The NHS (National Health Service) Thread

[Sharpe's Fox]

Not proof at all, just a difference of opinion .

You do realise you've just quoted an employee of Jeremy Hunt, right? Not exactly unbiased is it? Maybe a quote from the actual study would be more applicable:

In the paper, they wrote: "The average number of patients attending A&E on weekend days and dying within 30 days is similar to weekdays. The crude death rate following an A&E attendance is significantly lower at the weekend compared to during the week (0.99 per cent vs. 1.03 per cent).

[Webbo]

What?

Have you read the article?

The mortality rate is less at the weekend.

The Government rightly say they have a problem with only the sickest patients being admitted at weekends. They want elective services at weekends. That's fine, but there aren't enough of us.

Elective services have nothing to do with mortality.

Junior doctors already provide 24/7 emergency care.

Why is this so hard?

Depends how you interpret  the statistics . I'd say the conclusions are debatable to say the least.

[Bryn]

Again, what?

You're happy with Jeremy Hunt blaming us using a study of which the author and his political ally stated himself that you cannot conclude there is a problem with weekend staffing, which a series of scientists, statisticians and health professionals have criticised, but you're not happy with actually looking at 4.6m emergency admissions and counting how many died and when?

I'm out.

[Bryn]

I recognise how poor the English is in that post but I think the incoherence enhances the sense of my incredulity.

[Bryn]

Not that the absence of a weekend effect makes the desire for robust 7 day emergency care wrong. We're just already providing it, making us provide more elective care when there are already gaps of as much as 40% of EMERGENCY rotas is retarded and dangerous, and to then ask us to swallow pay cuts of several thousand of pounds along with it?

Edited 6 May 2016 by Bryn

[Webbo]

Not that the absence of a weekend effect makes the desire for robust 7 day emergency care wrong. We're just already providing it, making us provide more elective care when there are already gaps of as much as 40% of EMERGENCY rotas is retarded and dangerous, and to then ask us to swallow pay cuts of several thousand of pounds along with it?

So it's about pay after all? I can respect that, not that I believe you're facing a cut, but at least it's honest.

[Facecloth]

Webbo staunchly backs the Tories shocker!

There's no point guys. I swear to god he'd find a way to support them if they wanted to make breathing illegal. Dave and his bunch of numbskulls can do no wrong.

You'll notice he conveniently ignored Shape's post about quoting one of Hunt's employees and not the study.

I'm sorry Webbo mate, not intending to single you out, but it's beyond the joke how you'll defend them when faced with solid evidence they've ****ed something up.

[Bryn]

So it's about pay after all? I can respect that, not that I believe you're facing a cut, but at least it's honest.

Of course it's PARTLY about pay and conditions, that's the only legal basis for strike action. But fundamentally, if it was pay in isolation, not a chance 99% of doctors vote to strike, no way in hell. There are also factors such as safeguarding our hours and training opportunities, discrimination against women and various others. The impact this will have on recruitment and retention will be devastating at a time when there simply aren't enough staff to meet growing demand. These form the legal basis for industrial action. When have I ever denied this?

But in essence, we cannot sign a contract that commits us to providing a service we cannot do safely, we safely cannot sign a contract committing ourselves to providing 2 more days of elective service at a time when there are gaping holes in the EMERGENCY rota. This is the simplest and most important issue, and if this was not an issue you would not have overwhelming support from the profession and from our consultants and allied health professionals, and majority support from the public and patient groups.

Edited 7 May 2016 by Bryn

[Webbo]

Webbo staunchly backs the Tories shocker!

There's no point guys. I swear to god he'd find a way to support them if they wanted to make breathing illegal. Dave and his bunch of numbskulls can do no wrong.

You'll notice he conveniently ignored Shape's post about quoting one of Hunt's employees and not the study.

I'm sorry Webbo mate, not intending to single you out, but it's beyond the joke how you'll defend them when faced with solid evidence they've ****ed something up.

Why does it bother you? There are people on here who blame the Tories if the weather's bad, you never complain about them.

I 've never pretended to be anything other than a supporter of the conservatives and the reason for that is that I tend to agree with them. Just because you disagree with them it doesn't mean they're wrong.

[Bryn]

I'm not even saying all the Tories are evil for this. My personal belief is that Hunt is an NHS abolitionist and that many of his backers are too, but I'm prepared to believe that the majority of politicians simply want a comprehensive 7 day NHS and that if absolutely fine, we would love that too. You think that, even if you consider me a workshy selfish socialist upstart, I don't want access to the full range of services when I'm stick in ED on a Sunday? That makes my life a whole lot easier.

