NHS problems etc

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  • Munsford0
    Munsford0 Posts: 606
    In school vocational studies used to be lessons / training for the less academic who were going on to manual trades like bricklaying, plumbing etc.

    I've never heard a brickie claim it's a vocation though
  • First.Aspect
    First.Aspect Posts: 14,290

    Worthiness, despite Webboo's moralising, is pretty much irrelevant.

    It's supply and demand, and with nursing the it's not a well functioning market because there's only one employer. Hence sub-optimal wages and vacancies.

    Inevitably, we all know, consciously or otherwise, that the conditions nurses have to work in, because of the above, is pretty grim, so we treat them like angels and clap and all the rest of it to compensate for that fact.

    I couldn't do the work, for sure, but is it pretty grim? Assuming the actual act of nursing is acceptable (which I just have to go with because people are eww), then from what I have experienced, a lot of nursing is quick, quick, slow. So nurses cope with peaks, sometimes sudden and unexpected, followed by a lot of relatively low pressure time. I base this on some hours in a heart and lung ward, and a couple of weeks in an orthapedic ward.

    I think, albeit extrapolating from personal experience, that the really acutely bad conditions are specific to certain specialties - most obviously A&E which is an absolute basket case (also from personal experience, until I passed out).

    So I don't disagree with you RC, but with a bit of a closer look at where the problems lie, will the solution be more effective?
  • photonic69
    photonic69 Posts: 2,347

    ...

    Maybe if we accepted kids from less advantaged backgrounds ....

    These are the pharmacists of tomorrow. Some are already practicing ;)


    Sometimes. Maybe. Possibly.

  • rick_chasey
    rick_chasey Posts: 71,577

    Worthiness, despite Webboo's moralising, is pretty much irrelevant.

    It's supply and demand, and with nursing the it's not a well functioning market because there's only one employer. Hence sub-optimal wages and vacancies.

    Inevitably, we all know, consciously or otherwise, that the conditions nurses have to work in, because of the above, is pretty grim, so we treat them like angels and clap and all the rest of it to compensate for that fact.

    I couldn't do the work, for sure, but is it pretty grim? Assuming the actual act of nursing is acceptable (which I just have to go with because people are eww), then from what I have experienced, a lot of nursing is quick, quick, slow. So nurses cope with peaks, sometimes sudden and unexpected, followed by a lot of relatively low pressure time. I base this on some hours in a heart and lung ward, and a couple of weeks in an orthapedic ward.

    I think, albeit extrapolating from personal experience, that the really acutely bad conditions are specific to certain specialties - most obviously A&E which is an absolute basket case (also from personal experience, until I passed out).

    So I don't disagree with you RC, but with a bit of a closer look at where the problems lie, will the solution be more effective?
    I think a lot of the existing problems are that a ward typically needs, say, 12 nurses to run, but only 8 are actually running it and of those 3 are agency workers who aren't familiar with the ins-and-outs of the ward.

    I suspect raising the wages would alleviate some of those problems.


    Regarding the 'bed' shortages, I think the leadership has miscalculated and gone too far on the efficiency savings. Whether they were put under too much pressure by treasury, who knows.
  • First.Aspect
    First.Aspect Posts: 14,290
    You see, I think there are enough beds for the people who need them, just not enough for the people who need them in addition to the people who needed them last week.

    And that a sensible wage settlement yes is needed, beyond which it is a blunt instrument and not a substitute for fixing the machine as a whole.
  • rick_chasey
    rick_chasey Posts: 71,577

    You see, I think there are enough beds for the people who need them, just not enough for the people who need them in addition to the people who needed them last week.

    And that a sensible wage settlement yes is needed, beyond which it is a blunt instrument and not a substitute for fixing the machine as a whole.

    If you think wages are only part of the vacancies problem, what is the rest of the problem?
  • First.Aspect
    First.Aspect Posts: 14,290

    You see, I think there are enough beds for the people who need them, just not enough for the people who need them in addition to the people who needed them last week.

    And that a sensible wage settlement yes is needed, beyond which it is a blunt instrument and not a substitute for fixing the machine as a whole.

    If you think wages are only part of the vacancies problem, what is the rest of the problem?
    See above.
  • rick_chasey
    rick_chasey Posts: 71,577
    I don't see anything else about vacancies above?
  • photonic69
    photonic69 Posts: 2,347
    What happened to all those nightingale hospitals they hastily built to cope with COVID that were never used? Surely they can be put into use to discharge patients to to alleviate some of the pressure on beds?


    Sometimes. Maybe. Possibly.

  • First.Aspect
    First.Aspect Posts: 14,290

    I don't see anything else about vacancies above?

