[Closed] NHS cuts - you're in charge - what services do you get rid of?

I'd be cutting out gastric bands for one, time for people to take responsibility for their own actions. Likewise smoking related illnesses.

IVF.
Home help for fatties.
Anything that happened at a trail centre.

That's got to save hundreds.

Obviously anyone on benefits, twice the savings there to be had!

I'd kill every third pensioner that turned up. Thus reducing the care and treatment bill, and also providing some excitement in their dull confused lives, with a game of state sponsored Russian Roulette

Its a win win

Not an NHS service as such but I would chop WRVS (or RVS as they are now called)

The well meaning but bumbling old ladies never, ever, seem to get the hang of operating the tills. They also occupy some of the most profitable retail space available which could be better used to return more money to the hospital.

Other than that I struggle to think of anything that wont make me sound all Daily Mail!

I'd be cutting out gastric bands for one, time for people to take responsibility for their own actions.

Your problem there is you will then spend more treating their weight related illnesses than the cost of the gastric band surgery!

I'd be cutting out gastric bands for one, time for people to take responsibility for their own actions. Likewise smoking related illnesses.

But both your ideas would end up costing the NHS more money...

Your problem there is you will then spend more treating their weight related illnesses than the cost of the gastric band surgery!

Not if you cut spending on treatment of obesity related illness you wont.

you can save a fortune by getting rid of all of the anesthetists and just getting everybody to MTFU.

But both your ideas would end up costing the NHS more money...

Lets simplify then - healthcare for fatties and smokers

Edit: and if your ever abusive towards staff, you're out too.

I'd be cutting out gastric bands for one, time for people to take responsibility for their own actions.

Your problem there is you will then spend more treating their weight related illnesses than the cost of the gastric band surgery!

What about drinkers and junkies?

time for people to take responsibility for their own actions.

Does that included banning treatment for idiots who fall of their bikes? 😉

Would you therefore cut spending on all weight related illness, including anorexia?

If the suggestion is that people choose to be fat, you could apply that to people who crash cars, fall of bikes, burn themselves on a barbecue................................... all of these people have an element of choice.

Why not just privatise the NHS. The greater the level of risk you expose yourself to, the higher your insurance premiums.

I'd cut the tiers of 'management' for one - there's bound to be a few roles that we could do without - consultancy gets the same treatment.

Maybe we should make them ask random people on the street if costs sound daft or not before approving projects - "£xxxm for an extention to the bosses office ok? .... no? .... declined!".

The best thing IMO would be allow people to finish their own life.

The NHS spends a fortune keeping people alive for longer with very little quality of life. Let people end their life when they want, and save a fortune.

I'd cut the tiers of 'management' for one - there's bound to be a few roles that we could do without - consultancy gets the same treatment.

I am so glad your not an NHS manager! Tiers of management have been cut from the NHS. Most clanicians I speak to say this has gone too far to the extent that now clinicans are spending time do management, as opposed to doing their clinical roles. Plus the fact that they have little/no management experience. So come up with a more realistic cheap attack please 😆

 

Stop free boob jobs~ they're milking the system

Get rid of the homeopaths

Homeopathy.

Edit: and psychics.

How about getting rid of half these "managers" that do sweet FA on the wards.
Seriously I wonder how much of the NHS huge wage bills are taken by middle management.

sweepy - Member

Get rid of the homeopaths

which would also add costs to the NHS...

Choosing to be fat is never likely to work out well, choosing to drive will generally be ok, choosing to do exercise probably shouldn't be frowned upon even if it goes wrong now n again, burning yourself on a BBQ means either MTFU or removal of their Man Card

I would do away with free prescriptions here in Scotland. I can afford to pay for mine, if I couldn't then I would probably be exempt anyway. That would be a huge saving.

Get rid of interpreters and producing documents in 27 different languages. It is a UK service that should only work in English. You dont expect english version of everything in french or spanish hospitals so why in UK ones?

I would also nationalise the GP service so GP's are paid to see patients and not run their own businesses.

Why not just privatise the NHS.

The more time I spend in the NHS the less I think that privatisation would be a bad thing.

It's all arse about face; we should be aiming to provide the best care that we can, not attempting to save money on healthcare.

There will come a time in all of your futures when you will appreciate why.

