cinnamon_girl – Member

My only observation was that some staff needed to work on their people skills.

I think my ortho consultant might have been the inspiration for House MD. But he’s good at bolting legs back on so I don’t object too much.

Woah, rewind. There are people on here that think that the US health (doesn’t) care system is GOOD? oh dear…

I can’t see many people who do think that…

The issue is why our system isn’t better.

The issue is why our system isn’t better.

Well I’ve made my offering on that score. There is plenty more wrong, but it’s a start.
It’s all irrelevant; we’re all going to hell in a handcart anyway.
I’m out.

Perhaps a re-focusing of minds is in order here.

Privatise it! That’s proved the solution to the problems of every public service. I mean…. just look at the railways

The issue is simply will privatisation in one form or another “improve” the service?

It’s no coincidence that this kind of report comes along by at a time when the Government is looking to “reform” the NHS. So we all know their answer. Whats yours?

The only experience in the last few years as a customer was sitting in casualty for five hours with a child with a broken wrist

Perhaps the nursing staff were busy serving tea and biscuits on a ward somewhere? as seems to be the call.

Stoatsbrother – Member

I can’t see many people who do think that…

The issue is why our system isn’t better.

Money – pure and simple. We pay less for our healthcare than most comparable countries.

The unnacceptable part of this is that it is happening after a period where the NHS was sprayed with cash. Labour what doubled the real terms spend on healthcare? Everybody got a payrise…..

Oh and please, enough with all the Tory-hate. The Coalition is increasing health spending in real terms at a time when other departments are taking cuts of up to 25%. Labour policy at the election was to cut spending.

McBoo – your ideological hatred of the NHS shines thru.

its really simple we get the service we pay for – underfunded and overworked staff = gap s in care such as you highlighted.

When the NHS budget rises another 20% above inflation to match the levels of healthcare spending in say Germany or France then we will be able to have a similar quality system.

The service has vastly improved and increased its scope during the time labour funded it properly

The tories are making massive cuts in the money spent on care – partly buy wasting so much on reorganising it again and partly by stealth cuts. Thats the reality on the shop floor – massive cuts accross the board

The coalition are fattening up the nhs, by investing cash into new buildings and empire building for the sale of the century in the next few years, youve only got to look at the new names appearing on hospitals ,hospitals split into smaler parts for easier sale, all with their own car parks as well,instead of one hospital site, and one dedicated car park..

TandemJeremy – Member
McBoo – your ideological hatred of the NHS shines thru.

Nope, I try not to be ideological about anything. Just try and form my own opinions by weighing up the evidence and my and my family’s experience. But thanks for the personal attack.

Oh and please, enough with all the Tory-hate. The Coalition is increasing health spending in real terms at a time when other departments are taking cuts of up to 25%. Labour policy at the election was to cut spending.

Yes of course, the NHS always does much better under Tory governments than under Labour ones. Because the Tories have a passionate commitment to the socialist principle of free healthcare for all, whilst Labour on the other hand has always been opposed such wastefulness – everyone knows that.

Along with your defence of international global investment bankers who refuse to pay interest on money they owe the inland revenue, you show all the skills of a Tory front bench politician mcboo.

I take it you’re a stinking rich multimillionaire and not just a mug ?

mcboo – well its clear you know the price of it but not the value. Its clear you are not coming to this with an open mind

I spent a few nights in hospital bed-bound a couple of years ago.

The standard of healthcare was very good, the other care not so – this wasn’t a big deal for me as I don’t have a problem with been ‘forward’ plus had plenty of cash for the little ‘chap’ (not sure what he did, porter maybe?) to pop to the shop/cafe for me. He made some money, and I was comfortable.

Hate to imagine been in there longer term under other circumstances.

TJ – money might have been an excuse 5-6 years ago – but as a proportion of GDP, the NHS is now not much cheaper than many successful European systems.

For me the challenge is how you introduce financial and clinical accountability to the system, with some sensible competition to spur people and services on, and penalise failing teams rather than reward them, without dismantling the ethos and structure of the current service.

