No they don't do it for the money but salary needs to be comparable to other professions with similar levels of training and responsibility.
Whoopee do, Doctors work quite hard. They are also well paid in comparative terms. There are other medical professions that work equally hard, often more so that are much more poorly rewarded and in terms of their direct effect upon the health of the individual they are at least equal in importance, Midwives and Paramedics to name but two.
Why ..perhaps they are all overpaid?
Not really having a dig at Doctors here it is just that some folk get massive pay and they can all tell you a reason why
Doctors probably have a better argument than say an accountant or a lawyer or similar [vastly in some cases] overpaid professional
FWIW my nationalisation and salary caps solution is not universally popular 😉
PS we are thread drifting Dr do a great job IMHO and the NHS solution involves far more than looking at Dr's
If I could change anything.... I'd change nothing.
I'd just stop meddling with the NHS for a few years, allow them enough time to get over all the change management they have been having to deal with, allow them time to start concentrating on the job at hand.
That's what I'd do
Or just accept that they are there to save lives in a way that makes budgeting almost impossible if you are serious about things being free at the point of treatment. Of course, introducing a law banning people both within and without the NHS from taking the piss would be required.
Alternatively, you could just save money by allowing the cast of Holby and Casualty to do operations on real people. They seem to be very professional and good at saving lives.
Amongst all the managerial culling, some of the senior clinical staff need some real world budgeting lessons.
Education of population regarding what services are for which illness,
There are some re-coding issues that are long overdue for revision that skew the stats badly
NHS direct could do with a better management
CQC could do with some better management
Sorry drac, but some ambulance services could do with some better management
Some of the more outlandish targets really need to be re-thought
Some outsourced stuff needs to come back to salaried, and some salaried bits need to be outsourced
Care in community needs better funding ( midwives, outreach, district nursing)
For starters
There is loads wrong with it and loads right with it, but the core problem for me is that is all disjointed, and does not have a clear idea of what it is meant to be doing. It should be protected from all government parties trying to meddle with it and should be reviewed by an independent body to basically bring it in to the modern world.
A lot of buildings are not fit for purpose anymore, the targets should be scrapped across the board and simple operating goals put in place, the doctors and nurses should have clearer operating divisions, nurses need to get on and do what doctors tell them and not hang around bitching in their coffee rooms.
there should be a common computer system bought from one of many systems availabel to run hospitals, the NHS is no different to the rest of the world so a bespoke multi billion pound system doesnt need to be developed.
the beaurocracy around patient notes needs to be cut and ideally computerised as this is what is tying up the clinical staff the most.
and allow the hospitals to do private work to make profit if they want, but profit for the NHS as a whole.
my tuppence worth.
its great but both labour and tory are making a mess of it.
In answer to the orginal question we could exclude cover for anyone who's never had a job. We could also kill anyone aged over 80. But let's not stop there lets kill everyone who doesn't or isn't able to make a contribution to society, so that's virtually all disabled people then, that should save a few bob. Seriously ... the only way to make things better is private healthcare for everyone apart from those who don't work. With healthcare plans built into employment benefits like pensions are.
@jekkyl - what like the NI contributions I have been paying for the past 30 years?
I would look to centralise rather than decentralise the management functions, daily control at the coalface with overarching direction from a single point. Not all of the overblown trusts and the maddening variations between them, it is a National Health Service rather than regional or city service so let's get it back to being a national asset.
Have to agree with the sentiment that whatever is done it should lie outside political interference. How that's achieved is anyone's guess.
a bit harsh
a friend of mine has cerebal palsy and won an olympic gold medal in cycling, so i'd say a lot of disabled people make a big contribution.
nhs cant keep anything available 24hrs
Oh, I think it can.
how about a cross party panel of MPs who come up with a ten year strategy that sits outside of the election time frames, so not always the same MPs, but at least cross party consensus on a ten year plan.
may stop all the meddling.
but also to seperate the union from the bodies that represent the doctors nurses, but to also have a body that represents hospital manager as that is in itself a profession that need better managing lol
Something that's rattled around my brain for a while but probably has a glaring flaw in it is the following;
- I love the NHS and would never even think to go private.
- I'm not poor but not rich either.
- I hate long waiting times, especially when in need of medical treatment.
I suspect that's not an uncommon combination.
When I go to the Docs and need further treatment there's an inevitable waiting list. If the Doctor said to me "You need X doing, and there's a waiting list of 8 weeks, OR you could pay Z to get it done privately next week", if I thought Z was reasonable I'd probably take him up on that, but without the prompt I'd never even think of investigating private options.
The NHS saves a bit of cash and frees up some hospital time plus an 'evil' private enterprise wins some custom it wouldn't normally have got.
