[b]THM[/b] I and pretty well all my colleagues feel the NHS was at its very best about 4-5 years ago. But rather than build on that - a new layer of Market Rhetoric and a failure to act on evidence rather than ideology has led to an utter clusterf***
The Conservatives declared the NHS broken, and proceded to break it... And all the performance data and satisfaction surveys tends to bear this out. 🙁
Odd that its only the tories on here who seem to get upset about the widely held view that the Tories are trying to privatise the NHS..possibly by destroying it first. personally I think many would support this if they knew it was not electoral suicide hence they do this instead. you can call it BS if you like but then one has to remember your own political leanings.
I wonder why the defensive tories call it noise and try to deflect the debate?
If only the tories would be honest about what they mean when they say "Honest debate" we might make some progress. What do you mean? If only everyone had your grasp of the truth- by the way what exactly is your business again 😆part of the reason it the crap noise the prevents rational debate.
The real issue here is we all know Hunt lied/misused in his use of the statistics [which has led to deaths as folk dont attend hospitals at the weekend when they are ill] and his methods/approach have angered an already annoyed workforce who are not exactly renowned for being on the coal [ see what i did there] face of industrial disputes and challenging the govt of the day. IMHO a decent manager would realise he is part of the problem and move him on- I have no idea why May has backed him so much as they have now drawn a line in the sand and they dont want to back down as they will look weak - compromise has been made less likely by both groups actions but the new PM had a chance to kick start a new debate she ignored it as emphatically as possible.
As for the real debate you saying that - does anyone speak more in tongues/obtusely on here than you? [ chewk?] Oh the irony
here you go state clearly what the "fundamental reform" is that is required as it's rather vague/nebulous concept
go on what do we need to do then- you do practice what you preach dont you?
...and it doesn't need 'fundamental reform' FFS.
It needs funding properly now and a commitment to funding it properly in the future.
The NHS is the only healthcare that 90 odd % of the people in the UK will ever have, it's been paid for by the previous generations and should be as good as we can make it, not as cheap as we can get away with.
...and let's be sensible and rational; if you choose to move away from a centrally funded model it will cost more.
Odd that its only the tories on here who seem to get upset about the widely held view that the Tories are trying to privatise the NHS
Hmm, about as odd as it being only the hand wringing Lefties who seem to get upset about the widely held view that Corbyn is unelectable
...not as cheap as we can get away with
I'm happy to take a chance on a bit cheaper than that.
So what would you think would be the best way to cheapen it?
How about shutting for bank holidays?
May has not moved him on because he is not yet toxic enough, so plenty more lies and upset before she replaces him with someone who presents as more humble and a (relatively!!) palatable alternative in time for shiny new manifesto promises. At least if it was my job to advise (and I could still sleep at night) then that's what I would recommend.
Also the Westminster heirarchy gave way to the establishment one: look who he is related to. Hunt is simply the best connected minister in the 'real' world outside the parliamentary/elected Conservative party, and it simply will not do to be just moving him on like that. My bet is that May tried to replace him, and then someone's mum rang someone's uncle who had a quiet word in a private members club with someone's aide and then suddenly May saw the error of her ways.
THM I and pretty well all my colleagues feel the NHS was at its very best about 4-5 years ago. But rather than build on that - a new layer of Market Rhetoric and a failure to act on evidence rather than ideology has led to an utter clusterf***
Well we can agree to disagree, I remember an NHS team come to my business school in the early 90s to discuss "change management" (anyone remember that fad?). I asked them why they were introducing all their pointless changes - kicking the can down the road - instead of dealing with root causes - and no that is not just money. I told them that their "changes" were a waste of time and that things would get worse if they continued to avoid the big decisions. And here we are 25 years later, with little progress.
zokes, you might want to check (1) when the Tories (spit) came to power and (2) how the left-of-centre, anti austerity SNP differ in terms of implemented policies (reality not rhetoric).
and it doesn't need 'fundamental reform' FFS.
la, la, la.... 😯
I am sure we all understand your position much better now about exactly what is required and why their is a need for reform based on your rather old anecdote
When you speak with such clarity lord only knows why they were not convinced
If hunt is taken ill or stabbed in the back by his own party, most of us wonder if any junior drs will rush up and help him, or just leave him to drown in the pit of his own making , and let someone else deal with fractures in his party.