What do you think of the issues about how nursing has changed which are raised above and in radio/newspaper commentary?

Still a significant difference stoatsbrother. around 20% per head less funding

from a slightly cynical perspective. I was overhearing the sister on my Ward discussing that apparently the nursing union are considering strike action over pensions ( which I massively disagree with) on 30th Nov. Who runs the care quality commission? timing of the release of this report seems a bit convinient to remove public support from the nurses?

TandemJeremy – Member
mcboo – well its clear you know the price of it but not the value. Its clear you are not coming to this with an open mind

Riiiiiiiiiiiiiiiiiiight

Yes mcboo – ‘cos this is such an objective assessment

mcboo – Member

The unnacceptable part of this is that it is happening after a period where the NHS was sprayed with cash. Labour what doubled the real terms spend on healthcare? Everybody got a payrise….. 🙄

The public support the nurses when they do the job properley, not neglect patients who are old and infirm , who cnat look after them selves.

Most workers can strike, some peeps will support them and some dont,a report on poor quality care, which is based on truth, and had trained nurses involved just shows up failures in the system that need to be sorted, if staff dont like the job or the pension, then leave.

some sensible competition to spur people and services on

The idea of competition is just rhetoric, it isn’t the best solution in many systems, such as the NHS. What is needed is getting the whole organisation and its partners pulling together for the same goals, not competing against each other. Create a system with winners you also get losers, the competition is damaging to the system.

Yes mcboo – ‘cos this is such an objective assessment

mcboo – Member

The unnacceptable part of this is that it is happening after a period where the NHS was sprayed with cash. Labour what doubled the real terms spend on healthcare? Everybody got a payrise…..

Which part of that isn’t objective?

Hugely increased health spending is Labour 1997-2010 crowning achievment, I don’t remember Brown being shy about talking about it at every opportunity. Didn’t NHS staff get a pretty substantial payrise?

Some of that spending was sorely needed and who would begrudge doctors and nurses a lift from the relatively low salaries they were on in the 80s and early 90s. But the money wasn’t all well spent and there isnt a whole lot more.

Which part of that isn’t objective?

The unnacceptable part of this is that it is happening after a period where the NHS was sprayed with cash. Labour what doubled the real terms spend on healthcare? Everybody got a payrise…..

Pejorative terms. prejudging the outcome, use of “sprayed”

Really – its laughable who much you want to twist the facts to fit your preconceptions

But the money wasn’t all well spent and there isnt a whole lot more.

and more. Any evidence that the money was not well spent?

Any evidence that the money was not well spent?

How about we start with this?

http://www.guardian.co.uk/society/2011/oct/13/nhs-hospitals-care-of-elderly

Nice circular argument. so that story shows to you that the money spent is wasted? No evidence or reasoning to back this up.

Now I’ll ask again. Any evidence to back up your idea?

I know the NHS improved dramatically for the injection of cash. A&E waits down, waiting lists down, outcomes improved, new treatments developed and offered. All backed by hard data. Try the kings fund for data

Of course since the tories got in and started cutting the NHS and preparing it for privatisation waiting times have shot up. What a surprise

Any evidence that the money was not well spent?

Hows about 4 million quid a year on Homeopathy?

http://news.bbc.co.uk/1/hi/8524926.stm

was that money well spent TJ?

TJ – From the Kings Fund:

In 2003/04, the NHS cost £63.7 billion pounds. In 2004/05, hospital and community services
(the largest component of NHS spending) have received an additional £5.1 billion pounds.
However, much of this will go on pay and other ‘cost pressures’, such as clinical negligence
claims and the additional cost of new drugs. As a result, the extra money available for
additional patient services is only 2.4%.

In addition, NHS productivity (the amount of activity provided in the NHS for every pound spent)
has been falling, according to the official measure. On the face of it, this suggests that the NHS
is getting worse value for money than it used to.

Money well spent? 😐

I don’t have much time, but I’d just want to add my 2pworth.