    Vacancies are one of the problems. What are the underlying causes? Personally, I don't like the idea of just pouring more water in, until we do something to fix the leak.
  • briantrumpet
    briantrumpet Posts: 17,324

    What happened to all those nightingale hospitals they hastily built to cope with COVID that were never used? Surely they can be put into use to discharge patients to to alleviate some of the pressure on beds?

    All decommissioned, I think - they never had the staff to run them.
  • What happened to all those nightingale hospitals they hastily built to cope with COVID that were never used? Surely they can be put into use to discharge patients to to alleviate some of the pressure on beds?

    When you hear about the lack of beds, it's not necessarily in the literal sense. It's to do with staffing and resource. The issue with nightingale hospitals was that they didn't have the staff to manage them in the first place.
  • First.Aspect
    First.Aspect Posts: 14,290

    What happened to all those nightingale hospitals they hastily built to cope with COVID that were never used? Surely they can be put into use to discharge patients to to alleviate some of the pressure on beds?

    All decommissioned, I think - they never had the staff to run them.
    Not sure about that. The one in Glasgow didn't have the demand. Which is a good thing.
  • Munsford0
    Munsford0 Posts: 606
    As I remember it the Nightingale 'hospitals' were hastily set up in anticipation of having large numbers of recovering patients requiring beds and some kind of assistance with ventilation. Christ only knows how they would have been adequately / safely staffed had they been actually required. Fortunately the vaccination program and rapid advances in Covid treatment / care meant they were never needed.
  • Surprised they didn't suggest using the closed Bensons showrooms if all they thought they needed were beds.
  • rick_chasey
    rick_chasey Posts: 71,577

    I don't see anything else about vacancies above?

    Vacancies are one of the problems. What are the underlying causes? Personally, I don't like the idea of just pouring more water in, until we do something to fix the leak.
    I think it's mainly money tbh.

    You can earn similar with more social hours at the supermarket check in.
  • Dorset_Boy
    Dorset_Boy Posts: 6,727

    What happened to all those nightingale hospitals they hastily built to cope with COVID that were never used? Surely they can be put into use to discharge patients to to alleviate some of the pressure on beds?

    The venues are back being used as concert and sports venues. So no, they can't be used again as they are being used for the reason they were originally built.
  • briantrumpet
    briantrumpet Posts: 17,324

    What happened to all those nightingale hospitals they hastily built to cope with COVID that were never used? Surely they can be put into use to discharge patients to to alleviate some of the pressure on beds?

    The venues are back being used as concert and sports venues. So no, they can't be used again as they are being used for the reason they were originally built.

    The Exeter one was a DIY centre, which is ironic, given that that's what the NHS is becoming under the Tories.
  • Re doctors salaries this may be controversial but there are a disproportionate number from private schools and affluent backgrounds in general. That is going to feed into their expectations about salaries - they may feel £60-100k is insufficient because daddy was on several times that.

    Maybe if we accepted kids from less advantaged backgrounds are just as able but that it's hard to get straight A*s if you went to some shite comprehensive - and find a way to get more of those kids into the profession - then we'd have a medical profession less demanding of excessive pay. Ideally of course we'd have the same kind of investment in state education nationwide that London had some time ago (and ban private schools) so we don't have to look at exam results through a prism of where they were achieved.

    There are plenty of "Straight A*" students who didn't make the cut for medical / dentistry school and/or Oxbridge. There are more bright kids (as measured by A* grades at A-level than there are places on such courses. Which is actually the cause of "social injustice" as to get access to such courses, kids also need to be in the top performers in respect of entrance exams, assessment tests, interviews etc. Decent state comps can teach their bright kids to get plenty of A*, but private schools, as a function of resources and experience, have an advantage in getting kids over the line for medicine, dentistry and Oxbridge.

    There are a lot of medical students at Manchester (where Younger Daughter has recently started - not doing medicine) who are from the previous school year, who took a year off to perfect their application process having not made the cut anywhere for October 2021.

    Younger Daughter didn't make the cut for Oxford but decided that was Oxford's loss and rather than reapplying, went to Manchester without an additional year. It was going through this process vicariously that I realised just what an advantage the bright private school kids have over the bright state school kids. None of the private school kids who have places at medical school or on technical courses at Oxbridge etc. have been gifted them via "connections". They've just been able to realise a greater % of their potential to stand out during the applications process.

  • I don't see anything else about vacancies above?

    Vacancies are one of the problems. What are the underlying causes? Personally, I don't like the idea of just pouring more water in, until we do something to fix the leak.
    I think it's mainly money tbh.

