The NHS is going to be stretched, population growth alone will see to that, health tourism will add to the problem in certain areas, and the biggest issue is the aging population with multiple chronic conditions

Whatever the party in power the NHS will still be lottery, great care mixed in with failing services staffed by teams more interested in Facebook

It will also suffer from the people who for whatever reason abuse the service because they feel they are entitled to.

But it will still be there

It will still be there and people who continually predict it’s down fall because “the Tories are trying to rip it apart” or “labour is distroying the economy and can’t afford it” are either scaremongering or deluded, they also do the people who work hard everyday to provide its services a massive disservice.

Unfortunately it will never be good enough, not for lack of good staff I’ll add.

There will never be enough money, it’s a simple fact. If it had twice the money the situation would not change.

Treatments get better, people will live longer, the longer they live the more treatments they need, treatments get better people live longer.

Cancel one heart transplant how many hips could you replace or extra nurses could you have. It always has and always will be a juggling act and no matter who is charge or how much money it has, it will never be enough and we will complain its going down the pan. But it will still be there.

Would I like to see more spent on it, hell yes, but you can only spend what you have and you can only spend it once, pick what you want to take it from. Glad it’s not my choice.

The voice of reason thanks johnikgriff.

Fact is the Tories have been in power long enough over the last 66 years to have dismantled the NHS if they thought it would not be political suicide to do so. The NHS isn’t going anywhere. What we have to decide is how much of our national wealth we spend on it and what that money gets spent on. Currently we spend 20% of public spending on it. I’d be interested to hear how much people on here think is enough.

In 5 years time the NHS will still be run by too many overpaid & inept ‘managers’.
Like most (if not all) other public services.

Fact is the Tories have been in power long enough over the last 66 years to have dismantled the NHS if they thought it would not be political suicide to do so

In the past 66 years they have been buzy & privatised everything else – (except the Forests and they has a dammed go try at that). They have now got the process down to a fine art. Expect pay to be frozen for another 5 years and 7 day a week working introduced without any shift bonuses to force the unions into a confrontation so that we can all blame the lazy shiftless staff and cheer the privatization.

In order to survive the NHS has to be affordable and sustainable

You do realize it’s already both & all other options are more expensive.

It will have been destroyed by people who would rather undergo intrusive and potentially life threatening surgery than reduce the frequency at which their hand filled with greasy sugary treats reaches their mouth.

Hopefully better…

I work with a lot of healthcare people looking at improvements and lean type stuff (not in the UK) when we deal with those working on the front line it’s really hard for them to get a perspective of how things are going overall and how things can be improved. When you can take a view of that and stop them from being flat out for a moment things happen and get better.

Some really simple things like early interventions, keeping people out of hospitals & faster turn arounds make a huge difference. Some of the stuff we have been working on is coming online soon and it will help and make a difference to patients.

Knocking attempts to improve process and make things more efficient is burying your head in the sand. But as usual if you try and suggest spending some money on making the system better you get told how many babies will die for that money, not how many you will save if it’s successful.

In 5 years time the NHS will still be run by too many overpaid & inept ‘managers’.
Like most (if not all) other public services.

Based on working for a year or so in our local one, it already is…

Met one of the managers recently and he had a new +£1k iMac. Year-end money, had to be spent… Nothing really has changed.

there was a doctor on LBC recently, being asked about the current problems.

He said that he gets people phoning up for an appointment within hours of getting a sore throat, whereas in the old days or with any sensible person they might wait a bit to let it run its course, or maybe even treat themselves with something from the chemist.

And then if they don’t get some antibiotics prescribed, even though they are told they won’t do anything, they will often then go to A&E to try there.

So maybe there should be a campaign of public service broadcasts, like the old green-cross-code man, to try to educate these people – even to explain what a strain they are causing by doing this.

Either that or monitor how many abuses of the NHS they make through their own stupidity, and sterilise them if they keep doing it to stop them breeding and passing on their ‘stupid’ genes…

And he mentioned the 111 service flooding A&E and the ambulance service for fear of being sued over a mistake.

It will have been destroyed by people who would rather undergo intrusive and potentially life threatening surgery than reduce the frequency at which their hand filled with greasy sugary treats reaches their mouth.

This will play a huge part in any future problems that the NHS encounters with regards spending huge amounts of cash on specific patient groups.
The people who do this will not, of course, take any responsibility for either their own health or the part they play in helping break the NHS. It’ll all be the fault of NHS staff and politicians.

there was a doctor on LBC recently, being asked about the current problems.