There could even be a transfer of a small percentage the private fee back to the NHS coffers for referring someone...
Or have I overlooked some glaring loophole?
have I overlooked some glaring loophole?
What about the other NHS patients you have pushed further back to the end of the queue ?
[quote=verses ]
Or have I overlooked some glaring loophole?
Yes. It's often the same folk carrying out the procedure so by paying extra you are effectively making the queue longer for everyone else.
I knew there must be something I'd missed...
IMO the doctors and consultants should be made to choose - private or NHS, in the former you are on your own like anyone else in business, invest in kit, take out insurances, build facilities and try to woo customers. The latter should be as they are when they work in the NHS. I'm sure there will be a perfect reason why this cannot be done but it makes sense to me.
In the former you are on your own like anyone else in business, invest in kit, take out insurances, build facilities and try to woo customers.
A bit like current general practice then?
DrP
Yes. It's often the same folk carrying out the procedure so by paying extra you are effectively making the queue longer for everyone else.
Not sure if I agree with that.
Mr Surgeon is contracted to work 40 hours per week for NHS, during that time he does operations.
If after those 40 hours he decides to do private work instead of playing golf, it shouldn't (in theory) impact on the 40hrs he does for the NHS.
I suspect the flaw in that is the sheer cost of private work. Unless you have insurance, private treatment could be eye wateringly expensive. If it was urgent, you would be bypassing waiting lists anyway.
Make all the doors smaller so fat people cant get in,
if you smoke , no treatment until you give up,
Paramedic cars to work as taxis when not required for patients, they have 3 empty seats, and youll get to your destiantion quicker with blue lights,
air ambulances to offer leisure flights, at cost plus a good profit,
Ambulances to be used to deliver internet Bike stock, nothing like getting the latest XTR stuff off a bloke in a fgreen overall anmd blue lights and siren to let you know ghe /she is at the door,
All drunks to be treated at the local medical centre not blocking up the hospital casulty,
stop IVF, if ou want a kid get a previously born one, plenty for adoption,
legalise all non legal drugs and charge for them under medical supervision,
all cosmetic surgey to be stopped especially for ugly people unles theyre physicaly in need of the treatment,
any woman/man not in a nurses uniform carrying a file around, should be sacked , to many of them at all hospitals,
some of the above are not to be taken seriously, but DC will clutch at any straw to keep his job, so watch the headlines,.
rogerthecat - Member
IMO the doctors and consultants should be made to choose - private or NHS, in the former you are on your own like anyone else in business, invest in kit, take out insurances, build facilities and try to woo customers. The latter should be as they are when they work in the NHS. I'm sure there will be a perfect reason why this cannot be done but it makes sense to me.
Seems ridiculous that you can go on a waiting list to see a consultant or pay to go private to be seen within days only to find its the same damn person
Seems ridiculous that you can go on a waiting list to see a consultant or pay to go private to be seen within days only to find its the same damn person
Do you think? Surely what everybody does in their private time is up to them? Some people chose to ride bikes, some work overtime, some have second jobs.
Consultants who only ever operate on relatively well people might be the equivalent of mountain bikers who only ever ride the blue routes...
Seems ridiculous that you can go on a waiting list to see a consultant or pay to go private to be seen within days only to find its the same damn person
Well, it would be ridiculous if the act of seeing the same person privately in a day impacted on the 'longer' waiting list.
But it doesn't.
If the surgeon DOESN'T do private work, then you've simply the single option of the NHS waiting list.
Think of a doctor working privately AND for the NHS as two separate people, and it becomes less ridiculous.
DrP
Which do they prioritize, NHS or private?
If you have private insurance you must use it.
A number of private health insurance policies will pay you money to use the NHS. Often its cheaper for the insurance co to bribe you to use the NHS than to pay for the private treatment.
Yes, you may go on to the NHS waiting list but you get stuffed a few hundred pounds.
Interesting article from the Independent on the subject:
Cheers
Danny B
"I dont think that GP's do it for the money or that any Dr does and if they do they should probably leave the profession"
Interestingly the doctors I have spoken to seem very very much motivated by money. They all have flash cars / watches / homes / kids in private school etc...
And my point was not that consultants didn't deserve £100k+ it is that the NHS simply cannot afford to sustain such huge salaries, and that a reduction of, say 10%, is really not going to hurt these people.
Many companies, when in trouble ask staff to take pay cuts in order to survive. I was suggesting the same with the NHS, with the well paid staff. If they leave so be it, those will be the ones motivated by money. The ones that care about people will stay.
