The NHS (National Health Service) Thread

[GingerrrFox]

Personally I feel that the A&E department should remain "free" and any treatment that relates to an accident is free. Also that retired pensioners over the age of 65 should have access to completely free health care.

 

However the rest should have private healthcare insurance (either through company medical insurance or off your own back) and then have access to proper treatment when we need it. What's the difference between having car insurance and home insurance to health insurance?

 

Personally I would rather have first class treatment at a facility fit for purpose rather than be worried about the level of care I would receive simply through over-worked staff with limited budgets that are constrained by outside influences, and it is of my belief that the only way this can happen is by some form of privatisation.

Edited 23 March 2016 by GingerrrFox

[sphericalfox]

Personally I feel that the A&E department should remain "free" and any treatment that relates to an accident is free. Also that retired pensioners over the age of 65 should have access to completely free health care.

 

However the rest should have private healthcare insurance (either through company medical insurance or off your own back) and then have access to proper treatment when we need it. What's the difference between having car insurance and home insurance to health insurance?

 

Personally I would rather have first class treatment at a facility fit for purpose rather than be worried about the level of care I would receive simply through over-worked staff with limited budgets that are constrained by outside influences, and it is of my belief that the only way this can happen is by some form of privatisation.

 

There's a million and one scenarios, exceptions, and possible grey areas where someone might refused treatment, as they would possibly need aftercare brought on by this accident. What happens to the single mother, who's son/daughter has an a life threatening disease or genetic disorder/disability that requires treatment or round the clock care/medications. Do we say no to treating them because it's not A&E? How do they pay for the treatment or medication?

 

If the government spent half the time the spend trying to deliberately try to push hospitals, community hospitals, and primary care to the brink by lying to the public about how much money their pumping into the system extra on top of allocations to the public, in order to trick them into thinking the system is failing no matter what, and should go to efficient private providers, and actually spent time trying addressing areas that would make a difference seeking better ways of collaborative partnership working, then those perhaps the overworked workers of the NHS could provide you more reassurance that they would deliver a safe, efficient, and quality service that makes them proud, and makes a difference to peoples lives who regularly use the system, or those who inevitably will someday.

 

Having worked in private health insurance, denying a multitude of claims daily, because either they didn't have the cover necessary on their policy, they were assessed to have something related to a exclusion, or perhaps didn't include this on their self assessment in fear of being denied treatment/ cover at a later date. Crying pensioners who's claims were being denied because of various reason, but primarily as I recall being because they over the years had to reduce their policy coverage, or their broker did it and didn't explain or they didn't understand what the consequences of this were, when it actually counted.

 

From my experience both private and public, and having experience the American system, privatisation is a downward spiral that only will only result in the poor suffering without any, the rich enjoying paying through the nose for quality care, and those in the middle paying through the nose for barely adequate care.

[GaelicFox]

If they give me back my national insurance and a good lump of my tax I'll happily pay for private healthcare insurance

If you think privatisation alone is the answer pay a visit to ireland where they have a model loosely based on the American model

It's a fecking disaster with people dying on trollies in hospital corridors

The NHS ISNT PERFECT

But it's amazing none the less

[GaelicFox]

There's a million and one scenarios, exceptions, and possible grey areas where someone might refused treatment, as they would possibly need aftercare brought on by this accident. What happens to the single mother, who's son/daughter has an a life threatening disease or genetic disorder/disability that requires treatment or round the clock care/medications. Do we say no to treating them because it's not A&E? How do they pay for the treatment or medication?

If the government spent half the time the spend trying to deliberately try to push hospitals, community hospitals, and primary care to the brink by lying to the public about how much money their pumping into the system extra on top of allocations to the public, in order to trick them into thinking the system is failing no matter what, and should go to efficient private providers, and actually spent time trying addressing areas that would make a difference seeking better ways of collaborative partnership working, then those perhaps the overworked workers of the NHS could provide you more reassurance that they would deliver a safe, efficient, and quality service that makes them proud, and makes a difference to peoples lives who regularly use the system, or those who inevitably will someday.

