Whose fault is it for the 'failures' of the NHS?
There seems to be loads of news currently about failures within the NHS whether it's understaffing, problems with specific hospitals/trusts, issues with privatisation, problems with A&E etc.
But whose fault is it for these 'failures'? Is it the current government's fault?
Discuss
But whose fault is it for these 'failures'? Is it the current government's fault?
Discuss
Scroll to see replies
Original post by skotch
There seems to be loads of news currently about failures within the NHS whether it's understaffing, problems with specific hospitals/trusts, issues with privatisation, problems with A&E etc.
But whose fault is it for these 'failures'? Is it the current government's fault?
Discuss
But whose fault is it for these 'failures'? Is it the current government's fault?
Discuss
In terms of the poor treatment of whistle blowers, for example with the Mid-Staffordshire NHS Foundation Trust, I think that it would be the fault of the people who caused the culture of 'keeping quiet', who I presume are the very senior managers within the Trust.
In terms of privatisation, I think it would be down to the MPs and the governments.
Understaffing of NHS staff is quite clearly a monetary issue, which ultimately is down to the Chancellor of the Exchequer, as he is the one who decides the budget for the Department of Health.
Original post by thegodofgod
In terms of privatisation, I think it would be down to the MPs and the governments.
Understaffing of NHS staff is quite clearly a monetary issue, which ultimately is down to the Chancellor of the Exchequer, as he is the one who decides the budget for the Department of Health.
In terms of privatisation, I think it would be down to the MPs and the governments.
Understaffing of NHS staff is quite clearly a monetary issue, which ultimately is down to the Chancellor of the Exchequer, as he is the one who decides the budget for the Department of Health.
Except that during the last government, they shovelled money into the NHS furnace like it was going out of fashion, and things got worse.
Original post by Clip
Except that during the last government, they shovelled money into the NHS furnace like it was going out of fashion, and things got worse.
Yes, that may be so, but now that they've started removing layers of middle management and other bureaucrats, the Department of Health will have a lot more money to spend on staff where it is really needed.
Current A&E strain is down to a lack of senior medical cover, the inability of the government (thanks to making populist commitments to keeping A&E Departments open despite the need for rationalisation of services) and cuts to local authorities and social care, as well as inpatient mental health services, meaning A&E is often the only place people have to go for their care needs despite it not being the most appropriate place. This is compounded by an ageing population with more complex needs.
Short staffing is down to budgetary restrictions within individual Trusts, compounded by government 'efficiency' savings and an effective cut to the NHS budget (when you consider that the NHS needs bigger increases than it has been given just to stay the same financially).
The last government is responsible ineffective for GP contracts, but did treble the NHS budget and saved it from collapse after years of Tory negligence.
I think we need a huge rethink about the way we care for people and the services we provide. It is really inefficient and actually quite dangerous to maintain smaller A&Es when all evidence points to better outcomes for patients when services are centred in large acute centres with community services in smaller hospitals. The same applies to maternity services, Trauma services and stroke services. However I don't think the current reorganisation of the NHS will allow for strategic decisions like the one above to be made because there will be little clear direction and GPs will be loathed to downgrade their local hospital even if it is the most appropriate decision to make.
I do firmly believe in the NHS and that it's amongst the best healthcare providers in the world, but the current crisis needs some radical thinking to solve.
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Short staffing is down to budgetary restrictions within individual Trusts, compounded by government 'efficiency' savings and an effective cut to the NHS budget (when you consider that the NHS needs bigger increases than it has been given just to stay the same financially).
The last government is responsible ineffective for GP contracts, but did treble the NHS budget and saved it from collapse after years of Tory negligence.
I think we need a huge rethink about the way we care for people and the services we provide. It is really inefficient and actually quite dangerous to maintain smaller A&Es when all evidence points to better outcomes for patients when services are centred in large acute centres with community services in smaller hospitals. The same applies to maternity services, Trauma services and stroke services. However I don't think the current reorganisation of the NHS will allow for strategic decisions like the one above to be made because there will be little clear direction and GPs will be loathed to downgrade their local hospital even if it is the most appropriate decision to make.
I do firmly believe in the NHS and that it's amongst the best healthcare providers in the world, but the current crisis needs some radical thinking to solve.