He said that he gets people phoning up for an appointment within hours of getting a sore throat, whereas in the old days or with any sensible person they might wait a bit to let it run its course, or maybe even treat themselves with something from the chemist.

And then if they don’t get some antibiotics prescribed, even though they are told they won’t do anything, they will often then go to A&E to try there.

The prats that are doing this who are incapable of thinking for themselves or looking after themselves usually seem to be the ones who, when they can’t get antibiotics from the GP, then decide to call 999 for an ambulance to get them to hospital as they claim they’re dying/can’t afford a taxi/will be seen quicker at A+E etc.

I think that the lack of personal responsibility of a huge part of the population causes probably 50% of the problems the NHS has with regards capacity. Sadly I can’t see that changing any time soon.

Still trying to satisfy unlimited demand with limited resources

Hopefully the “debate” on how to address this unsolvable dilemma will move on from lazy talk of privatisation and restricted comparisons with the US. Neither are helpful.

The Swiss, Germans and Dutch have made some progress towards these issue, but we stick our heads in the sand because we claim to have the best system in the world – not really. Meanwhile we have a massive conflict of interest in that isle who benefit form providing alternative private solutions also control the quality if the alternative. You couldn’t make it up…..

Its the small differences that you, the end user won’t notice at first. As more contracts go to any chosen provider, the treatment you receive will come from a variety of sources. At first things might even get better. I shall share an ambulance based model for you, as thats my area of knowledge, but the same applies across the board and is already active in some areas.

Patient calls 999, requests ambulance, is assessed, triaged and an ambulance is required (this part is hard to privatise as its non profit making).

Using realtime tracking, the system decides which is the nearest appropriate ambulance to the incident (NHS/Bobs blood wagonz/ Mediprofit etc). Dispatcher has no decision over which resource is chosen, the computer decides to keep the market fair.

Ambualnce arrives at scene with no or little decision making around skill set of staff, equipment available, back up available etc.

Small companies won’t have the financial capacity to have the range of services and skill that NHS providers do, therefore NHS resources will get tied up on complex/long jobs while small private “transport only” companies will deal with multiple small jobs. Jobs will be chargable at the same rate to prevent providers over using resources to boost profits. AS such, the provider with the minimal level of care/resource/training will make the most money. There is a finite number of jobs available to to compete the NHS will have to undercut its own services, but as a public funded body they will be expected to maintain the uneconomical services as well. Financial constraints will limit services, targets won’t be met an NHS services will be further shut down.

Two years ago, with winter constraints we used a private company that sent 10 year old ex NHS emergency ambulances out with trained staff, limited supplies and little patient comeback if there was a problem as they were “representing” the NHS. If there was any kind of problem or they were out of their depth they called for an NHS Paramedic. They used NHS fuel, NHS supplies and Did everything they could to look like NHS staff. We paid hundreds of thousands for this “service”.

Now repeat the same for physio (all my NHS physio was with private providers until i needed specialist care, then it was back to the NHS), GP services (OOH is mostly run on private contract), minor injuries (mostly private providers, complex cases/closing time casing get an NHS ambulance to NHS A&E), Counselling, occupational health, occupational therapies, addiction treatment (mostly charity based to be fair), mammography, CT/MRI scanning (thats a treat, “sorry there is no spare parts available for your NHS CT scanner at the moment, but you can hire our mobile unit, complete with staff..”

This is just a view point of local services, I’m sure there is more.

In 5 years I expect I’ll be a Paramedic for Bobz Blud Wagonz, on 25% lower salary, paying for all my own equipment, training and development and desperately trying to pay the bills each month.

The prats that are doing this who are incapable of thinking for themselves or looking after themselves usually seem to be the ones who, when they can’t get antibiotics from the GP, then decide to call 999 for an ambulance to get them to hospital as they claim they’re dying/can’t afford a taxi/will be seen quicker at A+E etc.

Flat rate charge to use any NHS service. £25 to see your GP, walk in centre, A and E etc. Been talked about for a while and is already used in other countries so I wouldn’t be surprised to see it come in here.

An effective public advertising campaign to help people understand the issue of going to your GP or A and E for minor ailments would be good. Expensive though and is not drugs or nurses so it will be ripped to shreds by the opposition.

Better funded than it would have been.

Not really, all parties were going to ring fence funding. It will be more stretched under the Tories as they’ll cut social care more, so the NHS will have to pick up that as well.

Flat rate charge to use any NHS service. £25 to see your GP,

flat rate charge will be no good at deterring the stupid though as they will get their benefits to pay it.

