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NHS building budget 'cut by 21 per cent' watch

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    (Original post by zippyRN)
    what like all the old crumbling lunatic asylums ?

    or all the hospitals that were closed when their services were transferred to new hospital on the site of an existing hospital ...

    ( e.g. St Georges in Lincoln ... when all the acute services in Lincoln were brought onto one site in the 'new' Lincoln county hospital

    or

    the closure of Dewsbury and Batley hospitals when all the services were centralised onto the Staincliffe site and Dewsbury and district hospital ...

    or

    the closure of all the unsustainable little hospitals which provided very poor care with appaling levels of lack of medical cover )


    we've not even mentioned the reduction in length of stay, day surgery, movement of certain services out into the community, the removal of hospital beds being run for social care purposes ( e.g. the care of the elderly and psychogeriatric facilities )

    how about the chronic underfunding of the NHS by every labour government from 1948 onwards until the pointless targets and remove an innovation , rebadge with liarbore spin and relaunch it practices of Bliar and Broon

    'foundation trusts' - bring back freedoms that Liarbore took off trusts after coming to power in 1997

    'practice based commissioning ' rebadged GP fundholding which again liarbore took off primary care whn they came to power

    people love to refer to 18 month waiting lists etc ... again for elective procedures not for clinically urgent problems, the 18 week target is again a triumph of crowd pleasing spin just like the 4 hour A+E target - which has arguably harmed care in many cases
    Interesting rant. Unfortunately you don't appear to have any evidence to back it up. The simple fact is that instead of "chronic underfunding", NHS spending has increased every year since 1997 - see the table at http://www.civitas.org.uk/nhs/download/NHSfinances.pdf. In 1997, £35billion was spent each year; today it is £110bn. A&E waits are down, number of hospitals is up, number of nurses is up, investment has nearly tripled and waiting lists are at record lows - I really don't see how any sensible person could argue against the proposition that the NHS has improved dramatically since 1997, which is why I suppose the Tories now seem to support the changes that have taken place. To accuse Labour of under-funding the NHS, particularly as early as 1948, is just nonsense.
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    (Original post by jacketpotato)
    Interesting rant. Unfortunately you don't appear to have any evidence to back it up. The simple fact is that instead of "chronic underfunding", NHS spending has increased every year since 1997 - see the table at http://www.civitas.org.uk/nhs/download/NHSfinances.pdf. In 1997, £35billion was spent each year; today it is £110bn.
    and in real terms ?

    and how much of this money is being wasted on none job s and over promoted failed backed bean stacker liarbore lackeys

    A&E waits are down,
    great

    sadly there's no clinical justification for most of it and the pointless 4 hour target is exactly that pointless, the service recieved by many A+E patients is worse under this regime than it would be had a sensible clinically focussed outcome measure been adopted ...

    it's failure to discharge some from A+E in four hours and two minutes , fully assessed and treated , but it's great success to admit the same person for 72 hours because they spent 3 hours and 58 minutes in the emergency department

    number of hospitals is up, number of nurses is up, investment has nearly tripled and waiting lists are at record lows - I really don't see how any sensible person could argue against the proposition that the NHS has improved dramatically since 1997,
    yes the NHS has improved on the basis of the sound foundations built in the late 1980s and early 1990s of the trust system and GP fundholding , which liarbore stifled only to relaunch after wasting millions trying to 'improve' them with more big government and jobs for cronies

    To accuse Labour of under-funding the NHS, particularly as early as 1948, is just nonsense.
    try telling that to people who have waited 50 years for their new hospital !
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    (Original post by jacketpotato)
    Interesting rant. Unfortunately you don't appear to have any evidence to back it up. The simple fact is that instead of "chronic underfunding", NHS spending has increased every year since 1997 - see the table at http://www.civitas.org.uk/nhs/download/NHSfinances.pdf. In 1997, £35billion was spent each year; today it is £110bn. A&E waits are down, number of hospitals is up, number of nurses is up, investment has nearly tripled and waiting lists are at record lows - I really don't see how any sensible person could argue against the proposition that the NHS has improved dramatically since 1997, which is why I suppose the Tories now seem to support the changes that have taken place. To accuse Labour of under-funding the NHS, particularly as early as 1948, is just nonsense.
    His point on more hospitals it that hospital numbers are irrelavent, quality and size etc is more important.

    And A&E waiting times dropping does not mean a good thing if in order to hit your targets you rush everything.

