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    In my area, A&E is in trouble because all our Walk-In Centres were closed and the three Minor Injuries Units within a fifteen mile radius are all closed overnight. Only one of them is open 7 days a week and that's 13 miles away from the big population centres and would mean me catching three buses over two hours. Not exactly practical if you have a broken bone or are in pain from an injury. GP surgeries no longer offer an out-of-hours service - when their Reception is closed, their automated message directs you to call 111, who have nowhere other than A&E to send us to for 14 hours a day.

    A&E is struggling round here, because 6pm-8am daily, that's the only NHS place open.
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    (Original post by Klix88)
    In my area, A&E is in trouble because all our Walk-In Centres were closed and the three Minor Injuries Units within a fifteen mile radius are all closed overnight. Only one of them is open 7 days a week and that's 13 miles away from the big population centres and would mean me catching three buses over two hours. Not exactly practical if you have a broken bone or are in pain from an injury. GP surgeries no longer offer an out-of-hours service - when their Reception is closed, their automated message directs you to call 111, who have nowhere other than A&E to send us to for 14 hours a day.

    A&E is struggling round here, because 6pm-8am daily, that's the only NHS place open.
    There will be out-of-hours GP provision. If your practice doesn't do it, then it defaults to the local NHS Area Team.

    Anyway, sounds nice. In Scotland we've never had walk-in centres.
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    (Original post by L i b)
    There will be out-of-hours GP provision. If your practice doesn't do it, then it defaults to the local NHS Area Team.
    There is no out of hours GP provision where I am. Scotland sounds fantastic if they still have it.

    The Area Team is an administrative body. It's part of the top-heavy NHS management structure which commissions and manages services. They offer no direct clinical/medical services to the public. Even if they did, they would have nowhere to send us other than A&E.

    From their website:

    Role of the Area Team:

    Maintain system oversight
    Assure the work of the Wessex CCGs, co-ordinating the annual planning process and supporting them to be the best they can be
    Directly commission primary care services, specialised health services and public health screening services
    Lead for the NHS on emergency planning and response
    Manage the monthly Quality Surveillance Group (QSG)
    Oversee the performance of independent contractors, including the appraisal and revalidation of all doctors
    Oversee the work of the four Strategic Clinical Networks
    Oversee significant service reconfiguration
    Manage Cancer Drugs Fund and Individual Funding Requests for specialised care on behalf of South of England
    I've tried calling my GP out of hours. The lights are off. It's call 111, 999 or wait until the surgery opens.
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    (Original post by Schmeckel)
    Well, I'd most likely text 'urgent' to 64446.
    Well, most Emergency departments don't really run at profit so you'll have to go to an NHS hospital.


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    (Original post by Klix88)
    There is no out of hours GP provision where I am. Scotland sounds fantastic if they still have it.

    <snip>

    I've tried calling my GP out of hours. The lights are off. It's call 111, 999 or wait until the surgery opens.
    there is out of hours GP provision across the UK

    in many places it is accessed through 111 thanks to the wonderful 'new' GP contracts berought in during the 13 years of the Great Leader and the Dear Leader meaning it was cheaper to opt out and then pick up the odd shift OOH for the then PCT to make that small sum back than to provide your own OOH cover.
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    The NHS hasn't 'suddenly' collapsed. It's not collapsed entirely, for starters. Secondly, none of this is sudden, people have been warning about this for donkey's years. If you cut budgets year on year and ask people to make crazy efficiency savings year on year, there is going to be a point where you can no longer cut 'irrelevant' things and you have to start making cuts in actual services that people need. The NHS has been making efficiency savings for years and years!

    Privatisation is also mad. Take Circle which ran Hinchingbrooke hospital for some time, and suddenly dropped out because lo and behold it's not profitable to run. Private companies can just bail when they're not making enough £££ and that affects actual real people and the rest of the NHS.

    Private companies make their profit by taking all the easy work off the NHS. Simple as. The NHS then looks increasingly inefficient because all of the simple cases have been contracted out to privateers who may or may not even be as qualified (GPs are running specialist services in some areas!), and the way that the NHS is paid means the private companies are taking all of the work where the money is and leaving the hospitals to deal with everybody else. For instance you get a lot more money for seeing new patients rather than follow-up, so if you as a private company take only conditions which are one-stop to be seen and don't take on any complex cases which will take a lot of monitoring and repeat visits to try and get on top of - you're quids in. Hospitals would then be losing money because they would no longer have such a good case mix of new patients vs. follow up patients, and unfortunately the new patients used to help cover some of the funding gap for the follow up patients!
    This isn't just new patient versus follow-up but a whole raft of things which can be selectively creamed off.

