If you were in charge of the NHS what would you cut? Watch

skotch
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#41
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#41
While I'm at it, I may as well say something sensationalist...

The government should stop investing billions on unnecessary things like wars and invest in the things that matter, like national healthcare.

:getmecoat:
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The Egg Militia
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#42
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(Original post by user1-4)
i want to say this, bus how would someone put this into a nice formal interview answer?
Do i just say, 'well, i wouldnt treat the alcoholics?'
Or is that too blatant and would make me look bad
I'm sorry if someone already answered this question, but absolutely do not under any circumstance say you wouldn't treat someone on such grounds. They engrave a 'no discrimination' of treating patients from day one of your training. Obviously, if there was an abusive patient you could refuse to help them, as it isn't in our job description to take abuse of any kind.

11 years NHS employee, 3rd year radiography student.
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taysidefrog
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#43
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#43
No translators (except Gaelic, Welsh and sign language) for anyone who has lived in the UK for over a year unless they are a refugee who has to live here for safety. Economic migrants should learn the language or pay for their own translators.
If I chose to live in France or Poland I doubt the state would pay for a translator for me.
Our use of translators in Fife NHS has rocketed in the past 8 years, mainly for Polish economic immigrants, and I see it as a misuse of NHS money. There could also be translators for people who need emergency surgery, but in general you speak the local lingo or you pay for your own translator if you're choosing to live here.
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shiggydiggy
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#44
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(Original post by Beska)
Homeopathy - nil evidence for, lots of evidence against and in the world of increasingly evidence-based practice I think it's only right that evidence is used to identify areas of the NHS where savings can be made. Homeopathy costs the NHS £4-12m a year (so not a lot) but every little helps in times of austerity, and the continued running of purely homeopathic hospitals is madness considering there are A+E closures, ward closures, etc. around the country. It's madness that the NHS is paying millions of pounds for water.

This is a controversial, though.
I vaguely recall reading some evidence which suggested that, although no better than placebo, homeopathic treatments were actually cost effective for things like mechanical lower back pain and resulted in financial savings. The patients felt like they were receiving treatment, were generally happier and spent less time hassling GPs and orthopods.

So it's not as ridiculous as it appears.
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SirVeillance
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#45
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#45
Cut down on bureacracy! It's a joke when nurses jobs are being cut left right and centre
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AdamskiUK
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#46
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IVF. Why should the public pay for you to have kids? At the end of the day, based on a one-time success rate for IVF (which obviously isn't the case with many people), you pay a value of money which you would pay if you had the child anyway. So you have to pay to conceive and that costs you what you would have spent on a child per annum over the course of up to 3 years.

Definitely only 1 shot at IVF.

Don't get me wrong, I can only imagine the heartache of not being able to have your own kids, but I haven't submitted this post for an ethical debate. It's just something which isn't essential whatsoever.
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Asklepios
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#47
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I'd say cut down on the number of managers - although we do need some administration, it can easily be reduced. You here stories of people in the NHS managing the most pointless of things. I'd say one manager and a couple of secretaries per department should suffice. Maybe we can give doctors more of an administrative role too - it'd be good to have someone in charge who actually has some clue about the actual needs of the hospital and not just lay people making stupid policies that make little difference to hospital efficiency.
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Beska
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#48
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#48
(Original post by shiggydiggy)
I vaguely recall reading some evidence which suggested that, although no better than placebo, homeopathic treatments were actually cost effective for things like mechanical lower back pain and resulted in financial savings. The patients felt like they were receiving treatment, were generally happier and spent less time hassling GPs and orthopods.

So it's not as ridiculous as it appears.
Any references?

Even if it's proven to help 100% of people with lower back pain and save 100% the money they would have spent going to their GP over and over, there's no reason to fund it for anything else and definitely no reason to fund the 4-5 odd hospitals dedicated to it. Heart disease is the biggest killer and there isn't 4-5 dedicated heart disease hospitals.
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manu01
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#49
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(Original post by Amyk89)
Or bring back overtime. The staff on wards (most already do extra for the same amount) would be much more willing to cover shortfalls if they got paid overtime, would still be cheaper than agency staff.
Yeah that's also a good alternative.
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Swanbow
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#50
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(Original post by Biblio)
So naive "NHS is revealed to be the fifth largest, with 1.7 million workers across England, Wales, Scotland and Northern Ireland." The NHS is the fifth largest employer in the world, lol you need dem mangers
Yes, but management in this country is sub-standard. We need better managers in the NHS, with pay dependant on results.
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shiggydiggy
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#51
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(Original post by Beska)
Any references?

Even if it's proven to help 100% of people with lower back pain and save 100% the money they would have spent going to their GP over and over, there's no reason to fund it for anything else and definitely no reason to fund the 4-5 odd hospitals dedicated to it. Heart disease is the biggest killer and there isn't 4-5 dedicated heart disease hospitals.
I could probably dig out a reference at some point.

I agree about your point that it shouldn't be funded for anything else if it doesn't bring in the same amount of savings and it's bizzare to think that there are hospitals dedicated to the stuff. But, my point is that homeopathy, as ridiculous as it is, has its uses in specific circumstances.

(Original post by user1-4)
i want to say this, bus how would someone put this into a nice formal interview answer?
Do i just say, 'well, i wouldnt treat the alcoholics?'
Or is that too blatant and would make me look bad
At a medical interview? I think that would be the point at which the interviewer would immediately reject you and stop paying attention to the rest of the interview. It goes against so many core medical principals and actually, you'll find that people with addictions makes up a decent proportion of your work.

