NHS needs an update Watch

Other_Owl
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Just to out point a view things?
Why is the NHS still running on the 1948 model?
Now-a-days People are living longer, new meds and cures. People are using on a more regular basis.
Same with the state pension back then people died there mid sixties now people are living into their 80's?
Why are the system still running on XP and the Tories closing down hospitals?
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Murgbot
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I think the issue we have is that people now see the NHS as so sacred that if anyone suggests changes then they automatically see it as privatisation.

As an example, my mum works at the hospital and came home a few months ago saying they are privatising her hospital. There was mass panic amongst the staff. When I read the letter that wasn’t the case at all. They were creating a subsidiary group owned by the NHS to manage cleaning staff etc. I actually think that this is a really good idea and there is some debate about this being “a step towards privatisation” however, that requires the NHS to sell the subsidiary group off and at present there are laws to prevent that.

If the NHS is going to continue we need to think of new ways to run it because with the population we have the current model is just not sustainable.
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quasa
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(Original post by Other_Owl)
Just to out point a view things?
Why is the NHS still running on the 1948 model?
Now-a-days People are living longer, new meds and cures. People are using on a more regular basis.
Same with the state pension back then people died there mid sixties now people are living into their 80's?
Why are the system still running on XP and the Tories closing down hospitals?
essentially if the NHS semi-privatesed, it would be good. problem is tonnes of people will be angry, but what alternative is there, increased taxes, closing down more hospitals / departments / pharmacies. It is a fine line between being a hero or zero re sorting the NHS. sadly the way politicans work is they dont actually hold focus groups with patients and the Doh (which runs the NHS) is run by economists instead of health professionals so they are oblivious to the needs of health professionals and just look at things from a fiscal perspective and see things from a where can I save / cut perspective (why it took so long for jeremy hunt to get sacked is a mystery)
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InArduisFouette
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75% plus of NHS services have been provided privately since 1948

Your GP - traditionally a private contractor either a sole trader or a partnership , although with PMS and changes to GMS this is no longer necessarily the case

same with your typical dentists

your community pharmacy - all ways been private whether that;s a small local pharmacy business or one of the chains

opticians - again mainly local independents but the presence of chains in the business long predates the Vision express etc of the world ... (the availablity of onsite lens grindig equipment sparked off that particular jump in the market - although on site lens grinding is virtually gone again but
the new materials and coatings have meant that clean room lens prep is needed )

between 1948 and 1974 , NHS ambulance services were funded by the NHS, the responsibility for commissioning lay with local authorities ( on a county basis ) and provided by a mixture of Models of service provision ( attached to frie services, standalone / semi stand alone under council trans port dept , buying from St John or red cross in whole or part )
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Audrey18
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(Original post by Other_Owl)
Just to out point a view things?
Why is the NHS still running on the 1948 model?
Now-a-days People are living longer, new meds and cures. People are using on a more regular basis.
Same with the state pension back then people died there mid sixties now people are living into their 80's?
Why are the system still running on XP and the Tories closing down hospitals?
(Original post by InArduisFouette)
75% plus of NHS services have been provided privately since 1948

Your GP - traditionally a private contractor either a sole trader or a partnership , although with PMS and changes to GMS this is no longer necessarily the case

same with your typical dentists

your community pharmacy - all ways been private whether that;s a small local pharmacy business or one of the chains

opticians - again mainly local independents but the presence of chains in the business long predates the Vision express etc of the world ... (the availablity of onsite lens grindig equipment sparked off that particular jump in the market - although on site lens grinding is virtually gone again but
the new materials and coatings have meant that clean room lens prep is needed )

between 1948 and 1974 , NHS ambulance services were funded by the NHS, the responsibility for commissioning lay with local authorities ( on a county basis ) and provided by a mixture of Models of service provision ( attached to frie services, standalone / semi stand alone under council trans port dept , buying from St John or red cross in whole or part )
It's not a update they need. It's an entire revamp they should get!

https://www.bbc.com/news/health-42347942

https://fullfact.org/health/how-many...ly-mid-staffs/
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InArduisFouette
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(Original post by Audrey18)
It's not a update they need. It's an entire revamp they should get!

https://www.bbc.com/news/health-42347942

https://fullfact.org/health/how-many...ly-mid-staffs/
my point with referring to the volume of NHS services and complete majority of NHS funded interactions taking place i nthe private sector , is to debunk the myth of the monolithic NHS that provided all services directly .

a (mainly) Taxation funded service, predominatly free at the point of delivery is not required to have any state owned elements.

few if any services internationally have anywhere near the same volume of state own providers as the NHS has.
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squeakysquirrel
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(Original post by Other_Owl)
Just to out point a view things?
Why is the NHS still running on the 1948 model?
Now-a-days People are living longer, new meds and cures. People are using on a more regular basis.
Same with the state pension back then people died there mid sixties now people are living into their 80's?
Why are the system still running on XP and the Tories closing down hospitals?
Ah this is my personal bugbear. I work for the nhs and absolutely love the principle, but we have moved on from70 years ago. So some of my ideas are

1. Everyone must pay something for their care on a sliding scale according to income. If you give for free people take advantage
2. If you have a disease that is self inflicted e.g. emphysema due to smoking you must give up smoking in order to get any more than basic care. Same goes for alcohism, drug abuse

