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    (Original post by Tiger Rag)
    Except, they're not making you wait for no good reason. For all you know, the GP could be seeing someone has a much more serious medical problem than you.
    that's why you can tell the secretary that it's an emergency if it is serious and the first instance...but if I know that I have something and I'm not allowed to get the treatment without first seeing a doctor, my purpose isn't to see the doctor at all but merely to jump through a hoop for the sake of regulations. so I don't even really *need* their advice. I just need them to sign my prescription. that's why I ought to be seen quicker - it's more likely than I am in need of it (or the prescription) AND I will take a shorter time, most likely, seeing them anyway.
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      (Original post by markova21)
      I clicked on every one of them. Cool.
      Why though?!
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      (Original post by Mathemagicien)
      Why though?!
      Ha! Well i've just had my dinner; i'm very full and sleepy, with one of my three cats snuggled up next to me, and I had never clicked on one of those to the end before and wanted to see where it ended and what happened at the end. [I lead a sad life ].
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      Couple of ideas:
      -Make people pay for ambulance trips when they were unnecessary.
      -Reduce the number of bureaucrats and put the money saved from this into doctors and nurses pay, research into new treatments or just the infrastructure of the hospitals.
      -Make over 60's pay for their prescriptions as, due to the compression of morbidity, their medical care will cost more than any other age group.
      -Also have an equivalent of A&E for less serious incidents so A&E doesn't have ridiculously long waiting times, they do at some hospitals but this should be standard.
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      (Original post by sleepysnooze)
      I *did* say singapore *and* taiwan.
      taiwan is 3rd and basically has the exact same system as singapore
      Why are they ranked so differently then? This table doesn't seem the most reliable...

      okay I will?
      I was saying that i doubt the methodology of whoever came up with that list.

      But given that Sri Lanka is a government-funded government-run system like the UK I guess... you still can? No objection?

      this is the index of "health care", not "health" though
      and, again, surely they balance their generally better health with an aging population factor?
      Intricately linked.

      Sadly their methodology explanation is totally inadequate, so your guess is as good as mine.

      I don't think the UK is the worst system in the world, not by a long shot, I just think that it's inefficient.
      Lots of inefficiencies. But its hard to think of a healthcare system that isn't.

      The fundamental problem with applying the private sector to clinical medical provision is that consumers do not have a true choice. Your average patient doesn't know which hospital has the best outcomes for heart attacks, and the factors that may explain seemingly poor outcomes, and even if they did they certainly aren't in a position to decide mid-agonising chest pain. All applying the private sector to clinical decision making does is incentivise spending. When you pay a doctor/hospital £1000 per CT scan they order, they're more likely to recommend you get a CT scan. Funny that.

      There are some places where it has a role - a private ward with nicer rooms is fair game - the patient can make a valid comparison there. The government's current approach - to create thousands of mini-monopolies with minimal quality control and minimal penalties is a company decides to drop out at short notice - is a pure cost-cutting measure and recipe for disaster.

      maybe I confused singapore with south korea - I haven't even look at these figures in years
      Singapore is a commonly cited example whereas S.Korea isn't - i don't think you picked wrong.

      (Original post by sleepysnooze)
      the prescription system is so cumbersome to people with this kind of situation.
      Allowing antibiotics in particular without prescription is a terrible idea. Our control has meant we're far better off compared to the rampant antibiotic resistance affecting other parts of the world like, for instance, Sri Lanka and its neighbours.

