The NHS (National Health Service) Thread

[Jon the Hat]

I reject any insinuation that the workforce can give any more than it does already, the only reason it functions as it does is because we're all grinding ourselves into the ground for it.

Not that I think throwing money without a strategy at it does any good either.

 

I am not questioning effort, but that is not the same as effectiveness.  You need engagement and enablement to have a fully functioning workforce, and the NHS clearly has problems with both.  Struggling through under pressure is not the same as being effective.  The NHS is also unable to get rid of underperforming employees due to Unions, which puts more pressure of the remaining people.

[Rincewind]

Perhaps there should be a Health minister that understands the pressure doctors are under and actually listen to them and their concerns. Hunt knew they were not happy about the measures but brought them in anyway. Is that a good way to engage with  the public?

[Jon the Hat]

Perhaps there should be a Health minister that understands the pressure doctors are under and actually listen to them and their concerns. Hunt knew they were not happy about the measures but brought them in anyway. Is that a good way to engage with  the public?

 

They spent month listening to the BMA and their concerns, they just didn't agree with them.

[Alf Bentley]

I don't recall you getting upset when the media slams bankers, politicians and the like of all being self serving greedy scum

 

I don't think it is that unreasonable to say that the public sector has a problem with ridding itself of incompetent and lazy employees, in a way that the private sector doesn't.  I don't think it is unreasonable to say that the NHS workforce has an engagement problems in many places either, and as I said you could argue why till the cows come home, but certainly political interference from unions who want to block Tory plans is part of it.  I probably made my point a little bluntly there, as there is also no doubt the impact of more and more pressure on services, without additional resource to cover it, and I have no doubt at all that there is a majority of people in the NHS working their arses off to do their very best.  That is not the best environment for anyone though either is it?

I don't think it is unreasonable to hold the public sector to a higher standard than the public sector either, given they are spending public money, taken without choice from the people (same applies to private contractors to the public sector of course, which is also a problem). 

 

 

I try not to get upset about anything on here (mainly succeed; occasionally fail). I certainly wasn't "upset" at your comments - more "surprised and disappointed" ( ).

 

You've given a more nuanced explanation now, anyway, even if I still have issues with your comments re. lack of engagement and politically-motivated unions: Have NHS employees suddenly become disengaged? Have unions never existed in the NHS before, given the lack of previous strikes? Or might there be 2 sides to the story? Might the majority of doctors genuinely feel that govt plans are unfair and unworkable?

 

You seem to want to paint me as some unthinking, knee-jerk lefty. If anyone slammed politicians in general as "self-serving greedy scum", I would absolutely disagree with that. I've posted on here before expressing the view that MPs should be paid more, not less, and that most of them (from whatever party) work long, hard hours and are often motivated by public service and the public good (as they perceive it from their different political perspectives), not just by self-advancement, never mind self-enrichment. I specifically remember quoting my lefty Mum's praise for Michael Howard, of all people, as an excellent constituency MP. I'd certainly slam many (not all) Tory policies, but that's just political opinions. As I see it, there's a minority of useless/corrupt people in every party and every profession, but most are good (if fallible, particularly if "the system" fails).

 

Likewise, with bankers. They perform many essential functions and I'm sure most of them work very hard, accept a lot of pressure, show great expertise and act as responsible professionals. Many large banks acted greedily and irresponsibly at the time of the crash, but I imagine it would be difficult to make a responsible stand if you knew that your competitors were making big bucks by taking big risks (to the extent that the risks could have been anticipated, which they could, to some extent). So, deregulating politicians (of every hue), incompetent regulators and dubious ratings agencies also bear responsibility, as do consumers for buying mortgage products they couldn't really afford. Part of why big bankers get such a bad press is that they're perceived to have got off lightly compared to the rest of the austerity-afflicted populace - and to be showing great arrogance in awarding themselves extraordinary bonuses during hard times that they helped to cause. I've no sympathy with them on that score.

 

Sorry for the (partial) diversion from thread topic. I won't pursue that diversion any further.