Politicians repeatedly demonstrate that they have no understanding of the situation, right up to David Cameron and Hunt themselves. And despite their patent ignorance, they won't listen to their NHS employees screaming at them that they are at serious risk of breaking the health service and jeopardising patient safety.

[Webbo]

I'm not even saying all the Tories are evil for this. My personal belief is that Hunt is an NHS abolitionist and that many of his backers are too, but I'm prepared to believe that the majority of politicians simply want a comprehensive 7 day NHS and that if absolutely fine, we would love that too. You think that, even if you consider me a workshy selfish socialist upstart, I don't want access to the full range of services when I'm stick in ED on a Sunday? That makes my life a whole lot easier.

Politicians repeatedly demonstrate that they have no understanding of the situation, right up to David Cameron and Hunt themselves. And despite their patent ignorance, they won't listen to their NHS employees screaming at them that they are at serious risk of breaking the health service and jeopardising patient safety.

I don't think you're a socialist at all. If you were, you're entitled to your opinion.

They've been saying the Tories are going to privatise the nhs for 30 years now and it hasn't happened yet. It would be electoral suicide, it's not going to happen.

[Facecloth]

Why does it bother you? There are people on here who blame the Tories if the weather's bad, you never complain about them.

I 've never pretended to be anything other than a supporter of the conservatives and the reason for that is that I tend to agree with them. Just because you disagree with them it doesn't mean they're wrong.

So you admit it?

There's absolute no point in you putting your opinion to this discussion then is there because they might as well suggest Eric Pickles is going to do a steaming turd on everyone's head every morning and you agree with it. There's nothing wrong with supporting a political party but there's absolutely no point in you engaging in a discussion about things like this if your just going to blindly ignore facts. Like I said, earlier you've totally ignored someone when they've pointed out that you've quoted a Hunt employee rather than the study, to instead keep peddling the bullshit Tory fed party line that 90% of people know is bullshit, but even when faced with damning proof it is, you still keep throwing it out there.

It bothers me because it worry me that anyone can be so entrenched, one way or the other, there's no thought involved in your political view, just Tory good, Labour bad.

[Bryn]

Saying it openly is electoral suicide yes.

[Webbo]

So you admit it?

There's absolute no point in you putting your opinion to this discussion then is there because they might as well suggest Eric Pickles is going to do a steaming turd on everyone's head every morning and you agree with it. There's nothing wrong with supporting a political party but there's absolutely no point in you engaging in a discussion about things like this if your just going to blindly ignore facts. Like I said, earlier you've totally ignored someone when they've pointed out that you've quoted a Hunt employee rather than the study, to instead keep peddling the bullshit Tory fed party line that 90% of people know is bullshit, but even when faced with damning proof it is, you still keep throwing it out there.

It bothers me because it worry me that anyone can be so entrenched, one way or the other, there's no thought involved in your political view, just Tory good, Labour bad.

A Hunt employee? You mean a civil servant? These are not facts just an interpretation of statistics which as we all know can say anything you want them to say. There has been spin on both sides I wouldn't deny that. That's normal procedure in politics.

Why do you think the govt are doing this if it's so terrible an idea? Do you think it's just evil Tories being spiteful for no good reason? With the aging population the nhs is unsustainable in its present form long term. If you want it to survive you've got to make it more cost effective.

Edited 7 May 2016 by Webbo

[Facecloth]

A Hunt employee? You mean a civil servant? These are not facts just an interpretation of statistics which as we all know can say anything you want them to say. There has been spin on both sides I wouldn't deny that. That's normal procedure in politics.

Why do you think the govt are doing this if it's so terrible an idea? Do you think it's just evil Tories being spiteful for no good reason? With the aging population the nhs is unsustainable in its present form long term. If you want it to survive you've got to make it more cost effective.

Yes the NHS does need to be cost effective but they'll be other ways to save money rather than punish the people on the front line. I know of someone office based, part time earning the salary of 3 nurses. I wonder how some savings might be made?

But it's not, as Bryn said solely about pay. It about the lies about weekend deaths, about the safeguarding of hours and discrimination against women. Cost cutting is fine, but let's not screw people over whilst doing it.

I don't think the Tories are evil, but do think their out of touch and misguided at times which is proven by the astonishing number of u-turns they've performed. But I'm not so blinkered that I think Labour were faultless in power either, which seems to be your stance on the Tories ( and not just in this issue).

[Webbo]

I've no problem with cutting the pen pushers as well.

I'm not Tory good Labour bad either. There have been things I've disagreed with , I just don't rant and rave about it. I don't think I rant and rave about Labour either.I very rarely make points in these threads I just respond to other people's points and I ignore more than I reply to.