Having worked in private health insurance, denying a multitude of claims daily, because either they didn't have the cover necessary on their policy, they were assessed to have something related to a exclusion, or perhaps didn't include this on their self assessment in fear of being denied treatment/ cover at a later date. Crying pensioners who's claims were being denied because of various reason, but primarily as I recall being because they over the years had to reduce their policy coverage, or their broker did it and didn't explain or they didn't understand what the consequences of this were, when it actually counted.

From my experience both private and public, and having experience the American system, privatisation is a downward spiral that only will only result in the poor suffering without any, the rich enjoying paying through the nose for quality care, and those in the middle paying through the nose for barely adequate care.

Spot on your last paragraph !

[Buce]

Leaked email - Cameron 'starving NHS of funds':

http://www.theguardian.com/politics/2016/apr/01/senior-tories-brexit-vote-leave-attacks-david-cameron-letter-nhs-staff

Edited 2 April 2016 by Buce

[The Doctor]

Personally I feel that the A&E department should remain "free" and any treatment that relates to an accident is free. Also that retired pensioners over the age of 65 should have access to completely free health care.

 

However the rest should have private healthcare insurance (either through company medical insurance or off your own back) and then have access to proper treatment when we need it. What's the difference between having car insurance and home insurance to health insurance?

 

Personally I would rather have first class treatment at a facility fit for purpose rather than be worried about the level of care I would receive simply through over-worked staff with limited budgets that are constrained by outside influences, and it is of my belief that the only way this can happen is by some form of privatisation.

 

So basically you want the American system, which is in no way a massive failure (lags behind the UK and other industrial nations with universal/near universal healthcare in practically every aspect).

 

Genuinely amazing that people would rather have a definitely inadequate privatised service rather than sorting out the issues remaining in an already superior nationalised service.

[Rincewind]

So basically you want the American system, which is in no way a massive failure (lags behind the UK and other industrial nations with universal/near universal healthcare in practically every aspect).

 

Genuinely amazing that people would rather have a definitely inadequate privatised service rather than sorting out the issues remaining in an already superior nationalised service.

I think it may be the ones that either use or can afford the private medical care that are in favour of it. To go for NHS care would mean receiving inadequate care in their eyes.

Although I hope that it is only the minority and the majority are listened to by those in power. 

[Strokes]

So basically you want the American system, which is in no way a massive failure (lags behind the UK and other industrial nations with universal/near universal healthcare in practically every aspect).

 

Genuinely amazing that people would rather have a definitely inadequate privatised service rather than sorting out the issues remaining in an already superior nationalised service.

My experiences with the NHS have been appalling, some more recent than others. I would be in favour of anything radical, restructuring or privatisation.

[Thracian]

As referred to elsewhere I've spent much of the last few days seeing the NHS in action - or mostly inaction - at a Midlands hospital - and, just like you, I've also been appalled at the shortcomings.

 

Negligent and unprofessional inefficiency in one instance, woeful lack of communication most of the time, slowness to facilitate what I believe to be important tests, various consultants failing to agree on the best course of action - perhaps due to lack of sufficient information - yet not doing enough to get that information to hand quickly.

 

And all that  despite the broader NHS taking over a month to consider the problem without yet coming up with a clear diagnosis let alone a best approach to treatment of what seems to be a serious threat.         

 

It also seems as if the NHS  only functions at full throttle from Monday-to-Friday.

 

The staff car park was only sparsely occupied on Friday night, Saturday and Sunday, suggesting that it's more of a skeleton service at weekends rather than a body dedicated to helping as many people as possible as effectively and as quickly as they can - and with all options open all the time.

 

For instance what happens to the MRI machines at weekends? Are they in constant operation? Or are they put into mothballs two days a week? 

And is there such a shortage of them that people are queuing up to use them even on weekdays because that's the way it seems when you need one.    

 

There's plenty of supplementary staff filling forms in and carrying confidential files but hardly a decision-maker to be spoken with from Friday midnight to Monday morning and even when there is someone, once the "bell" goes for their shift ending, that's it, the problem's in someone else's hands and the whole debate seems to start again, going backwards and forwards between the medics with barely a sentence or two of information or explanation to the patient from some doctors.

 

Even soliciting a much-needed commode (required three times in five minutes which suggested a problem in itself) seemed to breed resentment and when someone did take the time and trouble to try to help (on another matter) she was quickly reprimanded by a senior nurse and told to attend to other things forthwith.

 

It's as if everyone's afraid of being held accountable and therefore the less said to the patient or "the public" the better.  