    Wrong sort of statistics to look at.
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    (Original post by zippyRN)
    and in real terms ?
    The table I linked shows real term increases. Simply google "real term increase NHS spending" if you want to corroborate this - you'll come across a fair few newspaper articles about Tory plans to slow real-term growth.

    great

    sadly there's no clinical justification for most of it and the pointless 4 hour target is exactly that pointless, the service recieved by many A+E patients is worse under this regime than it would be had a sensible clinically focussed outcome measure been adopted ...

    it's failure to discharge some from A+E in four hours and two minutes , fully assessed and treated , but it's great success to admit the same person for 72 hours because they spent 3 hours and 58 minutes in the emergency department
    Perhaps :shrug: Though unless I'm mistaken, the target is to be assessed, transferred or discharged within 4hours - not simply to be discharged. Its definitely something that is hard to quantify, but I think we do need some measure, stupidly waiting times in A&E have been a problem in this country for quite a long time.

    try telling that to people who have waited 50 years for their new hospital !
    You might legitimately be of the view that we should dramatically increase our healthcare spending, but it would be very unfair to single out Labour on this issue.

    (Original post by crazylemon)
    His point on more hospitals it that hospital numbers are irrelavent, quality and size etc is more important.

    And A&E waiting times dropping does not mean a good thing if in order to hit your targets you rush everything.

    Wrong sort of statistics to look at.
    Yes, I agree. Someone should probably shoot me for mentioning A&E. But I think there is plenty of other evidence to look at. Things like the increased number of nurses, operation waiting lists (average is now 4 weeks, I believe - the target under the last government was 18 weeks) and out-of-hours GPs are less controversial things that all point to improved quality.
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    (Original post by jacketpotato)
    The table I linked shows real term increases. Simply google "real term increase NHS spending" if you want to corroborate this - you'll come across a fair few newspaper articles about Tory plans to slow real-term growth.


    Perhaps :shrug: Though unless I'm mistaken, the target is to be assessed, transferred or discharged within 4hours - not simply to be discharged. Its definitely something that is hard to quantify, but I think we do need some measure, stupidly waiting times in A&E have been a problem in this country for quite a long time.


    You might legitimately be of the view that we should dramatically increase our healthcare spending, but it would be very unfair to single out Labour on this issue.


    Yes, I agree. Someone should probably shoot me for mentioning A&E. But I think there is plenty of other evidence to look at. Things like the increased number of nurses, operation waiting lists (average is now 4 weeks, I believe - the target under the last government was 18 weeks) and out-of-hours GPs are less controversial things that all point to improved quality.
    Are you ******* with me? It costs more now and is a less competent and full service!

    Most important thing here is spending losts of money doesn't always mean it will get better, huge sums have been wasted because the government doesn't know how to work with the private sector without being raped by it cause they don't understand business or realise that alot of work done before was off books which a private company is never going to do.
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    (Original post by crazylemon)
    Are you ******* with me? It costs more now and is a less competent and full service!
    I'm not sure what you mean. Seeing your GP is free. Seeing a GP out-of-hours used to be virtually impossible; there has been an enormous increase in evening/weekend availability recently. According to the Labour site, "over three quarters of GP practices are open for at least one evening or weekend surgery a week – compared with just 12 per cent in April 2008".
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    Will this affect the compensation given to doctors?
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    (Original post by jacketpotato)
    I'm not sure what you mean. Seeing your GP is free. Seeing a GP out-of-hours used to be virtually impossible; there has been an enormous increase in evening/weekend availability recently. According to the Labour site, "over three quarters of GP practices are open for at least one evening or weekend surgery a week – compared with just 12 per cent in April 2008".
    The cost to the government, not the individual!

    Most OOH GP services are now run by little organisations such as Camidoc who cover a PCT area and so if you ring up your GP at night you get someone else on the phone, usually based at a hospital, and would be expected to go to said hospital if you required treatment. This is a lot more expensive to run as it requires space in hospitals to be put aside, extra admin, GPs who are paid excessively for these extra hours etc, compared to the old ringing up your GP practice and possibly getting a GP to come in the middle of the night.

    Whilst I do think provision has increased for OOH GP services it has done so in the least efficient way possible... They are also hellish in my experience as everyone with any mild compliant is there and so you end up waiting hours to be seen! It would be much better to give local GP practices shared on-call hours so that fewer people are seen, closer to home, by GPs paid at a normal salary rate.

    EDIT: Evening/weekend surgery figures have gone up but caused huge waves with GPs, the provision for these can often mean daytime surgery hours decrease too. So it's just rearrangement - the benefits of which are pretty subjective.
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    (Original post by jacketpotato)
    I'm not sure what you mean. Seeing your GP is free. Seeing a GP out-of-hours used to be virtually impossible; there has been an enormous increase in evening/weekend availability recently. According to the Labour site, "over three quarters of GP practices are open for at least one evening or weekend surgery a week – compared with just 12 per cent in April 2008".

    utter rubbish

    many GP practices offered early evening and Saturday morning surgeries under the old contract - it managed the demand for out of hours services well and didn't result in the poor standards of clinical care and unnecessary 999 and A+E activity the current arrangements do ...