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Original post by Clip
Except that during the last government, they shovelled money into the NHS furnace like it was going out of fashion, and things got worse.
On what measure did things get worse?
All outcomes for patients were better when Labour left office than when they came to it. There were more nurses and doctors than ever before, and waiting times for routine operations were at their lowest ever. Public satisfaction with the NHS at the end of Labour's time in office was higher than ever before.
We had the best outcomes in the world for patients using NHS services thanks to sustained investment by government after years of neglect under Major and Thatcher.
Not by any means was it perfect but the last Labour government actually turned the NHS in to a far better one than the one they inherited.
How do you think it got worse?
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Original post by thegodofgod
Yes, that may be so, but now that they've started removing layers of middle management and other bureaucrats, the Department of Health will have a lot more money to spend on staff where it is really needed.
The NHS is actually quite efficient. Unfortunately, in an organisation that employs over a million people and serves over 60 million people, you kind of do need to have managers. When you compare it to other western health systems, we don't actually do too bad on bureaucracy.
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I imagine a lot of the parties in the next election will be using the NHS as their selling point.
So there's understaffing as well as inefficiencies... But the inefficiencies are (partially) a by-product of having such a vast workforce? Is that right?
How can these failures be rectified then? Because surely increasing the workforce would just add to the inefficiencies?
So there's understaffing as well as inefficiencies... But the inefficiencies are (partially) a by-product of having such a vast workforce? Is that right?
How can these failures be rectified then? Because surely increasing the workforce would just add to the inefficiencies?
Its the medical schools' fault for not accepting enough applicant so that there would be more consultant to help out. Consequently, patients arent taken care of
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Too many middle managers on a power trip, not enough useful staff to care for patients.
Original post by euphful
The last government is responsible ineffective for GP contracts, but did treble the NHS budget and saved it from collapse after years of Tory negligence.
I think we need a huge rethink about the way we care for people and the services we provide. It is really inefficient and actually quite dangerous to maintain smaller A&Es when all evidence points to better outcomes for patients when services are centred in large acute centres with community services in smaller hospitals. The same applies to maternity services, Trauma services and stroke services. However I don't think the current reorganisation of the NHS will allow for strategic decisions like the one above to be made because there will be little clear direction and GPs will be loathed to downgrade their local hospital even if it is the most appropriate decision to make.
I do firmly believe in the NHS and that it's amongst the best healthcare providers in the world, but the current crisis needs some radical thinking to solve.
Posted from TSR Mobile
The last government is responsible ineffective for GP contracts, but did treble the NHS budget and saved it from collapse after years of Tory negligence.
I think we need a huge rethink about the way we care for people and the services we provide. It is really inefficient and actually quite dangerous to maintain smaller A&Es when all evidence points to better outcomes for patients when services are centred in large acute centres with community services in smaller hospitals. The same applies to maternity services, Trauma services and stroke services. However I don't think the current reorganisation of the NHS will allow for strategic decisions like the one above to be made because there will be little clear direction and GPs will be loathed to downgrade their local hospital even if it is the most appropriate decision to make.
I do firmly believe in the NHS and that it's amongst the best healthcare providers in the world, but the current crisis needs some radical thinking to solve.
Posted from TSR Mobile
I'm not sure dumping the blame at the door of the GPs is entirely fair. You must remember that at the time there was a long standing recruitment crisis with GPs as funnily enough juniors had very little interest in taking 24 hour care for a heap of patients requiring far more out of hours provision than was ever planned for, in exchange for far less take home pay than they could get in hospital. Had the contract not made things significantly more attractive for GPs we would have seen general practice go the way of NHS dentistry.
Funnily enough we are now discussing at length how to persuade people to consider a career in A&E (a lobotomy not being as common as it once was) as they are starting to build up the frustrations of working far more antisocial hours, on far less interesting stuff, for the same money as you can make having a pleasant chat at civilised times of day on psych (though they also have a recruitment problem to be fair, I'm not entirely sure why).
In essence market forces good when it drives things in the direction that can be argued to help the public purse, but bad when people don't fancy being treated like a doormat and so choose to do something else.