      You have, of course, picked one of the areas in which antibiotics are most over-prescribed for. You can recite the criteria which determine whether a tonsillitis is likely to be bacterial or viral i assume?
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      (Original post by sleepysnooze)
      what I'm saying that if I have had an illness whereby the treatment requires a doctor's prescriptions (i.e. let's say steroids for iritis or antibiotics for tonsillitis) my time that I have to wait to see a doctor ought to be in proportion to the certainty that I have the same illness again. if I've had it twice, I ought to see a doctor twice as quickly for it. if I have it three times, then maybe three times quicker, etc. I shouldn't be made to wait almost an hour just to reaffirm my own knowledge on what the obvious condition is. if I'm not allowed or trusted to get the prescription myself (which I think I ought to be if I have a history of a certain condition that I can prove), then at the very least I ought to have better access, because making me wait for almost an hour for no good reason for a very quick appointment is ****ing stupid.
      I get your frustration and all but I don't think it's worth the risk for your inconvenience. You don't know you need it. Doctors can barely even prescribe themselves. I think we're quite proud of our (the UK's) strict antibiotic control.
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      (Original post by aj123456)
      How would you save the NHS?
      The key problem is the fact that it is underfunded. However, all of the retards who complain about quality would go on to complain about a hike in taxes. Also, by reducing pay, Doctors, Nurses and anyone who works at the NHS are demotivated by the fact that they aren't earning as muc as they were, and are basically being treated like ****. A Urologist in America, on average, earns 4x the amount a Urologist in the UK does, so when you then decrease the pay even further, you decrease the standard of living and the efficiency decreases even further. We need a Health Minister who actually has worked as a Doctor, or better yet, a "Council of Doctors", who could decide collectively what will happen to the NHS. Also, to anyone who reads this far (congrats, I tend to rant), don't think that Doctors are doing it totally from the kindness of their hearts. You cannot go into a demanding job like medicine and get paid **** money whose pay is rivalled by unskilled labour (when you are a junior you can apparently earn more as someone who works at IKEA or LIDLS than as a junior doctor, and you get *****y jobs in the hospital you work in, or generally at least)
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      (Original post by nexttime)
      I work in the NHS. This is how I would fix it:

      0) Firstly, if anyone in charge had been acting for anything other than self-interest in the last 50 years we would not be in this situation. We knew a population bubble of elderly was coming literally since the 50s. We should have been saving for this event as a nation for 30 years, we should have increased the number of med school places and hospital beds starting 10 years ago, we should have increased nursing school places 5 years ago. We'd then have enough money, beds, doctors and nurses to live out the crisis over the next 10-15 years or so.
      Instead, we've got the biggest national debt since WWII, 12% vacancy rate for doctors (with loads about to retire/return to Europe), 8% vacancy rate for nurses (with loads about to retire/return to Europe), and a bed crisis that means we rarely have free beds in the summer in year 1-2 of this 15+ year problem. We have been totally betrayed by the previous generation and so are totally screwed now no matter what we do. BUT there are some things we can do to ease it...

      0a) Don't declare war on your staff immediately before the big crisis. Its really bad for staff retention and morale. Hunt didn't just introduce a new contract. He deliberately, repeatedly and publicly belittled and insulted his workforce (doctors and other). No wonder so many are looking abroad and 50% of 2nd year doctors didn't apply to continue (most will come back after a break, but that's a lot of doctor-years to lose).

      1) Reduce the bureaucratic workload for front line staff. The current trend, which is ingrained into how doctors/nurses are hired and promoted, is that when there is a problem you introduce a new form to fill. There is no consideration that time spent form filling leads to problems in itself. Change the training and clinical governance structure to recognise that time is a commodity, and time having clinical staff filling out forms is a waste, not a good thing.

      2) Don't leave the EU/soft brexit due to impact on recruitment. I know - boo not more brexit talk - but the NHS is one of the bodies set to lose out the most from Brexit. About 10% of doctors are from the EU. About a third of newly recruited nurses last year were from the EU. EU nurses are broadly better trained than UK ones (their training is longer and they practice more independently) and their English tends to be better than non-EU nurses.
      It will also significantly impact on medical research, where funding, personnel and collaboration have become very intertwined with our EU neighbours.

      3) No more PFI. Another way in which we've been sold out is PFI. My local hospital spends 22% of its budget on PFI buildings. Its now being asked to cut 20% of its budget... but PFI can't be cut. So that's actually 25% of its non-PFI budget.
      25% cost-cutting whilst maintaining the same service. No business can do that.

      4) Stop the national mandate to charge immigrants for emergency care. The government mandates hospitals create specific teams to chase payment from non-EU nationals for emergency treatment they received. These goon squads cost the NHS about twice what they make (unpublished data). Let the hospitals decide locally how to deal with such bills - it is them who get the money, its not like they lack incentive.

