Praise for the NHS

2 weeks ago, in Gloucester hospital, gowned up and ready for an operation on my right hand for

Dupuytren's Contracture (you can google that).

With my gown pulled down and cannulas inserted the pretty Anaethatist leaned over me and said

"You have lovely skin", then switched my lights out.

First-class service, no pain and four digestives plus buttered toast and a hot mug of tea afterwards.
 
You are beginning to appear to lack comprehension. I made my position regarding colour quite clear - i have no problem with it. My issues are about competence. FYI I spent over 10 years working in an environment where my 'white' skin was part of a tiny minority. I was treated extremely well and responded in kind and were I younger I would return tomorrow. Construct a valid argument and you have my attention. Persist with nonsense assumptions and you can take yourself off.
That's not how your post comes across.
 
2 weeks ago, in Gloucester hospital, gowned up and ready for an operation on my right hand for

Dupuytren's Contracture (you can google that).

With my gown pulled down and cannulas inserted the pretty Anaethatist leaned over me and said

"You have lovely skin", then switched my lights out.

First-class service, no pain and four digestives plus buttered toast and a hot mug of tea afterwards.
Did you get his number?
 
That's not how your post comes across.
There is a common, all too common trend, for any criticism involving race, ethnicity sexual orientation to result in counter-criticism of the critic rather than the argument thus presented. I do not feel any compulsion to cloak my concerns with any guise of PC. Nor do I feel it necessary to qualify my arguments with reference to all the excellent, competent people in the NHS who do wonderful work. But I can assure you, we are becoming, and have already in some locations predominantly in the South East, become a third world health service in a supposedly first world country.

Now this may be inevitable based on demographic and economic forces and whiile race and colour are not underlying causal phenomena, they are visible indicators of source locations where educational, technical, organizational and societal standards can be well below the statutory requirements that we have come to expect in the UK (I use the term 'statutory' loosely to mean both legal and societal norms). As these standards are eroded by the aforementioned socio-economic forces, and because 'joe public' generally have no insights into the educational, technical and organizational processes and procedures, it means that perception and interpretation take a higher order than might otherwise be the case.

My observations related to a migrant registrar Ottorhinolaryngologist who suggested a chochlear implant surgical solution to a profoundly deaf patient suffering from type II Osteogenesis Imperfecta Tarda - a procedure which, according to academic papers on the subject, has only been attempted on a handful (or less) of similar cases with very limited results. So much so that the literature, based on MRI investigations states that Osteogenesis Imperfecta is a contraindication for the suggested procedure. I have other experiences that are relevant, but too many to adequately address here and so, for now, I shall rest my case.
 
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Mr Tweedy

Old-Salt
My observations related to a migrant registrar Ottorhinolaryngologist who suggested a chochlear implant surgical solution to a profoundly deaf patient suffering from type II Osteogenesis Imperfecta Tarda - a procedure which, according to academic papers on the subject, has only been attempted on a handful (or less) of similar cases with very limited results. So much so that the literature, based on MRI investigations states that Osteogenesis Imperfecta is a contraindication for the suggested procedure. I have other experiences that are relevant, but too many to adequately address here and so, for now, I shall rest my case.


What the Holy F**ck has his suggestion got to do with his immigration status, or otherwise?

Clearly you are more of an expert on this procedure than the registrar in question, so why didn't you carry out the "correct" procedure yourself?

On the basis of one anecdote that you are prepared to mention, you "Rest your Case"? You have no case.