The Nhs needs a shake up, to many grades and job demarcations, to many contractors and empire builders, along with much to many agency staff.
Talk to older nusring staff and they will tell you nurses did the cleaning /feeding and toilet duties along with other patient care activities, the matron and sister ruled with an iron rod and their word was law on a ward,now we have endless grades of staff and management along with office staff seemingly floating around and not involved in ptient care or achieving much for anyone.
Talk to older nusring staff and they will tell you nurses did the cleaning /feeding and toilet duties along with other patient care activities,
We still do.
...and the issue is not managers, it's systematic under funding. Hence the 'too many agency staff'; you only need agency staff to fill gaps.
zokes, you might want to check (1) when the Tories (spit) came to power
May 2010. Sure, you were in coalition with the lib dems, but you were the major coalition party, and most of the policy was yours
and (2) how the left-of-centre, anti austerity SNP differ in terms of implemented policies (reality not rhetoric).
When Sturgeon has been PM for a while, this point will have a purpose in the discussion.
Just break it up and put in a system similar to that in Europe. After the initial grumpiness the Doctors will be happy eventually as they'll get more pay.
Who's "you"?
Sturgeon relies on that kind of myopia? Meanwhile
If we keep pretending that this is a party political issue then we will keep suffering the inevitable results. Everyone deserves better.
Just break it up and put in a system similar to that in Europe.
[url= http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?end=2014&locations=GB-FR-DE-SE-CH-NL-IT-ES-DK-BE-AT-PT-NO-IE&start=2014&view=bar ]You mean pay much more towards healthcare like they do? (World Bank)[/url]
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If you are prepared to pay more why don't we just stick with out comparatively efficient NHS and give it more money?
After the initial grumpiness the Doctors will be happy eventually as they'll get more pay.
Maybe some of those grumpy doctors actually believe in the NHS?
After all, if they were only interested in money then they could go private or move to a country that pays better.
Jeremy has been an excellent Health Secretary, he is an excellent Health Secretary and this deal is about a deal that is safe for patients and I think it’s crucial.If you look at what we’re doing as a Government with the NHS – we’ve got record levels of funding into the NHS, we’ve got more doctors now in the NHS than we’ve seen in its history and this is a deal that is safe for patients.
The Government is putting patients first – the BMA should be putting patients first, not playing politics.
sage words from our 'prime minister' earlier 😯
But it's not just the PM who thinks the BMA Junior Doctors' sub ctte should be putting patients first and not going on strike - the following also concur:
- The Academy of Medical Royal Colleges
- The 14 x Consultant and GP Representatives who voted against strike action (out of the 30 people that had voting rights)
- The BMA Junior Doctors' lead negotiator who agreed the curent / revised deal with the DH and says the final deal is fair and stood down when they refused to accept it.
What's happening is that most of the Junior Doctors have accepted the revised contract terms but their representatives in the BMA are still hell bent on strike action and driving their own political / personal agendas.
This outcome has been entirely predictable for the last 18 months based on what the BMA's negotiators have said. There is also the issue of the BMA's accidental (or otherwise) willingness to mislead the Junior Doctors by releasing a completely flawed pay calculator that by their own admission was built off completely incorrect assumptions and guesses even though this wasn't made clear to the people using it.
The BMAs dodgy pay calculator is without question the thing that tipped the negotiations into a dispute and the BMA were very very slow to recognise this to the point that many JDs still don't even know the original numbers were guesses rather than a true reflection of the offer being made at that time.
As an aside, why does this archaic system refer to highly trained staff as Juniors in the first place? Did Fatcha introduce the term?
If you are prepared to pay more why don't we just stick with out comparatively efficient NHS and give it more money?
Yes I would be prepared to pay more, but not to the NHS because I don't believe chucking more money at the current NHS system will produce the changes required. It was built in a world 60 odd years ago to provide backstop care for the ill, it now provides services way beyond that and a free for all model just isn't suitable IMO.