 

I really don't know what should be done for the better but the politics and underlying internal resentment doesn't help and I can easily understand why some would look for an alternative system because the current situation is way below what's needed and an entirely different experience to the exemplary service offered in private hospitals - at least when a friend ended up there in frustration after being offered so little help at the LRI.

 

Of course private practice has nothing like the pressures of the NHS and yet so many within the medical profession still support open borders, wholesale immigration and pressures way beyond the level where they can cope, given that they clearly cannot - or will not - cope properly as it is.         

[Bryn]

As referred to elsewhere I've spent much of the last few days seeing the NHS in action - or mostly inaction - at a Midlands hospital - and, just like you, I've also been appalled at the shortcomings.

 

Negligent and unprofessional inefficiency in one instance, woeful lack of communication most of the time, slowness to facilitate what I believe to be important tests, various consultants failing to agree on the best course of action - perhaps due to lack of sufficient information - yet not doing enough to get that information to hand quickly.

 

And all that  despite the broader NHS taking over a month to consider the problem without yet coming up with a clear diagnosis let alone a best approach to treatment of what seems to be a serious threat.         

 

It also seems as if the NHS  only functions at full throttle from Monday-to-Friday.

 

The staff car park was only sparsely occupied on Friday night, Saturday and Sunday, suggesting that it's more of a skeleton service at weekends rather than a body dedicated to helping as many people as possible as effectively and as quickly as they can - and with all options open all the time.

 

For instance what happens to the MRI machines at weekends? Are they in constant operation? Or are they put into mothballs two days a week? 

And is there such a shortage of them that people are queuing up to use them even on weekdays because that's the way it seems when you need one.    

 

There's plenty of supplementary staff filling forms in and carrying confidential files but hardly a decision-maker to be spoken with from Friday midnight to Monday morning and even when there is someone, once the "bell" goes for their shift ending, that's it, the problem's in someone else's hands and the whole debate seems to start again, going backwards and forwards between the medics with barely a sentence or two of information or explanation to the patient from some doctors.

 

Even soliciting a much-needed commode (required three times in five minutes which suggested a problem in itself) seemed to breed resentment and when someone did take the time and trouble to try to help (on another matter) she was quickly reprimanded by a senior nurse and told to attend to other things forthwith.

 

It's as if everyone's afraid of being held accountable and therefore the less said to the patient or "the public" the better.  

 

I really don't know what should be done for the better but the politics and underlying internal resentment doesn't help and I can easily understand why some would look for an alternative system because the current situation is way below what's needed and an entirely different experience to the exemplary service offered in private hospitals - at least when a friend ended up there in frustration after being offered so little help at the LRI.

 

Of course private practice has nothing like the pressures of the NHS and yet so many within the medical profession still support open borders, wholesale immigration and pressures way beyond the level where they can cope, given that they clearly cannot - or will not - cope properly as it is.         

There are measures of truth and of ignorance in this.

 

I think clear communication is pivotally important in healthcare. I know from feedback I receive on my placements that it's my personal strong suit. I'm inferior when it comes to practical skills compared to some of my peers, my clinical knowledge is average and some people are better under pressure but I know I communicate well and I know how much it improves the experience. Sadly, it does go by the wayside. Yesterday I left a poor lady who'd been admitted for observation after a head injury who wasn't seen by us until mid-afternoon and had no information until that time. I know she was medically safe. She needed 24 hours minimum after her injury (she'd come off a horse) and wasn't close to that yet, she was receiving her neurological observations in a timely fashion and her care was proceeding exactly as it should but she didn't know that and was understandably concerned. I got to her at about 3pm and when I left she had the answers she needed and we had a positive conversation and I think she accepted the circumstances and that's the best I can hope for really. She may yet put a complaint it, as is her right and I hope she does. I would have loved to have gotten to her sooner but when I started my shift yesterday there were precisely 36 unseen patients in our department, many of them sick with a sprinkling of inappropriate usages of an ED, and they had to be prioritised. That's how our system works and we are chronically and endemically understaffed and underresourced. It would be a blatant lie to deny that some clinicians don't prioritise the communication aspect of the job in the same way I do and that leads to unsatisfactory patient experiences and that isn't good enough. I think that mentality, of not wanting to communicate, is diminishing rapidly as a result of changes to attitude and training, but sadly it's come as the demands on the NHS have skyrocketed. From my experience of two separate trusts, there is an earnest desire to improve standards and a lot of work goes on behind the scenes but frankly if we don't get more resources soon the whole thing will collapse and we are, alas, only human, and we get pissed off a lot of the time.