Some of the world's greatest doctors, working out of British hospitals have been immigrants or descended from immigrants. Off the top of my head, some current examples include;

Professor Ajith Kumar Siriwardena - born to First generation Sri Lankan Parents - professor of hepato-pancreatico-biliary surgery at the University of Manchester
Professor Sir Magdi Jacoub - world leading pioneer of aortic Valve surgery - Born and educated in Egypt
Professor Shoumo Bhattacharya - Professor of Cardiac medicine at oxford University - Indian
Ajay Kumar Kakkar - born in Britain to first generation immigrants (his father, also a doctor, developed the use of low molecular weight heparin) - Professor of Surgery at University College London.
Professor Mathias Gautel - German born and educated - Head of Medical Bio-sciences and research at King's College London

Some surgeons I have worked with, all of whom are leading experts in their field:

Shahzad Raja - leading Cardio-thoracic surgeon, specialising in TAVI procedures - Born and educated in Pakistan
Toufan Bahrami - Leading minimally invasive Cardiac surgeon - North African French, educated in Paris
Professor Aung Ye Oo - world leading Aortic surgeon, Born and educated in Myanmar
Maninder Kalkat - Born and Trained in India
Professor Domenico Pagano - Italian, Trained in Naples
Ahmed Ashoub - Born and trained in Pakistan

I could go on, with a very long list. Which of these gentlemen, experts in their field, could you suggest, are making the NHS into a "third world service"?

You are, I can suggest with some confidence, an ignorant racist, dressing up your prejudice with fancy language.
 
What the Holy F**ck has his suggestion got to do with his immigration status, or otherwise?

Clearly you are more of an expert on this procedure than the registrar in question, so why didn't you carry out the "correct" procedure yourself?

On the basis of one anecdote that you are prepared to mention, you "Rest your Case"? You have no case.

Some of the world's greatest doctors, working out of British hospitals have been immigrants or descended from immigrants. Off the top of my head, some current examples include;

Professor Ajith Kumar Siriwardena - born to First generation Sri Lankan Parents - professor of hepato-pancreatico-biliary surgery at the University of Manchester
Professor Sir Magdi Jacoub - world leading pioneer of aortic Valve surgery - Born and educated in Egypt
Professor Shoumo Bhattacharya - Professor of Cardiac medicine at oxford University - Indian
Ajay Kumar Kakkar - born in Britain to first generation immigrants (his father, also a doctor, developed the use of low molecular weight heparin) - Professor of Surgery at University College London.
Professor Mathias Gautel - German born and educated - Head of Medical Bio-sciences and research at King's College London

Some surgeons I have worked with, all of whom are leading experts in their field:

Shahzad Raja - leading Cardio-thoracic surgeon, specialising in TAVI procedures - Born and educated in Pakistan
Toufan Bahrami - Leading minimally invasive Cardiac surgeon - North African French, educated in Paris
Professor Aung Ye Oo - world leading Aortic surgeon, Born and educated in Myanmar
Maninder Kalkat - Born and Trained in India
Professor Domenico Pagano - Italian, Trained in Naples
Ahmed Ashoub - Born and trained in Pakistan

I could go on, with a very long list. Which of these gentlemen, experts in their field, could you suggest, are making the NHS into a "third world service"?

You are, I can suggest with some confidence, an ignorant racist, dressing up your prejudice with fancy language.
Complete rubbish. My argument is that some of those working in the NHS do not have the competence I would expect precisely because of the limitations of the education and training available in their home country. Why do you think many of these people come here? They come to learn (ETA as did most of those you cite who did so at a different point in time). Unfortunately the staffing pressures that the NHS is currently under means that they some junior medical staff and Registrars are elevated beyond their capabilities. Most doctors want to develop their skills and that is fine with me if it is safe. This guy was not safe because he was suggesting a procedure of which he was not fully informed. I am not going to waste my time rebutting the rubbish you have written about me. As for the examples you cite, great, I could add a few myself, but that was neither the point nor the issue under discussion. You are conflating things that have no correlation.

ETA In a Report by the General Medical Council regarding complaints against doctors, had the following to say:

"Those who graduated outside the UK tend to receive proportionately more sanctions or warnings than UK graduates. Among UK graduates non-specialist doctors identifying as black and minority ethnic (BME) tend to receive proportionately more sanctions or warnings than those identifying as white, whereas for specialists the rate is similar."