Frankly, the word 'unkind' doesn't adequately describe this attitude. It's just simply heartless and uncaring. I would be ashamed to work with someone who held this belief. Please don't become a doctor if you don't care.
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shiggydiggy
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#52
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#52
(Original post by arson_fire)
Don`t know how I forgot about it, but IVF should go. Can`t see how its justified at public expense.
(Original post by AdamskiUK)
IVF. Why should the public pay for you to have kids? At the end of the day, based on a one-time success rate for IVF (which obviously isn't the case with many people), you pay a value of money which you would pay if you had the child anyway.
Why? Being able to have a child is listed as a basic human right. There is more to medicine about curing diseases. It's about improving quality of life and reducing disability. Why shouldn't medicine intervene in a pathological process which is causing distress and compromising a basic human right?
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taysidefrog
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#53
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Whether or not fertility services should be provided by the NHS has often been debated by doctors and others.
On the pro side infertility is often caused by diseases, doctors treat diseases so should treat infetility, being involuntarily infertile makes people miserable, misery/ depression is a disease, happy people are more productive.
On the anti side, being infertile doesn't actually shorten your life or make you physically unwell, many people are infertile because they just started trying to conceive too late in life, the world is already overpopulated and as a society we don't need more children.
I think a discussion of whether or not fertility services should be cut in an interview would go down better than "I wouldn't treat addicts", although whether or not the NHS should fund maintainance prescriptions for addicts as opposed to reduction regimes is debatable, we don't give alcoholics regular whisky why should we give opiate addicts regular methadone? One of the main benefits of maintainance opiates is in crime reduction so should it come out of the police budget and the NHS just fund people who actually want to kick the habit and put them on a strict reducing regime?
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CamH
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#54
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#54
I'd say: The NHS has 1.4 million employees and a budget of ~£100bn. Within that there are many people who's careers have been dedicated to optimising care for cost, all of them equipped with much more knowledge, information and resources than me. To assume my 10 minute thought experiment would somehow give better results than all of that would be foolish and arrogant.
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Bronco2012
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#55
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(Original post by arson_fire)
I`d shut A&E at the weekends to all but life-threatening conditions - kick out the drunks with a cut finger or a tummy ache.

Bill for ambulances where its blatantly not needed.

Stop giving junkies free methadone and bus passes.

Make a token charge to see a GP.
What about broken legs and stuff?
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Octopus_Garden
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#56
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(Original post by taysidefrog)
No translators (except Gaelic, Welsh and sign language) for anyone who has lived in the UK for over a year unless they are a refugee who has to live here for safety. Economic migrants should learn the language or pay for their own translators.
If I chose to live in France or Poland I doubt the state would pay for a translator for me.
Our use of translators in Fife NHS has rocketed in the past 8 years, mainly for Polish economic immigrants, and I see it as a misuse of NHS money. There could also be translators for people who need emergency surgery, but in general you speak the local lingo or you pay for your own translator if you're choosing to live here.
So what would happen without NHS translators?

I think you'd find A&E would be clogged up as ill people (I've noticed my additional languages disappear when I'm ill or in pain) struggle to explain where the pain is, and what happened. They won't just meekly go away! The UK doesn't just provide translation services out of kindness, we provide them because it makes life easier for us.

Medical staff, whether they're at the GP's or a hospital or anywhere else, want to get on with doing their job, not spend twenty minutes miming.
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That Bearded Man
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#57
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#57
(Original post by Beska)
Homeopathy - nil evidence for, lots of evidence against and in the world of increasingly evidence-based practice I think it's only right that evidence is used to identify areas of the NHS where savings can be made. Homeopathy costs the NHS £4-12m a year (so not a lot) but every little helps in times of austerity, and the continued running of purely homeopathic hospitals is madness considering there are A+E closures, ward closures, etc. around the country. It's madness that the NHS is paying millions of pounds for water.

This is a controversial, though.
Bingo
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That Bearded Man
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#58
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Say that as well as homeopathy - you could target pre-hospital care for investment, screening, community care etc. that way you will save money on beds in the long run
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Octopus_Garden
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#59
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(Original post by Quiddi)
it would create and incentive for people to learn english
They already have an incentive- they are in the UK and almost everything is in English! Employers and agencies insist on minimum standards of English comprehension in order to comply with health and safety regulations. Last Christmas, I was working with a man who'd been in England three months and learning English for three months. You would not have known (I was thinking a year or so) but he would likely have needed an interpreter for almost anything medical!

In fact, chances are that they are perfectly competent at all other times, but when they are in pain, their ability to answer technical questions goes out the window. Gross generalisation, but Polish immigrants are famed for their brilliant English...
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taysidefrog
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"I think you'd find A&E would be clogged up as ill people (I've noticed my additional languages disappear when I'm ill or in pain) struggle to explain where the pain is, and what happened. They won't just meekly go away! The UK doesn't just provide translation services out of kindness, we provide them because it makes life easier for us."

I didn't say translators shouldn't be provided, just that tax payers shouldn't provide them. If you are unwell in a foreign country and you have chosen to live in that country for over a year then if you require a translator you pay for it, not other people pay for it. It isn't a health expense it's a "can't be bothered to learn the language" expense. The NHS should be free at the point of use in the languages of the UK (or sign language/ Braille)
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