 

I suspect the overwhelming reason the car park is empty at the weekend is because NHS staff rarely have their own car park, it is shared with patients, both in and outpatients, and their relatives, and there are fewer of them over the weekend. In addition, we do much less elective work over the weekend. Are you really that bothered that you can't see a chiropodist over the weekend? I agree in an ideal world we'd be able to provide that, but we can't cover anymore with the staff we have. This is precisely what the government is asking us to do and it is unsafe. Please don't conflate elective and emergency care, they are not the same thing and one is far more important than the other.

MRI scans are rarely emergent. Have you any idea how much it costs to operate one? Resources are finite. If you need an emergency MRI over the weekend, you will ge tone. That is the beauty of our system. On a shoestring, our emergency care is scarcely excelled worldwide, and there are numerous economic analyses and patient testimonies from other countries to attest to this.

Senior decision makers are expensive and as such are in short supply. The consultant will probably cover the entire weekend and can't feasibly be present the whole time. There will be a senior registrar and then his medical team. Without knowing your specific circumstances, I can't comment on which tests you deemed important that weren't done or which decisions you wanted to have made, and I'm certainly not asking you to explain them as that is your business.

 

"It's as if everyone's afraid of being held accountable and therefore the less said to the patient or "the public" the better." This is probably true to an extent, but is an attitude that should shift as blame culture diminishes. For example, doctors used to be discouraged from apologising as it may incur liability, now the principle that saying sorry does not constitute admitting civil liability means the younger generation say sorry a lot more and this hopefully will become more evident.

Your private hospital comment is a bit daft I'm afraid, you can't be surprised that a private hospital, lavishly funded and with no burden of emergency care, runs a bit quicker than your local A+E. A lot of people go private for a cancer diagnosis, for an example, and are then promptly bounced back into the NHS because it provides the actual treatment better, generally in a timely and evidence-based fashion, although we do need to improve in that area.

It's difficult to try and explain your issues Thracian because they're obviously grounded in specific and personal experiences which I wouldn't expect you to explain. Fundamentally, where you see poor practice you must report it formally because  there is, certainly amongst clinicians I know, a genuine desire to learn from our mistakes. I can't comment for senior management and I am aware of instances of alleged cover-ups.

 

The NHS is frankly a miracle in providing the case it does, it's emergency care is world class, still, albeit you might wait a while. You won't find an emergency service in the world that doesn't struggle with demand and waiting times. It's mismanaged from the highest level, understaffed, underresourced and underappreciated.

Also, the anti Europe brigade can piss right off, given the extent to which we're filling our gaping nursing rotas with extremely highly qualified Spanish and Portuguese nurses.

[Rincewind]

When I had to go in hospital I was quite happy at the care given. I may have had to wait but I saw people coming in who were much worse than me so accepted it. I do not demean myself more special than others. Even the time I had a broken wrist and left in a chair I could not complain too much. I could have kicked up a fuss but that would have taken staff from other areas and patients. One occasion it took around 8 hours before I was allowed home.

I must say though when in the ward the food was not that great. The nurses even served that and often came around with drinks. 

[Thracian]

There are measures of truth and of ignorance in this.

 

