Reply to: NHS

[MrMarkyMark]

...and there's part of the problem.


Some idiot a few years ago decided that nurses should all have university education, and nursing went from being a practical and theoretical qualification to having a strong focus on the theoretical with little on the practical. You end up with nurses who know how to theoretically diagnose and treat, but haven't learned how to deal with human patients.


The comment my wife would make is that as a nurse you could learn more about a patient when you were making their bed than the doctor could learn from examining them. Now the nurses are qualified, but they get someone else in to make the beds.
(BTW, making beds is just an example, it is not the sole reason)


Nursing is physically demanding as well as mentally, it also requires the person to have good communication and personal skills. Trying to turn it into a degree qualification or only for "the brightest" means that you end up losing "the best" because they aren't always the most academically minded.

Yep, my missus Mum has just retired from nursing.

She would agree with all of this

[d000hg]

Since NHS budget is ring-fenced we almost do have a separate NHS tax, we just don't know how much of our tax goes into it.

Except that don't you get something from HMRC showing the breakdown of tax? I got one last year though I don't recall it in the past.

[SueEllen]

Diabetes costs the NHS £1m per hour, so I read yesterday. So yes, let's have more stomach stapling for fatties.

It's something like 11% of the NHS budget I heard last year.

All those amputations and heart attacks cost us loads of money.

[WTFH]

I'd also raise the pay and status of nurses and doctors, those on the front line who deserve it should be rewarded for the training and dedication to doing a job that I definitely wouldn't want

to that end I'd also make training / university education for healthcare professionals free or vastly subsidised, encourage the best and brightest into the profession (although I think bursaries already exist I just don't know the low level details)

...and there's part of the problem.


Some idiot a few years ago decided that nurses should all have university education, and nursing went from being a practical and theoretical qualification to having a strong focus on the theoretical with little on the practical. You end up with nurses who know how to theoretically diagnose and treat, but haven't learned how to deal with human patients.


The comment my wife would make is that as a nurse you could learn more about a patient when you were making their bed than the doctor could learn from examining them. Now the nurses are qualified, but they get someone else in to make the beds.
(BTW, making beds is just an example, it is not the sole reason)


Nursing is physically demanding as well as mentally, it also requires the person to have good communication and personal skills. Trying to turn it into a degree qualification or only for "the brightest" means that you end up losing "the best" because they aren't always the most academically minded.

[VectraMan]

The reason people get their stomach stapled on the NHS is to save the NHS money in the long term e.g. diabetes drugs, bp drugs, pain killers- which they will all get free due to being diabetic. However once you have your stomach stapled on the NHS removal of the loose skin you get as a result of you losing weight you have to pay for.

Diabetes costs the NHS £1m per hour, so I read yesterday. So yes, let's have more stomach stapling for fatties.

[filthy1980]

So you include people who have had breast cancer on your list? The vast majority of cosmetic breast surgery on the NHS is due to that.

The reason people get their stomach stapled on the NHS is to save the NHS money in the long term e.g. diabetes drugs, bp drugs, pain killers- which they will all get free due to being diabetic. However once you have your stomach stapled on the NHS removal of the loose skin you get as a result of you losing weight you have to pay for.


Problem is most doctors know feck all about this. So the NHS would have to hire all these people from the private sector many of whom don't agree with the dietary guidelines and exercise that the NHS pushes, which is why they work in the private sector in the first place.


Remember the government pushed a doctor of a committee for saying cannabis wasn't dangerous so you don't have a hope in hells chance of getting that through.


You mean the BMA - yeah they would resist. Nurses etc would be happy as your plans would give them more autonomy in treating patients so a higher status.

those cosmetic examples were just off the top of my head I'm sure there are better ones that would illustrate my point but it's Friday afternoon and I've already switched off

no problems with NHS hiring nutritionists from the private sector, the cost vs benefit would weigh up over the long term, plus there's plenty of fat in middle management in the NHS that could be trimmed

societal attitudes towards cannabis are changing, government will follow suit, might take a generation though

I'd also raise the pay and status of nurses and doctors, those on the front line who deserve it should be rewarded for the training and dedication to doing a job that I definitely wouldn't want

to that end I'd also make training / university education for healthcare professionals free or vastly subsidised, encourage the best and brightest into the profession (although I think bursaries already exist I just don't know the low level details)

[SueEllen]

like many things the NHS has two fundamentals: Supply & Demand

there will never be enough Supply (money) for the NHS and Demand (sick people) will always be there

I say cut both

reduce the scope of what the NHS delivers

focus should be on saving lives, all other non health impacting services should be offered but at a cost, i.e. you can have a boob job / stomach staple on the NHS but you have to pay, introduce some free market principes into the NHS, they've got skilled resources and the infrastructure why not try and monetise it

So you include people who have had breast cancer on your list? The vast majority of cosmetic breast surgery on the NHS is due to that.

The reason people get their stomach stapled on the NHS is to save the NHS money in the long term e.g. diabetes drugs, bp drugs, pain killers- which they will all get free due to being diabetic. However once you have your stomach stapled on the NHS removal of the loose skin you get as a result of you losing weight you have to pay for.

for the long term 50 years+: reduce demand
put more money into healthy living programmes, help change the culture around diet and exercise, the healthier people keep their bodies the less likely they are to be in need of NHS services and less frequently too

Problem is most doctors know feck all about this. So the NHS would have to hire all these people from the private sector many of whom don't agree with the dietary guidelines and exercise that the NHS pushes, which is why they work in the private sector in the first place.

oh an I would also legalise cannabis, and prescribe it as an alternative to painkillers, anxiety etc

maybe even sell it from nhs dispensaries the tax generated would be huge (as proved by Colorado in the US) plus you can reduce the demand on the NHS at the same time

Remember the government pushed a doctor of a committee for saying cannabis wasn't dangerous so you don't have a hope in hells chance of getting that through.

no doubt the most resistant to these types of changes will be the unions but I'd cut them too

You mean the BMA - yeah they would resist. Nurses etc would be happy as your plans would give them more autonomy in treating patients so a higher status.