[Rincewind]

Good post Alf. I am in a less cynical mood today. Regarding MP's I suppose there are two ways of looking at them 1 they are all as bad as one another or 2 the bad ones spoil it for the majority. This is a list of MP's and Lords from all parties who have interests in private healthcare. Obviously many can be dismissed as irrelevant as the interest is only something like a few shares. Nothing wrong with that. I know it is from 2014 but it is one of the first in the google list. There are quite a few Labour MP's and Peers listed so there is no bias in that regard.

 

http://socialinvestigations.blogspot.co.uk/2014/03/compilation-of-parliamentary-financial.html

[Rincewind]

I think Jeremy Hunt has upset someone

 

http://indy100.independent.co.uk/article/jeremy-hunt-tries-to-celebrate-international-nurses-day-gets-torn-apart-in-the-comments--bJh62uGYGb

 

I bet he also thinks white socks look good with sandals.

Edited 13 May 2016 by Rincewind

[DJ Barry Hammond]

I think Jeremy Hunt has upset someone

 

http://indy100.independent.co.uk/article/jeremy-hunt-tries-to-celebrate-international-nurses-day-gets-torn-apart-in-the-comments--bJh62uGYGb

 

I bet he also thinks white socks look good with sandals.

The guys got a thick skin, non of it will go in - he may even see the responses as a perverse badge of honour.

[Rincewind]

The guys got a thick skin, non of it will go in - he may even see the responses as a perverse badge of honour.

or just rants from 'crazy lefties' 

[DJ Barry Hammond]

There is a deal!

(for now at least)

[Darkon84]

Until the BMA move the goalposts again

 

Seriously though, it's good news that it's moving forward, I think everyone's sick of it by now.

 

http://www.bbc.co.uk/news/health-36325045

[Bryn]

Initial thoughts based on one read of the ACAS statement.

1) The pay offered for nights and weekends appears to have gone down even further

2) Some of the crucial conditions for safe and fair working, such as whistle blowing protection, have been achieved, but it seems to have be in exchange for an even deeper pay cut than ever proposed. Time and a half overnight has gone down to 37%, 37% on a Saturday has gone down to 2-10% for an entire weekend, the basic pay increase has gone from 13.5% to 11% and the highest rate for an ST8 of probably about 10-15 years of experience and just below consultant level has been abolished.

3) Still no explanation for how fewer doctors working fewer hours are meant to cover more days per week safely when there are already rotas gaps of up to 40%.

I don't see this getting past a referendum.

[DJ Barry Hammond]

Initial thoughts based on one read of the ACAS statement.

1) The pay offered for nights and weekends appears to have gone down even further

2) Some of the crucial conditions for safe and fair working, such as whistle blowing protection, have been achieved, but it seems to have be in exchange for an even deeper pay cut than ever proposed. Time and a half overnight has gone down to 37%, 37% on a Saturday has gone down to 2-10% for an entire weekend, the basic pay increase has gone from 13.5% to 11% and the highest rate for an ST8 of probably about 10-15 years of experience and just below consultant level has been abolished.

3) Still no explanation for how fewer doctors working fewer hours are meant to cover more days per week safely when there are already rotas gaps of up to 40%.

I don't see this getting past a referendum.

Is this bit new?

6. Seven-day Services

The BMA will, along with other trade union colleagues, the professions and NHS representative bodies, be asked to join a group advising NHS England on the policy direction relating to seven-day services. In addition a sub-group of the Social Partnership Forum will be established to consider and monitor how seven day service policy impacts on the workforce.

Taken from: http://m.acas.org.uk/media/pdf/l/p/ACAS_FINAL_AGREED_NHS_Emp_BMA_DoH_Package_180516.pdf

Edited 18 May 2016 by DJ Barry Hammond

[Bryn]

I think so. It's nothing concrete though is it. Neither is not putting whistle blowing protection into legislation, neither is an hours guardian.

I'll tell you what will happen. We will vote to sign the contract with a slender majority because we've had enough of striking and won't get anywhere. Then a huge number of us will leave. Those that are left will simmer with resentment. Numbers applying to specialty training will continue to fall. And the NHS, with its targets achieved numbers plummeting every year since 2010, will break.