After all, if they were only interested in money then they could go private or move to a country that pays better.
They keep telling us that, that is exactly what they'd do, go to Australia, USA or where ever. And as for private well a fair few double dip already.
Dragon - lots of juniors are going to NZ and Oz already, not sure numbers have gone up YET though.
Private wise - most consultants work 40-44 hours for NHS and do private work in addition to this by choosing to work in their free time. This doesn't seem unreasonable and a lot of work done in private hospitals is NHS work sent elsewhere as demand overwhelms the system.
The NHS is not perfect but the alternatives aren't perfect - 44% of all money spent on healthcare in the US goes on billing and billing admin - i.e. is not spent on treating the punters - that is not a great system...
(I accept the NHS needs continuing adaption and change. Jury out on juniors pay - is it interesting that I got paid more in 2002 as a junior doc than they do now - the cost of living is a whole lot more in 2016 than in 2002)
What's happening is that most of the Junior Doctors have accepted the revised contract terms but their representatives in the BMA are still hell bent on strike action and driving their own political / personal agendas.
Umm wasn't the contract recommended by the BMA and then rejected by the doctors when they were asked to vote?
I don't think the pay is necessarily better in those places..
My other half was a midwife in NZ for 7 years or so, and the unfortunate fact is that healthcare staff elsewhere are treated with a level of respect, humanity and dignity that makes the NHS appear a complete farce by comparison
WTF 😯revised deal with the DH and says the final deal is fair and stood down when they refused to accept it.What's happening is that most of the Junior Doctors have accepted the revised contract terms but their representatives in the BMA are still hell bent on strike action
Seriously WTAF - that "argument" is all over the place.
You just said they recommended and the members turned it down then you say the ones who recommended it are "hell bent" on strike and the ones who voted for the strike, with a majority, have accepted the revised contract- seriously WTF goes on in your head?
That is a shockingly bad thinking and i am genuinely embarrassed for you that you would openly write that down like it made sense. 😯
By all means speak like the PM re the dispute but FFS make sense - even tenuous would be a vast vast improvement
My other half was a midwife in NZ for 7 years or so, and the unfortunate fact is that healthcare staff elsewhere are treated with a level of respect, humanity and dignity that makes the NHS appear a complete farce by comparison
Shh (1) the NHS is the best in the world and (2) NZ replaced its public funded system with market/insurance elements and [s]privatisation[/s] a mix of public and private service provision.
You might have got away with it this time yunki, but careful!
just5minutes - MemberWhat's happening is that most of the Junior Doctors have accepted the revised contract terms but their representatives in the BMA are still hell bent on strike action and driving their own political / personal agendas.
I can't tell if you know this is wrong and you're just going with the traditional "big lie" approach, or if you've actually convinced yourself it's true. TBH you don't come out of it too well either way and anyone who's paying the slightest attention knows you're talking absolute pish so probably no harm done but still, have a word.
You might have got away with it this time yunki, but careful!
I get the distinct impression that it's much more to do with cultural differences rather than funding
Isn't it weird that so many people (media and individuals) are up in arms about the irresponsibility of the junior doctors strike and the safety concerns that may result...BUT..these same people don't seem to voice their concerns in the same way about the affects on the patients from the NHS cuts etc...
Why do people want to vilify the doctors regards something they haven't been so bothered about in the past.... hypocrites I say...
EVB - perhaps the same "people" can draw a distinction between the two issues
Sir John Oldham hits the spot in the Torygraph (yes, ok) today
Sir John Oldham hits the spot in the Torygraph (yes, ok) today
This dispute is not about saving our NHS or patient safety. It is about pay and conditions. That is not to belittle the latter, [b]but merely to be factual.[/b]Equally there are serious issues concerning NHS and social care funding, and patient safety [b]which must be dealt with but cannot be resolved as a contractual issue.[/b]
[b]There are three options:[/b] the NHS and social care do less; match resources with demand through more taxation; or raise money from “co-payments” from patients.