      5) Increase funding to be in line with similar EU countries. We spend substantially less than e.g. France, Germany, Netherlands. I know its hard times what with needing to pay for Trident and brexit etc but simple fact is: you can't expect the NHS to deliver a comparable service to those who spend so much more.
      OR
      5a) Be honest to the public. Tell the public which services are going to be cut because the NHS can't afford it. Carrying on as we are is just illogical and bad for everyone. Surgeons sit around doing nothing because there are no beds to send patients to. Paramedics hang around outside as they can't drop off their patients. All the while cancer ops get cancelled and true life threatening emergencies have to wait hours for an ambulance. Someone needs to strap on their man pants and tell the public which expensive cancer drugs are going to be pulled and which operations aren't going to be offered so that we can free up money for more beds and staff. So that we can go back to having a functioning service.

      6) Put most of the above funding and newly retained/acquired EU workforce into social services and care homes. An NHS bed costs about £200 per day even without any treatment being provided. A care home bed costs a lot less. Stop being inefficient and sort it out.
      Additionally, care homes need to be banned from refusing to accept new patients on Fridays and weekends (as is common currently). For all Hunt's rhetoric on 7 day NHS, this is something he hasn't even attempted to tackle.

      7) Reduce spend on locums, but not by just banning hospitals from paying for the staff they need as is the current approach. Reduce locum spending by making jobs attractive so you have enough staff in the first place. Insulting staff = bad for locum spending. Treating staff well = good. Revolutionary.

      8) Reduce legal threat to hospital staff. I appreciate that the courts play a vital role in regulating the medical profession, but if we're to be able to deal with the current crisis we need to be able to look after patients, not filling out forms for a hypothetical legal case just in case someone sues, as is the case currently. I'm not saying it has to be total or permanent, but dealing with a crisis means making sacrifices. Closely linked to point 5a).

      9) Rationalise private sector involvement. I believe there is a role for the private sector, but not in the way the government is doing things. Long contracts that give private companies effective monopolies (e.g. catering contracts in hospitals), and contracts where the company is minimally accountable for its standards (e.g. contracts to perform clinical scans or lab tests without then implementing substantial government-run quality control measures) just waste NHS resources. Hitchingbrooke was a complete scandal yet the government doesn't seem the slightest bit deterred (?).

      10) Stop faffing around and get an IT system that works. Europe manages it - doctors/students there find it funny that we still have paper systems. Just pay them money and take their system. Denmark's is good, go with that. How hard can it be?
      IT has so much potential to solve so many inefficiencies in day to day ward work, yet no one seems to take any action.

      11) Proper education, but more about palliative care and options surrounding end of life rather than when/when not to attend A&E. Teaching people when to go to A&E is no small task, and there's loads of info out there - not least 111 (a terrible example of privatisation btw, but its still better than nothing). I think a large advertising campaign saying don't come to A&E because e.g. your finger nail came off will be expensive and have limited impact. They are also fairly easy cases to deal with.
      HOWEVER - end of life is the opposite of that. Its something we don't often talk about, but surveys show there is a huge discrepancy between where people want to die (generally at home) vs where they do die (generally in hospital). Now its nowhere near as simple as just telling people to stay at home then - its a distressing time for relatives and they need support. But so often you see people coming in and going through the full works and getting admitted because obviously they're really sick... but actually they didn't want to be there. Their family brought them in because they were worried. I think clear education, for the patient and the family, on what the options are, on what might happen and how we can deal with that (in or out of hospital) would have a much bigger impact on hospital beds AND improve dignity regarding end of live.

      But no matter what we do - and i suspect it will be none of the above - we are going to be for a hard hard time over the next few years. Pray that you/your loved ones don't get sick

      TL.DR points in bold.
      Regarding private involvement, it's easy to argue contracts have to be long, the problem with short contracts is that if the enterprise is failing (which it probably is) it's just saying "private sector, come sort out our mess at great expense and then give it back to us after." For investment the investor needs to profit from it, something which tends not to happen on short contracts
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      (Original post by Fractite)
      Teach people to be a little sharper with their general health. Quite a number of hospital visits are for completely avoidable problems that they could sort out themselves if they were just a little more aware.
      Whats the evidence behind this?

