NHS problems etc

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  • webboo
    webboo Posts: 6,087

    .

    webboo said:

    When I retired from nursing I did go back and work part time for about 9 months before sacking it off and working as a conservation assistant for the National Trust.
    Just a touch less stressful but then they don’t pay much.

    Where did you get to work, for the national trust. I'm guess the "office" was quite nice?
    Nunnington Hall near Helmsley North Yorkshire. I just did 3 months as we then moved away from the area. The house was closed to visitors for most of the time I was there, so I got to assist in cleaning the collection and got in the way when they installed some giant Grayson Perry tapestry’s.
  • ddraver
    ddraver Posts: 26,318
    Thread needs a title change...
    We're in danger of confusing passion with incompetence
    - @ddraver
  • briantrumpet
    briantrumpet Posts: 17,324
    ddraver said:

    Thread needs a title change...


    "etc"
  • Stevo_666
    Stevo_666 Posts: 57,731

    Pross said:

    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.
    just because somebody is very good at cutting people up does not make them competent at comparing salaries between different sectors.

    I am amazed at you not questioning his wisdom by spending 20 seconds on Google.

    To save you the trouble, if we assume your check out staff works a 40 hour week then they are earning £21k a year. For qualified nurses the starting salary is £27k and the RCN puts the average at £33k. If we take that up to £40k to allow for the generous pension then your surgeon would only be correct if your checkout person was working a 80 week.
    "All the nurses in my ward quit and I now see a lot of them at the check in at the supermarket"

    Who am I to judge.

    Will not take heat for sharing what other people tell me.
    You would think that even if they have had enough of nursing they could find jobs other than working at a supermarket checkout with a degree to their name. Sounds like he was talking censored to me.

    I think that working on supermarket checkouts is quite therapeutic if you've had enough of workshit and mortal responsibility, especially if you still like meeting people and exchanging pleasantries.
    Out of interest, @ballysmate (who hasn't been seen on here in while) retired from his job in the corporate world and now stacks shelves down at his local Tesco, for the same reason.
    "I spent most of my money on birds, booze and fast cars: the rest of it I just squandered." [George Best]
  • briantrumpet
    briantrumpet Posts: 17,324
    Stevo_666 said:

    Pross said:

    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.
    just because somebody is very good at cutting people up does not make them competent at comparing salaries between different sectors.

    I am amazed at you not questioning his wisdom by spending 20 seconds on Google.

    To save you the trouble, if we assume your check out staff works a 40 hour week then they are earning £21k a year. For qualified nurses the starting salary is £27k and the RCN puts the average at £33k. If we take that up to £40k to allow for the generous pension then your surgeon would only be correct if your checkout person was working a 80 week.
    "All the nurses in my ward quit and I now see a lot of them at the check in at the supermarket"

    Who am I to judge.

    Will not take heat for sharing what other people tell me.
    You would think that even if they have had enough of nursing they could find jobs other than working at a supermarket checkout with a degree to their name. Sounds like he was talking censored to me.

    I think that working on supermarket checkouts is quite therapeutic if you've had enough of workshit and mortal responsibility, especially if you still like meeting people and exchanging pleasantries.
    Out of interest, @ballysmate (who hasn't been seen on here in while) retired from his job in the corporate world and now stacks shelves down at his local Tesco, for the same reason.

    And I had a musician/teaching colleague who did the same... well, they didn't really like children, which would make teaching them a bit of a drag...
  • rjsterry
    rjsterry Posts: 27,249

    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.
    Is that correct? The school must be a small town in its own right.
    https://www.teachincambs.org.uk/schools/hills-road-sixth-form-college/

    Having responded to strong and sustained demand for places over a number of years, we now have nearly 2,700 full-time 16-19 students for whom we provide a choice of 35 A level subjects
    Thanks. So if I’m reading it right, that’s a “6th form only” school that takes in younger kids from 18 schools in the the area. Efficient, if maybe rather impersonal!

    It's just a sixth form college. I really liked mind. Was treated like an adult. University was a step backwards. I think I read that students from sixth form colleges do better at university.
    Did my A-levels at school, but my Foundation course at an FE college and remember thinking how marked the difference was when I went to University.
    1985 Mercian King of Mercia - work in progress (Hah! Who am I kidding?)
    Pinnacle Monzonite

    Part of the anti-growth coalition
  • morstar
    morstar Posts: 6,190
    edited January 2023
    He said 2,000 per year. I.e. 10K and the school is therefore clearly over represented (if the maths is correct).

    Re stress. Whilst A&E it is easy to see why it is stressful due to the high throughput, to ignore other types of stress is disingenuous.