1. The fact that we are crating up the WWII generation on understaffed, under-resourced elderly care units indicates that something is seriously wrong in this country. IMO, that transcends any issues with the NHS (highly significant as they are) – & the projected demography requires a shift in attitude by all of us.

2. I do not doubt that there are slack nurses – indeed, I’ve met ’em. Nor would I seek to excuse poor practice. But stuff not getting done because of deliberate neglect is very different from stuff not getting done because there ain’t enough boots on the ground. In that respect, little has changed since the day of Graham Pink. Elderly care has always been a cinderella service – starved of investment, even as we prolong life and improve treatments. On, say, a 26 bedded ward in my old hospital, it would not be unusual for night shifts to be staffed with 2 x RNs and 2 x care assistants. Given the workload – a large number of dependent (and frequently confused & frightened) patients – how in Flo’s name are the staff expected to do it all (think: keeping the patients clean & comfortable, adequately hydrated & nourished, IVs, drug rounds, liasing with medics, handover to other wards, answering the phone, escorting patients off the ward for scans etc), not least given that everything has to be documented, or it’s your registration on the line? Now, my own view is that once you have a tickbox for stuff you should be doing anyway (e.g. 2 hour intentional rounding), then the profession has already failed – the answer to the problems created by lack of staff isn’t to create yet more paperwork. Besides, try and document everything, update the bed status and check blood results on the computer – and somebody will still accuse you of reading Heat magazine at the nurses’ station.

3. Acuity on general wards has shot up since the mythical golden age of Hattie Jacques. Patients who once would have occupied HDU beds are now nursed on general wards, with considerably worse nurse:patient ratios than high care settings. As part of their role, staff nurses have taken on far more ‘medical’ tasks, partly as a consequence of the reduction in medical cover (medical/surgical ‘firms’ are ever smaller, with resulting on-call overstretch). The senior nursing hierarchy seem to have treated this as a glorious opportunity for professional empowerment, but they generally ain’t the ones having to deal with it on a friday night. Specialist and extended role nurses (e.g. tissue viability, drug support, ITU outreach etc) do a superb job – but they should be working in partnership with medics, not replacing them.

4. IMO, the debate about the ‘academicisation’ of nurse training is something of sideshow (and one frequently given to Daily Wail hysteria). Are people saying that academic ability and simple compassion are a contradiction in terms? FFS, it’s perfectly possible to know your biochem backwards and be capable of comforting a patient. What has gone (IMO) very wrong is the import of faux-sociology nonsense into nurse training. No course can prepare you for the wards, but your time can be used well – & frankly I’d have preferred to have been drilled in stuff other than ‘reflective practice’. That doesn’t mean that uni-trained nurses are too posh to wash – some of the best I’ve ever worked with are fresh out since P2000, and some of the worst have been decidedly old guard. Besides, the care assistants who now have the majority of patient contact time are frequently themselves nurses, medics, physios etc in training. And if you are a senior HCA or AP, you are more-or-less the equivalent of the old SEN (but without the recognition). There is a route to band 5 (staff) status for such inviduals, many of whom have absolutely gleaming skills and clinical acumen. But the long-running argument over nurse education still doesn’t alter one basic fact: there ain’t enough of them, and the single biggest improvement to patient care in this country would be to sort out the bludy awful nurse:patient ratios. As for whether the ConDem reforms will achieve that… 😕

other half has done home care. Problems as follows unrealistic work loads, you have to get round a number of people and you are given an expected time, a time that takes no account of what the client actually needs. Add in that the money you earn is based on what the council thinks it takes not what it takes. ie unpaid overtime to get the job done.

The other issue is a large proportion of the people who end up as care workers, to be fair most people would turn them nose up at the job and the regular “wipe arses for a living” jibes you get.

Would you really want to be earning minimum wage and deal with the crap you get subjected to?

Yes there are good carers as well as bad, but the way staff are treated in many homes it is hardly surprising that the start to get jaded and stop caring.

