The Health Reforms Explained.

[Robster65]

If they want to improve the NHS have it run along the same lines as the BBC - protected funding and run by people who know what they are doing instead of a bunch of politicians whose last A&E visit was as a drunken student. I mean have it run by doctors and nurses for doctors and nurses and all health professionals to achieve the best for the patient as opposed to the bank balance.
Improving nursing? We have within the UK a body of highly qualified and highly capable nurses that are let down by the system within which they work. It is a case of too many chiefs and not enough Indians complicated by ream upon ream of paper work which could be reduced, standardised across the nation and written by the nurses instead of the lawyers. Oh, and sisters/charge nurses who get their hands dirty please. At the end of the day we want to care, one of the reasons why we are nurses. That said we are let down and our employers set us up to fail through a variety of means.

Valid points Tom, but do the clinical management want to spend time on budgets and policies, rather than treating ?

And would they be too 'involved' to make difficult ethical funding decisions?

eg. A or B but not A and B. Might be difficult for someone who sees the impact on the patients to make that decision. Sometimes easier as a purely financial/political decision, all other things being equal.

Just playign devil's advocate.🙂

Rob

 

[Freddie99]

Fair enough, yes there are things that simply just can't be done on the NHS. We are here to service the health of a nation. Accountants must have a say in this. What I am trying to say is that they seem to have too much of a say and very little understanding of how the money should be dispersed. Simply shaking up how the NHS acquires it's supplies would save a fortune on purchasing power. Within the hospital I work in several different brands of syringe are used. All in the same size and such like. The NHS has the purchasing power to negotiate deals with the manufacturers. Perhaps standardising kit nationwide would be a wise idea?
Things such as associate practicioners, these people hold a foundation science degree that qualifies them to the level of a first year student nurse. Pointless as far as I am concerned. Fewer of these and more registered nurses. More in house training provided on the ward for the ward staff by the ward to make the staff more efficient. I come from being a health care assistant where I was taught to do things that I only see trained nurses or student nurses doing here. Simply making the staff more efficient would be very handy, especially in areas where the patient to nurse ratio is not at all pleasant.

 

[mcdonagh47]

If they want to improve the NHS have it run along the same lines as the BBC - protected funding and run by people who know what they are doing instead of a bunch of politicians whose last A&E visit was as a drunken student. I mean have it run by doctors and nurses for doctors and nurses and all health professionals to achieve the best for the patient as opposed to the bank balance.

Health is far too important to be left to the Doctors.

 

[Northerner]

Fair enough, yes there are things that simply just can't be done on the NHS. We are here to service the health of a nation. Accountants must have a say in this. What I am trying to say is that they seem to have too much of a say and very little understanding of how the money should be dispersed. Simply shaking up how the NHS acquires it's supplies would save a fortune on purchasing power. Within the hospital I work in several different brands of syringe are used. All in the same size and such like. The NHS has the purchasing power to negotiate deals with the manufacturers. Perhaps standardising kit nationwide would be a wise idea?

As long as they don't standardise meters! 😉

 

[Freddie99]

As long as they don't standardise meters! 😉

Perhaps then a reduced choice that has been road tested by both patients and professionals then or obtain similar deals as the NHS has with Bayer in relation to consumables.

 

[mcdonagh47]

Fair enough, yes there are things that simply just can't be done on the NHS. We are here to service the health of a nation. Accountants must have a say in this. What I am trying to say is that they seem to have too much of a say and very little understanding of how the money should be dispersed. Simply shaking up how the NHS acquires it's supplies would save a fortune on purchasing power. Within the hospital I work in several different brands of syringe are used. All in the same size and such like. The NHS has the purchasing power to negotiate deals with the manufacturers. Perhaps standardising kit nationwide would be a wise idea?

But that runs against Competition which is the Right Wing Ideology being imposed on the NHS in this Top Down Reorganistion that wzs promised not to happen.

 

[Freddie99]

Perhaps a root and branch reform is what is needed then. Much has changed since 1947 and we must ensure the survival of the NHS by whatever means are required.

 

[Twitchy]

It's the concern that GPs might not want 'expensive' patients like diabetics that worries me- what if you move areas & the gp consortia in the new place see your records & think 'blimey, what's a pump? Sounds expensive! Rings a bell about not achieving good enough control on injections...Obviously they weren't trying!! Don't want this basket case draining our pot of money- they'll want test strips & annual checks too no doubt!!!' 😡 Being seriously cynical here, but I bet it will happen in places!!!

 

[Robster65]

All sensible thoughts as far as I can see Tom. The problem with 'getting in accountants' or managers is that it can attract self-serving people.

Once they get in, they surround themselves with similar types to ring-fence their empire and before you know it the entire organisation runs to service their needs.

It does seem to be what's happened to a degree. Lots of little empires with safeguarded budgets and deals that, as you say, should be centralised and nationalised with a limited choice which is then decided at local level. We, the diabetic patient, can still get the free meters from DSNs/GPs via reps but the choice of strips is limited to cost-effectiveness and clinical performance. The big companies would need to reduce their profits/costs to match the cheaper than chips imports. But raise the minimum standards to avoid 'too cheap' products.

Rob

 

[Northerner]

It's the concern that GPs might not want 'expensive' patients like diabetics that worries me- what if you move areas & the gp consortia in the new place see your records & think 'blimey, what's a pump? Sounds expensive! Rings a bell about not achieving good enough control on injections...Obviously they weren't trying!! Don't want this basket case draining our pot of money- they'll want test strips & annual checks too no doubt!!!' 😡 Being seriously cynical here, but I bet it will happen in places!!!