I think clear communication is pivotally important in healthcare. I know from feedback I receive on my placements that it's my personal strong suit. I'm inferior when it comes to practical skills compared to some of my peers, my clinical knowledge is average and some people are better under pressure but I know I communicate well and I know how much it improves the experience. Sadly, it does go by the wayside. Yesterday I left a poor lady who'd been admitted for observation after a head injury who wasn't seen by us until mid-afternoon and had no information until that time. I know she was medically safe. She needed 24 hours minimum after her injury (she'd come off a horse) and wasn't close to that yet, she was receiving her neurological observations in a timely fashion and her care was proceeding exactly as it should but she didn't know that and was understandably concerned. I got to her at about 3pm and when I left she had the answers she needed and we had a positive conversation and I think she accepted the circumstances and that's the best I can hope for really. She may yet put a complaint it, as is her right and I hope she does. I would have loved to have gotten to her sooner but when I started my shift yesterday there were precisely 36 unseen patients in our department, many of them sick with a sprinkling of inappropriate usages of an ED, and they had to be prioritised. That's how our system works and we are chronically and endemically understaffed and underresourced. It would be a blatant lie to deny that some clinicians don't prioritise the communication aspect of the job in the same way I do and that leads to unsatisfactory patient experiences and that isn't good enough. I think that mentality, of not wanting to communicate, is diminishing rapidly as a result of changes to attitude and training, but sadly it's come as the demands on the NHS have skyrocketed. From my experience of two separate trusts, there is an earnest desire to improve standards and a lot of work goes on behind the scenes but frankly if we don't get more resources soon the whole thing will collapse and we are, alas, only human, and we get pissed off a lot of the time.

 

I suspect the overwhelming reason the car park is empty at the weekend is because NHS staff rarely have their own car park, it is shared with patients, both in and outpatients, and their relatives, and there are fewer of them over the weekend. In addition, we do much less elective work over the weekend. Are you really that bothered that you can't see a chiropodist over the weekend? I agree in an ideal world we'd be able to provide that, but we can't cover anymore with the staff we have. This is precisely what the government is asking us to do and it is unsafe. Please don't conflate elective and emergency care, they are not the same thing and one is far more important than the other.

MRI scans are rarely emergent. Have you any idea how much it costs to operate one? Resources are finite. If you need an emergency MRI over the weekend, you will ge tone. That is the beauty of our system. On a shoestring, our emergency care is scarcely excelled worldwide, and there are numerous economic analyses and patient testimonies from other countries to attest to this.

Senior decision makers are expensive and as such are in short supply. The consultant will probably cover the entire weekend and can't feasibly be present the whole time. There will be a senior registrar and then his medical team. Without knowing your specific circumstances, I can't comment on which tests you deemed important that weren't done or which decisions you wanted to have made, and I'm certainly not asking you to explain them as that is your business.

 

"It's as if everyone's afraid of being held accountable and therefore the less said to the patient or "the public" the better." This is probably true to an extent, but is an attitude that should shift as blame culture diminishes. For example, doctors used to be discouraged from apologising as it may incur liability, now the principle that saying sorry does not constitute admitting civil liability means the younger generation say sorry a lot more and this hopefully will become more evident.

Your private hospital comment is a bit daft I'm afraid, you can't be surprised that a private hospital, lavishly funded and with no burden of emergency care, runs a bit quicker than your local A+E. A lot of people go private for a cancer diagnosis, for an example, and are then promptly bounced back into the NHS because it provides the actual treatment better, generally in a timely and evidence-based fashion, although we do need to improve in that area.

It's difficult to try and explain your issues Thracian because they're obviously grounded in specific and personal experiences which I wouldn't expect you to explain. Fundamentally, where you see poor practice you must report it formally because  there is, certainly amongst clinicians I know, a genuine desire to learn from our mistakes. I can't comment for senior management and I am aware of instances of alleged cover-ups.

 

The NHS is frankly a miracle in providing the case it does, it's emergency care is world class, still, albeit you might wait a while. You won't find an emergency service in the world that doesn't struggle with demand and waiting times. It's mismanaged from the highest level, understaffed, underresourced and underappreciated.

Also, the anti Europe brigade can piss right off, given the extent to which we're filling our gaping nursing rotas with extremely highly qualified Spanish and Portuguese nurses.

 

Thanks for the insight Bryn - I appreciate it. After days of waiting the MRI scan was performed the very evening I complained. Turned out the scan had not been booked because the patient was regarded as an outpatient rather than being down as an in-patient...the sort of mistake I found hard to comprehend but no more than that.

 

As for explaining particlar circumstances i did elicit a sincere, profound and entirely voluntary apology from one member of staff which I thought took some bottle and I would not want to compromise anyone by being specific because people get tired when under pressure and we all make mistakes.

 

As for the "anti-Europe brigade"  only an idiot would fail to appreciate the efforts of staff wherever they come from but that doesn't explain why we fail to train sufficient numbers in our own univiersities nor why we continue to overload our country with people when our infrastructure is so demonstrably wilting under the pressure, as you yourself indicate.

