NHS winter 'crisis'

[Garethw]

Er..........

1) You sound like the BNP(Or New Labour - "British jobs for British people")

2)The NHS is dependent on the work of migrants. You want people to work for a system but at the same time stopping them for accessing it due to their nationality.

3)Your suggestion seems very unpopular with people who work in the NHS - https://www.theguardian.com/society...ism-claims-distraction-from-nhs-real-problems


4)And finally there is very little concert evidence that "health tourism" cost the NHS hundreds of million of pounds - https://www.theguardian.com/politics/reality-check/2013/oct/22/health-tourists-costing-nhs-2bn

Your BNP comment is bang out of order. Excuse me for wanting to put British tax payers first!

The NHS is at breaking point and I’d be happy for any preventative measure to be put in place to ensure it still exists when my son is grown up!

That article is utter fecking bullshit. A single overnight stay in a hospital cost the NHS thousands of pounds and that’s without taking Any treatment (x rays, IV lines etc) into consideration. If the figure was only £12 million (rather than the widely believed £2 billion!) why are measures being introduced that will require medical staff to ask individuals for proof that they are living here?

It’s very simple in my opinion, if you don’t live and work in this country then you shouldn’t be entitled to free medical care. I certainly wouldn’t expect it if I was abroad without insurance

Why should Jane Bloggs from Eastern Europe jump on a plane heavily pregnant purely to have her baby for free over here rather than pay back home?

Foreign people on working Visas that are contributing (like the nhs workers you mentioned) by paying tax etc, should of course be treated under the nhs.

 

[Stanley Road]

In Holland, foreign day trippers without any form of insurance are presented with a pin machine and charged around 1k per night. how do I know this? The mrs worked 12 years as a nurse in our local hospital.

 

[Paul the Wolf]

In Holland, foreign day trippers without any form of insurance are presented with a pin machine and charged around 1k per night. how do I know this? The mrs worked 12 years as a nurse in our local hospital.

Do you have a medical card in Holland that you present when you receive medical treatment? We do in France - Carte Vitale
https://en.wikipedia.org/wiki/Carte_Vitale

 

[africanspur]

Your BNP comment is bang out of order. Excuse me for wanting to put British tax payers first!

The NHS is at breaking point and I’d be happy for any preventative measure to be put in place to ensure it still exists when my son is grown up!

That article is utter fecking bullshit. A single overnight stay in a hospital cost the NHS thousands of pounds and that’s without taking Any treatment (x rays, IV lines etc) into consideration. If the figure was only £12 million (rather than the widely believed £2 billion!) why are measures being introduced that will require medical staff to ask individuals for proof that they are living here?

It’s very simple in my opinion, if you don’t live and work in this country then you shouldn’t be entitled to free medical care. I certainly wouldn’t expect it if I was abroad without insurance

Why should Jane Bloggs from Eastern Europe jump on a plane heavily pregnant purely to have her baby for free over here rather than pay back home?

Foreign people on working Visas that are contributing (like the nhs workers you mentioned) by paying tax etc, should of course be treated under the nhs.

I'll need to try to look for the statistics behind it but so called 'health tourism' is a tiny percentage of the NHS budget and some estimates have it that it would cost more to have the system to catch all of these foreigners than it would save by trying to charge them.

Outside of the big urban centres, I can assure you that foreigners are not coming to be treated in large numbers in the UK. I work in London now but in 4-5 years of working in the South East, I think I treated 1 person who wasn't obviously eligible for NHS care. The hospital I work for now (Guys & St Thomas) has a specialised overseas department to recoup funds because its obviously much more prevalent there.

Why are measures being introduced that will require medical staff to enquire? Because its politically expedient to blame immigration and the EU for our ills in the current climate and the government have no qualms on taking advantage. Just because a government is introducing an idea, it doesn't mean that it is a good idea or policy.

Who said Jane Bloggs is jumping over here from Eastern Europe to have her baby for free?

You should of course not expect free medical treatment abroad though, you're right.

 

[Mozza]

That article is utter fecking bullshit. A single overnight stay in a hospital cost the NHS thousands of pounds and that’s without taking Any treatment (x rays, IV lines etc) into consideration. If the figure was only £12 million (rather than the widely believed £2 billion!) why are measures being introduced that will require medical staff to ask individuals for proof that they are living here?