Why not just privatise the NHS. The greater the level of risk you expose yourself to, the higher your insurance premiums.

I think we'd find a refreshing honesty on the insurance application forms...

Qu: Do you participate in any extreme sports?
A: Y, Mountain Biking
Response: Gnarl factor 9, High risk of trauma.

Qu: Do you post regularly on STW?
A: Y
Response: Gnarl factor 1, High risk of obesity, RSI, high blood pressure, ostriches. Low risk of trauma.

which would also add costs to the NHS...

No it wouldn't, you could just give out water, with a bit of credible mumbo jumbo. Any minimum wage fool could do that.

we should be aiming to provide the best care that we can, not attempting to save money on healthcare.

...but...reviewing how to pay for it.

Get rid of all the 'made up' admin / managerial jobs that are there to analyse figures that another made up department has created.

Let the clinicians / Drs / Nurses to get on with fixing / doing the medicial stuff and spending the majority of their time not filling out forms and reporting on made up subjective targets.

Choosing to be fat is never likely to work out well

Unless if you are one of those large women who get paid to sit on men.
Or a sumo wrestler

Its not Service cuts that are needed. It's slack, inept, multi layered management structures that need streamlined.

Get Gerry Robinson onto the case

Breast enlargements and other vanity operations. Plastic surgery should be there for people who have been disfigured or to correct a defect.
The right to end your life if you are of sound mind. I couldn't imagine anything worse than been locked in a body that no longer functions and us a burden on my loved ones.

Managers!!

I bet there's a manager for every aspect involved in the NHS, and they have to answer to another manager who reports to another for three or four layers until it reaches the main man.

Where Mrs J works, not the NHS but the Civil Service, there are folks who are "Managers" who keep a diary which the staff also do to progress work on time. Of course all management positions are "Ring-fenced" whenever cut-backs are going through, so you get rid of the staff.

The problem with medical cutbacks is that they often sound reasonable to people until they directly effect either you or your nearest and dearest. Medical advancements have been amazing since the start of the NHS. There are now so many treatments available(and to spend money on) that were not even dreamed of and cures which have kept people alive even longer(to suffer other expensive illnesses). Sadly it's now becoming a victim of its own success and becoming unaffordable. When I say unaffordable, what I mean is unaffordable unless the populous at large is prepared to elect a government that increases taxation even more to pay for it, or we choose another method of paying for it like a privatised system with some winners and lot more losers.

I'd hate to be the person that gets to make these choices in real life.

An axe through management and their band 5/6 PAs oh and PA assistants.

Bring back on call GPs 24/7

Increase the treat to relieve symptoms of long term conditions rather than people hanging on with little existence. Although that is finally on a snowball.

Stop stupid target times that invoke fines far too many pointless targets.

Stop free prescriptions for those on benefits unless it's their illness that means they can't work.

Hospital meals - if I'm sick I go right off my food, and if I'm healthy they're not appetising anyway.

If we're cutting out treatment on self-inflicted issues like smoking-related or obesity-related diseases, we'll probably save a fortune on mountainbikers' broken bones too.

Personally... We extend end-of-life and IMO we do it because we can, without asking enough whether we should. My grandma outlived herself- her body was well looked after but for the last years she wasn't there at all. I don't believe she'd have allowed that to happen had she known. My grandad refused care and died on his terms, dementia took that option from my grandma. But I have absolutely no idea how this can be dealt with morally, ethically, medically...

I'd sack all administrative staff that are only there to facilitate government driven NHS overhauls

All maternity services! Less babies being born = less patients to treat in the future.

binners - Member
I'd kill every third pensioner that turned up

I think they already do that 🙂

While I have some sympathy for the guys saying 'no treatment for fatties or smokers' it does point to an attitude of 'no treatment for anyone whose problem could be deemed to have been caused by themselves' ie a huge percentage of people in hospital. So in a car crash do we treat the victim, but not the guy who caused the crash? Or neither of them, they shouldn't have got into their cars in the first place coz they're dangerous.

😀 @ no anaesthetists MTFU comment

IMHO services do not need to be cut. There are so many efficiency savings that can be made that would save substantial sums of money.

A couple of examples;

1) Patient comes in to hospital with some strips of pills - some of them complete. All these are put in the bin and replacements prescribed. They come to leave - any unused medication is binned and replacements prescribed to take home. Costs a fortune in binned drugs.

