to afford private medical insurance, that was just something that was given to my ex husband by his employers, so it was a fluke really.
And sorry for being cynical, but if NHS doctors are doing private medicine on the side, if that option was taken away from them, would they remain in Britain or go where the money is? but that is me just being cynical !! I honestly do not know what the answer is.
I can't comment on the politics of the NHS, only on my experiences that I have had within the NHS, but I will say, I have never had a problem with the nursing staff, in any hospital I have been in (and I have been in quite a few both in England and Scotland !)
tonkatojo
11-Feb-13, 13:11
Honestly, I do agree with what you are saying. In my case the consultant I had was private and not part of the NHS in any way, but, I cant answer for the rest of the medical staff there (http://www.bmihealthcare.co.uk/fawkham). And back then we would not have been able to afford private medical insurance, that was just something that was given to my ex husband by his employers, so it was a fluke really.
And sorry for being cynical, but if NHS doctors are doing private medicine on the side, if that option was taken away from them, would they remain in Britain or go where the money is? but that is me just being cynical !! I honestly do not know what the answer is.
I can't comment on the politics of the NHS, only on my experiences that I have had within the NHS, but I will say, I have never had a problem with the nursing staff, in any hospital I have been in (and I have been in quite a few both in England and Scotland !)
I wasn't being critical of you sorry if it came across that way.
cptdodger
11-Feb-13, 13:21
Honestly, you did'nt, I know you were not being critical of me ! It's just the situation that is very frustrating regarding the NHS, and the problems it has today.
[QUOTE=cptdodger;1007152]About twenty years ago now I was having terrible problems with my health, (I wont go into all the gory details!) every month I was in terrible pain which caused me to either be physically sick or in some instances pass out with the pain. For over six months I was going back and forward to the GP for tests, then he referred me to the local hospital, when I went there, they were just going to carry out identical tests, which at that point showed nothing, so I left. I was actually beginning to question my sanity! My now ex husband had Bupa which covered him and myself, so I went back to the GP and got referred to a private hospital.
I had the first appointment on the Monday, by the Wednesday I was in having a laparoscopy, which showed the problem, the following Monday, I had the operation to resolve the issue (which thank goodness it did).
While I understand what you are saying about private health care tonkatojo, it was a last resort for me. If it had'nt been for that, I highly doubt I could have gone on much longer suffering that pain. And I certainly would not want to get to a point whereas private medicine was our only option as in America. All I can say is it helped me when I really needed it.[/QUO
It is good you got sorted, but my point is if there were no private facilities they would be put on the NHS, I cannot say for certain but most operations done in the "private" health are done not by private doctors but NHS ones on the side, now if the "private" was not available the doctors would have more time for NHS patients and beds in NHS would not be set aside for private income. When these NHS beds are used for "private" use do they employ extra nurses and suplies for them or are the normal staff used, I know which I think are. Do bupa hospitals have their own doctors trained by them or nursing staff ?.
My opinion is there should be no private health in the UK as it takes from the NHS and those who cannot afford health insurances suffer as they are further down the lists, but the cry will be, richer more well off can afford to pay to jump the queue, well pay the NHS to do them so all can benefit from the extra income not the moonlighting personel as is now and perhaps the waiting times in hospitals will come down and the extra income will buy the new equipment for all to use not the chosen few. Just my opinion.
It is as likely to be the other way round i.e. private Consultants also working in the NHS.
tonkatojo
11-Feb-13, 19:20
[QUOTE=tonkatojo;1007184]
It is as likely to be the other way round i.e. private Consultants also working in the NHS.
Trained where I wonder.
cptdodger
11-Feb-13, 19:52
[QUOTE=ducati;1007219]
Trained where I wonder.
That's an interesting point. I had a look at the website I posted above, and sorry if it's long and drawn out, but this is what it says regarding their consultants -
All consultants treating patients at BMI Healthcare hospitals have fulfilled rigorous eligibility criteria that are used to ensure patients receive the highest possible standard of care.
All consultants are reviewed every 2 years to ensure the upkeep of these criteria. Examples of the criteria include:
Inclusion on the specialist register of the General Medical Council or General Dental Council;
Currently holding a permanent appointment as a consultant or senior lecturer in an NHS hospital, or having equivalent status and clinical experience;
Performing procedures or techniques that are only part of his or her normal practice, which he or she can provide evidence of adequate training and ongoing experience;
Complying with the "Principles for a Private Medicine Clinical Quality Framework" of the Private Practice Forum of the Academy of Medical Royal Colleges;
Meeting the Continuing Medical Education requirements of their relevant Royal College, and for revalidation by the General Medical Council or General Dental Council;
Participating in BMI Healthcare’s clinical audit programme, including National Confidential Enquiries;
Having adequate professional indemnity insurance.
Having never thought of it, I would imagine doctors train to be doctors at university and an NHS hospital, and then after however many years they decide which area to specialize in be it private or NHS.
Many consultants have contracts with the NHS & private hospitals, or their own private practice. It's not exactly on the side or moonlighting.
I believe there is a place for private healthcare but it should be in private practice and private hospitals, the NHS shouldn't be providing it to bolster the coffers.
Without private treatment some may not get any treatment whatsoever.
As for training it is like any other industry, they train people and they may move on or stay, much like a building company with apprentices. Equally the NHS can employ people from outside the NHS or from abroad.
To be honest having a diverse medical / clinical staff background can help to bring in new ideas and procedures and keep pushing medicine forward rather than sitting in the 1950's mentality that some places seem to adhere to.
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