To appease ignorant racists

To shift the blame for NHS failure from Government to foreigners so ignorant racists will vote for them come election time

 

[Garethw]

To appease ignorant racists

To shift the blame for NHS failure from Government to foreigners so ignorant racists will vote for them come election time

Why is it racist to expect foreigners to pay their way? If I needed medical attention while I was in Holland or France and I didn’t have travel insurance I’d expect to pay for it.

The Tories are running the NHS into the ground, so you are right, they are doing everything they can to deflect blame away from themselves.

 

[Mozza]

Why is it racist to expect foreigners to pay their way? If I needed medical attention while I was in Holland or France and I didn’t have travel insurance I’d expect to pay for it.

The Tories are running the NHS into the ground, so you are right, they are doing everything they can to deflect blame away from themselves.

It's not, but like the argument about charging for appointments, it's whether it is cost effective to do so. There is no evidence of great numbers of people travelling to the UK for treatment and within the EU we have a system to recover money for treating each others citizens.

Focus your anger at Tory budget cuts, foreigners are not destroying the NHS

 

[Fully Fledged]

I'll need to try to look for the statistics behind it but so called 'health tourism' is a tiny percentage of the NHS budget and some estimates have it that it would cost more to have the system to catch all of these foreigners than it would save by trying to charge them.

Outside of the big urban centres, I can assure you that foreigners are not coming to be treated in large numbers in the UK. I work in London now but in 4-5 years of working in the South East, I think I treated 1 person who wasn't obviously eligible for NHS care. The hospital I work for now (Guys & St Thomas) has a specialised overseas department to recoup funds because its obviously much more prevalent there.

Why are measures being introduced that will require medical staff to enquire? Because its politically expedient to blame immigration and the EU for our ills in the current climate and the government have no qualms on taking advantage. Just because a government is introducing an idea, it doesn't mean that it is a good idea or policy.

Who said Jane Bloggs is jumping over here from Eastern Europe to have her baby for free?

You should of course not expect free medical treatment abroad though, you're right.

The European Health Insurance Card (EHIC), which replaced the old E111 in 2006, lets you get free or reduced cost healthcare in Europe. Apply for free online ... If you receive treatment under this type of healthcare system, you are expected to pay the same co-payment charge as a patient from that country.

 

[Stanley Road]

Do you have a medical card in Holland that you present when you receive medical treatment? We do in France - Carte Vitale
https://en.wikipedia.org/wiki/Carte_Vitale

We have one but i rarely produce it at the same dept twice. There used to be a coloured stiicker on my pass and it was beurocratic bullshit. Each year a different colour and at the turn of the new year if you had an appt, no you need to go and register for a new sticker, hated it but now its changed.

 

[esmufc07]

More bad news out today, but it's got to a point now where it's so bad that it's not surprising anymore, which is scandalous in itself.

What steps would you lot take to fix the NHS?

 

[Silva]

What steps would you lot take to fix the NHS?

Disband the conservative party.

 

[Zlatattack]

Your BNP comment is bang out of order. Excuse me for wanting to put British tax payers first!

The NHS is at breaking point and I’d be happy for any preventative measure to be put in place to ensure it still exists when my son is grown up!

humanity doesn't have a nationality.

 

[Zlatattack]

It's not, but like the argument about charging for appointments, it's whether it is cost effective to do so. There is no evidence of great numbers of people travelling to the UK for treatment and within the EU we have a system to recover money for treating each others citizens.

Focus your anger at Tory budget cuts, foreigners are not destroying the NHS

Well said. The NHS is being hit by the tories in multiple ways;

1. They cut funding which reduces staff and services
2. Healthcare is not a steady industry, it has peaks and troughs of work, so help cover that, the hospitals are forced to hire expensive temps, temps who are owned by agencies belonging to Tory backers.
3. Admin and background processes are all outsourced. this starts of cheap and then the prices skyrocket. Many contracts are won by tories and their backers.

it's pure corruption.

They are deliberately straining the system so that they can shoe horn in privatization via the back door.

 

[Smores]

More bad news out today, but it's got to a point now where it's so bad that it's not surprising anymore, which is scandalous in itself.