 

And with so many foreign doctors and nurses coming to the UK I can't help but wonder about the impact of their health services - and the more so given your reference to ours being the best in respect of emergency care which I don't doubt with my little grandaughter having recently benefitted from the same.  

 

I'm not at all anti-Europe - I'm anti EU and ever more so the more I hear the debate. I see no reason why the UK can't manage its own affairs and still contract such working professionals as it sees fit. Long before the EU I worked on contract in Europe as a squash professional and thoroughly enjoyed it. Mind you I'd be more than vigilant in checking language skillls and qualifications.

 

Again, personal experience in Birmingham has more than emphasised the need for foreign medical staff to understand what's said to them - or written in front of them - and to be fully understood themselves.

 

I listened to a conversation on a local hospital ward last night - in heavily accented English  - and could hardly decipher 30% per cent of it. When I asked the people next to me - they said they couldn't understand either.  

 

++++        

Edited 7 April 2016 by Thracian

[Bryn]

Thanks for the insight Bryn - I appreciate it. After days of waiting the MRI scan was performed the very evening I complained. Turned out the scan had not been booked because the patient was regarded as an outpatient rather than being down as an in-patient...the sort of mistake I found hard to comprehend but no more than that.

 

As for explaining particlar circumstances i did elicit a sincere, profound and entirely voluntary apology from one member of staff which I thought took some bottle and I would not want to compromise anyone by being specific because people get tired when under pressure and we all make mistakes.

 

As for the "anti-Europe brigade"  only an idiot would fail to appreciate the efforts of staff wherever they come from but that doesn't explain why we fail to train sufficient numbers in our own univiersities nor why we continue to overload our country with people when our infrastructure is so demonstrably wilting under the pressure, as you yourself indicate.

 

And with so many foreign doctors and nurses coming to the UK I can't help but wonder about the impact of their health services - and the more so given your reference to ours being the best in respect of emergency care which I don't doubt with my little grandaughter having recently benefitted from the same.  

 

I'm not at all anti-Europe - I'm anti EU and ever more so the more I hear the debate. I see no reason why the UK can't manage its own affairs and still contract such working professionals as it sees fit. Long before the EU I worked on contract in Europe as a squash professional and thoroughly enjoyed it. Mind you I'd be more than vigilant in checking language skillls and qualifications.

 

Again, personal experience in Birmingham has more than emphasised the need for foreign medical staff to understand what's said to them - or written in front of them - and to be fully understood themselves.

 

I listened to a conversation on a local hospital ward last night - in heavily accented English  - and could hardly decipher 30% per cent of it. When I asked the people next to me - they said they couldn't understand either.  

 

++++        

 

I'm glad it got done. Can't explain why it was outpatient, perhaps a local policy.

 

Language is always going to be a difficult issue. I worked in a French hospital and found it monstrously difficult (thankfully I was in a fully supervised role so wasn't able to harm anyone!). The majority of the ones that come across are absurdly good, and actually sometimes the ones with the thickest accents are British citizens, so it's tricky.

 

We certainly need to be training more of our own doctors and nurses. This needed to start years ago.

[leicsmac]

Just a quick reminder that perhaps we should be careful of what we wish for:

 

 

I know those on here advocating reform are (probably) not advocating an American-style system, but I think it's a pretty damning look at the nature of the US healthcare and insurance system when this many folk are losing the shirts off their backs just because they were unlucky enough to get badly sick or injured.

[Buce]

Just a quick reminder that perhaps we should be careful of what we wish for:

I know those on here advocating reform are (probably) not advocating an American-style system, but I think it's a pretty damning look at the nature of the US healthcare and insurance system when this many folk are losing the shirts off their backs just because they were unlucky enough to get badly sick or injured.

That wouldn't happen under this govt, though.

By the time ATOS had made a decision on whether they were ill enough to desrve treatment, they would have long since died.

[DJ Barry Hammond]

I'm glad it got done. Can't explain why it was outpatient, perhaps a local policy.

 

Language is always going to be a difficult issue. I worked in a French hospital and found it monstrously difficult (thankfully I was in a fully supervised role so wasn't able to harm anyone!). The majority of the ones that come across are absurdly good, and actually sometimes the ones with the thickest accents are British citizens, so it's tricky.