2) Wards have special bins for clinical waste. Quite often these well outnumber bins for normal waste so patients and nurses alike use the most conveniently placed bin whether for meant for clinical waste or not. I have done a fag packet calculation for the ward where my wife works - they have 8 clinical waste bins emptied at least once a day = £360 per day. 4 wards on her unit = £1440 per day or over £500k per year. Better use and management of clinical waste disposal you could probably get this down by a half. £250k saving on one hospital unit alone.

3) Staffing levels. Most wards have to bring in bank workers as they simply do not have enough staff on the wards. They could employ a 2 more full time nurses for the amount they pay for 1 bank nurse. Employ more full time, contracted staff not less = savings (also less staff off sick due to stress etc so even less need for bank workers).

4) Delays in discharging patients - quite often a patient is due to be discharged on x day but due to delays in getting prescriptions sorted, seeing this specialist or that before leaving, care plans not being finalised they stay in a extra night or 2 - at £400 per night. I had an operation privately and was in for the absolute minimun I was medically required to be there. My wife reckons had I been NHS I would have been there another 3 days or so. Getting patients out on time but safely could saving £millions.

There are so many of these seemingly small improvements that could run up to £millions of savings. May be I should do some proper research in to it!

Cheers

Danny B

I'd sack all administrative staff that are only there to facilitate government driven NHS overhauls

So how would you overhaul things then?

Get rid of the fat cats,

no bonuses,

manage stock efficiently,

quality control of contractors to ensure that they are fulfilling their role,

cut the red tape involved in buying cheaper stuff,

reduce the current in defibrilators.

Turn all the lights on and off every 2 seconds, it'll save ££££££££££££££s

I've worked in the NHS on a few contracts in my time - quite often covering for people who were on long term sick leave, would come back to work for the requisite amount of time to keep their job, and then go back on long term sick leave again.

In the administrative and managerial ranks there is a lot of p*** taking and very little done to address poor performance at work.

Re-use needles~ that'd reduce the number of useless pricks

Ok I cant comment on all NHS Trust. But certainly the one I work for has made huge cuts in Management & Admin. As I have said above, clinicians are say this has gone too far, and is effecting their clinical roles.

Danny B sorry your figures are way out.

Private industry has a huge part to play in NHS. Having worked in private industry and the NHS, and know for a fact that companies that deal with the NHS, on the whole try to exploit it as much as they can.

The NHS needs to think more commercially and operate a bit like an iPad app (bear with me here)

Service is free at delivery but you can buy extras (like in app purchases)

In A&E? - You can wait in the waiting room for free or access a lounge with WiFi, coffee and newspapers for £5 p/h

Getting some surgery on you stomach for free? - get liposuction done for an extra £500

Broken collar bone? - get it repaired for free or replaced with a pimped titanium one engraved with your initials for £600

Staying on a ward? - hotel room service inc meals etc for £50 per day.

Painkillers? - Average ones for free, good ones pay extra

Okay some more serious than others but there are a few there that I would pay for.

Frank, thats because your a rich middle class person.

The average person who uses Acute services is not rich and can not pay for those things.

Besides which, there are strict rules about how much private income you can generate

On a more serious note, accountable management backed up by robust policies would go a long way to addressing poor performance and attendance. There are too many average people working in the public sector.

franksinatra - Member - Quote
I would do away with free prescriptions here in Scotland. I can afford to pay for mine, if I couldn't then I would probably be exempt anyway. That would be a huge saving.

Not to be sniffed at but not a "huge" saving and you'd also need to factor in the cost of administration and the fact that some folk still wouldn't pay and could end up needing more (costly) care.

I was only semi serious Funky.

I used to sell to the NHS, in two different roles. In each role I was able to take the piss and charge far more than any private, commercial organisation would pay.

Trusts need to think much more commercially and ensure that the non clinical side is managed by people with real world, commercial experience.

As someone said: Saturday night drunks should be charged. Cash or up before the beak might work? And add in a sliding scale - twice as much next time.

Around 90% of prescriptions would be provided free as they are in England (children, elderly etc)

Crikey, I'm surprised it is that much. Fair enough then, I cannot fix the NHS.