What steps would you lot take to fix the NHS?

Is exactly the picture the Tories want to paint unfortunately. The BBC News website had a very good article with infographics explaining it.

The Tories need to be more effectively challenged on the "More money than ever before" bullshit. The budget is supposed to go up and the increase is historically low. Whilst they do what to solve the underlying sugar, obesity, age factors?

Hunt still being in charge shows you how much they care. He's a good whipping boy and he's happy to be so.

 

[Nick 0208 Ldn]

On Shelagh Fogarty's show, where they are thinking sensibly, they talk about cross-party solutions and Royal commissions. You know, cut rhough the 4-5 year electoral cycles and policy pendulum.

 

[freeurmind]

More bad news out today, but it's got to a point now where it's so bad that it's not surprising anymore, which is scandalous in itself.

What steps would you lot take to fix the NHS?

Free at delivery point, totally government controlled healthcare doesn't work well. Very difficult to contain costs and vulnerable to corruption, inefficiency and large scale bureaucracy.

- Make the insurance companies offer everyone a universal health-care package with the price of the deductible and/or premiums fixed by government with the welfare state filling in for unemployed and low income persons. Government dictates which conditions are covered by this package. Insurers are not allowed to deny anyone coverage. People can get additional insurance form the private sector. Government covers losses on universal premiums.

-Those who wish to opt out of the universal package have their deductible save in a "health insurance savings account" which is used to cover arising medical costs, after it is depleted they pay out of pocket for everything except emergency care. Foreign nationals with no legal status are only allowed emergency care, everything else is paid out of pocket.

-Allocate sufficient funds to the healthcare system. Adjust retirement age, pension contributions and taxes accordingly.

-Subsidize healthcare education for persons from families earning below a certain amount.

 

[Mozza]

On Shelagh Fogarty's show, where they are thinking sensibly, they talk about cross-party solutions and Royal commissions. You know, cut rhough the 4-5 year electoral cycles and policy pendulum.

Royal commission will paralyse investment, 'we are awaiting the findings of the commission', and it's findings will be tailored to suit the tories. Get a right winger to chair commission to recommend right wing solutions to the NHS

 

[Nick 0208 Ldn]

Royal commission will paralyse investment, 'we are awaiting the findings of the commission', and it's findings will be tailored to suit the tories. Get a right winger to chair commission to recommend right wing solutions to the NHS

Annual investment is is immediate logistics, a commission is what we intend for the next 5-20 years. For example, i rather doubt whether such would have recommended PFI as Labour implemented it.

If we take away the conspiracy theories for a moment, we're looking to achieve an efficient yet suitably funded health service, one where emergency and specialist care is free at the point of use and of a higher quality than present. This to be combined with better services locally and a greater sense of personal responsibility going forward.
There is no election winning groundswell for an entirely privatised system, although the country does have to decide what is practicable over the longer term. Whoever you vote for that fork in the road is obvious enough.

 

[Marcelinho87]

 

[berbatrick]

one where emergency and specialist care is free at the point of use and of a higher quality than present.

How much do you think people should pay for longer-term issues, check-ups, etc.?

 

[Nick 0208 Ldn]

How much do you think people should pay for longer-term issues, check-ups, etc.?

Well zero charges for anything of a serious nature. So any visits related to cancer remain free for example, or preventive scans/treatments for other life-altering or life-threatening hireditary conditions.

However...i have reason to attending St Thomas' Hospital in Westminster at least once a year, with such likely to continue for decades to come (unless i meet a premature end ). The tests are thankfully routine and have never shown up anything major; therefore, would a minimum cost of £10-20 for my field test be prohibitive? Nicer still, you could have a guaranteed percentage distributed to those permanent staff with whom you interact (call it a small expression of additional gratitude from patient to doctor/nurse/tech). Similarly i am able to receive visual aids free of charge, yet might a discounted rate be fairer for those with the means?

In exchange though, i'd quite like to see the return of previously cut services to the local area.

Alternatnively, we fall back on increased taxation alone in terms of necessary funding reform. Something has to be done however, for our expectations cannot be met under the current model: higher pay, more nurses and doctors, increased capacity, upgraded buildings, the latest treeatments and future research e.t.c. Politicians of all stripes throw around financial pledges near election time, but these are reactionary policy rather than thought-out responses conforming to a structured plan.