 

We certainly need to be training more of our own doctors and nurses. This needed to start years ago.

Wondering what you made of the cross party "why not trial this" idea that's been put forward today and how you felt about the pending escalation in strike action?

Must admit, I'm not sure escalating is a good way to go.

[Bryn]

We don't really have a lot of choice, we can't safely deliver the service they're asking so how we can we sign the contract?

 

They needed to have a frank conversation about the future of the NHS and design a contract that was fit for purpose, not just deliver a pre-election soundbite and force us over a barrel before they've ever planned or costed it.

 

I don't trust them not to cherry pick the finest and best staffed trusts in the country, give them funds to hire extra doctors and then pilot it, so **** that. We need to go back to the start. There aren't enough doctors to provide a 7 day emergency NHS, the system will collapse with this contract.

[Bryn]

"We're staging implementation to ensure it works as intended. Any further delay just means we will take longer to eliminate weekend effect."

Despite the fact that it's been demonstrated to them hundreds of time that there is no causal link between weekend staffing and this "weekend effect", that's still their reasoning. They are negligent liars. I will not sign their imposed contract and nor will a sizeable chunk of my colleagues.

Edited 24 April 2016 by Bryn

[Dodgy Bob]

Probably my lack of knowledge (as usual) but doesn't the government's 'pay protection' offer render all of the complaints about pay cuts effectively moot?

[Manwell Pablo]

A wonderful service that is currently under-funded and over-worked.

 

There's too much management. Get rid of those - who just fill in paperwork. 

 

Is there?

 

Apart from a incorrect tired old Clique what are you basing that on exactly.

 

I'd think about your answer very carefully as I've been working in the NHS for 10 years.

 

EDIT: Thankfully the thread improves drastically after this gem, agree with the "setting fire to money" quote in particular, it is under funded but could do a lot more to help itself.

 

The problem is most definitely not the quantity of "management" it is, in certain areas, the quality. And another thing that has already been pointed hard, it's bloody hard to sack people in the NHS.

Edited 25 April 2016 by Manwell Pablo

[The Railway Man]

Could be a big week this one.

 

Thought Paddy Ashdown nailed it on Question Time, surprised the Doctors have jumped to this action, they were winning and the pressure was on Hunt, if it goes wrong this week and people die public support ll vanish overnight.

[Fox92]

Is there?

 

Apart from a incorrect tired old Clique what are you basing that on exactly.

 

I'd think about your answer very carefully as I've been working in the NHS for 10 years.

 

EDIT: Thankfully the thread improves drastically after this gem, agree with the "setting fire to money" quote in particular, it is under funded but could do a lot more to help itself.

 

The problem is most definitely not the quantity of "management" it is, in certain areas, the quality. And another thing that has already been pointed hard, it's bloody hard to sack people in the NHS.

 

Too many people have power though. Even matrons have control over budgets these days don't they?

[Great Boos Up]

Too many people have power though. Even matrons have control over budgets these days don't they?

That's part of the modern day problem; I don't think there are any matrons anymore.

"my ward my rules" have gone.

[Bryn]

Probably my lack of knowledge (as usual) but doesn't the government's 'pay protection' offer render all of the complaints about pay cuts effectively moot?

No because it's temporary. It's a way of lying and saying the contract isn't a pay cut. It's a tactic to hope we will cave and **** future generations of doctors over cause it won't quite affect us anymore.

[Dodgy Bob]

No because it's temporary. It's a way of lying and saying the contract isn't a pay cut. It's a tactic to hope we will cave and **** future generations of doctors over cause it won't quite affect us anymore.

I've read that the pay protection lasts for a minimum of three years. In situations like this I'm inclined to think that terms shouldn't be changed after somebody has already committed themselves to a career path. While various factors make that kind of uncertainty a fact of life for most of us, that's not really an excuse a government should use (although they do all the time with everything from pensions to tax to welfare).

I'd have no issue with pay being cut for future doctors, I wouldn't describe that as them being "****ed over" because they'd still have the choice not to become a doctor if they didn't feel the rewards were good enough. But it does seem a raw deal for those who have already committed a lot of time and energy into their training. Then again, raw deals are the order of the day and doctors are still exceptionally well paid, so my sympathy is fairly limited.