[SueEllen]

If your leg was dangling off or you had acute abdominal pain you wouldn't be sat in the waiting room, you'd be seen immediately. Same if you had chest pain, or were having a stroke. The people in the waiting room are the ones whose head pans aren't endangering them in any way, or whose abdominal pains would go away if they ate a Rennie.

You forget those who have self-medicated on alcohol.

When one of my mates had a head injury years ago there were a few people in the waiting room with various serious looking injuries to limbs but because they were on their own medication they were left for a couple of hours.

[NickFitz]

If I was sat in an A&E waiting room for several hours on a Friday night with my leg dangling off, a pan stuck to my head and suffering tremendous abdominal pain, having paid an NHS tax I would not feel in any way differently reassured compared to having paid 'tax and national insurance'.

If your leg was dangling off or you had acute abdominal pain you wouldn't be sat in the waiting room, you'd be seen immediately. Same if you had chest pain, or were having a stroke. The people in the waiting room are the ones whose head pans aren't endangering them in any way, or whose abdominal pains would go away if they ate a Rennie.

Unfortunately, the same stupidity that leads them to regard a minor ailment or misfortune as an emergency also renders them unable to comprehend that the reason they were left waiting for hours was because they shouldn't have been there in the first place. Then they whine to their local rag about it, and the Daily Mail nicks it off the local rag's website and pretends the whole thing says something about the NHS and not about the moron with a pan on their head

[OwlHoot]

From the article

The panel includes:
◾former NHS England head Sir David Nicholson
◾former Royal College of GPs head Clare Gerada
◾former Royal College of Nursing head Peter Carter
◾Patients Association chief executive Katherine Murphy

Commissioned by the Liberal Democrats ...

What a futile waste of time giving this tulip a moment's thought or discussion!

[filthy1980]

like many things the NHS has two fundamentals: Supply & Demand

there will never be enough Supply (money) for the NHS and Demand (sick people) will always be there

I say cut both

reduce the scope of what the NHS delivers

focus should be on saving lives, all other non health impacting services should be offered but at a cost, i.e. you can have a boob job / stomach staple on the NHS but you have to pay, introduce some free market principes into the NHS, they've got skilled resources and the infrastructure why not try and monetise it

for the long term 50 years+: reduce demand
put more money into healthy living programmes, help change the culture around diet and exercise, the healthier people keep their bodies the less likely they are to be in need of NHS services and less frequently too

oh an I would also legalise cannabis, and prescribe it as an alternative to painkillers, anxiety etc

maybe even sell it from nhs dispensaries the tax generated would be huge (as proved by Colorado in the US) plus you can reduce the demand on the NHS at the same time

no doubt the most resistant to these types of changes will be the unions but I'd cut them too

[AtW]

Taxpayers must have the dominant role

[motoukenin]

"The NHS in England is under financial pressure. There is an intensifying debate about whether more money is needed and if so how much.

Among the options being suggested is a dedicated tax for the health service - transparent, easily understandable and less prone to political interference, or so the theory goes. So how realistic might it be?

The ring-fencing of tax for a specific purpose is known as hypothecation. One example, though not technically a tax, is the television licence fee, which is a levy specifically to fund the BBC.

The idea of a hypothecated tax for health has been knocked back and forth between economists for many years. "

It just so happens that the yield to the government from NI, about £126bn annually, is not far off the total spend on the NHS across the UK. (AtW's comment: how convenient! )

This would reflect the original purpose of NI after World War Two, which was to allow workers to insure themselves against sickness or other loss of earnings.

The lines have since become blurred, with NI now in effect an extension of income tax.

The panel's call for more money will hit taxpayers' wallets, whether its through income tax or a new health and social care levy.

The experts believe an extra £20bn is needed for the NHS in 2020 over and above current plans, with a few billion more needed for social care.

That would represent a big hit on taxpayers, individual or corporate.

But the supporters of a dedicated health and social care tax believe it would give voters reassurance that their money was going to the right place."

Should the NHS have its own tax? - BBC News

Hypoyhication is the HMRC's prefered method of pooling taxes, this is because although they collect the tax they are not in charge of what it is spent on.
Government departments dont work in harmony, if a request for X amount of money is required then HMRC have to provide it, either by borrowing or from taxes, so the Treasury who have a very dominant role in government would never allow this to happen and have said so many times.

[VectraMan]

Makes sense to me. At least then everyone would have a connection with what healthcare actually costs, unlike now where it's all part of the black hole that is tax and we never know if it's being spent on medical treatments or Theresa May's shoe collection.

[Chuck]

I would have thought there would not be much effort or cost required in centrally defining an IT framework for Trusts - even if they are then left to implement it themselves. Going forward, having similar systems at each Trust would make a joined up NHS IT systems somewhat easier to achieve.

I think they tried that. It cost billions and failed. That's not to say it isn't the right thing to do, just that you can't trust this vast, incompetent, organisation, and the consultancies that advise it, to get it right.