NHS faces biggest financial crisis 'in a generation'

[Nick 0208 Ldn]

NHS faces biggest financial crisis 'in a generation'

http://www.telegraph.co.uk/news/nhs/11921381/NHS-faces-biggest-financial-crisis-in-a-generation.html



Considering the sums involved and that the £8bn figure was a relative surprise in itself, a government of either hue wold be confronted with a serious problem here.

 

[Jippy]

It's a serious money pit. Maybe it will have to go down the means-tested route, but I imagine that would be massively complicated and expensive to administer.

 

[Dans]

I think people will simply have to pay more tax or take out additional private health insurance policies to cover perhaps major surgery.

My suspiscion is that people in general are becoming less and less healthy and storing up problems for later life. Now that the age pyramid is tipping on it's head, this is only going to get much, much worse.

A long term plan is needed - but UK govts are incapable of such plans because they only care about being re-elected in 4 years time and our parties don't seem capable of working together for the greater good for such a goal.

 

[Nick 0208 Ldn]

Seven-day NHS doomed to fail without 38,000 extra doctors, the president of the Royal College of Physicians says.

A long term plan is needed - but UK govts are incapable of such plans because they only care about being re-elected in 4 years time and our parties don't seem capable of working together for the greater good for such a goal.

The NHS as originally constituted is almost a sacred cow for those in Labour circles, whereas many Tories look at it and compare it to a black hole. I cannot recall a single occasion in which i've heard the two sides discuss the topic sensibly.

Just last week, an NHS Trust in Staffordshire announced that patients would no longer be guaranteed access to a hearing aid. In the event of mild-moderate levels of hearing loss, some patients will have to source theirs privately. @Jippy's suggestion of means testing might've been a better compromise under the circumstances.

 

[Eyepopper]

Same as the health service in Ireland. How the hell have governments all over the world made such a mess of such an essential service that we are ALL destined to call on at some stage?

More and more health seems to be something governments are trying to outsource responsibility for to private insurers.. I guess they're looking at the US and seeing how well it's worked there.

Earlier this year the government introduced a levy for anyone over 35 who had never had private insurance.. basically a massive sales and marketing drive on behalf of private insurers.

 

[Pogue Mahone]

Same as the health service in Ireland. How the hell have governments all over the world made such a mess of such an essential service that we are ALL destined to call on at some stage?

More and more health seems to be something governments are trying to outsource responsibility for to private insurers.. I guess they're looking at the US and seeing how well it's worked there.

Earlier this year the government introduced a levy for anyone over 35 who had never had private insurance.. basically a massive sales and marketing drive on behalf of private insurers.

Demographics have fecked them over. Not only is the population increasing in number, it's getting older and sicker. Add to that the ever-increasing price of the various interventions used to keep old people alive longer and it's a cost spiral that no government is capable of keeping on top of. Healthcare has become a bottomless pit for state resources. At least, nobody has found the bottom yet and they quite probably never will.

 

[Mojo_]

More good news for the tories and privateers. So many fundamental problems causing this I don't even know where to begin.

 

[Mihajlovic]

Long term health conditions-rather than illnesses susceptible to a one-off cure-take 70% of the health service budget. There is a lot of work being done in order to tackle those issues but the population's attitude needs to change drastically in order to prevent avoidable illnesses. One in five kids are obese, a third of adults drinks too much, one in five adults still fecking smokes, half of the population don't get enough exercise, so the health risks are only getting worse and with it the cost for treatment increases. Diabetes UK estimated that the NHS is already spending £10 billion a year on diabetes. Britain's young people have the highest consumption of sugary drink in Europe- and as soon as they get older they start binge drinking, I think there are around 3,000 alcohol related admissions to A&E every day. People's behavior needs a radical change otherwise this is only going to get worse than it already is.

 

[Eyepopper]

Demographics have fecked them over. Not only is the population increasing in number, it's getting older and sicker. Add to that the ever-increasing price of the various interventions used to keep old people alive longer and it's a cost spiral that no government is capable of keeping on top of. Healthcare has become a bottomless pit for state resources. At least, nobody has found the bottom yet and they quite probably never will.

Is it the short term 'reelection' mindset of govts or what? I mean everything you say is true obviously, and you'll know better than me, but its not as if any of that just happened all of a sudden.