    You can earn similar with more social hours at the supermarket check in.
    I assume he means a more fundamental look at how to fix the NHS without pourig in more money.
    ie we seem to be fiated with funnelling people into hospitals. What do other countries do, are there better alternatives?
    Is it too big and we should split bits off?
    Is it not big enough and we should add bits in?
  • First.Aspect
    First.Aspect Posts: 14,290

    I don't see anything else about vacancies above?

    Vacancies are one of the problems. What are the underlying causes? Personally, I don't like the idea of just pouring more water in, until we do something to fix the leak.
    I think it's mainly money tbh.

    You can earn similar with more social hours at the supermarket check in.
    Similar to who? Nurses?

    That's nonsense.
  • I don't see anything else about vacancies above?

    Vacancies are one of the problems. What are the underlying causes? Personally, I don't like the idea of just pouring more water in, until we do something to fix the leak.
    I think it's mainly money tbh.

    You can earn similar with more social hours at the supermarket check in.
    Similar to who? Nurses?

    That's nonsense.
    They have supermarket check ins in Cambridge - it's a different world.
  • First.Aspect
    First.Aspect Posts: 14,290
    edited January 2023

    I don't see anything else about vacancies above?

    Vacancies are one of the problems. What are the underlying causes? Personally, I don't like the idea of just pouring more water in, until we do something to fix the leak.
    I think it's mainly money tbh.

    You can earn similar with more social hours at the supermarket check in.
    Similar to who? Nurses?

    That's nonsense.
    They have supermarket check ins in Cambridge - it's a different world.
    We must be talking about waitrose.
  • TheBigBean
    TheBigBean Posts: 20,277

    Re doctors salaries this may be controversial but there are a disproportionate number from private schools and affluent backgrounds in general. That is going to feed into their expectations about salaries - they may feel £60-100k is insufficient because daddy was on several times that.

    Maybe if we accepted kids from less advantaged backgrounds are just as able but that it's hard to get straight A*s if you went to some shite comprehensive - and find a way to get more of those kids into the profession - then we'd have a medical profession less demanding of excessive pay. Ideally of course we'd have the same kind of investment in state education nationwide that London had some time ago (and ban private schools) so we don't have to look at exam results through a prism of where they were achieved.

    There are plenty of "Straight A*" students who didn't make the cut for medical / dentistry school and/or Oxbridge. There are more bright kids (as measured by A* grades at A-level than there are places on such courses. Which is actually the cause of "social injustice" as to get access to such courses, kids also need to be in the top performers in respect of entrance exams, assessment tests, interviews etc. Decent state comps can teach their bright kids to get plenty of A*, but private schools, as a function of resources and experience, have an advantage in getting kids over the line for medicine, dentistry and Oxbridge.

    There are a lot of medical students at Manchester (where Younger Daughter has recently started - not doing medicine) who are from the previous school year, who took a year off to perfect their application process having not made the cut anywhere for October 2021.

    Younger Daughter didn't make the cut for Oxford but decided that was Oxford's loss and rather than reapplying, went to Manchester without an additional year. It was going through this process vicariously that I realised just what an advantage the bright private school kids have over the bright state school kids. None of the private school kids who have places at medical school or on technical courses at Oxbridge etc. have been gifted them via "connections". They've just been able to realise a greater % of their potential to stand out during the applications process.

    Oxbridge are reducing their private school intake now. A colleague's kids' school has gone from around 40 places a year to 20.
  • Pross
    Pross Posts: 39,826

    I don't see anything else about vacancies above?

    Vacancies are one of the problems. What are the underlying causes? Personally, I don't like the idea of just pouring more water in, until we do something to fix the leak.
    I think it's mainly money tbh.

    You can earn similar with more social hours at the supermarket check in.
    I think that's a slight exageration, from my understanding of the pay scales the starting salary at Band 5 (which I believe is the grade for a newly qualified nurse but stand to be corrected) is £27,055 and they are eligible for a step up to £29,180 after two years then £32,934 after another two years. The hourly rate starts at just under £14 so it is around 40% higher than the average for a Tesco sales assistant. There is also more scope for progression.

    I'm not arguing that the salary is suitable for the work although the starting point is higher than many other graduate roles and similar to teaching. There are also presumably major differences in the conditions you are working in depending on what type of nursing you are doing, not everyone is facing the same level of stress that you get in an emergency department.
  • First.Aspect
    First.Aspect Posts: 14,290

    Re doctors salaries this may be controversial but there are a disproportionate number from private schools and affluent backgrounds in general. That is going to feed into their expectations about salaries - they may feel £60-100k is insufficient because daddy was on several times that.