If someone disagrees with me I'm quite happy to debate it but please don't tell me I'm just being biased and I can't possibly believe what I'm saying.

[DJ Barry Hammond]

I've no problem with cutting the pen pushers as well.

I'm not Tory good Labour bad either. There have been things I've disagreed with , I just don't rant and rave about it. I don't think I rant and rave about Labour either.I very rarely make points in these threads I just respond to other people's points and I ignore more than I reply to.

If someone disagrees with me I'm quite happy to debate it but please don't tell me I'm just being biased and I can't possibly believe what I'm saying.

Even if you agree with Hunt's proposals (not that I'm completely clear on what they are now, there has been some muddying of waters in places, possibly in preparation of scaling back on the policy), something you have to consider is how poor Hunt's handling of the situation has been.

You'd have to recognise that if he wants to bring about positive change in this area, he's going to have a greater success if he brings the majority of Junior Doctor's with him in his vision - rather than picking a fight and forcing something on them. His general demeanour was very antagonistic and seemed so far, far away from being open and agreeable to a consensus way forward.

The fact that over 3 years of discussions there have been over 90 revisions of the initial contract suggest it was poorly conceived in the first place - and given the government has getting a pretty good track record of poorly conceived policy ideas that they've later renegade on... it would be sensible to view the governments position on this matter with scepticism.

[Webbo]

It's all about perceptions. You could just as easily say that 90 amendments mean the govt are trying to meet the doctors half way.

The doctors refused to to agree so the govt said they'd impose it, now they're ready to talk. You could say the tactic worked. One interpretation is no more biased than the other.

[sphericalfox]

I don't think you're a socialist at all. If you were, you're entitled to your opinion.

They've been saying the Tories are going to privatise the nhs for 30 years now and it hasn't happened yet. It would be electoral suicide, it's not going to happen.

 

You genuinely haven't a clue do you? As someone who actually sees behind the curtain, I can assure you they are not doing it openly.

[Webbo]

You genuinely haven't a clue do you? As someone who actually sees behind the curtain, I can assure you they are not doing it openly.

And you'll be saying the same in 5,10 and 20 years time.

[Jon the Hat]

No one is ever going to privatise the NHS.  Seriously, it is not going to happen. 

 

Lets be clear though, if the majority of people who think the NHS care is great had been treated in the health systems of say Australia, then they would not be standing up saying it doesn't need to change massively.  I say this with a lot of family background in the NHS, including my wife who has worked in Australia, and both NHS and Private hospitals in the UK, and I have also experienced as a patient emergency and elective care in NHS and Private in both countries.

[sphericalfox]

And you'll be saying the same in 5,10 and 20 years time.

 

Yes i will. They're hardly doing it overnight FFS. 

[Bryn]

The NHS does need to change, it probably is going to require more individual contributions because the demands are sky rocketing. The debate on the future of the NHS should be a public one and should have been held before doling out punitive contracts.

They haven't even declared what they think a 7 day NHS looks like, nor have the priced it up, which is embarrassing.

[Col city fan]

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.

You do know that MRI scans are often done over the weekends? In fact, many routine tests are done on Saturdays and Sundays. This is to try to get through the backlog of people wanting tests done at a time when the demand on the NHS is ever rising whilst the funding for the NHS is ever being cut back.

It's a pretty impossible situation and I think people should support the NHS rather than looking to slate it. If you don't, it'll go private in its entirety. THEN we'll see people really moaning.

And for those people who say it's not being privatised and never will be..open your eyes.

Edited 9 May 2016 by Col city fan

[Jon the Hat]

The funding for the NHS is not being cut back Col.  It is not increasing in line with demand agreed, because the government want to force those provising services to do it more efficiently, and it is a proven tactic that limiting resources makes people decide what is important.

Also, show me a western country with no public health provision?  If there is one thing you can be 100% sure on it is that the NHS is here to stay in one form or another.

The question here is what do you consider the NHS to be?  For me it is the principle of healthcare free at the point of use, and open to everyone equally.  This is not going anywhere. Whether the buildings are owned and managed by the NHS, or the cleaners employed by the NHS doesn't matter.  Many large organisations outsource all kinds of activities which are not core to their purpose, and the NHS should be no different.  The question around actual medical or surgical provision being privatised is more complex, however I wonder again what you are scared of?  Many of the doctors are the same ones.  Should we blame consultants for offering private practise alongside or in place of their NHW work?  The bastards, privatising our NHS.  This has always been there since the NHS began though no?

 

The whole Tories trying to private the NHS argument is basically a political weapon used to block any form of change that threatens the interests of a particular group or union.

Edited 9 May 2016 by Jon the Hat