Home Forums Chat Forum doctors on strike

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  • doctors on strike
  • samunkim
    Free Member

    First of all the management consultants & lobbyists are all American, so their high profit model is whats being sold to us. Secondly “thats how it works elsewhere” is always more expensive in relation to GDP

    So why not fund the NHS to those levels now.

    Oh I forgot ” Labour when they gave GPs substantially more money”. It should be of note that GPs are actually private contractors, so its a bit of straw-man to offer this ( failed contract negotiation ) to be extrapolated to the whole NHS.

    The Europe and TTIP thing only applies once competition is introduced into a market

    cinnamon_girl
    Full Member

    UK needs a proper grown up discussion about health provision in this country, what we’ve got doesn’t work and more money isn’t going to fix it.

    It’s my view the health service needs much more, not just the £8bn the Tories promised which the NHS said they need just to stand still. My view is giving the current NHS more money will improve nothing, we saw under Labour when they gave GPs substantially more money and new contracts the service got worse. We need a proper adult conversation how best to provide world class health services (we are far from those now) and how those should be funded.

    +1.

    docrobster
    Free Member

    under Labour when they gave GPs substantially more money and new contracts the service got worse. We need a proper adult conversation

    Jambafact
    General practice share of the total NHS budget has dropped to 7.2% on latest figures. An all time low.
    But still when more money is invested in primary care services the Tory press see this as bribes.
    By all means let’s have a conversation about funding. But let’s drop the GP bashing. You’ll miss us when we’ve gone.

    Junkyard
    Free Member

    giving the current NHS more money will improve nothing

    So its your argument that money does not increase capacity…are you feeling ok as that is self evidently false and a big nuts

    We need a proper adult conversation how best to provide world class health services (we are far from those now)

    We outperform the US and at less cost

    and how those should be funded.

    Everyone but RW zealots has the answer via general taxation and free at the point of use

    A better more integrated mix between private and state is the answer imho, thats how it works elsewhere

    Yes that is what they do but it costs way way more than we spend and yet you are still arguing we don’t need more money

    Facts for you to ignore

    http://www.theguardian.com/society/2016/feb/09/which-country-has-worlds-best-healthcare-system-this-is-the-nhs

    http://www.independent.co.uk/news/uk/uks-healthcare-ranked-the-best-out-of-11-western-countries-with-us-coming-last-9542833.html

    http://www.theguardian.com/society/2016/feb/09/which-country-has-worlds-best-healthcare-system-this-is-the-nhs

    Politically motivate folly that ignores the facts – you should have that as your signature 😉

    ernie_lynch
    Free Member

    teamhurtmore – Member

    Conveniently missing the obvious contradiction in that position.

    Lots of stepping back to the future going on at the moment – welcoming back “the struggle” comrades here and a return to isolationism/narrow minded xenophobia on the Europe referendum thread. Do we never learn?

    To the tune of the red flag: “We’ll keep the union flag flying high…” a very odd mix.

    Still in the winners v losers core part of the show, the Guardian seems to be going a little off-piste

    You know THM sometimes it’s OK not to say anything.

    So there’s no need to post meaningless waffle just because you can’t think of anything else to say 💡

    teamhurtmore
    Free Member

    Bless. How is the glass house?

    jambalaya
    Free Member

    Junky not sure how on earth you think the NHS out performs the US, I don’t know a single American who thinks the NHS is anything but terrible in terms of general health care provision (critical care recognised as excellent). “General taxation” is a very wide ranging phrase, vat on food ? We are being sold a bag of s**t by politicians of all colours that we can have a world class health service with the tax system and rates +/- a few percent. We cannot it needs much mire funding and a total reorganisation imho. I much prefer the French system (mix of private and state).

    I challenge you to find a French, German, Swiss, Dutch, Belgian or even US article which says the NHS is better than their domestic servies.

    We need to face up to the fact that our service is broken, Labour promised £2 of the £8bn the NHS said it needed to stand still and lost the election. We spend much less than the other countries and it shows in the quality and availability (waiting times) of our service, eg mym mum is unable to walk but its 12 weeks for an mri or 2 days if she pays £350. Totally broken imho

    docrobster
    Free Member

    You should try asking one of the 15% of us citizens who doesn’t have access to its excellent healthcare system.

    https://en.m.wikipedia.org/wiki/Health_insurance_coverage_in_the_United_States

    All for around double the cost of most European healthcare systems.