    the early GP co-ops again under the old contract were far better clinically than the current offerings, e.g. the first time i became aware of out of hours CO-ops was in the mid 1990s, when the four Gp practices that covered 6or 7 local villages started to work together out of hours - suddenly in stead of 1 in 3 and a bit ( 1 in 2 to 1 in 4 .5) the GPs were working 1 in 10 -14 - it was the GPs we all knew even if they weren't the ones from your list surgery ..
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    This is why Private health Care is the way forward.
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    To add my 2p to the debate, the biggest problem in the NHS is misdirection of funding, including:

    Decentralisation of supplies - opening up the market to competing brands was good but it should have been done in a more centralised way so that bigger discounts for larger orders could be gained whilst still keeping competition alive by threatening to change on next order etc.

    Poor quality management - Simply too many people who don't see the real issues. Whilst management is definitely needed I think there are too many people claiming salaries from Trusts who do next to nothing for them. The Trust HQ carpark in the weeks leading up to xmas and during the school summer holidays is always empty and hospitals still function. So why are they all needed? Numbers should be cut. Cutting salaries is likely to attract even worse applicants and so I don't think that's the way forward.

    Some frankly bizarre decisions to build new hospitals when money would have been better spent improving provision at existing ones. Central Middlesex, a mixed acute medical and minor surgery hospital is a brilliant example. Lovely building, clean and modern but it is within 10 minutes drive (in London traffic) of 3 other hospitals. The provision of care is shocking and anyone taken ill there is blue-lighted to one of the other hospitals. It was originally set up (2 years ago) for day surgery but that is to be stopped in a years time, leaving half the hospital redundant and a hell of a lot of money thrown down the drain. It's not a unique example unfortunately, but having worked there it is the one I know best.

    So whilst Labour are banging on about increased spending they have had to increase spending as so much money has been wasted. Not that 'Prudence' Brown and his spin-doctors let you know that of course.
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    (Original post by jacketpotato)
    I'm not sure what you mean. Seeing your GP is free. Seeing a GP out-of-hours used to be virtually impossible; there has been an enormous increase in evening/weekend availability recently. According to the Labour site, "over three quarters of GP practices are open for at least one evening or weekend surgery a week – compared with just 12 per cent in April 2008".
    The out of hours care beyond those few extra hours is now totally awful though since the new contract.

    It has also only happened cause government threatened GPs (pay cut if didn't agree to open), lots of the slots are also filled by people who just want to see the GP rather than timing.
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    (Original post by zippyRN)
    overspend

    1. failure of many staff groups but particularly Medicine, Radiology and pharmacy to engage in providing a fit for purpose service, meaning that huge numbers of bed days and vast quantities of Nursing time are misspent on atients who are only in hospital becasue of the failures of other staff groups to deliver their services in a timely manner


    the same can be said of pharmacy when dispensaries close before the end of the 'business day' rather than working an extended day meaning that patients where the discharge decision is made after 1400hours often end up staying for a further night becasue their TTOs are not done
    What time does your pharmacy close? I've never worked in a hospital pharmacy that closed before 5 on weekdays.

    Also, in my experience pharmacy can't deliver their services in a timely manner because they're the last ones to know! They can't magic medication out thin air when they're not informed the patient is going home until he/she is sat all packed up ready to go and the ambulance is coming to pick him/her up in 10 minutes!

    (Very pharmacy biased of me I know, but yours is very nurse biased )
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    (Original post by kevin_123)
    This is why Private health Care is the way forward.
    Where is that shown to be more efficient?
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    (Original post by Quady)
    Where is that shown to be more efficient?
    I dont know anything for a fact, but I would assume that private health care would mean competition, competition would make companies compete to be the best, at the moment, everything is done as cheaply and minimalstic as possible. Companies will do everything they can to keep YOU happy, if they don't, they'll loose business, at the moment, it doesn't matter because there is no choice, it's NHS or nothing...

    Again, I'm not claiming this to be true or anything.. it's just my theory..
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    Dude, its 21% of the building budget... that is not going to make the NHS worse.
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    (Original post by JakeM)
    Dude, its 21% of the building budget... that is not going to make the NHS worse.
    I think you missed my point.
    I am annoyed they are cutting the building budget when they should be cutting the actual health budget.
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    (Original post by Teaddict)
    I think you missed my point.
    I am annoyed they are cutting the building budget when they should be cutting the actual health budget.
    Why on earth would you want them to make the Healthcare worse?
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    (Original post by JakeM)
    Why on earth would you want them to make the Healthcare worse?
    To reduce a 26% state overspend?

    Where else do you want the 140bn of cuts?
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    (Original post by Quady)
    To reduce a 26% state overspend?

    Where else do you want the 140bn of cuts?
    Where I want the 140bn of cuts to come from doesn't mean anything, Im not a MP.
 
 
 
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