I shouldn't think that the GMC is institutionally racist, but merely reflecting the reality. But of course, rather than critique the argument and the evidence, you focus on the critic.
 
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Complete rubbish. My argument is that some of those working in the NHS do not have the competence I would expect precisely because of the limitations of the education and training available in their home country. Why do you think many of these people come here? They come to learn (ETA as did most of those you cite who did so at a different point in time). Unfortunately the staffing pressures that the NHS is currently under means that they some junior medical staff and Registrars are elevated beyond their capabilities. Most doctors want to develop their skills and that is fine with me if it is safe. This guy was not safe because he was suggesting a procedure of which he was not fully informed. I am not going to waste my time rebutting the rubbish you have written about me. As for the examples you cite, great, I could add a few myself, but that was neither the point nor the issue under discussion. You are conflating things that have no correlation.

ETA In a Report by the General Medical Council regarding complaints against doctors, had the following to say:

"Those who graduated outside the UK tend to receive proportionately more sanctions or warnings than UK graduates. Among UK graduates non-specialist doctors identifying as black and minority ethnic (BME) tend to receive proportionately more sanctions or warnings than those identifying as white, whereas for specialists the rate is similar."

I shouldn't think that the GMC is institutionally racist, but merely reflecting the reality. But of course, rather than critique the argument and the evidence, you focus on the critic.
I reiterate my earlier point - did you bother to report your concerns?
 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
Complete rubbish. My argument is that some of those working in the NHS do not have the competence I would expect precisely because of the limitations of the education and training available in their home country. Why do you think many of these people come here? They come to learn (ETA as did most of those you cite who did so at a different point in time). Unfortunately the staffing pressures that the NHS is currently under means that they some junior medical staff and Registrars are elevated beyond their capabilities. Most doctors want to develop their skills and that is fine with me if it is safe. This guy was not safe because he was suggesting a procedure of which he was not fully informed. I am not going to waste my time rebutting the rubbish you have written about me. As for the examples you cite, great, I could add a few myself, but that was neither the point nor the issue under discussion. You are conflating things that have no correlation.

ETA In a Report by the General Medical Council regarding complaints against doctors, had the following to say:

"Those who graduated outside the UK tend to receive proportionately more sanctions or warnings than UK graduates. Among UK graduates non-specialist doctors identifying as black and minority ethnic (BME) tend to receive proportionately more sanctions or warnings than those identifying as white, whereas for specialists the rate is similar."

I shouldn't think that the GMC is institutionally racist, but merely reflecting the reality. But of course, rather than critique the argument and the evidence, you focus on the critic.

The decision as to whether several of the regulators are indeed institutionally rascist and/or sexist is still pending.


Their boards and upper echelons are still white male heavy.
 
I reiterate my earlier point - did you bother to report your concerns?
I shall be asking focused questions when we meet the consultant. For the avoidance of doubt, given that the procedure is rare, have they done it before, what was the outcome, did they write a paper. Frankly, I doubt it will be worth conducting the preliminary investigations, but we shall see.
 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
for those worried about foreign imports, it's just a case of choosing the right hospital.

Was in theatre today in far North of Scotland. Closest we had to an overseas professional was a nurse from N Ireland!
 
for those worried about foreign imports, it's just a case of choosing the right hospital.

Was in theatre today in far North of Scotland. Closest we had to an overseas professional was a nurse from N Ireland!
In my most recent interaction in hospital I had a young house officer (or whatever they are called today) come in for an emergency call at around 2am when I was in a bit of trouble. after she had succeeded in stabilizing me we had a chat. She was Irish, from the North, but almost on the border and very nationalist in outlook. I told her I had been a soldier during the troubles - she was utterly brilliant and kept an eye on me from time to time until I was discharged..

Now how I came to be in that situation is another story, but it will suffice to say that I went into hospital for a day-case, expecting to be home later on that day - December 22 2018. I was discharged.....to another hospital on 25 February 2019 and finally discharged after three additional procedures on 29 April. Did I complain? Absolutely not, I was most thankful to get home. I read the notes, couldn't see any issues - but on the initial assessment three months prior to admission - a different story and indeed a different hospital.
 