    Junkyard
    Free Member

    Junky not sure how on earth you think the NHS out performs the US

    there was me thinking giving you the prrof would help you

    http://www.independent.co.uk/news/uk/uks-healthcare-ranked-the-best-out-of-11-western-countries-with-us-coming-last-9542833.html

    ah well at least i go this bit correct
    Facts for you to ignore

    I don’t know a single American who thinks the NHS is anything but terrible in terms of general health care provision (

    that actual research can in no way compete with your anecdote about your circle of friends.

    I challenge you to find a French, German, Swiss, Dutch, Belgian or even US article which says the NHS is better than their domestic servies.

    WHat for you would just ignore them

    I googled the bold bit fourth hit- you really should google your musings as it always show them to be deeply deeply flawed.

    Is anything you say ever true?

    ENjoy

    http://uk.businessinsider.com/an-american-uses-britain-nhs-2015-1?r=US&IR=T

    but its 12 weeks for an mri or 2 days if she pays £350. Totally broken imho

    Yes that is definitely not a funding issue and its a “totally broken” issue.

    If this is not you taking the piss or trolling then I dont know what it as its irrational, no fact based and not even funny.

    docrobster
    Free Member

    See also:
    http://www.kevinmd.com/blog/2014/09/admire-nhs-empower-primary-care-physicians.html
    Some Americans are quite jealous of our system.

    DrJ
    Full Member

    I challenge you to find a French, German, Swiss, Dutch, Belgian or even US article which says the NHS is better than their domestic servies.

    If your wife gets pregnant in Holland, ask her how she feels about giving birth without anaesthetic as she can’t get an epidural out of office hours.

    chewkw
    Free Member

    Crikey have they not accepted the new offer? 😯

    jet26
    Free Member

    Jambalaya – the US spends over 40% of their total spending on healthcare on administration of the billing system. Healthcare that spends over a third of its budget on nothing to do with healthcare is not in any way a good system.

    DrJ
    Full Member

    eg mym mum is unable to walk but its 12 weeks for an mri or 2 days if she pays £350.

    When I mentioned that my MRI had cost more like £1000 you pointed out that this was an insurance job. And you advocate insurance as the way forward?

    Junkyard
    Free Member

    People dont you be bringing facts into jambyland

    there is no way he is not just trolling no one can actually have made that claim as a serious point.

    chewkw
    Free Member

    Junkyard – lazarus

    People dont you be bringing facts into jambyland

    there is no way he is not just trolling no one can actually have made that claim as a serious point.

    Basically he is Trolly McTrollface

    No point just saying shouldn’t you just make counter argument?

    Or are you running out of points?

    ernie_lynch
    Free Member

    jambalaya – Member

    We spend much less than the other countries and it shows in the quality and availability

    Well done for making the link between spending and the quality of service.

    Although the United States proves that when profit is a major motivating factor it doesn’t provide value for money.

    ernie_lynch
    Free Member

    Btw jambalaya infant mortality rates whilst not perfect are nevertheless universally recognised as the single best measure of the quality of healthcare provisions in a country.

    Our infant mortality rate is a national embarrassment[/url]

    Quote :

    The United States has a higher infant mortality rate than any of the other 27 wealthy countries, according to a new report from the Centers for Disease Control. A baby born in the U.S. is nearly three times as likely to die during her first year of life as one born in Finland or Japan. That same American baby is about twice as likely to die in her first year as a Spanish or Korean one.

    Despite healthcare spending levels that are significantly higher than any other country in the world, a baby born in the U.S. is less likely to see his first birthday than one born in Hungary, Poland or Slovakia. Or in Belarus. Or in Cuba, for that matter.[/b]

    chewkw
    Free Member

    ernie_lynch – Member

    Are they comparing apple with apple or apple with honeydew or durian?

    Merican population 318 million plus?

    Finnish population 5.4 million?

    How do you compare that and also by taking into account the environment they live in?

    You need to provide more information regarding the reason of death.

    Lifer
    Free Member

    Instead of pulling numbers out of thin air why didn’t you just google it?