[quote=franksinatra ]> Around 90% of prescriptions would be provided free as they are in England (children, elderly etc)
Crikey, I'm surprised it is that much.
So was I 😯

Look into his eyes...he really meant it:

[img] [/img]

I would urge anyone thinking of voting Conservative at the next election to think very carefully if they would like the NHS to continue exist before marking that X.

On a more serious note, accountable management backed up by robust policies would go a long way to addressing poor performance and attendance. There are too many average people working in the public sector.

I agree with this to some extent. I have worked in top FTSE 25 companies, with some excellent staff, some with way less than average staff. Overall I do not think the mix good/poor is the same in private or public.

However people cant have their cake and eat it. If you want to attract good people to the NHS, you need to pay them good money, but yet everyone on here is saying get rid of expensive managers...

I have worked for 2 NHS organisations. One had too many senior managers who were quite frankly not great, the current Trust I work for has some of the most competent staff I have ever worked with (Private or Public)

I do agree though, the NHS has a great problem with getting rid of incompetent staff (managerial or clinical)

[quote=Papa_Lazarou ]Look into his eyes...he really meant it:

I would urge anyone thinking of voting Conservative at the next election to think very carefully if they would like the NHS to continue exist before marking that X.
Given that Ed Balls has already committed to following Tory policy on everything else, would you like to alter that statement?

Oh and how to save money = GET RID OF TRAIL CENTRES 🙂

This certainly has had an inpact on the number of people needing acute care.

I used to sell to the NHS, in two different roles. In each role I was able to take the piss and charge far more than any private, commercial organisation would pay.

Trusts need to think much more commercially and ensure that the non clinical side is managed by people with real world, commercial experience.

This ^^^ . The NHS paying to use their own pharmacies seems a bit barking mad to me....

anything cosmetic.

cut doctors salaries they are a huge expense, do they [i]need[/i] 100K + topped up with private work?

rationalise the management structure. bound to be plenty of savings there

manage third party contracts better with better value for money.

create a 'show back' model. Inform the patient of how much they cost the NHS every time they use it. (don't actually charge it though)... maybe ask for a % contribution, but not mandatory, plenty could afford something

I've never been entirely sure why as someone who can afford to pay for my own food when not damaged I can expect to be fed for free when in hospital. Charge those of us not on benefits for food and board when having a little stay. Probably make square route of f all difference though.

Hypochondriac tax at the GPs? My FIL would be broke if that was brought in!

I would urge anyone thinking of voting Conservative at the next election to think very carefully if they would like the NHS to continue exist before marking that X.

I'd withdraw treatment to Conservative Voters. They can't see beyond their own immediate needs (and consider themselves self-made anyway) so they'll have no cause to complain. Until its too late. And then nobody will be listening. Anyway - that should reduce the burden on the NHS by 1/6th. Is that enough or do we need to cut more?

Cut interpreters and benefit tourists

cut doctors salaries they are a huge expense, do they need 100K + topped up with private work?

An average doctor salary is no where near £100k. Only top consultants earn around the £100k mark, and thats when they have been in post for some years. Besides which they work stupid hours so pro rata it wont be anything like that high. What does private work have to do with it?

As above pay them less, but expect to only attract lower quality doctors.

Cut interpreters and benefit tourists

Yup. Britain poaches medical staff from poor third world countries to treat British people who can speak English, not foreign types. Cheeky gits.

oh - and maybe make suing hospitals a lot harder or find another way to reduce arse covering paperwork the poor doctors have to do. This winter I got to spend the night and day in a ward because they though I might have meningitis. I was placed opposite the doctors work station and I got 24hrs of watching what they did. They were on it the whole time, no pauses for internet forum faffery ( 😉 ) but soooooo much paperwork. You should have seen the number of bits of paper that needed to be filled in for my lumber puncture. The registrar who did it reckoned he spent 40mins out of every hour doing the paperwork and only 20mins doing proper doctoring.

) Patient comes in to hospital with some strips of pills - some of them complete. All these are put in the bin and replacements prescribed. They come to leave - any unused medication is binned and replacements prescribed to take home. Costs a fortune in binned drugs.

None of trusts around here do that. There's even a been a big push over recent years to encourage patients to bring their own meds in and it's one the questions ambulance crews ask "Have you got your meds?".