Good friend of mine had severe back problems. He'd been past from pillar to post before been sent to a specialist which was an eight week waiting list or go private. He didn't have the money so went on the waiting list. Another mate and myself loaned him the money to go private and he was seen by the same specialist 3 days later that he was already on the waiting list to see. His operation to fuse 2 vertebrae together was done then within 3 weeks. He couldn't make the distinction between his duties other than profit, nor can I.
and stop the endless rotation of doctors through different hospitals,
and if you do insist on doctors moving from hospital to hospital in the same trust then get them checked and valdidated once and not every time they rotate get them to take a day off and go through the same checks again!
Which do they prioritize, NHS or private?
They HAVE to perform set NHS duties. If the NHS duties were impacted upon (performance dropping etc) by private work, the private work would have to stop.
So, they prioritise NHS work, though have the opportunity to perform privately if they so wish.
Look at it this way - if I was inclined, I could set up "DrP's car wash emporium" and wash cars in the evening.
I couldn't wash your car in the day, as I'm at 'work'. Come the evening, I could sit down and count my piles of money..., or I could wash your car. At no point should I fail to perform my expected day duties over the car washing idea...
DrP
And my point was not that consultants didn't deserve £100k+ it is that the NHS simply cannot afford to sustain such huge salaries
Um, you've not really thought that through at all have you?
Does this mean you're saying [url= http://singletrackworld.com/forum/topic/nhs-cuts-youre-in-charge-what-services-do-you-get-rid-of/page/3#post-5043231 ]my idea[/url] doesn't/shouldn't create effectively longer waiting lists?
Great to hear from people with partners or experience in the NHS and some excellent informed opinions.
I would:
- Figure a way to get out of all poor value PFI deals/services.
- Create centres of excellence as opposed to several trusts in neighbouring areas providing similar services. Studies have shown that this works better when based on patient outcomes. E.g: Paediatric heart surgery.
- Get rid of the current IT contracts and use someone with actual technical experience delivering a similar product to evaluate what's required and put it out to tender. They're getting rinsed by the private sector for a poor product at the moment.
DrP
If I came along with my car to your car wash emporium would you wash it or ask me to go away, see if it gets cleaner during the next two weeks and, if it doesn't then come back to see you again 😉
When you are dealing with the same patients then it must be a conflict of interests. If you had the same patient on your waiting list on the NHS then how can it be ethical to see them privately for a fee which you benefit from.
NHS only available to people born in the UK!
If I came along with my car to your car wash emporium would you wash it or ask me to go away, see if it gets cleaner during the next two weeks and, if it doesn't then come back to see you again
Depends doesn't it.
If my fee was to come from a centralised pot, Realistically I would discuss with you that it's nice to have a clean car, but not necessary. I would maybe explain that your elderly neighbour needs her fuel pump fixed, so in terms of prioritising my time and skill, it's better to do that so she can drive her car again, as she needs it to socialise. I could put in place a system where we discuss ways that you could keep your car clean in the first place, so we don't have to rely on washing it so often.
However, if you explained you really wanted me to clean your car, and you were willing to pay [b]yourself[/b], then i could clean it for you. i would still explain it's not 100% necessary, though agree it looks nicer to have a clean car.....
DrP
EDIT: If I were a rather scrupulous group of 'practitioners', I would insist to you that despite looking clean after the initial job, you need to return every 2 weeks for a 'top up' clean, that despite there being no need for such an affair, I was still willing to charge you....
@DrP - but surely a very long working day with another job on top would have a detrimental effect upon performance.
..yet 'the general public' want us to cover out of hours 24/7....
You can't win can you.. 🙄
DrP
Dr P
can you explain what happens when private care goes tits up please.
what happens when private care goes tits up
You get transferred to an NHS hospital/into the care of the NHS and your care continues.
That doctor in Hollyoaks seems to be able to manage a nightclub in his spare time well enough. But then again he is a bit of a psycho.
Sorry drac, but some ambulance services could do with some better management
No shit Sherlock.
As for comparing NHS to a Supermarket and the NHS can't run anything 24Hrs. Really was that a serious post?
Anyway time for Star Trek b
Charge people for missed appointments to avoid cuts?
I missed a 11am apointment . Totally my fault . Offered to wait the rest of the day incase someoen else didnt turn up /was late. Was told not to bother .
I would not employ convicted armed robbers on £200k a year to 'manage' a £12m budget .
I would follow up verses idea of a top up scheme where , if you are financially able to pay to go private you can.
I would employ a team of people to go through every invoice with a rather fine toothecomb to see if anybody is charging £8 for a plaster , £9 for a bandage . And those people would be paid a living salary ,plus bonuses on any savings made.
If it possible i would convert the system to rolling 8 hour shifts to ensure all the expensive things like CAT scanners are not sitting idle for 2/3 of the time
but then i am not a manager , but i have met Gerry Robinson.