    Maybe if we accepted kids from less advantaged backgrounds are just as able but that it's hard to get straight A*s if you went to some shite comprehensive - and find a way to get more of those kids into the profession - then we'd have a medical profession less demanding of excessive pay. Ideally of course we'd have the same kind of investment in state education nationwide that London had some time ago (and ban private schools) so we don't have to look at exam results through a prism of where they were achieved.

    There are plenty of "Straight A*" students who didn't make the cut for medical / dentistry school and/or Oxbridge. There are more bright kids (as measured by A* grades at A-level than there are places on such courses. Which is actually the cause of "social injustice" as to get access to such courses, kids also need to be in the top performers in respect of entrance exams, assessment tests, interviews etc. Decent state comps can teach their bright kids to get plenty of A*, but private schools, as a function of resources and experience, have an advantage in getting kids over the line for medicine, dentistry and Oxbridge.

    There are a lot of medical students at Manchester (where Younger Daughter has recently started - not doing medicine) who are from the previous school year, who took a year off to perfect their application process having not made the cut anywhere for October 2021.

    Younger Daughter didn't make the cut for Oxford but decided that was Oxford's loss and rather than reapplying, went to Manchester without an additional year. It was going through this process vicariously that I realised just what an advantage the bright private school kids have over the bright state school kids. None of the private school kids who have places at medical school or on technical courses at Oxbridge etc. have been gifted them via "connections". They've just been able to realise a greater % of their potential to stand out during the applications process.

    Oxbridge are reducing their private school intake now. A colleague's kids' school has gone from around 40 places a year to 20.
    In a nutshell that is Oxbridge. I went to a comprehensive and then a sixth form college in an affluent part of Surrey. 20 places is still about 10 years' worth across both institutions.
  • Re doctors salaries this may be controversial but there are a disproportionate number from private schools and affluent backgrounds in general. That is going to feed into their expectations about salaries - they may feel £60-100k is insufficient because daddy was on several times that.

    Maybe if we accepted kids from less advantaged backgrounds are just as able but that it's hard to get straight A*s if you went to some shite comprehensive - and find a way to get more of those kids into the profession - then we'd have a medical profession less demanding of excessive pay. Ideally of course we'd have the same kind of investment in state education nationwide that London had some time ago (and ban private schools) so we don't have to look at exam results through a prism of where they were achieved.

    There are plenty of "Straight A*" students who didn't make the cut for medical / dentistry school and/or Oxbridge. There are more bright kids (as measured by A* grades at A-level than there are places on such courses. Which is actually the cause of "social injustice" as to get access to such courses, kids also need to be in the top performers in respect of entrance exams, assessment tests, interviews etc. Decent state comps can teach their bright kids to get plenty of A*, but private schools, as a function of resources and experience, have an advantage in getting kids over the line for medicine, dentistry and Oxbridge.

    There are a lot of medical students at Manchester (where Younger Daughter has recently started - not doing medicine) who are from the previous school year, who took a year off to perfect their application process having not made the cut anywhere for October 2021.

    Younger Daughter didn't make the cut for Oxford but decided that was Oxford's loss and rather than reapplying, went to Manchester without an additional year. It was going through this process vicariously that I realised just what an advantage the bright private school kids have over the bright state school kids. None of the private school kids who have places at medical school or on technical courses at Oxbridge etc. have been gifted them via "connections". They've just been able to realise a greater % of their potential to stand out during the applications process.

    Oxbridge are reducing their private school intake now. A colleague's kids' school has gone from around 40 places a year to 20.
    In a nutshell that is Oxbridge. I went to a comprehensive and then a sixth form college in an affluent part of Surrey. 20 places is still about 10 years' worth across both institutions.
    Quite remarkably with an annual intake of 7,000, that is roughly 1% of the annual number of births.

    Ignoring overseas applications if the colleague's kids' school has 2,000 pupils in each year then they would be at the right level.
  • rick_chasey
    rick_chasey Posts: 71,577

    I don't see anything else about vacancies above?

    Vacancies are one of the problems. What are the underlying causes? Personally, I don't like the idea of just pouring more water in, until we do something to fix the leak.
    I think it's mainly money tbh.

    You can earn similar with more social hours at the supermarket check in.
    Similar to who? Nurses?

    That's nonsense.
    Literally what the surgeon was saying to me yesterday.
  • First.Aspect
    First.Aspect Posts: 14,290
    Isn't 2000 an awfully large school? As in, the size if a Russel Group university.

    Am going to venture that private school is at least 1000% over represented.
  • rick_chasey
    rick_chasey Posts: 71,577

    Isn't 2000 an awfully large school? As in, the size if a Russel Group university.

    Am going to venture that private school is at least 1000% over represented.

    My sixth form had 2,500 pupils.