The impression I have, in Ireland at least, is that its not so much about how much we are spending but how we are spending it. Our local hospital opened a shiny new maternity unit there last year, with no midwives to actually work in it. A good friend of mine is a midwife and her opinion is that they would have been far better off with a few new midwives, even if it meant working in the older facilities.

The brand new labour ward is being used as a maternity ward because they don't have enough staff to use it.

I guess its hard for a politician to tie a red ribbon around doctors and nurses for a photo opportunity.

 

[VeevaVee]

Maybe if they actually streamlined the service they'd save a bit?
I'm no expert on the matter and don't pretend to be, but my Dad spend a small amount of time in the hospital recently and was made to wait a ridiculous amount of time for things and a lot of staff were standing around chatting for large amounts of time, before nipping off then returning to chat (we're talking hours wasted here). I get that it can be a stressful job at times and there should be some leniency but when it comes to budgets this surely is unacceptable?
He also had to return for a test at a certain time (not like waiting in A&E, which can be understandable), arrived 15 mins early, then was sat around for 2 and a half hours before he got seen to.

It doesn't take a genius to work out that there are some serious organisation issues, and while there is likely a bit more to it than meets the eye, time = money, and they seem to waste a large amount of it. I'm not blaming the staff here, I just think they need to do some serious re-organising on a grand scale. Obviously that wouldn't be an easy thing to do though.

 

[Mihajlovic]

Maybe if they actually streamlined the service they'd save a bit?
I'm no expert on the matter and don't pretend to be, but my Dad spend a small amount of time in the hospital recently and was made to wait a ridiculous amount of time for things and a lot of staff were standing around chatting for large amounts of time, before nipping off then returning to chat (we're talking hours wasted here). I get that it can be a stressful job at times and there should be some leniency but when it comes to budgets this surely is unacceptable?
He also had to return for a test at a certain time (not like waiting in A&E, which can be understandable), arrived 15 mins early, then was sat around for 2 and a half hours before he got seen to.

It doesn't take a genius to work out that there are some serious organisation issues, and while there is likely a bit more to it than meets the eye, time = money, and they seem to waste a large amount of it. I'm not blaming the staff here, I just think they need to do some serious re-organising on a grand scale. Obviously that wouldn't be an easy thing to do though.

Has your dad given this feedback to anyone? I think it's really important to capture this data and make a complaint and specify that the complaint is for example in regards to changing the system (and not as you said against any members of staff).

 

[Eyepopper]

Both my mum and dad have had cancer in the last 2 years and then my dad suffered a stroke and fell into a coma last Jan. The wife and I are expecting now too... So over the last 2 years I have spent an inordinate amount of time dealing with the Irish health system.. and it's reams of red tape.

I honestly don't know how doctors and nurses can motivate themselves to even get out of bed in the mornings, never mind put in the hours they do, and all the while, mostly, remain good natured, kind and considerate people.

 

[Mihajlovic]

Both my mum and dad have had cancer in the last 2 years and then my dad suffered a stroke and fell into a coma last Jan. The wife and I are expecting now too... So over the last 2 years I have spent an inordinate amount of time dealing with the Irish health system.. and it's reams of red tape.

I honestly don't know how doctors and nurses can motivate themselves to even get out of bed in the mornings, never mind put in the hours they do, and all the while, mostly, remain good natured, kind and considerate people.

Sad to hear this man. Impossible to imagine what you are going through.

Sadly the bigger the organisation the bigger the bureaucracy. And it can drive you mad. Still worth encouraging people to fight for even the smallest, positive changes which lead to any sort of improvement.

I also have nothing but admiration for the vast majority of nurses and the amount of hours they put into care.

 

[Stack]

The slow creep towards "encouraging" the masses to take out health insurance marches on. Its a world wide pressure.

 

[VeevaVee]

Has your dad given this feedback to anyone? I think it's really important to capture this data and make a complaint and specify that the complaint is for example in regards to changing the system (and not as you said against any members of staff).

I don't think he has. I'll suggest it when I next see him.

 

[Pogue Mahone]

Is it the short term 'reelection' mindset of govts or what? I mean everything you say is true obviously, and you'll know better than me, but its not as if any of that just happened all of a sudden.

The impression I have, in Ireland at least, is that its not so much about how much we are spending but how we are spending it. Our local hospital opened a shiny new maternity unit there last year, with no midwives to actually work in it. A good friend of mine is a midwife and her opinion is that they would have been far better off with a few new midwives, even if it meant working in the older facilities.