Edited 18 May 2016 by Bryn

[Bryn]

Oh and look out for the nursing contract negotiations.

You have to hand it to the DoH by the way. Handed the BMA it's arse on a plate.

[Bryn]

I've decided I'm not saying another word on this. It's done. The BMA have sold us out and agreed to a contract that is unsustainable and even more punitive than the one we striked for. We went through all that, patients went through all that, our consultants and nursing colleagues went through all that, for nothing. I could not be more dejected.

Edited 18 May 2016 by Bryn

[sphericalfox]

I think so. It's nothing concrete though is it. Neither is not putting whistle blowing protection into legislation, neither is an hours guardian.

I'll tell you what will happen. We will vote to sign the contract with a slender majority because we've had enough of striking and won't get anywhere. Then a huge number of us will leave. Those that are left will simmer with resentment. Numbers applying to specialty training will continue to fall. And the NHS, with its targets achieved numbers plummeting every year since 2010, will break.

 

That's the ultimate goal for the Tories.

[DJ Barry Hammond]

I've decided I'm not saying another word on this. It's done. The BMA have sold us out and agreed to a contract that is unsustainable and even more punitive than the one we striked for. We went through all that, patients went through all that, our consultants and nursing colleagues went through all that, for nothing. I could not be more dejected.

You won't get policy change, that much was clear, so you need to consider whether this was the best result you might have got.

And as you say, you can still make a point by voting with your feet OR if you can stomach it, working to rule and not putting in the unpaid extra's etc.

[z-layrex]

Waiting for the c***s to come for the nurses now.

[Parafox]

Waiting for the c***s to come for the nurses now.

 

And us... Paramedics and other ambulance staff

[Rincewind]

I'd like to see Hunt spend a couple of weeks working in an A&E ward.

[Jon the Hat]

Waiting for the c***s to come for the nurses now.

 

The 9-5 Monday to Friday clinic staff are not going to be very happy I guess.  Make it tough for those with kids.

[Guest MattP]

Oh and look out for the nursing contract negotiations.

You have to hand it to the DoH by the way. Handed the BMA it's arse on a plate.

 

From the representation that the BMA has sent onto the Radio and Television I'm not at all surprised, you did a far better job of defending the junior doctors on here thanall of them put together, everytime you saw a BMA official being interviewed you came away from it thinking it was everything to do with Saturday pay and nothing else.

 

That's the ultimate goal for the Tories.

 

You lot have been saying that since the 50's, no one believes it except yourselves.

[Rincewind]

Someone once said that to take over the people it is done a little at a time so that it is not noticed. Interesting thought of the day.

[Parafox]

As for seven day working, as has been said many times over that is how it is now, particularly in A & E. Junior doctors work on all the wards at nights and weekends.

 

Have you noticed though, that no-one gets discharged from a ward over the weekend (with the probable exception of a medical assessment ward)?

 

That's because a senior medic, SHO, or Consultant has to make the final decision on discharge after a review of the patient in discussion with the doctor responsible and reading the notes. Ward SHO's and Consultants don't do weekends.

 

So it's not the junior doctors who are at fault but are being targeted, it's the senior medical staff who need to do their bit to make a it true 7 day a week service.

[sphericalfox]

As for seven day working, as has been said many times over that is how it is now, particularly in A & E. Junior doctors work on all the wards at nights and weekends.

Have you noticed though, that no-one gets discharged from a ward over the weekend (with the probable exception of a medical assessment ward)?

That's because a senior medic, SHO, or Consultant has to make the final decision on discharge after a review of the patient in discussion with the doctor responsible and reading the notes. Ward SHO's and Consultants don't do weekends.

So it's not the junior doctors who are at fault but are being targeted, it's the senior medical staff who need to do their bit to make a it true 7 day a week service.

A major factor in discharge is not just a suitable person to discharge them, but a suitable place to discharge to, with the necessary after care needed. Very few oatients who need dischargubg into a home will be released as homes in tge majority don't receive discharge patients on a weekend, and should the patient be sent home, the available transport firstly available, then the necessary community care available on a weekend most importantly available to manage them.