      What hospital visits should patients be self-treating?
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      (Original post by Eleanor12345678)
      -Also have an equivalent of A&E for less serious incidents so A&E doesn't have ridiculously long waiting times, they do at some hospitals but this should be standard.
      We do have a minor injuries centre down here. But unlike A&E, it's not open 24/7.
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      (Original post by Jammy Duel)
      Regarding private involvement, it's easy to argue contracts have to be long, the problem with short contracts is that if the enterprise is failing (which it probably is) it's just saying "private sector, come sort out our mess at great expense and then give it back to us after." For investment the investor needs to profit from it, something which tends not to happen on short contracts
      Not against that - the monopoly creation is more the problem.

      There would need to be proper penalties for the investor pulling out early though. Circle pulling out of Hitchingbrooke left the government with a huge clean-up bill to fix what they left behind.
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      (Original post by MagicNMedicine)
      Whats the evidence behind this?

      What hospital visits should patients be self-treating?
      Things like colds and coughs that I've seen people go to GP's for. Unless it's persistent, sure.
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      (Original post by SHallowvale)
      I think this question highlights one of the reasons why the NHS is suffering.

      I, personally, could do absolutely nothing to save the NHS. Nor could any other individual.

      It is the responsibility of everyone to make sure that less pressure is placed on NHS services, be it through understanding when/when not to go to A&E or visit your GP, or living a healthier life so you don't develop a disease which is expensive to treat (such as diabetes).

      If we give ourselves this idea that the only thing which could 'save' the NHS is some man or woman who can wave a magic wand and make it better is never going to help improve the situation of health in this country, which is pretty poor.
      That wont get rid of people who actually need to use the NHS. I don't know why this needs pointing out. The NHS is not full of hypochondriacs.
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      (Original post by ChaoticButterfly)
      That wont get rid of people who actually need to use the NHS. I don't know why this needs pointing out. The NHS is not full of hypochondriacs.
      It won't, but they are still two factors that will influence the long term strength of the NHS.

      Of course there will be people who genuinely need to use these services, healthy or not.
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      (Original post by aj123456)
      How would you save the NHS?
      I'd put it out of its misery. It's not sustainable. It's a sinkhole on the budget. Singapore does healthcare far better than we do and we should learn from our friends abroad before we bankrupt ourselves.
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      (Original post by jape)
      I'd put it out of its misery. It's not sustainable. It's a sinkhole on the budget.
      A sinkhole... that occupies a smaller proportion versus other similar countries' budgets? That achieves similar, in some ways better results?

      What is your definition of 'sinkhole' exactly?!

      Singapore does healthcare far better than we do and we should learn from our friends abroad before we bankrupt ourselves.
      Ah Singapore - the example picked by people who know enough to not pick America, but don't know enough to sensibly comment.

      As above - not a valid comparison. If we had their population pyramid we'd have amazing healthcare too.

      Our population is demographically most similar to countries like the Netherlands, France, Germany, Denmark. Those are your valid comparisons.
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      (Original post by Fractite)
      Things like colds and coughs that I've seen people go to GP's for. Unless it's persistent, sure.
      The GPs won't refer them to hospital if its not serious.

      The crisis in the NHS is in hospitals, not because people are going to GPs for coughs and colds.
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      (Original post by MagicNMedicine)
      The GPs won't refer them to hospital if its not serious.

      The crisis in the NHS is in hospitals, not because people are going to GPs for coughs and colds.
      It all works through. People only go to the GP when they need, less people go to the GP. Less people go to the GP, shorter waiting times. Shorter waiting times, more people get seen quicker and better outcomes. It also means they might not go to A&E, which means shorter times there too. And the most obvious crisis is in hospitals, but there's a big problem in primary/other care too. It's all linked and every little helps!
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      (Original post by aj123456)
      How would you save the NHS?
      Carousel.?
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      I'd slit its throat.
     
     
     
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