How to "save" the NHS

The frightening thing is that your experience goes all the way through the system. I had two years of that getting to the point I could get an MRI scan with I estimate 50 phone calls pushing it through the system myself as my GP had gone AWOL. When I eventually got one it was in a privately contracted scan suite in a truck parked outside the hospital. Just one consultant radiographer and one nurse and super efficient. The nurse apologised for being 15 minutes late getting me from the waiting room. I said not to worry as I had been waiting two years. The consultant radiographer literally his jaw dropped open in disbelief. Just think my experience and your experience multiplied millions of times. Think of all the man years of literally useless phone calls being passed around.

I think you're getting close to the biggest problem - attitudes. I have some experience of "change" in industry, not a happy time but I remember two lessons: throwing money at a problem is usually money wasted, and the hard bit - you have to get the workforce on-side, pulling in the right direction and focussing on the end product.
 
You have to get the workforce on-side, pulling in the right direction and focussing on the end product.
Yet that failed with British Leyland workers, and the miners. That other 'great' British institution, the BBC don't seem to understand that they are for the chopping block shortly neither.
 

nightnurse

Old-Salt
Folks, can anyone offer up real world personal examples of NHS mismanagement or waste for example?
For example; back when I was sparking, my company was working on a NHS contract at a large 'jewel in the crown' type of hospital in London.
I know that food has a lot of rules around it, and that there are stiff penalties for breaching these rules but the level of food waste that I saw, time after time, whilst I worked there made me just that little bit more outraged and sad each passing day.
Cages of sandwiches, fruit, cake type bars were chucked each day.
Why couldn't this be handed over to the homeless I though.
After all, genuinely hungry people wouldn't care if a sandwich was a day out of date.
Fish type sarnies excluded obviously!
where shall I start?
I work in veterinary medicine but briefly toyed with the idea of training in human medicine so for a while had a foot in each camp.The animal charity I worked for at the time benefitted from several horseboxes full of stuff ex NHS. Box upon box of drapes for surgery - the reason being the wrong ones had been ordered and the ortho surgeon didn't like them as they were too 'stiff' (kept us in drapes fro a couple of years - and these things aren't cheap), Water seal chest drains - brand new unopened , assigned to a patient in a ward where patient had either dropped off the perch or got better so no longer needed - too much paperwork involved in getting them back into stores so pushed to one side for disposal. Neonatal incubator, clip broken on one of the access points so up for disposal - I spent I think about 12 quid on a new clip and got a freebie incubator which would have cost a few thousand, same with an ecg, syringe driver, infusion pump - all being chucked out for extremely minor reasons all back in use within a short time of me getting my hands on them. Bandages where the outer wrap (inner wrap intact) - same with ET tubes, anaesthetic circuits - in fact I was getting so much stuff I had to become very choosy in the finish.
The NHS from my experience is also overstaffed (ok I know I wont be popular for that one) but there are far too many people working for the NHS who spend their working lives trying not to work , - as an example during an extended work experience in one department during a patient transfer some blood and nastiness was left on a wall.(non infectious just the sort of stuff that tends to leak out from a car v motorcycle impact) I did what I would do in the vet world and attempted to clean it up - got shouted at and told to leave it alone it was for the cleaners to do. When I left that dept 8 weeks later although some of it had been cleaned away there was still plenty of evidence left. It would have been so much easier and less costly to have cleaned it away properly at the time when it was fresh rather than leave it to weld itself to the wall and require the closure of a two bed area for a deep clean at a later date.
Loads more examples but mindful how long this post is already
 
Yet that failed with British Leyland workers, and the miners. That other 'great' British institution, the BBC don't seem to understand that they are for the chopping block shortly neither.

I don't think it failed with the mining industry. There was a big turn-round from the end of the 1984/5 strike to privatisation in 1994, a story that doesn't get much attention.
 
There were no ambulances at all when I had my first cardiac. 2nd time was at the GP's, hour wait, left on the corridor on the trolley for 3 hours. 3rd time, called ambulance for knowing what was happening, 2 hour wait; in the ambulance outside my house for an hour before paramedic turns up, given morphine and sat waiting whilst I'm having the heart attack, then fcek knows again on a trolley, waiting.
Gawd bless NW Ambulance Trust, eh.
Heroes every one.
Errmmm....
 
Someone made the point up thread that wages are so bad for nursing staff in the UK that it is common for NHS trained staff to go abroad where wages and conditions are meant to be better. I've heard of this long before now. Canada, Aus, and the US seem to be the destination of choice I understand.
Is the cost of their training recouped by the NHS?
Personally I'd doubt it very much, but happy to be proven wrong. Because if the NHS can't be arrsed to chase health tourism, I certainly can't imagine that they will chase training costs.
Am I talking bollocks here folks?
My own sister spent four years training as a nurse (I could be wrong about the timeline here) but she wasn't post qualified for long before she jacked nursing in and retrained as a teacher.
An ex neighbour of mine trained as a mid wife and she didn't last too long either. She got pregnant, and as far as I know never went back.
 