[b]All are politically unpalatable, [/b]which is why two years ago in an independent report (One Person ,One Team, One System, which was adopted by the Labour Party as its policy) I urged a “national conversation” with citizens on the options on the scope and funding of health care. I repeat that call today. [b]The matter is urgent and the BMA’s strikes will simply make this financial position, and the consequences, worse.[/b]
As I sad before - its too important an issue to be left to politicians, doctors and their union. The can cant be kicked too much further as the bend in the road is fast approaching
@thm...did you feel it whistling passed you as you missed the point I was making..... 😀
No, sorry (but in fairness I didnt understand the second bit)
You beat me to my edit @tgm. The point I was trying to make (which was lost in me using the emotuve 'hyoocrites') is that the passion sadly is more political based rather than genuine care for the service towards the patients...and I think it is deeply wrong to vilify a whole section of the NHS because of these political arguments...
I am not commenting on whwther the strike is right or not...simply that the arguments are flawed and hypocritical...
Well I agree on the argument issue - hence my earlier comments that ALL parties should hang their heads in shame as they have ALL deliberately muddied the central issue(s)
Sadly, none of this is new where health is concerned
is that the passion sadly is more political based rather than genuine care for the service towards the patients...
There are some that argue this can be flipped and aimed at elements of the JDC as well as people attacking the juniors. It does seem to be a dispute that has a political flavour on both sides.
The level of escalation is a strategic mistake though - it will lose the support of many more juniors (both via safety concerns and loss of income), and the general public. I see the GMC has issued a warning to doctors thinking of taking part, which I would have thought could be a significant factor if any are wavering.
It will be interesting to see how many juniors choose to work rather than strike this time around. If support ebbs away it will be hard to sustain the actions until Christmas.
One down, three to go
Yes, wonder how important the GMC intervention was?
I don't think the GMC intervention will have much impact on doctors tbh, there's a lot of distrust and lack of confidence there already after they appointed one of Hunt's advisors as CEO. I think it's designed to influence public opinion not doctors.
[b]Slight resurrection but relevant:[/b]
jambalaya - Member
As I have posted before medical school is hugely over subscribed, there is a very long list of people who want to be Doctors and have the skills to do so but can't get a place to study.
Mr Hunt has announced a 25% increase in junior doctor places (from 6,000 to 7,500 a year) in an effort to ensure we still have [i]some[/i] doctors left after Brexit.
Worth reading the full article.
http://www.bbc.co.uk/news/health-37546360
Mr Hunt has announced a 25% increase in junior doctor places (from 6,000 to 7,500 a year) in an effort to ensure we still have some doctors left after Brexit.
Along with the proposal that they have to work 4 years in the NHS as payback for public funding of their clinical training. It might be better to try to retain them with the prospect of a better, more rewarding career in an adequately resourced NHS without the Hunt's imposition of deleterious working conditions.
Australians getting pissed off again with economic migrants from failing nations flooding their country
https://www.ft.com/content/38513e9a-a029-11e6-86d5-4e36b35c3550
I think a slow clap for jeremy hunt, is called for
There's an interesting quote in the FT piece from a UK trained medics now working in Australia which points to one of the core problems in the NHS - that of a culture which is resistant at nearly every level to any form of change or taking what works from abroad and implementing it here... the "not invented here" syndrome that also exists between individual trusts, let alone between the NHS and other health systems.
“I spent a decade working at a hospital in Adelaide and then went back to work in the NHS in Wales. I thought I could bring back some of the positives and techniques I’d learnt in Australia to the UK. But there was resistance from administrators, and the focus was on merely keeping our heads above water, rather than introducing newfangled systems and processes from the colonies."
and the focus was on merely keeping our heads above water
the size and scale of the top down reorganisation and cuts forced on the NHS this is hardly surprising
I thought I could bring back some of the positives and techniques I’d learnt in Australia to the UK
Pitty it doesn't actually state what they are. Our Trust is actively looking for changes that can improve patient experience/save money.