The brand new labour ward is being used as a maternity ward because they don't have enough staff to use it.

I guess its hard for a politician to tie a red ribbon around doctors and nurses for a photo opportunity.

A little from Column A, a little from Column B. Trying to find the most cost-effective way to run an adequate healthcare service for a rapidly aging population is a horrendous task, which might well be beyond the best and brightest around. Throw in the political capital that comes from various grand gestures in the sector (every voter knows someone who was sick, right?) and you've got a perfect storm. Loads of kicking cans down the road, cosmetic changes and hare-brained new initiatives which every health minister in charge when they're launched knows he/she won't be round to see to fruition. It's hard to find a better example of the kind of damaging short-termism that electoral cycles provoke. The whole thing is a massive cluster-feck.

Maybe if they actually streamlined the service they'd save a bit?
I'm no expert on the matter and don't pretend to be, but my Dad spend a small amount of time in the hospital recently and was made to wait a ridiculous amount of time for things and a lot of staff were standing around chatting for large amounts of time, before nipping off then returning to chat (we're talking hours wasted here). I get that it can be a stressful job at times and there should be some leniency but when it comes to budgets this surely is unacceptable?
He also had to return for a test at a certain time (not like waiting in A&E, which can be understandable), arrived 15 mins early, then was sat around for 2 and a half hours before he got seen to.

It doesn't take a genius to work out that there are some serious organisation issues, and while there is likely a bit more to it than meets the eye, time = money, and they seem to waste a large amount of it. I'm not blaming the staff here, I just think they need to do some serious re-organising on a grand scale. Obviously that wouldn't be an easy thing to do though.

A lot of that is the nature of the job. The workload is unpredictable, even outside A&E. On quiet days, you get staff with nothing to do. On busy days you get people waiting ages for routine tests because the people supposed to do them are busy elsewhere. Matching supply and demand in terms of personnel is incredibly hard to do.

You are right, though. It's all painfully inefficient. That's the public sector for you. Of course, the alternative is a system more like the US, where you never have to wait for anything but you end up paying an absolute chuffing fortune (either directly or indirectly) for even the most minor of ailments. In an ideal world, you'd take the best elements of the public and private sector and combine them together. Which has been the holy grail of everyone in healthcare for decades. The Aussies came close, with mandatory health payments taken out of everyone's wages at source. However, there's no way any British or Irish political party will ever the balls to suggest asking every voter in the country should pay a brand new tax, just to keep running a health service that their income tax is already supposed to be paying for.

 

[Dans]

Long term health conditions-rather than illnesses susceptible to a one-off cure-take 70% of the health service budget. There is a lot of work being done in order to tackle those issues but the population's attitude needs to change drastically in order to prevent avoidable illnesses. One in five kids are obese, a third of adults drinks too much, one in five adults still fecking smokes, half of the population don't get enough exercise, so the health risks are only getting worse and with it the cost for treatment increases. Diabetes UK estimated that the NHS is already spending £10 billion a year on diabetes. Britain's young people have the highest consumption of sugary drink in Europe- and as soon as they get older they start binge drinking, I think there are around 3,000 alcohol related admissions to A&E every day. People's behavior needs a radical change otherwise this is only going to get worse than it already is.

Spot on. And if they can't change their behaviour, they should carry the health care costs themselves rather than letting others foot their bills.

 

[Wumminator]

Spot on. And if they can't change their behaviour, they should carry the health care costs themselves rather than letting others foot their bills.

Should they feck.

That line of thinking would end up in some horrible places.

 

[Dans]

Should they feck.

That line of thinking would end up in some horrible places.

Long term it should end up with people taking more responsibilty for their own health and well being. That's not a horrible place - it's our obligation to the society we live in.

 

[Pexbo]

Demographics have fecked them over. Not only is the population increasing in number, it's getting older and sicker. Add to that the ever-increasing price of the various interventions used to keep old people alive longer and it's a cost spiral that no government is capable of keeping on top of. Healthcare has become a bottomless pit for state resources. At least, nobody has found the bottom yet and they quite probably never will.

It'd probably be great for the economy if the NHS failed and life expectancy fell. Think of all those second homes on the market and bungalows that would be perfect for young families but currently have a stubborn old lady living on her own for 20 years too long in them.