 

[Mozza]

Annual investment is is immediate logistics, a commission is what we intend for the next 5-20 years. For example, i rather doubt whether such would have recommended PFI as Labour implemented it.

I wouldn't be so sure of that, PFI was a tory idea and is an excellent way to siphon some of the spend on the NHS into their and thier donars hands

If we take away the conspiracy theories for a moment, we're looking to achieve an efficient yet suitably funded health service, one where emergency and specialist care is free at the point of use and of a higher quality than present. This to be combined with better services locally and a greater sense of personal responsibility going forward.
There is no election winning groundswell for an entirely privatised system, although the country does have to decide what is practicable over the longer term. Whoever you vote for that fork in the road is obvious enough.

Its not a conspiracy theory. This is how commisons work. You tailor the result by picking the fellow who's been trained to your point of view, worked for the right think tank, written the right articles.

Yes their is no groundswell for an entirely privatised system, so the Tories have settled for the next best thing. Partial privatisation allows them and their supporters to take some of the NHS budget into their own pockets.

The NHS is in managed decline, just good enough to keep people voting blue, not shit enough to scare people into voting Labour.

 

[Heardy]

Free at delivery point, totally government controlled healthcare doesn't work well. Very difficult to contain costs and vulnerable to corruption, inefficiency and large scale bureaucracy.

- Make the insurance companies offer everyone a universal health-care package with the price of the deductible and/or premiums fixed by government with the welfare state filling in for unemployed and low income persons. Government dictates which conditions are covered by this package. Insurers are not allowed to deny anyone coverage. People can get additional insurance form the private sector. Government covers losses on universal premiums.

-Those who wish to opt out of the universal package have their deductible save in a "health insurance savings account" which is used to cover arising medical costs, after it is depleted they pay out of pocket for everything except emergency care. Foreign nationals with no legal status are only allowed emergency care, everything else is paid out of pocket.

-Allocate sufficient funds to the healthcare system. Adjust retirement age, pension contributions and taxes accordingly.

-Subsidize healthcare education for persons from families earning below a certain amount.

Some interesting points, but regarding the bit in bold - how much further can this be pushed? Having generations working into their mid-70s is too old IMO.

It might however push people to an earlier grave mind you, which if you're trying to tackle an underlying cause of the faltering NHS, being the ageing population, you might just go about achieving it...

 

[711]

Well zero charges for anything of a serious nature. So any visits related to cancer remain free for example, or preventive scans/treatments for other life-altering or life-threatening hireditary conditions.

However...i have reason to attending St Thomas' Hospital in Westminster at least once a year, with such likely to continue for decades to come (unless i meet a premature end ). The tests are thankfully routine and have never shown up anything major; therefore, would a minimum cost of £10-20 for my field test be prohibitive? Nicer still, you could have a guaranteed percentage distributed to those permanent staff with whom you interact (call it a small expression of additional gratitude from patient to doctor/nurse/tech). Similarly i am able to receive visual aids free of charge, yet might a discounted rate be fairer for those with the means?

In exchange though, i'd quite like to see the return of previously cut services to the local area.

Alteratnively, we fall back on increased taxation alone in terms of necessary funding reform. Something has to be done however, for our expectations cannot be met under the current model: higher pay, more nurses and doctors, increased capacity, upgraded buildings, the latest treeatments and future research e.t.c. Politicians of all stripes throw around financial pledges near election time, but these are reactionary policy rather than thought-out responses conforming to a structured plan.

Are you sure you're not just saying that you're willing to pay a bit extra in charges, but not a lot extra in taxes? And would it be such a good use of resources to introduce an army of clerks and their managers to collect and administrate all the various charges that might be levied?

I'd have thought the most efficient and fairest way of raising more money for health would be through the existing tax system.

 

[Nick 0208 Ldn]

Are you sure you're not just saying that you're willing to pay a bit extra in charges, but not a lot extra in taxes? And would it be such a good use of resources to introduce an army of clerks and their managers to collect and administrate all the various charges that might be levied?

I'd have thought the most efficient and fairest way of raising more money for health would be through the existing tax system.