    You cannot make efficiencies through privatisation of healthcare without either this "taking the cream off the top" method (and sinking the services left behind) or reducing the quality of healthcare. We could save loads of cash by denying people access to specialised drugs, for instance. Or by reducing access to imaging. But nobody wants to do that, for obvious reasons that it damages what the NHS is there for - people's health!

    The two biggest reasons for the crashing of A&E recently are:
    1. People going to A&E for idiot things. A runny nose for instance. Why not go and see a GP? Oh wait you did see an out of hours GP, but you just ignored them for reasons unknown. Or you couldn't get a GP appointment for your runny nose til the day after tomorrow - but we all know runny noses are urgent and must be seen within 24hrs!!! In fact it'll probably be better by then, all by itself. This is not the thing which has tipped A&E over all by itself, but people seriously need to get some perspective on their problems and deal with certain fact-of-life illnesses by themselves.

    2. Bed blocking. Social and community care has been gunned down. We're all getting older, but we're not being looked after very well (due to lack of funds/resources/common sense in a few cases) and so more people get tipped into illness who wouldn't otherwise. Then it's impossible to discharge them because their home circumstances (read: social situation) are inadequate, and getting something done about that is very slow. People are taking up beds and then more sick people come into A&E and cannot be put into those beds because they're already occupied by people who can't be discharged to poor circumstances. So they sit in A&E rather than on the ward they ought to be on (and breach the 4hr wait) and then there's no space in A&E. To make more space and more beds, all elective operations in the hospital are cancelled so the beds can be used for these emergency patients -anybody who needed something elective to be done, well poor old them. Then because these people are sitting down there, there's no space in A&E so the people brought in by ambulances plus the ambulance men and women are queued in the corridor. Meaning the ambulances are also not free. It's like a vicious cycle. There's a lot of input into hospitals in terms of number of patients, but not enough output. The problem is partly healthcare but also a lot of it is just plain old social care that's been rammed under this government.

    That's my view on it anyway.
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    (Original post by Schmeckel)
    In my opinion, anything that decreases the tax burden on the average Briton is going in the right direction. I believe that privatising the NHS would be a major source of relief from tax burden, even adjusting for the loss the average Briton would have to pay owing to doctors' fees an'all.
    Lower tax would massively increases inequality though. The wealthy get to
    keep at lot more money. I actually think the UK should follow a Scandinavian model of very high tax (~75% top bracket) but extremely good free public services.
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    (Original post by tombayes)
    Lower tax would massively increases inequality though. The wealthy get to
    keep at lot more money. I actually think the UK should follow a Scandinavian model of very high tax (~75% top bracket) but extremely good free public services.
    Please don't use the words 'very high' and 'tax' in the same sentence. It makes me want to shoot myself.

    Nothing wrong with inequality, as long as it's the right sort of inequality. There will always be the rich and the poor in the world. Gentlemen and scum. The educated and the uneducated. Patricians and plebeians. Bourgeois and proletarians.

    The only thing you can do is try to prevent it going out of hand... but gently. Not with heavy-handed schemes like income redistributions. Income redistribution is essentially a penalty for the successful so that the unsuccessful can benefit---try to handicap people, essentially. Real life isn't sport---you can't give someone a handicap (in the golf sense) just because they seem to be making a hash of things. You can try gently to guide the unsuccessful to find success... and you can also try to make sure that the successful are making their money ethically... but you can't rob from the rich and give to the poor unless you're **** Turpin, and he was hanged for that.
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    (Original post by Schmeckel)
    Nothing wrong with inequality, as long as it's the right sort of inequality. There will always be the rich and the poor in the world. Gentlemen and scum. The educated and the uneducated. Patricians and plebeians. Bourgeois and proletarians.

    The only thing you can do is try to prevent it going out of hand... but gently. Not with heavy-handed schemes like income redistributions...
    I am not against inequality just unnecessary inequality. Also, you seem not to have much of an understanding of tax - high tax does not mean people are worse off, for example in the 1979 the highest band was 83% but this money was used to fund programs allowing the UK to reach one of the highest percentage of home ownership. However, in Major's Government there were huge reduction in both direct and indirect tax which has continued until today leading to too much of the 'bad' type foreign investment (i.e. they are buying up property). The problem with lower tax is that the rich get richer; which is not a problem in itself, but they tend to buy less 'economically useful' items compared to that wealth distributed between say 100 people . E.g. that wealthy person may buy property, diamonds, private jets, etc but this does not create jobs, help economic growth, etc.

