Happy Birthday NHS!

#21
After our experience of the NHS last year all I wanted to do was burn down a hospital. As far as I was concerned the only bit that worked was the private sector bit (my GP, who was bloody great). As for the important part, our lass, it was a bloody disaster. Misdiagnosis in X-ray, failed communication (fax machines FFS) between hospitals, inadequate care in the Acute Medical Unit, premature discharge from Section and a mental health crisis team who would often fail to turn up to appointments, change them without telling you and then prescribe incorrect medication. Oh, forgot to mention the disappearance of personal property. Their sheer incompetence must have cost the NHS and the police thousands, let alone what I know what it cost us and my then employer.

I've posted elsewhere that based on my personal experience I would reduce the NHS budget and give the money to the police as they seem to be picking up the pieces of NHS failures. Frankly if it hadn't been for Dorset Police and my GP I would probably have ended up under Section alongside our lass.
 
#22
I know the NHS is under pressure but you fellas should try and preserve it. The U.S. spends far more on healthcare while making people pay for most of the treatments. Unless you have a good job and a decent income, with decent healthcare plan you're kinda f-kd. Sure there's Medicare but even that costs..
 
#24
One thing we do need is a cultural shift away from black and white thinking - you are well, then become ill/injured, and get treated and are 100% well.

1. Preventative medicine - dealing with blood pressure, stress, being overweight, smoking, excess drinking, safe sex and so on has the potential to save billions, free up hospital beds, save thousands of lives, and prevent lives being blighted by disability.

2. Great spending on rehabilitation would not only free up acute hospital beds, but would reduce the quality of life of people like my Stroke disabled Mum, reduce social care needs, and allow many to return to the workforce.

We often hear simplistic answers, for example more competitive sports in schools would reduce obesity and type 2 Diabetes. The trouble is evidence from the UK, US, and elsewhere suggests otherwise. The hard reality is that proponents of such ideas have good memories of school sports. Those who do not are more likely to actually need exercise.

I go circuit training most weeks. The thing that is obvious to me, is that most of the people who got do not really need it, but those who do need it would never dream of attending.
 
#25
Anyone who has tried restructuring or changing even small things seems to have been met with massive resistance. It's too big to fail but has gathered too much momentum to change. Centralising services may work on a power point presentation but it doesn't factor in reality. The German system seems better. Why? What are they doing differently?

Multinational Comparisons of Health Systems Data, 2018 | Commonwealth Fund
Partly because the principle behind Bismarck Health systems (such as the German one) is that the the relationship is between a treating clinician (or hospital) and the patient, facilitated and paid for by an insurer, and only regulated at arms length by government. Healthcare is therefore not run by government (although some providers are owned by (local and state) government, but this is the exception rather than the rule), and therefore somewhat less prone to being used as a political football.

Funding for Healthcare does not go through the filter of central government, but is hypothecated by being paid direct to insurers, so can't be fought over by ministers desperate to protect their bit of the treasury pie.

They also pay a higher proportion of their income for healthcare, so overall it is better funded........

It is not without it's problems though. Decentralisation and a lack of coordinated returns centrally can make monitoring and managing quality problematic, and a lack of any central commissioning function can mean an over provision of services in particular specialities (the lucrative ones) and a lack of provision in others (the less lucrative ones). Whilst over provision can mean very short waiting times for surgery, it can also mean that the surgeons may not be doing enough to remain at the top of their game.

Comparison of different Health Systems can be very problematic due to the way that hey measure and record activity and outcomes, and it is easy to fall into the easy "Tabloid headline" trap of simply comparing numbers and assuming one is better than the other - but that doesn't alter the fact that the NHS is in real trouble both financially and from a quality point of view, and the nation needs to stop trying to protect the "Sacred Cow" from any sort of change, if we are to allow the sort of radical rethink that it needs for the 21st century.

It is not the "jewel in the crown" that it is so often described as by the tabloids and politicians. It may have been in 1948, but even then, it was neither the first National Health system, or the best. It was, however the first nationalised health system.

While we still keep thinking of it like this, and still keep trying to not allow radical change to the "beloved" NHS, we will never get the NHS that we really should (and could ) have.
 
#26
Partly because the principle behind Bismarck Health systems (such as the German one) is that the the relationship is between a treating clinician (or hospital) and the patient, facilitated and paid for by an insurer, and only regulated at arms length by government. Healthcare is therefore not run by government (although some providers are owned by (local and state) government, but this is the exception rather than the rule), and therefore somewhat less prone to being used as a political football.

Funding for Healthcare does not go through the filter of central government, but is hypothecated by being paid direct to insurers, so can't be fought over by ministers desperate to protect their bit of the treasury pie.

They also pay a higher proportion of their income for healthcare, so overall it is better funded........

It is not without it's problems though. Decentralisation and a lack of coordinated returns centrally can make monitoring and managing quality problematic, and a lack of any central commissioning function can mean an over provision of services in particular specialities (the lucrative ones) and a lack of provision in others (the less lucrative ones). Whilst over provision can mean very short waiting times for surgery, it can also mean that the surgeons may not be doing enough to remain at the top of their game.

Comparison of different Health Systems can be very problematic due to the way that hey measure and record activity and outcomes, and it is easy to fall into the easy "Tabloid headline" trap of simply comparing numbers and assuming one is better than the other - but that doesn't alter the fact that the NHS is in real trouble both financially and from a quality point of view, and the nation needs to stop trying to protect the "Sacred Cow" from any sort of change, if we are to allow the sort of radical rethink that it needs for the 21st century.

It is not the "jewel in the crown" that it is so often described as by the tabloids and politicians. It may have been in 1948, but even then, it was neither the first National Health system, or the best. It was, however the first nationalised health system.

While we still keep thinking of it like this, and still keep trying to not allow radical change to the "beloved" NHS, we will never get the NHS that we really should (and could ) have.
Excellent and informative answer. Thanks.
 
#27
Point of Order:

I believe the correct nomenclature is now

OUR NHS (Copyright: every bleeding politician, and boy do I wish they were all bleeding)

Happy to help, no thanks necessary.
 
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