There did seem to be a common misconception that this was the case but very very few people believe that now thanks to educating them with those pointless leaflets.

An average doctor salary is no where near £100k. Only top consultants earn around the £100k mark, and thats when they have been in post for some years. Besides which they work stupid hours so pro rata it wont be anything like that high. What does private work have to do with it?

Having had this discussion with my doctor mate he said in just his area of a hospital there were 52 consultants. All earning more than £100k. Across the entire hospital the wage bill is huge. Once you get to a certain salary point, the extra cash is not needed...maybe they just buy one less rolex a year? He is 33 looking for his consultant post, and can;t get one, not because the role isn't needed but because the hospital can't afford to pay for another consultant.

Cuts need to come from somewhere. I'd suggest from those who have the highest income / best earning potential (they can top up with private work, not so easy for support staff to do this)

I would urge anyone thinking of voting Conservative at the next election to think very carefully if they would like the NHS to continue exist before marking that X.

As has been said ^^ and contrary to what funcydunc says, it is not a cut in services but a cut in management which is required. If anyone denies there has been a huge amount of managerial 'empire building' over the years, they have their heads well and truly buried in the sand. Cut out the people who's sole purpose is to devise, set, impliment and monitor targets (which change seemingly daily and serve little purpose other than to appease gullible voters and satisfy knee jerk reactions) and we will go some way to getting back to the core 'business' of treating the sick.

I've been shafted by them both over the years!

Both what ......the Tories in the Conservative Party [i]and[/i] the Tories in New Labour ?

If only we had a multiparty parliamentary system, eh ?

Conservatives are more ruthless though Woody having been in long enough to run through them twice.

I'd withdraw treatment to Conservative Voters. They can't see beyond their own immediate needs

^^^this.

Would Labour be any better than the Tories? Well they wouldn't put someone like Andrew Lansley in charge, who used to be on the payroll of one of the major private healthcare providers who went on to get major NHS contracts as it was carved off.

Are you seriously thinking the Tory party have the healthcare of the nation as a greater concern than carving up what they ideologically consider a beacon of socialism for the benefit of their big donor private healthcare buddies?

No matter how good your private medical cover, there are certain parts of the NHS used by everyone, eg: A&E, for which there are no private alternatives.

Just look at the above poster – they promised not to cut the NHS and have done just that.

[b]You can’t trust the Tories with the NHS.[/b]

I think we need to accept we need to pay more to get a better service

I would also cap payments for the top paid staff and also to the pharma companies

If you want to get really shitty force folk to actually diet and exercise to get treatment - ie actually follow doctors orders

Not really sure who we compel healthy living tbh

Of course the Tories hate the NHS and see it as socialist - I really dont get it why they accept compulsory education but not healthcare. Dont they realise they need a reasonably well educated and reasonably educated population in order to exploit their labour for profit?

No point appealing to their sense of morality is there

Cut out the people who's sole purpose is to devise, set, impliment and monitor targets (which change seemingly daily and serve little purpose other than to appease gullible voters and satisfy knee jerk reactions) and we will go some way to getting back to the core 'business' of treating the sick.

and then very quickly run out of money to continue treating the sick. Many targets nowadays are based around affordability of service delivery.

Mrs S is a doctor. She earns every penny fairly. For many years she worked for not much more than minimum wage when her hours were taken into account. As a GP, she works incredibly hard, her decisions carry a lot of risk and it has taken her a lot of years, many sacrifices and hard graft to get to this stage of her career.

One economic theory states that in most cases big salaries are earned by people who have to make decisions that other people do not want to make. Doctors regularly make decisions which can have a dramatic impact on people lives, hence high salaries

Thing is, a lot of the things that improve clinical outcomes are *really* unpopular

like closing small local A&E departments and concentrating resources in dedicated trauma units has been!

My suggestion would be to see local 'minor injuries' and 'walk in' units colocated with permanent General practitioner cover on a duty roster (instead of having out of hours doctors wasting their time driving around) and open from 8am till say 10pm daily - that would take a lot of the pressure off the trauma units and the 'I've got a headache' as they would be referred there by 111 instead of ambulance

Homeopathy should definitely be available on the NHS if it's been demonstrated to have a placebo effect.

But the practitioners should only be paid £0.01 for each patient.