    Obviously this is just one side there are valid arguments for lower tax but you should be aware lower tax is not always good. A good example is if the wealthiest 1% of UK residents paid an extra 0.5% in tax each, everyone could use the tube and buses for free (The Economist). Or if the wealthiest 1% of UK residents paid an extra 0.5% in tax each, everyone could have no university tuition fees. Does this not increase social mobility?
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    (Original post by tombayes)
    I am not against inequality just unnecessary inequality. Also, you seem not to have much of an understanding of tax - high tax does not mean people are worse off, for example in the 1979 the highest band was 83% but this money was used to fund programs allowing the UK to reach one of the highest percentage of home ownership. However, in Major's Government there were huge reduction in both direct and indirect tax which has continued until today leading to too much of the 'bad' type foreign investment (i.e. they are buying up property). The problem with lower tax is that the rich get richer; which is not a problem in itself, but they tend to buy less 'economically useful' items compared to that wealth distributed between say 100 people . E.g. that wealthy person may buy property, diamonds, private jets, etc but this does not create jobs, help economic growth, etc.

    Obviously this is just one side there are valid arguments for lower tax but you should be aware lower tax is not always good. A good example is if the wealthiest 1% of UK residents paid an extra 0.5% in tax each, everyone could use the tube and buses for free (The Economist). Or if the wealthiest 1% of UK residents paid an extra 0.5% in tax each, everyone could have no university tuition fees. Does this not increase social mobility?
    If I wasn't on track to become a tax lawyer and thus would lose money on this, I'd be in favour of a uniform tax rate, say 30%. Rich, or poor. No deductions.

    I'd be willing to have it higher, as high as 50 or 60%---but equal for ALL, not letting the poor benefit more.

    In regards to Major, I pity the old boy---never could measure up to his predecessor (may Her great name be magnified and sanctified) and UK politics just went downhill after he left office.
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    (Original post by Schmeckel)
    If I wasn't on track to become a tax lawyer and thus would lose money on this, I'd be in favour of a uniform tax rate, say 30%. Rich, or poor. No deductions.

    I'd be willing to have it higher, as high as 50 or 60%---but equal for ALL, not letting the poor benefit more.
    We already have VAT which is fixed for everyone. Your idea of uniform tax would make the poor poorer and the rich even richer - have you ever thought of becoming a politician?
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    (Original post by tombayes)
    We already have VAT which is fixed for everyone. Your idea of uniform tax would make the poor poorer and the rich even richer - have you ever thought of becoming a politician?
    Of course I have. I ultimately decided against it, as a politician is accountable to his constituents, whereas a corporate executive or a barrister is accountable only to God Himself. Plus, it's easier to launder money as a barrister

    Besides, as I said before, I'm for the middle class. Not for the poor. If the poor get poorer, that's not my business---in fact, I used to bait tramps by burning money in front of them.
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    (Original post by Schmeckel)
    I'm for the middle class. Not for the poor.
    Actually an argument against high tax is that it hits the middle class the hardest. The rich are able to move their money around to avoid the higher tax e.g. offshore banking, etc

    Also, what are you studying?
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    (Original post by tombayes)
    Actually an argument against high tax is that it hits the middle class the hardest. The rich are able to move their money around to avoid the higher tax e.g. offshore banking, etc

    Also, what are you studying?
    Well, that's why I was talking about equal tax for everyone. The middle class would be unaffected, the rich would be unable to wiggle out of paying it (no deductions!), and the poor---well, f*ck the poor.

    About to study Law.
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    (Original post by Schmeckel)
    a barrister is accountable only to God Himself. Plus, it's easier to launder money as a barrister
    So which one is god:

    The BSB? Head of Chambers? The clerk(s)? The judge? Your client?

    You're full of rubbish.
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    (Original post by InnerTemple)
    So which one is god:

    The BSB? Head of Chambers? The clerk(s)? The judge? Your client?

    You're full of rubbish.
    I was joking, hence the smiley face icon. I may be full of miscellaneous waste product, but you have zero sense of humour.

    Besides, no reason why the Clerk, the Client, and the Holy Judge couldn't form an Unholy Trinity :P
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    (Original post by Schmeckel)
    the rich would be unable to wiggle out of paying it (no deductions!)
    I would not be so sure.
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    (Original post by Schmeckel)
    I was joking, hence the smiley face icon. I may be full of miscellaneous waste product, but you have zero sense of humour.

    Besides, no reason why the Clerk, the Client, and the Holy Judge couldn't form an Unholy Trinity :P
    I've no time for humour.

    I am sorry for saying you are full of rubbish - on this occasion.

    I think those three regularly come together to cause misery to the bewigged.
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    Too many managers getting all the money?
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    (Original post by InnerTemple)
    I've no time for humour.

    I am sorry for saying you are full of rubbish - on this occasion.

    I think those three regularly come together to cause misery to the bewigged.
    I'd rather take ten Unholy Trinities than one Satan (in the form of the BSB).
 
 
 
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