    If you’re understaffed, it can be very stressful even if there isn’t obviously a lot going on. You may have angry patients not being responded to, admin not done, not the right or enough equipment to do the job to standard etc.

    My job can be pressured and it is me alone in my room with a PC. It would not be at all obvious to an external observer whether I had an easy or hard day.
  • rick_chasey
    rick_chasey Posts: 71,585
    edited January 2023
    https://www.economist.com/finance-and-economics/2023/01/15/the-global-health-care-collapse

    Economist article. Seems the health system problems are by no means unique to the UK (though the NHS is so transparent with its data it's the easiest to spot)

    After discussing the NHS woes:

    Other countries have less comprehensive statistics, but equally miserable patients. In September Ipsos, a pollster, released a global survey that included a question on health-care quality. In almost all of the 20-odd rich countries, people were less likely than in 2021 to say that the service on offer was “good” or “very good”. In Britain the share saying so fell by five percentage points. In Canada it fell by ten. In Italy by 12.


    Italian hospitals inundated by covid patients in early 2020 are struggling once again. We analysed data from the Pope John XXIII hospital in Bergamo, the site of some of the harrowing images of people on ventilators nearly three years ago. In the year covid hit Italy, the hospital’s waiting lists rose slightly on some measures. They then fell slightly the next year. But in 2022 they jumped. Someone in the city looking for a non-urgent breast ultrasound may have to wait as long as two years. Officials in Emilia-Romagna, another region hit hard in 2020, have launched a plan to return waiting lists to pre-pandemic levels.

    Newspapers across the Anglosphere are filled with horror stories. In New South Wales, Australia, some 25% of patients had to wait more than half an hour to be transferred from paramedics to emergency-room staff in the third quarter of 2022, up from 11% two years before. In Canada waiting times have reached an all-time high, with a median delay of half a year between referral and treatment.

    Even the richest, most competent countries are feeling the strain. In Switzerland there are fewer free intensive-care beds than at most points in the pandemic. Germany is seeing similar problems, with a surge in patients reducing intensive-care capacity (see chart). In Singapore patients waited for about nine hours to be seen at the average polyclinic at the end of 2021. By October 2022 they were waiting for 13.

    America is doing better than most countries, thanks to the vast amount of money it spends on health care. But it is not doing well.
  • rick_chasey
    rick_chasey Posts: 71,585
    edited January 2023
    The conclusion, by the way, is exactly what I have been banging on about, re care industries costing more for the same.

    The problems facing health-care systems are not therefore caused by a lack of cash. Much of the increased spending has gone on programmes to combat covid, including testing and tracing, and buying vaccines. But funding is now rising across systems more broadly. In almost every rich country more people are working in health care than ever before. Total employment in hospitals in 2021 was 9% higher than in the year before the pandemic in the six oecd countries we surveyed. The latest data suggest that in Canada 1.6m people now work in health care, the most ever. In the eu more than 12m people work in “human-health activities”, a record. American hospitals employ 5.3m people, another record.

    Perhaps the real problem is not staff numbers, but how efficiently they are working. Real output in America’s hospital and ambulatory-health-care sector, which in effect measures the quantity of care provided, is only 3.9% above its pre-pandemic level, whereas output across the economy as a whole is 6.4% higher. In England elective-care activity (ie, surgery planned in advance) is slightly lower than it was before covid hit. In Western Australia the share of delayed elective surgeries jumped from 11% to 24% in the two years to November.

    Hospitals are, in other words, doing less with more. Although falling productivity is an economywide phenomenon, health care currently suffers from additional pressures.
  • morstar
    morstar Posts: 6,190
    But if you look at it solely in financial terms, this is probably just a logical outcome of the staff shortages.

    You pay more for bank (agency) staff and ultimately get less output as they have to get up to speed and don’t normalise a workload over a longer period.
  • rick_chasey
    rick_chasey Posts: 71,585
    morstar said:

    But if you look at it solely in financial terms, this is probably just a logical outcome of the staff shortages.

    You pay more for bank (agency) staff and ultimately get less output as they have to get up to speed and don’t normalise a workload over a longer period.

    That's not the conclusion of the article as I read it
  • Stevo_666
    Stevo_666 Posts: 57,731

    The conclusion, by the way, is exactly what I have been banging on about, re care industries costing more for the same.

    The problems facing health-care systems are not therefore caused by a lack of cash. Much of the increased spending has gone on programmes to combat covid, including testing and tracing, and buying vaccines. But funding is now rising across systems more broadly. In almost every rich country more people are working in health care than ever before. Total employment in hospitals in 2021 was 9% higher than in the year before the pandemic in the six oecd countries we surveyed. The latest data suggest that in Canada 1.6m people now work in health care, the most ever. In the eu more than 12m people work in “human-health activities”, a record. American hospitals employ 5.3m people, another record.