    GrahamS
    Full Member

    It is measured in deaths per 1000 live births chewkw, so population size doesn’t matter.

    chewkw
    Free Member

    GrahamS – Member
    It is measured in deaths per 1000 live births chewkw, so population size doesn’t matter.

    I know it’s per 1000 births.

    Okay, I shall just leave it at that …

    Lifer – Member
    Instead of pulling numbers out of thin air why didn’t you just google it?

    You are not helping aren’t you? 😀

    Lifer
    Free Member

    Teach a man to fish…

    samunkim
    Free Member

    Can I ask you all to view this. Lord Carter has spent the last 18months doing a root and branch analysis of the whole of NHS efficiency

    Report here for real pedants
    https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/499229/Operational_productivity_A.pdf

    chewkw
    Free Member

    Lifer – Member
    Teach a man to fish…

    You are not teaching?

    Lifer
    Free Member

    Lesson 1, before posting made up versions of easily verifiable facts

    Lifer – Member
    google it

    evh22
    Free Member

    samunkim thanks for the link. I tried to watch that video (i’m interesting in quality improvement: yes i’m not only a geek but a goody-two-shoes), but do they ever get to the point? I skimmed the report and it seems he spent 2 years telling us there is great variation in hospitals (but why?), and we should be more efficient (clearly). If, like in this video he spent half his time sharing anecdotes with people like Roy Lilley then that explains why the report just tells us what we already knew.

    samunkim
    Free Member

    Yep Sorry

    Skip the The first 30mins – its just Parkinson-esque waffle.

    But after that is gets better – promise 🙂

    evh22
    Free Member

    OK. Will watch tonight.

    jambalaya
    Free Member

    @doc I can’t comment on my GP as I haven’t seen her for 10 years, every time I try and make an appointment the wait is so long I take an emergency, when I need tomsee a Doctor its soon not in 3 days. I can see why A&E is swamped, I’ve been tempted to go myself. My comments on the new contract for GPs under Labour came from speaking to my two GP friends – one of whom said other GPs in her practice where just money grabbing “so and so’s” – there is always a spread of behaviour.

    DrJ its a while ago since I had my kids, my ex-wife repeatedly told me how great the Dutch system was with much higher rates of home births and lower mortality than the uk. Gas and Air instead of epidural ? Our third was a home birth with Gas and Air not needed. (First in NHS hospital, second in the US)

    Looking at the US overall is in my view a grave mistake, they don’t have universal health care as we do and they don’t want it, not even the Democrats. @ernie how is the NHS value for money when my mum has tomwait in agony for 6 months before taking a private MRI (at oir insistemce) and forcing the Doctor into a corner so they jad to give her the cortesone injection she needed ? The NHS is providing a second rate overall service which is all we pay for, as such imho its a poor use of money – thats not efficient

    Money alone won’t improve or fix things, we need both reform and more money. What does efficiency mean exactly, how do you measure having a 12 week wait for an MRI which costs £350 and is available immediately privately ?

    So who saw comments from the NHS CEO today saying we should look into up front payments for services in some cases. At last something sensible, hopefully no knee jerk reactions.

    jambalaya
    Free Member

    An example of why effiiciency is the wrong measure. As soon as you give staff a payrise the service becomes less efficient. So for everyone that would like staff to be better paid, me included, you are arguing for less efficiiency. What we need is a substantial improvemnet is service quality and that will cost a lot of money. At the moment the private system is largely seperate, in my view it must be much better integrated.

    ernie_lynch
    Free Member

    @ernie how is the NHS value for money when my mum has tomwait in agony for 6 months before taking a private MRI (at oir insistemce) and forcing the Doctor into a corner so they jad to give her the cortesone injection she needed ?

    Well that’s me convinced. It’s now obvious to me that we need to get rid of the NHS and replace it with private healthcare providers. If only I had known about your mother and her cortisone injection earlier.

    chewkw
    Free Member

    I have just stumbled upon this piece of information on the other thread.

    This NHS reforms has nothing to do with this highly acclaimed surgeon with the Lord title?

    Ara Darzi, Baron Darzi of Denham

    Does that mean the Junior Doctors are arguing against the world’s leading surgeon?