The only answer is shaming – when someone goes into the GP to ask for antibiotics for a cold, the GP can then march them out to the front of the waiting room, where people are already p1ssed off about there being a delay, and the GP then announces that this person is wasting everyones time, and why. Everyone can then point fingers and laugh, and that time-waster won’t do it again.

Same deal at A&E, time wasters can be marched out into the waiting room and everyone can laugh at them, even though it might actually be painful for some of the people in A&E to laugh…

In 5 years I expect I’ll be a Paramedic for Bobz Blud Wagonz, on 25% lower salary, paying for all my own equipment, training and development and desperately trying to pay the bills each month.

Why not start jimbobo’s blud wagonz? You seem to have the skills and experience to know what services to provide, and what would motivate paramedics and attract them to work for you. Bobz blud wagonz would be out of business before you know it.

Turnerguy they were probably there as the followed the advice of some here that’s it’s an accident so go to accident and emergency.

Better funded than it would have been.

Of course. It will need to be for companies to deliver on what they are commissioned to do and still make a realistic profit. Why would you bollix and obfuscate your way through multiple rereadings and amendments to the health and social care act without making really sure (and making potential private providers of services confident) that it would be properly funded? That would be like spending your dinner party budget on fancy invitations, placecards and napkins, and then not having enough money for a decent pudding ( 😉 )and coffee at the end.

This does not necessarily mean that increases in funding mean increases in throughput, quality and treatment outcomes though. These companies need to make a profit to exist, after all. What it does mean is that taxpayers money is being spent in a way which allows much more of it to leave the country through the various companies who are commissioned to do the work. (See railways thread and sncf’s investment in uk rail franchises).

Oh and +1 to the bits about social care. Even in children’s health where they have parents and families, it is frightening how much even today the poor resourcing of social care adds to the cost of nhs care (most particularly inpatient £1200 a night sort of stuff). Better funding can easily and quckly be swallowed up in delayed discharges or additional ‘borderline’ admissions which could have actually cost social care far less (if they had it, poor feckers) to avoid than it subsequently costs nhs england to deal with instead.

“Better funding to nhs” is a poor measure, great for the cover of the Mail, obviously welcomed by those in the nhs but quite simple to see how much more complicated it is than this.

Lying here in a private ward following an operation to correct a fracture that was not treated properly, i’d say the NHS will be as over-stretched as it is now.

Free at the point of delivery is the fundamental tenet. Exactly how this is delivered is the central divisive issue. Personally I believe it needs more management. George had the right idea.

I found Hugh Pym’s article here about UK spending/hospital beds/docs + nurses per capita compared with other OECD countries quite interesting. I don’t know about his influences, but the suggestion is to get health care at a level similar to the best performers, significant investment will be needed, and actually the NHS does reasonably well given its resources.

As a paramedic, I echo the concerns above: already we are seeing unidentifiable white vans with AMBULANCE emblazoned on them picking up contract work locally. Staff in green, public none the wiser, but levels of equipment and staff education vastly different to those provided directly by the NHS. Yes, I could set up TomBBludWagon Inc to compete, but in order to make money I would need to undercut, by providing the minimal amount of simple equipment and a couple of stretcher monkeys. This would lead to more admissions to A+E as my staff would not have the education and resources to see and treat/refer elsewhere, and the costs saved by the Ambulance Trust would be a burden on the Acute hospital trust.

In 5 years I expect I’ll be a Paramedic for Bobz Blud Wagonz, on 25% lower salary, paying for all my own equipment, training and development and desperately trying to pay the bills each month.

Maybe, maybe not….most PAPs (private ambulance providers) pay more than the NHS.
Most NHS Ambulance Techs/EMTs (the clinical grade lower than a Paramedic for those that dont know) are on band 4 and struggle to make ends meet in the South East, there are private firms recruiting for that role paying £37,000…thats more than most NHS Paramedics!
My hourly rate in the private sector is nearly double what my NHS pay currently provides…..trouble is it would mean leaving the comfort of a public sector pension, sick pay, etc etc

None of us in healthcare are going to be without work, society has become an inverted pyramid that is now top heavy….the over 85s are the fastest growing group in society, for the first time in history the over 60s now outnumber those under 16….these are terrifying statistics as the NHS is truly going to creak and groan under that load….glad i dont have to sort it out.

All you can do is sell yourself to the highest bidder and do your best to look after yourself….as a society we’re too fat, too old etc etc….its f@@ked, laugh about it and ride bikes instead!

The Germans have a more accountable system?