Yokel

LE
That and the fact that GP surgeries are nearly impossible to access so everyone is just going to A&E because they cant get treatment for things that they would have gone to the GP for. I know there are time wasters who go to A&E but most people are in pain and are ill in some form.

In my view a big reform for the NHS would be shut down all GP surgeries as they aren't really open anyway in most cases. Cancel all the GP contracts and directly employ GPs at 24 hours walk in places in towns and at an A&E triage centre at every hospital. Having a family doctor is a myth anyway. Nobody now sees the same GP twice nowadays. That way no GP waiting for an appointment, no clogging up A&E with people that don't need to be there. Also saves multiple referrals. If you saw a GP at the hospital and needed bloods or a scan get it done there and then come back and see the GP. In London a lot of people cant get on a GP list so they just always go to A&E. Its the reality anyway so lets deal with it.

Add to that a resurrected District nurse service in the community for retired nurses who have left the profession but who have skills to see chronically sick people and just keep an eye on meds, condition any arising issues. Saves a lot of GP visits too.

At my local medical practice you normally see the same GP - except in emergencies. Getting an appointment does not seem to be a major problem either. Perhaps it is easier outside of the cities?

This is 20 odd years ago, I had a casual job driving for the NHS. I was quite friendly with the pathology supplies team at one of the hospitals I covered.
Due to a mistake in ordering the orange and yellow sharps bins, instead of approximately 8inch high bins, a load of bins about 2 feet high and about 18 inches across appeared.
The paperwork to return these bins was so onerous, that I was asked to make them disappear. Now I appreciate that in the great scheme of things it isn't very significant, but the amount bureaucracy was baffling.
Some are still in use as bird food bins......

Successive Governments have tried to implement reforms that have increased the administrative burden. Using very simplistic measures as a way of gauging performance causes huge problems - such as patients waiting in ambulances which then cannot attend other emergencies.
 
Someone made the point up thread that wages are so bad for nursing staff in the UK that it is common for NHS trained staff to go abroad where wages and conditions are meant to be better....

That often comes up, without mentioning any figures. I'd suggest nurses pay is "about right", and there is the Pension.
 
The frightening thing is that your experience goes all the way through the system. I had two years of that getting to the point I could get an MRI scan with I estimate 50 phone calls pushing it through the system myself as my GP had gone AWOL. When I eventually got one it was in a privately contracted scan suite in a truck parked outside the hospital. Just one consultant radiographer and one nurse and super efficient. The nurse apologised for being 15 minutes late getting me from the waiting room. I said not to worry as I had been waiting two years. The consultant radiographer literally his jaw dropped open in disbelief. Just think my experience and your experience multiplied millions of times. Think of all the man years of literally useless phone calls being passed around.
Here in Oz, the medical imaging business is mostly in the private sector. GP wants an MRI / CT / X-ray, you get a prescription and book in to the imaging businesses of your choice. The wait is rarely more than a day.

An x-ray or CT scan is free, covered by Medicare. An MRI is about $500, but would be covered by insurance if you have it. If you’re an in-patient in a public hospital, it’s free.

GPs here are genuinely private businesses. You pay for their service (an appointment is about $70 ~ £35) but you claim most of it back from Medicare so the end result is about $20. I can often get a same day appointment, other practices can be harder.

The combination of Medicare levy and private insurance works out at about 5% of our income. My OH has just had a knee replacement; a 4 month wait and a co-payment of $600.

My observation from Australia, private sector involvement in primary care delivers a far better service than the NHS. And a combination of public and private insurance delivers better secondary care.

My starter for improving the NHS; make private health insurance salary sacrificeable.
 
By far the biggest waste of NHS resources that I have ever seen was as a prison officer.
You knew full well that 99% of cons were faking it, but they still had to go to hospital in an ambulance, accompanied by two staff members.
NHS prison staff never sermed to work at the weekend!

Last time I was in A&E (nothing major, clots in both lungs), there were about a dozen bored-looking police hanging around, 2 per "patient". I suspected from behaviour, etc that alcohol lay behind the patient's problems. I don't know why the local nick didn't just open a substation there with its own custody sergeant and cells.

And that took me back to the time I was waiting in A&E to get my daughter's broken hand seen to, but she kept getting "triaged" down the queue by lager-induced head injury victims (usually victimized by failure to main straight & level on a pavement, or failure to duck in time during brawl). I know only too well the problems head injuries can cause, but their avoidability and impact on others is the thing that annoyed me.
 
Here in Oz, the medical imaging business is mostly in the private sector. GP wants an MRI / CT / X-ray, you get a prescription and book in to the imaging businesses of your choice. The wait is rarely more than a day.

An x-ray or CT scan is free, covered by Medicare. An MRI is about $500, but would be covered by insurance if you have it. If you’re an in-patient in a public hospital, it’s free.

GPs here are genuinely private businesses. You pay for their service (an appointment is about $70 ~ £35) but you claim most of it back from Medicare so the end result is about $20. I can often get a same day appointment, other practices can be harder.