From appearances, it appears this already happens - no pumps available some places, no test strips or restrictions on them from some surgeries, insufficient checks done on patients once some surgeries once they have achieved their maximum QOF payments...

I was interested to hear recently that GPs who have the worst outcomes for thier diabetic patients are the ones that don't attend initiatives to improve their skills in that area - chicken/egg/egg/chicken

 

[Austin Mini]

My diabetic nurse says my blood sugars are excellent. My locum doctor says their too high. I told him he was wrong and that the nurse was a specialist. No he says Im the doctor. Hmmm If I fall out with the doctor I will be banned from the practice. Best to just agree with him and carry on.

 

[Freddie99]

What quite a few people seem to forget when we talk of reforming the NHS is that we have to work with what we have got already. We cannot reform everything at once and rapidly. These things will take time. The NHS has to evolve to face an ever changing series of ailments that can affect the population, for example at it's inception infectious disease was more likely to land you in hospital than anything else. Now it is a long term illness or something age related. Remember we are now living longer than ever before and with that comes a greater morbidity.

Rob,

We have within the NHS the ability to find solutions to our problems. We have to consider all options and we may not be able to see these ourselves, hence the need to bring in outside opinion. Innovation is also key in reducing stays and such.

More nurses too. Just more nurses.

Making the NHS an attractive place to work within would be nice. I am happy to cut my teeth within the system but if I am offered the chance to work abroad where the money is better and the staff are better valued then I am going to leap at that.

 

[Freddie99]

Enough pontificating from me now. Time to go and liquidate my assets.

 

[ypauly]

But that runs against Competition which is the Right Wing Ideology being imposed on the NHS in this Top Down Reorganistion that wzs promised not to happen.

You can't say it's right wing ideology when the competition and most of the rest of the plans were in labours 2010 manifesto. You also state andy burnham is winning the arguments i would agree but only because nobody has yet pointed out he wanted to do the same and indeed gave many speechs on empowering doctors so they make the decisions.

Incidently I am also against the changes.

 

[ypauly]

Said some time ago on here that Burnham would make a good leader of the opposition, Miliband is weak and next to useless when under question and during prime-ministers question time.

If he was in office now i.e had won in 2010 we would be having the same discussion.

These changes would still be these changes thats why labour have not promised to reverse them.

I think it is a very clever trick by labour, get everybody to point and shout big bad tories that way nobody is asking what they would do. They did promise reforms they did promise competition they did promise more power for GPs they also promised to save a fortune. how?

Really how?

 

[Twitchy]

All good points but the bottom line for me remains I no longer feel the nhs is safe in either party's hand & no matter whoever's fronting them these changes feel very threatening. 'choice' or competition paid off for me in that i got treatment in a better hospital but my take is if one hospital can manage to provide good care within budget then why the heck don't they all? Should it really be that you can choose c*** care here or good care there? ...what if you don't have the enablers to access & use that choice (supportive partner, finances ok for travel costs, internet access to research, etc etc etc). Why are two hospitals so different?! Seems to me theres a lot of mileage to go comparing what works with what doesnt & applying best practice before letting shareholder type companies deflect money from frontline services in any way in the name of 'competition' . 😡

 

[trophywench]

Amen to that, Twitchy.

I am actually VERY frightened about it all .....

 

[ypauly]

All good points but the bottom line for me remains I no longer feel the nhs is safe in either party's hand & no matter whoever's fronting them these changes feel very threatening. 'choice' or competition paid off for me in that i got treatment in a better hospital but my take is if one hospital can manage to provide good care within budget then why the heck don't they all? Should it really be that you can choose c*** care here or good care there? ...what if you don't have the enablers to access & use that choice (supportive partner, finances ok for travel costs, internet access to research, etc etc etc). Why are two hospitals so different?! Seems to me theres a lot of mileage to go comparing what works with what doesnt & applying best practice before letting shareholder type companies deflect money from frontline services in any way in the name of 'competition' . 😡

Well said. The sad part for me is the lack of choice, we should be able to choose a goverment that will do as WE wish and reoresent OUR feelings and with the two main parties playing the same silly games we dont get that choice, just a differeng coloured more of the same.

 

[Northerner]

Well said. The sad part for me is the lack of choice, we should be able to choose a goverment that will do as WE wish and reoresent OUR feelings and with the two main parties playing the same silly games we dont get that choice, just a differeng coloured more of the same.

I agree Paul. I'm not sure if it's just because I'm getting older, but it seems to be more and more the case that it's all about scoring points of each other rather than actually and sincerely trying to help the country. I listen to 'Today in Parliament' on R4 most nights, and it just becomes so repetitive listening to Cameron, Milliband et al. just trying to insult each other and blame each other, each without admitting to any fault or conceding any point from their opponent. Schoolboy politics

 

[cherrypie]

I don't think it is because you are getting older Alan.
Politics has lost it's way as instead of the here and now and what we are going to do about it, they slag each other off, complain about what one or the other parties did in the last twenty years, try and score points with their quips and generally give such a poor performance that is not in anyone's interest, especially not the taxpayers, to be bothered to listen to it.

If your kids don't behave their are consequences and I wish there was for Politicians. We can vote with our feet to show them how we feel about their performance but the question then is who would we vote for? They are all behaving badly and some should have been actors as they are there to give a performance and not solve the problems.

I have voted all my life and it was always clear who I would vote for but not anymore. If there was an election tomorrow I would abstain. That would not be because I wan't to waste a vote but because none of them have impressed me that they are trying to sort out the mess.

Why did Emily Pankhurst bother to make sacrifices so that women could vote? She must be turning in her grave at modern day Politicians' antics.