NHS - Why do they always get it wrong?

It is all about money.

Chaps

I think our health system is rapidly becoming two teir....the plebs use the NHS and the elite go private.

My wife had a op on her knee last week. The consultant said there was a years waiting listing on the NHS but only two weeks if done privately.

I have medical insurance so no worries.

She had the op last week. Since then she has visited the quack twice and a physio once The time with the quack was 10 minutes max and he submitted a bill of £120.00 per visit. The 30 minute physio was £66.00. So in one week they have racked in £300.00 for 50 minutes work.

More visits are planned.

These quacks are not interested in the NHS when there is private work about. They are businessmen. I do not blame them but the sytem is in need of some reorganisation.

Regards

Mick

 

Paul,
That is a national level.

Maybe that is the problem. Everyone don't know how to do the job just complain and everyone else who have the skill wouldn't get out of bed unless they are paid way too much.

However, since the report says the rest have bad track records you could get the contract easily if you could show you can get the job done and for a knock down price.

 

Going abroad

Chaps

Unless my mind is playing tricks, I am sure that it is often cost effective to have operations carried out abroad. I believe that India has first class eye hospitals and the savings easily outstrip the airfares.

Some possibly it could prove useful to look elsewhere.

Regards

Mick

 

It's actually a fair bit less to train as a GP - post graduation you have to spend something like a year doing a speciality like A&E and then a further year doing GP training - still 7 years in total mind.

Becoming a consultant is a different matter altogether - a few manage it by their late 30's but generally you are talking early 40's so you are talking about 15-20 years AFTER you've got your medical degree.

On the private side, specifially private hospitals - they are fine for minor ops but for something serious you're a lot safer in an NHS hospital. I guess the best thing for serious ops is to pay to have it done privately but in an NHS hospital.

The impression I get of the NHS from the outside (my wife is a surgeon now retraining as a GP) is that, unlike in private business, they are never willing or able to spend the time and money to actually see how all their processes could be made better/more efficient as whenever extra money goes in it has to result in reduced waiting lists etc. so they just hire more people to do more work inefficiently - bit of a catch 22 really.

Matt.

 

Oh well, if your mum's friends say that it's inefficient, who am I to argue?

We are seeing a lot of inappropriate referrals, partly as a result of that nice Mr Major's patients' charter. Additionally, the 'rights' culture means everyone now has the right to see a consultant, no matter how trivial the complaint.

On another point, I was appointed at the age of 33, but then I am a genius [see elsewhere for confirmation].

 

Devil says he is a hospital consultant. To be a GP in Uk you have to go thro 5 years undergraduate MBCHB. Then 1 year Pre-Registration Training. Follow by 3 years as Senior House Officer usually hospital based speciallties. Then 1 year of GP registrar trainee. Minimum 10 years. Some takes longer . Ask your wife.

 

I have and here is her answer:

Following graduation you have to do one year as a house officer. After this you have to do a minimum of 18 months as an SHO (this consists of three 6 month jobs - usually something like A&E, obs & gynea & paedeatrics) then you have to complete a year as a GP registrar trainee.

So, after graduation, it's a minimum of 3.5 years to become a GP.

Matt.

 

Thanks you for finding the correct answer for me.

 

I used to work in the NHs and have witnessed the problems 1st hand.

Ambulances are called out for trivialities like cut fingers and swollen testicles, some people think an ambulance gets you seen quicker, whereas its all about medical urgency, not how you get there.

An ambulance is for life threatening conditions or serious problems getting worse, not for a free taxi ride. Parents can drive their children, there is nothing an ambulance can do for a child with a fever or cold. Whatsover.

You are in the shit if you heart stops after 50 yrs old period, 5 in 100 come back. Mouth to mouth only keeps the brain alive CPR is US to get someone back, only to keep them going. Even with a defib and cardiac drugs, most don't come back. Its scary.

All ambulances do is monitor and administer life saving drugs, nothing more, apart from dress wounds and a light pain relief, and fractures.

The most common calls are:

chest pain lots
asthma
drunks drugs...lots
falls
rtas, minor.

an ambulance, apart from a few drugs for cardiac arrest carries

glucagon for diabetes
ventolin for asthma
oxygen, entonox for pain
aspirin, and glyceryl trinitrate for chest pain.
fluids for shock

that is it. drugswise.