To noteeth’s comments, I’d just like add – how many people think that a pay freeze, increased pension contribiutions, increased parking charges where I am (cheers, private sector parking company), increasing workload and decreasing resources to met that workload expectation is in anyway a motivational or incentivising factor to anyone considering starting a career in healthcare?
clue – someone pointed out earlier that we have massives of stupidly expensive equipment lying about not being used at night. use it at night? great idea, but where do we got the staff from? We already struggle to recruit enough people to operate a daytime service, and believe me there are not floods of people training to replace those who are leaving.
We’ve heard the daily mail’ist “if you don’t like it leave”. people have said that on here often enough. Well, congratulations – they’re leaving, and look at the result

Of course since the tories got in and started cutting the NHS

Cuts? What NHS cuts are those?

I’d go look through the web and produce something that illustrated perfectly the abovementioned fall in NHS productivity, but seeing as it’s you asking, whats the point? You’re the guy that won’t accept data from the IFS because they have a well known right wing bias.

I dont normally bother to comment on this sort of thing as it often gets you nowhere and to be honest I ride bikes and use cycling forums to take my mind off this sort of stuff but unfortunately I couldnt help but read this. As a registered nurse of ten years experience and three years before my training as a healthcare support worker i would like to offer noteeth a pat on the back for hitting the nail on the head. It was refreshing to read a really sensible well informed post from a fellow professional.

OECD Health Stat numbers 2008

Total Healthcare spending(i.e private and public as % of GDP)

US 16.4,France 11.1, Germany 10.7,Sweden 9.2, italy, spain, both 9, UK, Ireland, both 8.8, Norway 8.6, Japan 8.5, Finland 8.4

2009 where available

US 17.4,France 11.8,Germany 11.6, Sweden 10, UK 9.8, Norway, 9.6, Italy, Spain and Ireland all 9.5, Finland 9.2 – no figures for Japan.

A 20% increase in spending would take us to equal second in the world for health spending on these figures.

Cuts? What NHS cuts are those?

ermm you should google first, rant later…
http://www.telegraph.co.uk/health/healthnews/8341737/True-extent-of-NHS-job-cuts-revealed.html

Total health expenditure as a share of GDP, 2009

Z11, mcboo etc.

What you don’t account for in your criticism is anything to do with demographics.

You talk about an absolute rise in the overall budget, but conveniently forget that the UK population is growing – 5% over the last 10 years – hmmmmm….. so what would the implications of that be for the NHS budget even for services to remain the same I wonder?

Doen’t take a genius does it?

And, proportionately the elderly population (the ones who tend to need lots of health care) is growing even more.

Perhaps we could concentrate on how to make things better rather than using the topic as a political football, y’know, like politicians do?

Perhaps we could look at how we are going to manage the healthcare needs of an aging population, that’s you that is, in the future?

Perhaps you could argue for a few posts about the public and private sectors, then we could all get grumpy with one another and see if that helped?

Then as the issue drops off the front page and we all go back to arguing about helmets or hora, everything will be ok won’t it?

😐

Thanks hilldodger- couldn’t find the graphs, the Netherlands number appears to be slightly odd due to a change in methodology as it was only 9.9 in 2008.

OECD Health Stats 2009 (Government spending on healthcare as % of gdp)

France 9.2, Germany 8.9, US 8.3, UK 8.2, Sweden 8.2, Norway 8.1, Italy 7.4, Ireland 7.2, Spain 7, Finland 6.8.

My wife is a nurse working in a very busy Oncology unit. She has her own job to do and now also the job of another department due to staff leaving. The staff are leaving regularly but not being replaced due to cuts!
She works longer hours than contratced and is not paid any extra. She is constantly abused by the public who are forced to wait long beyond their appointment time due to the lack of staff.

Many times after she has come home in tears I suggest she leaves, but as a caring person she says ‘yes but then that gives the problems to someone else’.

She qualified over twenty years ago, and agrees the ‘new’ degree nurses don’t want to get the hands dirty and many of them don’t understand the principles of basic care.

Oh and the best bit…….. she’s just had her pay cut!

mefty – you need to look at total spend not just governemnt spend to get a real comparison. some of these countries have large private sectors doing what the NHS does