    Perhaps the real problem is not staff numbers, but how efficiently they are working. Real output in America’s hospital and ambulatory-health-care sector, which in effect measures the quantity of care provided, is only 3.9% above its pre-pandemic level, whereas output across the economy as a whole is 6.4% higher. In England elective-care activity (ie, surgery planned in advance) is slightly lower than it was before covid hit. In Western Australia the share of delayed elective surgeries jumped from 11% to 24% in the two years to November.

    Hospitals are, in other words, doing less with more. Although falling productivity is an economywide phenomenon, health care currently suffers from additional pressures.
    Agree with the point about it being a global issue. I had posted upthread an example from France but it's interesting to see how widespread it really is.
    "I spent most of my money on birds, booze and fast cars: the rest of it I just squandered." [George Best]
  • TheBigBean
    TheBigBean Posts: 20,280
    Starmer wrote an article this weekend about labour's solutions for the NHS.
  • Dorset_Boy
    Dorset_Boy Posts: 6,729
    Sky News yesterday were running a feature on the health care / hospital crisis in Ireland too.

    it is very good news that Starmer is willing to talk about NHS reform, but would he have the balls to set up a cross party panel to work it all out, and try to get a long term committment across the board?
  • rick_chasey
    rick_chasey Posts: 71,585

    Sky News yesterday were running a feature on the health care / hospital crisis in Ireland too.

    it is very good news that Starmer is willing to talk about NHS reform, but would he have the balls to set up a cross party panel to work it all out, and try to get a long term committment across the board?

    Who on the otherside of the fence to labour would have something constructive to say?

    I'm all for actual collaboration and compromise for this stuff as I think it makes for better policy making, but what about the Tories makes you think they'll be interested in anything other than wrecking?

    They're currently trying to allow police to stop protests even before they happen ffs.
  • I saw a lot of the response to Keir Starmer's article being that people couldn't understand a world where you could get referred to a specialist without seeing a GP first.

    Private health companies manage to do it without a GP being involved.
  • TheBigBean
    TheBigBean Posts: 20,280

    I saw a lot of the response to Keir Starmer's article being that people couldn't understand a world where you could get referred to a specialist without seeing a GP first.

    Private health companies manage to do it without a GP being involved.

    I'm currently able to self refer to a physio on the NHS.
  • webboo
    webboo Posts: 6,087
    Most NHS have self referrals for Physios and Mental health services. Might take a while to get seen.
    I contacted my health insurance re a referral to see someone about my hip. I had a telephone assessment with a physio later that morning. Who recommended I see an Orthopaedic surgeon, while still on the phone she transferred me back to insurer who booked me in to see said surgeon the following week.
  • Pross
    Pross Posts: 39,827

    Sky News yesterday were running a feature on the health care / hospital crisis in Ireland too.

    it is very good news that Starmer is willing to talk about NHS reform, but would he have the balls to set up a cross party panel to work it all out, and try to get a long term committment across the board?

    Who on the otherside of the fence to labour would have something constructive to say?

    I'm all for actual collaboration and compromise for this stuff as I think it makes for better policy making, but what about the Tories makes you think they'll be interested in anything other than wrecking?

    They're currently trying to allow police to stop protests even before they happen ffs.
    This is the sort of thing that doesn't help. If there is ever going to be a long-term strategy to modernise and improve the NHS it needs to involved all sides of the political spectrum as it will take multiple Parliaments to make any meaningful difference. Given the Tories have been in Government for the majority of my lifetime it would appear stupid to attempt to make changes without them being included.
  • Pross
    Pross Posts: 39,827
    I realised I was overdue for a check up at my NHS dentist and just called expecting to get an appointment in a couple of months only to be offered a choice of times next Monday so at least something seems to be working in the system.
  • pangolin
    pangolin Posts: 6,183
    Pross said:

    I realised I was overdue for a check up at my NHS dentist and just called expecting to get an appointment in a couple of months only to be offered a choice of times next Monday so at least something seems to be working in the system.

    Ours just closed it's NHS portion and booted us all off the books. Sent us a nice pamphlet about their payment plan options though.
    - Genesis Croix de Fer
    - Dolan Tuono
  • briantrumpet
    briantrumpet Posts: 17,324
    Pross said:

    I realised I was overdue for a check up at my NHS dentist and just called expecting to get an appointment in a couple of months only to be offered a choice of times next Monday so at least something seems to be working in the system.


    Lucky you. My last NHS dentist was going to turn private just before covid, changed his mind when he realised he'd be paid big money to do little/no work by staying NHS during the pandemic, then went private as soon asa the funding dried up. No new NHS dental places available anywhere within a 20-mile radius, and I suspect anywhere in Devon.
  • ddraver
    ddraver Posts: 26,318
    Been on the waiting list for Plymouth and the surrounding area for a year and a half now...