    Darzi was tasked with leading a national review to plan the course of the NHS over a decade, reporting back to the Prime Minister, Chancellor, and Secretary of State for Health in June 2008. He cooperated with the Department of Health to undertake the “NHS Next Stage Review”.[6]

    Darzi was quoted in The Times as saying that “…This Review should be both clinically-led and evidence-based”. The final report of the Review, High Quality Care for All, was published in June 2008 to considerable public and academic acclaim. The Financial Times stated that it was “the world’s most ambitious attempt to raise the quality and effectiveness of an entire nation’s healthcare”.[30] The Lancet acknowledged that:

    “Darzi has wisely thrown out regulation as the organising principle of the NHS. He has replaced it with quality…This cultural shift is a radical re-visioning of purpose for the NHS—away from the political command and control of processes and towards professional responsibility for clinical outcomes”[31]

    DrJ
    Full Member
    docrobster
    Free Member

    Regarding the “it just needs more money” vs “the whole system is broken we must replace it with another one” conundrum raised a few pages back, I received a link to this document on “sustainablility and transformation” plans today. It’s an interesting read, only 8 pages so worth finding 5 minutes to digest. However for those like me, with short attention spans, here is the last paragraph:

    what is truly unsustainable in the long run is providing a first-?class health service on a third class budget. And the decision, on top of this, to be spending only £8bn a year more on the NHS in England five years from now, in the interest of shrinking the state, is another political choice, which has less and less support even among mainstream economists.

    The choice to underfund the Nation’s Health Service (Whether that is the NHS or some other Health Service run for the Nation- semantics?) is a political one made by this government and the last one. Austerity is the excuse but really it is ideological in the interest of shrinking the state. Those bankers just did the tories a huge favour by crashing the global economy, just in time to start the dismantling of the NHS. Anyone who believed in conspiracy theories might wonder if it was all planned.

    What really annoys me is that the government does not have the guts to say publicly what it is doing and therefore be judged on it at the polling station next time around. But we know better to believe what governments tell us don’t we?

    sootyandjim
    Free Member

    [Quote]The NHS is providing a second rate overall service which is all we pay for, as such imho its a poor use of money – thats not efficient[/quote]

    Saywhatnow?

    Let’s break that down…

    [Quote]The NHS is providing a second rate overall service…[/quote]

    A) Compared to what and whom?

    [Quote]…which is all we pay for…[/quote]

    B) If you’ve given any examples to point (A) that feature higher per capita spending they can be considered null and void for comparison by your own remarks.

    [Quote]…as such imho it’s a poor use of money…[/quote]

    C) But if the NHS provides a better quality of service than those with higher per capita spending it is a more efficient service which, if economics are the main measure being used (you mention money a lot), means a ‘better’ service surely?

    [Quote]…that’s not efficient.[/quote]

    D) See point (C).

    mefty
    Free Member

    I think that it i pretty obvious what someone is going to say if they have written a book entitled

    Market Driven Politics: Neoliberal Democracy and the Public Interest

    docrobster
    Free Member

    Of course mefty feel free to discount the report based on the political leanings of its author. That’s your perogative. It doesn’t make it an less true though.
    The thing is that at the moment there are publications coming out daily saying the same thing. £8bn is not enough, and £22bn from efficiency savings is not possible. A lot of the report I linked to was merely quoting what has been said previously by the Kings fund, those rabid left wingers.
    If you want another source for the same message here is one:
    http://www.cipfa.org/~/media/files/cipfa%20thinks/briefings/briefing-paper-health-of-health-approved.pdf

    ninfan
    Free Member

    What really annoys me is that the government does not have the guts to say publicly what it is doing and therefore be judged on it at the polling station next time around. But we know better to believe what governments tell us don’t we?

    The Labour Party and its political minions and fellow travellers have been telling us for 36 years that the Tories either were ‘destroying the NHS’ ‘privatising the NHS’ or would do so if they won the next election.

    Remarkably, despite this extended period of subterfuge, government lies and imminent destruction (remember “24 hours to save the NHS”?), the NHS is not only still here, but treating more patients than ever, and the Tories continue to win elections.

    Makes you think, eh?

    docrobster
    Free Member

    Ninfan it does make me think yes.
    I think the population is in for a big surprise in the next few years.
    But what would I know, the economists will no doubt save the day once again.
    After all wealth is so much more important than health on Election Day.

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