 

[Dans]

Mental: Agency staff earn around 93 pounds an hour compared to full timers who earn 12 pounds an hour.

http://www.somersetcountygazette.co..._Park_Hospital_A_E_over_use_of_agency_nurses/

 

[sun_tzu]

Mental: Agency staff earn around 93 pounds an hour compared to full timers who earn 12 pounds an hour.

http://www.somersetcountygazette.co..._Park_Hospital_A_E_over_use_of_agency_nurses/

At a guess the 93 will be what they pay to an agency
Staff probably on triple or four times normal time (36 / 48 per hour) but the agency has to pay tax and ni (another 18 to 24 per hour)
My aunts used to get triple time from NHS regular for unsocial overtime... But could get more from an agency so if we assumed quad time that does not actually leave much for an agency
Leaving just under 20% margin for admin fees, advertising, payroll fees, overheads etc for the agency
Triple time makes it good operating margins.
They should admit there is a nursing shortage and make it easier to recruit from overseas but it's not something politically any government wants to admit.

 

[Sassy Colin]

The NHS faces a financial crisis every generation

 

[Kaos]

This sabotage job isn't even subtle anymore.

 

[Gambit]

At a guess the 93 will be what they pay to an agency
Staff probably on triple or four times normal time (36 / 48 per hour) but the agency has to pay tax and ni (another 18 to 24 per hour)
My aunts used to get triple time from NHS regular for unsocial overtime... But could get more from an agency so if we assumed quad time that does not actually leave much for an agency
Leaving just under 20% margin for admin fees, advertising, payroll fees, overheads etc for the agency
Triple time makes it good operating margins.
They should admit there is a nursing shortage and make it easier to recruit from overseas but it's not something politically any government wants to admit.

2 close friends of mine are nurses and they've had to go onto agency as the trusts are not allowed to hire and have to have a limit on their hours as handed down to them. They pair of them though are working full time on agency pay. They themselves are more than happy to earn a lot less for full time employment. This is how you cripple a national health service. This isn't some black hole we're throwing the money down because the system doesn't work.
This is a tactical dismantling of the NHS by the current government.

The system works fine but the legislation is there to do one thing only and that's to cripple it as it stands. If they unshackled the trusts targeted hours and employment they'd bring it all in under budget quite easily.

 

[Raees]

Ideally you want the NHS to focus on treating minor ailments, which people do not want to be forking shit loads on all the time and operations, one off serious incidents. The money that is wasted on long term diseases which people have brought on theirselves like obesity, sexually transmitted diseases, alcohol related issues and what not need to be treated privately and people fork out for treatment themselves.

The idea of a 7 day NHS is ridiculous, you can not expect people to work 7 days a week it is inhumane and totally unfair. Some ruthless and brutal decisions need to be made with the NHS and society at large needs to suck it up and adapt to it. For example looking after old people, the children of these older people need to bear more financial responsibility for the people who raised them their entire life.. not expect the state to look after them for free.

There needs to be a serious, adult discussion about the future of the NHS and one which is pragmatic, blunt and to the point. Sick and tired of people who have genuine issues and health problems which was not there fault, having to wait to receive treatment because some twat wants their breasts enlarged.

 

[Gambit]

Why do you think the tories who have cut funding and hours whilst diverting huge sums to privatised bsinesses which somehow get to operate under the Banner of NHS, now want a 7 day NHS. They want to break it and the rate they're going they will, then they can claim the only way to sort out the UK health service is to privatise completely.

 

[rednev]

As much as I distrust the Tory government and their international friends in the private healthcare industry/racket, the biggest threat to the NHS is the British people and our disgusting attitudes towards our own bodies. Even a perfectly run national heath service in the years to come will not be able to function properly given obesity statistics and aging demographics...there just isn't enough money. It's just a shame that most people don't give a shit that others will soon have to go without services we all should be entitled to due to the fact that an ever-increasing portion of NHS resources is being spent on fat lazy gluttonous fecks who have no sense of personal pride, let alone national/civic duty.

 

[Mihajlovic]

As much as I distrust the Tory government and their international friends in the private healthcare industry/racket, the biggest threat to the NHS is the British people and our disgusting attitudes towards our own bodies. Even a perfectly run national heath service in the years to come will not be able to function properly given obesity statistics and aging demographics...there just isn't enough money. It's just a shame that most people don't give a shit that others will soon have to go without services we all should be entitled to due to the fact that an ever-increasing portion of NHS resources is being spent on fat lazy gluttonous fecks who have no sense of personal pride, let alone national/civic duty.

Agreed.