    Hope my toothbrush is keeping up to speed
    We're in danger of confusing passion with incompetence
    - @ddraver
  • pblakeney
    pblakeney Posts: 25,228
    edited January 2023
    My experience of private dental care v NHS. Prettier receptionists, swanky reception areas, newer equipment, same level of treatment at much greater cost for the aforementioned.
    The above may be fact, or fiction, I may be serious, I may be jesting.
    I am not sure. You have no chance.
    Veronese68 wrote:
    PB is the most sensible person on here.
  • Jezyboy
    Jezyboy Posts: 2,785
    Pross said:

    Sky News yesterday were running a feature on the health care / hospital crisis in Ireland too.

    it is very good news that Starmer is willing to talk about NHS reform, but would he have the balls to set up a cross party panel to work it all out, and try to get a long term committment across the board?

    Who on the otherside of the fence to labour would have something constructive to say?

    I'm all for actual collaboration and compromise for this stuff as I think it makes for better policy making, but what about the Tories makes you think they'll be interested in anything other than wrecking?

    They're currently trying to allow police to stop protests even before they happen ffs.
    This is the sort of thing that doesn't help. If there is ever going to be a long-term strategy to modernise and improve the NHS it needs to involved all sides of the political spectrum as it will take multiple Parliaments to make any meaningful difference. Given the Tories have been in Government for the majority of my lifetime it would appear stupid to attempt to make changes without them being included.
    Given the similarity between Thatcher and Johnson basically seemed to be the colour of the rosette, I'm not sure cross party support is as meaningful as it sounds. Especially given one party tends to win a succession of elections on the trot.

    I do wonder whether reform will be anything more than a random reorganization of an org chart and maybe some extra bits of private/public sector collaboration.
  • Pross
    Pross Posts: 39,827
    I’d had NHS with the same dentist in my home town for decades. He then retired and I got transferred to another NHS dentist in the town (he made me realise why some people are scared of dentists!). He then killed himself, which I don’t think was related to the condition of my teeth, and it took ages to get back on a list in my current town.

    They’ve generally been very good, my regular dentist is excellent but was off for a long time after having a baby and the locums really weren’t great. Took a while to get an appointment again after lockdown but I was stunned to get an appointment this time within a week, it’s usually 2-3 months despite being fairly flexible.
  • rick_chasey
    rick_chasey Posts: 71,585
    edited January 2023
    Pross said:

    Sky News yesterday were running a feature on the health care / hospital crisis in Ireland too.

    it is very good news that Starmer is willing to talk about NHS reform, but would he have the balls to set up a cross party panel to work it all out, and try to get a long term committment across the board?

    Who on the otherside of the fence to labour would have something constructive to say?

    I'm all for actual collaboration and compromise for this stuff as I think it makes for better policy making, but what about the Tories makes you think they'll be interested in anything other than wrecking?

    They're currently trying to allow police to stop protests even before they happen ffs.
    This is the sort of thing that doesn't help. If there is ever going to be a long-term strategy to modernise and improve the NHS it needs to involved all sides of the political spectrum as it will take multiple Parliaments to make any meaningful difference. Given the Tories have been in Government for the majority of my lifetime it would appear stupid to attempt to make changes without them being included.
    Sure. I did sort of mean literally who, however.

    As in, which MPs in the Tory party would be constructive?
  • Pross
    Pross Posts: 39,827
    Just had my first flu jab as an over 50. If everything in the NHS was that efficient there’d be no issues. It took me longer to walk from reception to the treatment room than I was actually in the treatment room. Confirmed date of birth and no egg allergy, didn’t even sit down, jabbed and off.
  • briantrumpet
    briantrumpet Posts: 17,324
    Apart from dentistry and A&E waiting times, other bits of the NHS in Exeter, even my GP surgery, seem to be working reasonably well. A work colleague who has an ongoing heart problem was sent to A&E after he rang 111 and was wired up in A&E in about 45 minutes after arriving, having been prioritised by 111, and should be on the operating table within the next month. He isn't giving the impression that he's at death's door, and has been allowed back to work in the meantime.

    That's not to say that overall there isn't a crisis, which might or might not have been partly 'engineered' by Tory underfunding in order to make unpalatable solutions more attractive.
  • rjsterry
    rjsterry Posts: 27,249
    Grim thread on the damage that all the extended A&E waits do.

    1985 Mercian King of Mercia - work in progress (Hah! Who am I kidding?)
    Pinnacle Monzonite

    Part of the anti-growth coalition