3. All go appointments carry a cost again according to income
4. No more health tourism
5. Missed outpatient appointment you get a bill.
6. Ambulance unless life threatening you get a bill.
7. Build halfway house care areas for the "bedblockers" I don't like that word because it implies something.
8. Look at people's prescriptions. I have had many patients on and I am not joking more than 30 different medications at one time. These are just regular patients, not dialysis one or cancer ones. It is utterly ridiculous.
9. Bring all the outsourced aspects of the nhs back in house. Cleaning, catering etc.
10. Look at who supplies the nhs with drugs and equipment. We are being grossly overcharged in some cases.
That is al, for starters
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Tiger Rag
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(Original post by squeakysquirrel)
5. Missed outpatient appointment you get a bill.
6. Ambulance unless life threatening you get a bill.
I'm not disagreeing at all; but what happens if you can't afford to pay?
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InArduisFouette
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(Original post by squeakysquirrel)
Ah this is my personal bugbear. I work for the nhs and absolutely love the principle, but we have moved on from70 years ago. So some of my ideas are

1. Everyone must pay something for their care on a sliding scale according to income. If you give for free people take advantage
2. If you have a disease that is self inflicted e.g. emphysema due to smoking you must give up smoking in order to get any more than basic care. Same goes for alcohism, drug abuse

3. All go appointments carry a cost again according to income
4. No more health tourism
5. Missed outpatient appointment you get a bill.
6. Ambulance unless life threatening you get a bill.
7. Build halfway house care areas for the "bedblockers" I don't like that word because it implies something.
8. Look at people's prescriptions. I have had many patients on and I am not joking more than 30 different medications at one time. These are just regular patients, not dialysis one or cancer ones. It is utterly ridiculous.
9. Bring all the outsourced aspects of the nhs back in house. Cleaning, catering etc.
10. Look at who supplies the nhs with drugs and equipment. We are being grossly overcharged in some cases.
That is al, for starters
1. they do you - as income tax is progressive and NI while not a strict progressive tax does increase with earnings even above the UEL .

2. correlation is not causation , and you will allready find that this is the case , those who continue to smoke despite certain lung conditions are risk assessed out of some treatment options, ditto drinkers with liver disorders unless they make serious efforts to cut right down or stop

3. see previous with regard to tax and NI

4. you'll need to speak to the Labour party and the Trades Unions who made it a big issue. used to be entirely standard practice to screen NHS eligibility on admission to hospital

5+6 counter productive and impossible to enforce

7. they exist, plus spot purchase of residential and nursing home beds , but are often full due to incompetencne among social w**kers doesite the best efforts of the health staff

8. this is done

9. increases cost for no benefit

10 . ******** - some of the 'specials' stuff is down to poor practice by NHS staff such as demanding same day or 24 hour turnaround on the items
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Murgbot
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I think the idea behind charging for non-emergency ambulances etc is more to act as a deterrent to people not to actually charge them. However, it’s floored in that what if someone thinks their issue is life threatening and it turns out not to be? For example people who think they are having heart attacks but it turns out to be their first ever panic attack etc.
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Murgbot
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That said, I think there is something to deterring people through bills and such. It would be interesting to see if A and E usage on weekends decreased if you billed those who’s injuries were inflicted by drinking too much.
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Other_Owl
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(Original post by Murgbot)
I think the idea behind charging for non-emergency ambulances etc is more to act as a deterrent to people not to actually charge them. However, it’s floored in that what if someone thinks their issue is life threatening and it turns out not to be? For example people who think they are having heart attacks but it turns out to be their first ever panic attack etc.
In the USA they charge $2k for an ambulance.
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Murgbot
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(Original post by Other_Owl)
In the USA they charge $2k for an ambulance.
Yeah but in the US people die because they don’t have medical insurance I don’t think we should be taking tips from them tbh.
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Other_Owl
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(Original post by Murgbot)
Yeah but in the US people die because they don’t have medical insurance I don’t think we should be taking tips from them tbh.
The Tories do!
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Murgbot
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But the Tories are inherently elitist. There is a link between poverty and poor health, does that mean that those people who are most likely be ill shouldn’t have access to health care because they can’t afford to pay for it? I don’t want to live in a country like that
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HighOnGoofballs
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(Original post by squeakysquirrel)
1. Everyone must pay something for their care on a sliding scale according to income.
We already have that - it's called (a progressive) income tax.
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squeakysquirrel
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(Original post by HighOnGoofballs)
We already have that - it's called (a progressive) income tax.
If you don't work in the nhs you have little right to comment. I work in cancer services on the frontline. I know what I am talking about
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HighOnGoofballs
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(Original post by squeakysquirrel)
If you don't work in the nhs you have little right to comment. I work in cancer services on the frontline. I know what I am talking about
My parents both work in the NHS in Psychiatry and Gynecology - I, too, know what I'm talking about
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InArduisFouette
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(Original post by squeakysquirrel)
If you don't work in the nhs you have little right to comment. I work in cancer services on the frontline. I know what I am talking about
you quite simply do not know what you are talking about

of the past 20 years i've spent 3 years pre reg , not quite 11 years as NHS staff, not quite 3 years in private organisations providign NHS services and 4 years working in other sectors ...
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Tiger Rag
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(Original post by Murgbot)
I think the idea behind charging for non-emergency ambulances etc is more to act as a deterrent to people not to actually charge them. However, it’s floored in that what if someone thinks their issue is life threatening and it turns out not to be? For example people who think they are having heart attacks but it turns out to be their first ever panic attack etc.
I agree. I've gone to my GP with a problem which can sometimes be a serious underlying cause of something. My GP told me it that in my case it was nothing. But as something who isn't medically trained, I wasn't to know that.
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