I quite agree about consolidating services, but feel it needs to come with more appreciation of the dangers of selling off day surgery provision for instance to save money, closing the wards that supported it, and then not having the room for manoeuvre when bed demands change. Last I heard we currently have 40% fewer beds than 10 years ago and hence run at far tighter capacity. This in turn leads to substantial vulnerability to the system in instances of sudden increased demand. Not so bad when you can cancel every elective case planned for two weeks without substantial fines, but a big problem when you are running at capacity and you get rain on frozen streets and 250 orthopaedic cases arrive (something I saw last year), without the ability to affordably tell the stuff that can wait to do so.
The GPs are in my opinion clearly being set up for a fall on the commissioning. If they were interesting in doing that for a living (and competing in many cases with firms who do it for a living) they wouldn't have chosen a career in medicine. It will all fall down in the next couple of terms and clearly the only way to bring in suitable management will then be to privatise it.
Original post by ekpenyongnsa
Its the medical schools' fault for not accepting enough applicant so that there would be more consultant to help out. Consequently, patients arent taken care of
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Posted from TSR Mobile
Are you being serious?!
The NHS is a very public system dealing with issues where emotions run high. It will always have 'failings'. Even if overnight we increased standard of care x10, next month we'd just identify other 'failings' in places where it perviously wasn't high priority. That's the nature of a public service.
And that's an important role. Public services need regular review to keep them efficient.
We certainly do better than a private system, where every single patient needs their insurance checking before they are treated!
And that's an important role. Public services need regular review to keep them efficient.
Original post by euphful
The NHS is actually quite efficient. Unfortunately, in an organisation that employs over a million people and serves over 60 million people, you kind of do need to have managers. When you compare it to other western health systems, we don't actually do too bad on bureaucracy.
We certainly do better than a private system, where every single patient needs their insurance checking before they are treated!
(edited 10 years ago)
First, can we define failure? The Mid-Staffordshire scandal has been blown so far out of proportion that it really doesn't give much indication of failure. This is a long debate in itself, but it's worth considering that just because the media say a hospital has failed, and hence convince Government it's failed, that doesn't mean it truly did fail.
I'm sure there are issues, though, and that's mostly down to money and the way it's been allocated and spent. Wastage was, and still is, a huge problem; one example: someone I know working in the label industry figured they could have saved the NHS millions of pounds on labels. Sticky labels. Can you imagine how far that stretches?
Doctors are under stress in the NHS due to under-staffing and that can only be the Government's fault for choosing to allocate >£40B to HS2 rather than medical staff
I'm sure there are issues, though, and that's mostly down to money and the way it's been allocated and spent. Wastage was, and still is, a huge problem; one example: someone I know working in the label industry figured they could have saved the NHS millions of pounds on labels. Sticky labels. Can you imagine how far that stretches?
Doctors are under stress in the NHS due to under-staffing and that can only be the Government's fault for choosing to allocate >£40B to HS2 rather than medical staff
Poor selection criteria for doctors with too much focus on academic ability and commitment is one of the issues.
Source: Gone through process, received offer, and can confirm that you don't need to show that you care for patients well-being.
Source: Gone through process, received offer, and can confirm that you don't need to show that you care for patients well-being.
Original post by MedicineMann
Poor selection criteria for doctors with too much focus on academic ability and commitment is one of the issues.
Source: Gone through process, received offer, and can confirm that you don't need to show that you care for patients well-being.
Source: Gone through process, received offer, and can confirm that you don't need to show that you care for patients well-being.
They say a medical degree is similar to a driving test; whilst the skills you learn during the degree are useful and correct, when you come to practising as a doctor things are completely different. Much like a driving test - the way you drive once you've passed is very different from that required to pass the test.
Original post by thegodofgod
Are you being serious?!
Obviously not.was being sarcastic duh.. med schools do a pretty decent job in the selection of students
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Every new government likes to tinker with the NHS and none have them have ever got it right, it's a political pawn in the game of party politics. But despite this constant interfering we still have an excellent health care system, free at the point of use. That's in no small way down to fantastic doctors and nurses and their support staff.
It's never going to be perfect, but having people at the top that are NHS through and through and are not mates of a mate from Westminster, will go a long way to help.
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It's never going to be perfect, but having people at the top that are NHS through and through and are not mates of a mate from Westminster, will go a long way to help.
Posted from TSR Mobile
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