People aren't living considerably longer than 20 yrs ago, part of the reason is partly that they are retiring earlier,

they have been inundated with trivial health things thro' the media,

True certain illnesses are on the way up, doctors diagnose depression and asthma at the drop of a hat. Prozac costs £20 a month, this is typcial and is getting dished out for eating disorders,
seroxat is now used for shyness, £20 a month, too.

To put that into perspective, diazepam costs about 50p for loads, and an old but widely held effective anti depressant, dothiepin costs a few pounds, not £30 like the modern ones getting given like sweets for anything.

My explanation is a combination of awareness and brainwashing by the media, increased competition, envy of others, stress pace of life, a huge cocktail.

costs are spiralling...new drugs, diagnostic equipment.

Managers are rife and useless, they just create expensive procedures that don't work well.

you have all these useless men and women with half moon glasses talking over coffee all the time, that is meetings. nothing gets done except money paying these jerks. and consultants say nothing and cream 100s of thousands.

some ambulance services put up staff in hotels for the 9 week training, full board, + the cost of training, that is unnecessary, let them commute

You can learn accident and emergency medicine in 2 weeks max, inc driving, but they are scared about inadeqate training, so they make it long to satisfy the overseers, and give some more desk people the power to regulate it.
in realilty all they do is fill up the time talking a lot about nothing.
I have been there.

Plus you have the bus loads of illegal immigrants coming in getting cash, housing clogging the shops, roads, hospitals.

And the british taxpayer, whilst paying lots does not want to pay to have a decent country, I do. they don't realise they have to pay anyway, private for everything.

With the nhs, the private contractors will milk it as it has to happen. or we don't get healthcare.

a GP takes 3 yrs to train, not 1 BTW. It is useful if s/he has a good bit of xp tho' as it takes maturity and judgement, more than a cosseted hospital environment.

I am all for a free nhs, but I think it is beyond repair, the nature of the beast is such that it is a cash drain and it goes to all the beaurocrats.
i think the only way to save it and get good care is to make it totally private, that would streamline the cash and efficiency, but I worry about those who can't pay.

 

Nice reply, I am sure it will anger some people but it made a lot of sense.

Also I got my appointment at the end of May now, only 3 weeks after the latest date, since I was told it would be done within 2 months 3 months ago.

However the procedure of getting me this appoint seemed stupid:

When people come in needing semi emergency operations like me (i.e not imedetality life threatening) but can't wait 6 months they have to cancel other peoples appointments to fit the semi emergency ones in. Surely this is wrong? I feel so guilty that people have had canceled appointments because of me, but this isn't my fault its the systems.

 

I work for the NHS too, in the mental health team of a strategic health authority. Clearly any organisation of such a size will suffer from problems, but I'd broadly agree that in the NHS's case, it's the management structure that's to blame more than any of the people 'on the ground'. Almost everyone I meet in my work is hugely committed to delivering the best healthcare possible, but is invariably hamstrung by the clumsy systems within which they have to operate.

For example, strategic health authorities performance-manage the trusts that provide actual care to patients. In turn, we are accountable to, or must work in partnership with, the Department of Health, the Healthcare Commission (as it is now called - its name has changed twice in recent months), the National Institute for Clinical Excellence and the National Institute for Mental Health England. There are targets and benchmarks to be met with all these partners. In seeking the worthy goals of improvement and progress-tracking, the government has imposed a huge amount of extra administration on many.

It is extremely common for me to attend meetings which are entirely taken up with the various agencies introducing themselves, outlining their new roles, and re-identifying the problems and challenges we face in our sector. We all agree that there are significant tasks ahead, and try to move forward in the hope that we will get some work done before the goalposts are moved again. At the time of writing, the future of strategic health authorities themselves is in question - despite the fact that we were only brought into existence two years ago.

My suggestion for a way forward? Make the NHS independent of government. Do not privatise it, but allow it - like the Bank of England - to make its own decisions. Give it a rolling 5-year budget (instead of the 3 years we have now - only recently put in place: before that we could only plan 1 year ahead!). An organisation so vast cannot run well when its structures are constantly being tweaked, and new 'targets' introduced, to co-incide with general elections. Hand over control to the civil servants and healthcare professionals, who may well have broader visions and longer attention spans (not to mention longer careers!) than most politicians.

Meanwhile, good luck with your hernia op, AT!

 

Thanks, I am worried more about the acutaly stay in hospital and lying ont he operating theatre just as I am about to be put to sleep more than the operation itself.