The combination of Medicare levy and private insurance works out at about 5% of our income. My OH has just had a knee replacement; a 4 month wait and a co-payment of $600.

My observation from Australia, private sector involvement in primary care delivers a far better service than the NHS. And a combination of public and private insurance delivers better secondary care.

My starter for improving the NHS; make private health insurance salary sacrificeable.

That's still a fair old whack for many people. I prefer the zero cost at point of use model.

As for private insurance, some of us have medical histories that put our premiums in the same kind of category as "17-yr old chav from sink estate with points on his licence wants to insure a brand new Ferrari SF90".
 
That's still a fair old whack for many people. I prefer the zero cost at point of use model.

As for private insurance, some of us have medical histories that put our premiums in the same kind of category as "17-yr old chav from sink estate with points on his licence wants to insure a brand new Ferrari SF90".
Not when compared with a total Class A NI rate (both employer and employee) of 25%.
 
Not when compared with a total Class A NI rate (both employer and employee) of 25%.

Well, it's always more complicated than that. Many people don't have employers, and that's not just layabouts, it includes children, OAPs and those living in areas of low employment opportunities. I probably fall more into the non-socialist side of politics (Genghis was a commie), but I don't mind paying extra to give everyone access to medical treatment without having to worry about the cost. I keep in mind that wedges have thin ends and slopes can be slippery.

Even my employers' health plans weren't worth much to me because the things I knew I'd need treatment for were excluded because I'd already had them. (I started early in the injury and disease collection business and have a diverse portfolio)
 
But it's free, innit?

At point of delivery, yes. To everyone.

The NHS is not funded solely through NI, most of is done through general taxation (~80 %). NI is mainly for state benefits (including pensions).

 
At point of delivery, yes. To everyone.

The NHS is not funded solely through NI, most of is done through general taxation (~80 %). NI is mainly for state benefits (including pensions).


Fair enough, but 25% NI aggregated across employer and employees' contribution is verging on the ridiculous, on top of income tax/corporation tax and then a VAT rate of 20% on most of what's spent from the remainder on goods and services.
 
Folks, can anyone offer up real world personal examples of NHS mismanagement or waste for example?
For example; back when I was sparking, my company was working on a NHS contract at a large 'jewel in the crown' type of hospital in London.
I know that food has a lot of rules around it, and that there are stiff penalties for breaching these rules but the level of food waste that I saw, time after time, whilst I worked there made me just that little bit more outraged and sad each passing day.
Cages of sandwiches, fruit, cake type bars were chucked each day.
Why couldn't this be handed over to the homeless I though.
After all, genuinely hungry people wouldn't care if a sandwich was a day out of date.
Fish type sarnies excluded obviously!
It might be different now, but 18 years ago I needed a crutch to assist getting about for a fortnight after getting run over. I spent almost two days on the phone trying to hand them back (you got prescribed a pair regardless), only to find there was no returns system for them, or any mobility assistance device.
 
where shall I start?
I work in veterinary medicine but briefly toyed with the idea of training in human medicine so for a while had a foot in each camp.The animal charity I worked for at the time benefitted from several horseboxes full of stuff ex NHS. Box upon box of drapes for surgery - the reason being the wrong ones had been ordered and the ortho surgeon didn't like them as they were too 'stiff' (kept us in drapes fro a couple of years - and these things aren't cheap), Water seal chest drains - brand new unopened , assigned to a patient in a ward where patient had either dropped off the perch or got better so no longer needed - too much paperwork involved in getting them back into stores so pushed to one side for disposal. Neonatal incubator, clip broken on one of the access points so up for disposal - I spent I think about 12 quid on a new clip and got a freebie incubator which would have cost a few thousand, same with an ecg, syringe driver, infusion pump - all being chucked out for extremely minor reasons all back in use within a short time of me getting my hands on them. Bandages where the outer wrap (inner wrap intact) - same with ET tubes, anaesthetic circuits - in fact I was getting so much stuff I had to become very choosy in the finish.
The NHS from my experience is also overstaffed (ok I know I wont be popular for that one) but there are far too many people working for the NHS who spend their working lives trying not to work , - as an example during an extended work experience in one department during a patient transfer some blood and nastiness was left on a wall.(non infectious just the sort of stuff that tends to leak out from a car v motorcycle impact) I did what I would do in the vet world and attempted to clean it up - got shouted at and told to leave it alone it was for the cleaners to do. When I left that dept 8 weeks later although some of it had been cleaned away there was still plenty of evidence left. It would have been so much easier and less costly to have cleaned it away properly at the time when it was fresh rather than leave it to weld itself to the wall and require the closure of a two bed area for a deep clean at a later date.
Loads more examples but mindful how long this post is already
As far as I can see, every Nationalised industry in the history of nationalised industries ends up the same way ...... burdened with a mighty bureaucracy determined to consume as much money as it takes to serve it's own interests and the NHS is no exception.
We have Nurses, we have Doctors, we have all the staff needed to support the work carried out by those people and then we have "healthcare professionals" whatever they may be.
 
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