Ex cept that they'd likely get more out of me in charges than the proposed tax increases, at least at matters stand now. The vast majority could be entirely automated, just a case of logging in and selecting the right hospital and department(s) used.

What is either fair or efficient in a postcode lottery? Sure, you're paying into the great big NHS pot, but after that it could go just about anywhere. Even Corbyn and his money tree fall short of bridging the funding gap, let alone improving upon the status quo. Whichis before we get to the thorny issue of reducing demand, a responsibility which falls on the individual to a large degree.

 

[Ultimate Grib]

I'm a general manager in a large acute trust. Believe me when I say this is the worst it's ever been. Although I agree that the NHS has been underfunded for the last 7 years it's a little more complicated than that. The biggest challenge is simply the vast amount of older people requiring help...and just how complex that is. Most of this is down to the unbelievable cuts social care has had to endure. Health are picking up the pieces and are Ill equipped to do this ( hospitals are very dangerous places for older people). More money wouldn't help us in this situation...one we don't have the staff and we would just end up building bigger and bigger warehouses of older people with little hope of them getting home in a timely way. Just reinforcing the cycle.

Please be patient with us during this time though. It's true that at least for us this is the best we have ever prepared. But it was never going to be enough in a system that doesn't work for our frailest. It's relentless and unprecedented but everyone is doing their best.

You do not need to ask that. No one would ever dream of blaming anyone working in the NHS however ill advised they might be.

 

[711]

You do not need to ask that. No one would ever dream of blaming anyone working in the NHS however ill advised they might be.

Really? I've heard the 'too many managers' thing loads of times. Probably been said already in this thread alone.

 

[711]

Ex cept that they'd likely get more out of me in charges than the proposed tax increases, at least at matters stand now. The vast majority could be entirely automated, just a case of logging in and selecting the right hospital and department(s) used.

What is either fair or efficient in a postcode lottery? Sure, you're paying into the great big NHS pot, but after that it could go just about anywhere. Even Corbyn and his money tree fall short of bridging the funding gap, let alone improving upon the status quo. Whichis before we get to the thorny issue of reducing demand, a responsibility which falls on the individual to a large degree.

Instead of a postcode lottery with funds going 'just about anywhere' would you prefer more local funding then? So rich areas of the country have an excellent heath service but they're dying in Hull and Merseyside?

 

[WackyWengerWorld]

Your BNP comment is bang out of order. Excuse me for wanting to put British tax payers first!

The NHS is at breaking point and I’d be happy for any preventative measure to be put in place to ensure it still exists when my son is grown up!

That article is utter fecking bullshit. A single overnight stay in a hospital cost the NHS thousands of pounds and that’s without taking Any treatment (x rays, IV lines etc) into consideration. If the figure was only £12 million (rather than the widely believed £2 billion!) why are measures being introduced that will require medical staff to ask individuals for proof that they are living here?

It’s very simple in my opinion, if you don’t live and work in this country then you shouldn’t be entitled to free medical care. I certainly wouldn’t expect it if I was abroad without insurance

Why should Jane Bloggs from Eastern Europe jump on a plane heavily pregnant purely to have her baby for free over here rather than pay back home?

Foreign people on working Visas that are contributing (like the nhs workers you mentioned) by paying tax etc, should of course be treated under the nhs.

Should the British person who doesn't have your proposed NHS card be denied treatment? And how far are you willing to go, ie heart attacks? strokes? Turning away women in labour?

 

[Cheesy]

Often it's said that increased taxes won't address the root of the problem and that might be true but I feel like it's a necessary start to any progress that's going to be made.

In a way I feel like the NHS has almost been a victim of its own success...the fact it's improved living standards means people are naturally living for longer and require more care. As a result of that I feel like it's pretty much just been a given we're going to need to put more public expenditure into it due to that.

Obviously the problems extend beyond the Tory government but ultimately it's hard to look beyond them for a lot of the immediate problems when they've been pursuing an austerity agenda throughout their time in power...an agenda that by necessity leads to cuts. This is even more so when we remember they're a party who are generally speaking ideologically committed to a smaller state - there's little reason to believe that vision wouldn't also apply to healthcare as well as other sectors.