 

[Mozza]

Ideally you want the NHS to focus on treating minor ailments, which people do not want to be forking shit loads on all the time and operations, one off serious incidents. The money that is wasted on long term diseases which people have brought on theirselves like obesity, sexually transmitted diseases, alcohol related issues and what not need to be treated privately and people fork out for treatment themselves.

The idea of a 7 day NHS is ridiculous, you can not expect people to work 7 days a week it is inhumane and totally unfair. Some ruthless and brutal decisions need to be made with the NHS and society at large needs to suck it up and adapt to it. For example looking after old people, the children of these older people need to bear more financial responsibility for the people who raised them their entire life.. not expect the state to look after them for free.

There needs to be a serious, adult discussion about the future of the NHS and one which is pragmatic, blunt and to the point. Sick and tired of people who have genuine issues and health problems which was not there fault, having to wait to receive treatment because some twat wants their breasts enlarged.

When you go down the route of deciding who is deserving of treatment the numbers of people who are excluded will grow its a slippery slope

 

[Nick 0208 Ldn]

George Osborne will use Autumn Statement to increase NHS funding by £6billion

By Peter Dominiczak, Political Editor
24 Nov 2015

The NHS will receive a £6billion cash injection next year amid fears that a deepening financial crisis could threaten patient care, George Osborne will announce in this week’s Autumn Statement.

The Chancellor will on Wednesday unveil plans to bring forward a funding package that will allow the NHS to carry out 800,000 more operations and conduct 2 million more tests on patients with health concerns.

His announcement comes just days after figures shows that the NHS was in the grip of its worst ever financial crisis with debt levels expected to exceed £2bn by the end of the financial year.

The financial woes, allied with the threat of the first ever all out strike by junior doctors, has put the NHS on the brink of a looming winter crisis.

http://www.telegraph.co.uk/news/nhs...ment-to-increase-NHS-funding-by-6billion.html

 

[Ducklegs]

NHS management is truly shambolic.

 

[Chorley1974]

As much as I distrust the Tory government and their international friends in the private healthcare industry/racket, the biggest threat to the NHS is the British people and our disgusting attitudes towards our own bodies. Even a perfectly run national heath service in the years to come will not be able to function properly given obesity statistics and aging demographics...there just isn't enough money. It's just a shame that most people don't give a shit that others will soon have to go without services we all should be entitled to due to the fact that an ever-increasing portion of NHS resources is being spent on fat lazy gluttonous fecks who have no sense of personal pride, let alone national/civic duty.

This, and the fact that government after government has failed to get to grips with it's shambolic management.

 

[Nick 0208 Ldn]

Locum agencies making huge profits from fees charged for providing temporary hospital staff

 

[GloryHunter07]

Seems like the government is doing a similar job in the NHS to what it is in the social housing sector.

Huge lack of understanding combined with idealistic could lead to disaster.

 

[mikey_d]

Locum agencies making huge profits from fees charged for providing temporary hospital staff

Problem is you have a workforce that has been working the extra mile for years and years, but instead of recognition of that fact and some gratitude, they are facing worsening conditions year on year.

There's no great mystery why an increasingly disillusioned workforce are choosing to work as a locum when it's better pay, less hours, more flexible hours and less responsibility.

The only answer the government and mangers have is saying ok "we're just not hiring locums anymore" or "were going to pay them less". Both solutions just lead to not enough staff working until their faced with the decision to hires locum at any rate they want or close the department and publicly embarrass themselves and still pay loads of money to other hospitals to take their patients. No brainer really

 

[Will Absolute]

Add to that the ever-increasing price of the various interventions used to keep old people alive longer

Something very brutal about that form of words, Pogue.

I suppose you could say that all medical treatment is an attempt to keep someone alive longer. And everybody eventually dies anyway. So it's all a waste of money, I guess..

 

[barros]

That's why I'm against obamacare. We need the government away.....

 

[Silva]

That's why I'm against obamacare. We need the government away.....

It's still way better than what you have, if our health system got as bad as yours there'd be riots.

 

[barros]

It's still way better than what you have, if our health system got as bad as yours there'd be riots.

Your health system is not better than ours, I don't wait hours in an emergency room, I schedule any appointment around my work and not when they tell me when I can go. I see all of my doctors during the year and I have a few, every 5 years I have a colonoscopy done and and endoscopy. When I had surgery on my hernia I was asked when I wanted done and not when they wanted.
Yes I do have insurance.