Unfortunately a lot of the government policies/financial constraints we are now under prevent us from doing anything that would add value.
the size and scale of the top down reorganisation and cuts forced on the NHS this is hardly surprising
Equally you could say that the failure of the NHS to reform itself over many decades is precisely the reason that a "top down" change is now being prescribed - it's finally reached a demographic tipping point where it must now change, or fail ..and at scale. And surely that's not what anyone wants.
If we take a system view, Primary Care has been broken for a decade or more because the bulk of the funding still goes on maintaining a footprint of hospitals that was designed on a reasonably arbitrary basis back in the 1940s / 50s.
The view of what Primary Care should / shouldn't also hasn't really evolved in 3 decades despite the many advances in diagnostics and treatment - so we still have many thousands of single handed GP practices running even though we know they are significantly more likely to lead to poor care / outcomes.
The country has changed immeasurably since the NHS was originally conceived but the system has barely changed and continues to operate the pointless delineations between primary and secondary care that many other health systems have long since moved on from.
We now have one of the most obese and unhealthy societies in the western world and yet the NHS operating model is still focused on treating sickness not maintaining wellness. We're on track to spend 10% of the entire NHS budget on type 2 diabetes / comorbidities but we're still debating whether it's ok for GPs to tell obese patients they must lose weight.
We now have one of the most obese and unhealthy societies in the western world and yet the NHS operating model is still focused on treating sickness not maintaining wellness.
Indeed , however public health is now the responsibility of Local Councils
https://www.theguardian.com/local-government-network/2013/apr/18/council-public-health-responsibilities
who have also seen huge cuts to funding.....
We now have one of the most obese and unhealthy societies in the western world and yet the NHS operating model is still focused on treating sickness not maintaining wellness.
This quote aside, you are good at following the government sound bites, in fact are you Jeremy Hunt?
Massive amounts of work has been done trying to try and get healthier lifestyles and prevent the onset obesity/diabetes etc. Unfortunately the fact is, people like eating kebabs, drinking, smoking,and eating sugar etc. Oh and riding mountain bikes - (a big user of acute care.)
the system has barely changed and continues to operate the pointless delineations between primary and secondary care that many other health systems have long since moved on from.
Again massive amounts of work has been done to try and resolve this. The fact is that there isn't enough money in the whole system ie Acute Care, Primary Care, Public Health, Social Care. This magical government view of we can take funding from Acute care to social/care closer to home is bollox. There is simply too much activity that requires acute care to take that funding out.
Oh Google Vanguard. The government promised millions of extra cash to support making changes to the whole Acute Care, Primary Care, Public Health, Social Care system, and work has been done to get it all in place, only now for the government to revoke the funding.
Again I can see how you could potentially, maybe, somehow think it is the workers fault and not government policy 🙄
The government have also failed repeatedly to legislate against unhealthy foods and lig=festyles
obesity cost and kills more than smoking yet the government have rolled over to industry lobbying on minimum alcohol pricing, traffic light labeling for food etc
lets be honest tho theres one massive reason for the surge in jr doctors heading to Australia the last 2 years
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According to a colleague who did just that he said that while they are clamping down on docs at jr level, because 4 years ago they doubled the intake at medical school by subsidising tuition fees, that has yet to filter through so there is still a big shortage at consultant level, when is Hunt planning to change their contracts?
Massive amounts of work has been done trying to try and get healthier lifestyles and prevent the onset obesity/diabetes etc. Unfortunately the fact is, people like eating kebabs, drinking, smoking,and eating sugar etc.
From that Grauniad link - "Doctors are notoriously nervous of telling people they are overweight.." Seriously? Don't know if I've ever met a doctor who has displayed any kind of anxiety about calling a spade a spade.
Kimbers. He's wrong. 6300 entrants in 2004. Not much increase since. JH is talking about going up to 7500.
stoatsbrother
that was in Australia, not here, my ex-colleague moved out to sydney this summer
Just 5 mins - in my 30 odd years of working in the NHS I have lost count of the number of reforms and reorganisations that have been done all politically motivated and all making things worse
Simple solution - keep governments out of the bloody way
Junior doctors have lifted all threat of strike action and pledged to work with the Government to help introduce a controversial new contract.