Similarly, their treatment of junior doctors and nurses insofar as their reluctance to increase pay demonstrates a very different attitude compared to their willingness to give tax breaks etc on the argument of it being 'good for business'. Surely at this point a similar argument has to be applied to the NHS in regards to funding.

 

[Ultimate Grib]

Really? I've heard the 'too many managers' thing loads of times. Probably been said already in this thread alone.

Despite those people being ill advised they still don't blame the managers, they blame the hierarchy created by a wasteful top down reorganization not the people working in those roles who do their best day in day out with super-limited resources.

 

[Hernandez - BFA]

12 surgical procedures cancelled this week alone in a speciality at my hospital - because there aren't any beds to home them after the surgery.

It's an utter shit time to be working in NHS at the moment.

 

[Nick 0208 Ldn]

Instead of a postcode lottery with funds going 'just about anywhere' would you prefer more local funding then? So rich areas of the country have an excellent heath service but they're dying in Hull and Merseyside?

There should absolutely be more local accountability, be it through some portion of taxes or referenda when the NHS plants to cut/move the provison of care. Is it unreasonable for a voter to hope that some of their contribution makes improvements locally?

No proposed policy from any of the major political parties will deliver on what the public expects, not from what i've seen. Besides a few billion more in annual taxation, what's your suggestion?

 

[711]

There should absolutely be more local accountability, be it through some portion of taxes or referenda when the NHS plants to cut/move the provison of care. Is it unreasonable for a voter to hope that some of their contribution makes improvements locally?

No proposed policy from any of the major political parties will deliver on what the public expects, not from what i've seen. Besides a few billion more in annual taxation, what's your suggestion?

You're right about the few billion more in annual taxation. I'm neither wealthy nor poor, but I am ready to do my bit on that one. And not just pay a tenner once a year.

I think best progress would be made by letting the NHS managers manage, and listen to what they say is needed and should be done, rather than have a politically inspired reorganisation every four years. More listening and less pontificating.

 

[Nick 0208 Ldn]

You're right about the few billion more in annual taxation. I'm neither wealthy nor poor, but I am ready to do my bit on that one. And not just pay a tenner once a year.

I think best progress would be made by letting the NHS managers manage, and listen to what they say is needed and should be done, rather than have a politically inspired reorganisation every four years. More listening and less pontificating.

Meeow, that was awfully catty of you.

I don't believe that i suggestd it should be one or the other, rather that we need increased taxation and a whole lot else besides. There's more at play here than winter-related shortages and keeping pace with saffing numbers. Do we reverse the hospital closures of previous governments? To what extent can we expand the range of medication and treatments, so that patients don't have to seek them privately? What would be a fairer pay structure for nurses? How much should be expected of us in our daily lives to alleviate demand?

While i agree with you about the politicfally inspired reorganisations, NHS managers are sometimes part of the problem, nor is it their role to deliver hard truths to the public.

 

[711]

Didn't intend any cattiness sorry, the internets and that. Yeah, all good points, except I don't agree with NHS manager's role not being to deliver hard truths, I'd say that's what they're paid to do, on our behalf, even if we might not like it.

 

[Mozza]

Be very careful of Tories who talk of 'honest conversations' about the NHS, what they really mean is what can they cut in way of services.

Also watch out for 'localisation of services'. They give too little money to run the service then pretend it's the local bodies fault that the cuts have happened

 

[711]

Be very careful of Tories who talk of 'honest conversations' about the NHS, what they really mean is what can they cut in way of services.

Also watch out for 'localisation of services'. They give too little money to run the service then pretend it's the local bodies fault that the cuts have happened

Standard Tory practice.

 

[freeurmind]

12 surgical procedures cancelled this week alone in a speciality at my hospital - because there aren't any beds to home them after the surgery.

It's an utter shit time to be working in NHS at the moment.

No beds in the hospital or no beds at a care facility?

 

[Hernandez - BFA]

No beds in the hospital or no beds at a care facility?

Hospital. Over night they had to admit to many people that there were no room for the post-op patients the next day - so they had to cancel them.

I'm a doctor on a surgical ward at the moment, but 25%-50% of the patients on the ward at the moment aren't surgical related patients - hence why so many operations are being cancelled. You can't perform surgery on patients if you have nowhere to put them to observe them afterwards.