I was aboslutely not trying to take away anything from your experience, and the excellent care you obviously received, I was questioning your assertion that " In any other country I'd probably have died."

It is, unfortunately a blind faith that the NHS is the best there is , and therefore somehow untouchable that is one of the biggest blockers to the large scale radical reform that the NHS needs to truly be the best in the world.

Fair enough, I hear you and respect your opinion. All I can say is that I was at Death's Door, and no resource was spared to save me. I was, quite literally, almost dead. The Police and the NHS saved me, and I'll be forever grateful.
 
Fair enough, I hear you and respect your opinion. All I can say is that I was at Death's Door, and no resource was spared to save me. I was, quite literally, almost dead. The Police and the NHS saved me, and I'll be forever grateful.
I share your empathy with the NHS - no question. But it is in trouble from multi-dimensional causes. Frankly although I genuinely believe there are competence problems, they are not the root causes. Poor physical plant, inadequate estate, obsolete equipment, a dearth of information systems and, equally frankly, a management cadre that is terrified of change.
It needs rebuilding with the same effort and enthusiasm that created it.
 

quilter

War Hero
Last September a team of 'united nations' performed and took care of me for my hip replacement at Epsom hospital. Tomorrow a similar team no doubt is taking care of my hernia op (midday tomorrow) I have never cared from where the staff come from, they do their job and for that I am most grateful/appreciative., having had several major surgeries over time including several BMH stays overseas, all have been with multinationals and thanks to them I am here to tell the tale., my life has been saved several times. what I would point out though, sadly., hospital administration has rarely been as efficient as the medical/clinical care. Wish me a speedy recovery after my day surgery.
I thank my lucky stars I am an NHS patient. :cool:
 
According to this research recently published by London University, the UK resides 25th, 26th and 29th for five year survival rates of stomach, pancreatic and lung cancers. In no major cancer group does it sit in the top ten performers

Overall five year survival rates for all cancer diagnosed between 2010 and 2014 was half that of South Korea at 16%. Put that into perspective; of those diagnosed by the NHS with a cancer between 2010 and 2014, 84% are now dead.

One year survival rates are poor, which implies it’s taking too long for diagnosis and treatment. The target is I believe 62 days from diagnosis to treatment. But if it takes five weeks to see a GP and several more to get scans and see a specialist before diagnosis, then that 62 day target is meaningless.

I don’t want to bang on about Aus, but here you can usually get a same day GP appointment, be scanned the next day and into a specialist within a couple of weeks.

 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
A fin
According to this research recently published by London University, the UK resides 25th, 26th and 29th for five year survival rates of stomach, pancreatic and lung cancers. In no major cancer group does it sit in the top ten performers

Overall five year survival rates for all cancer diagnosed between 2010 and 2014 was half that of South Korea at 16%. Put that into perspective; of those diagnosed by the NHS with a cancer between 2010 and 2014, 84% are now dead.

One year survival rates are poor, which implies it’s taking too long for diagnosis and treatment. The target is I believe 62 days from diagnosis to treatment. But if it takes five weeks to see a GP and several more to get scans and see a specialist before diagnosis, then that 62 day target is meaningless.

I don’t want to bang on about Aus, but here you can usually get a same day GP appointment, be scanned the next day and into a specialist within a couple of weeks.


In my experience working in Health Centres and receiving referrals with GPs, there can be various appointment systems in place.
Most common are a mixture, there will be time set aside for telephone consultations, actually a faster way of dealing with many complaints and the GP will be performing the triage.
Then then are routine appointments, pre-booked for minor ailments, reviews, and follow ups
And then there will be space in the book for those who need seen that day based on various algorithm.

For instance, Tiny Miss F has various issues which require review, we can phone and will be given an appointment at a convenient time, usually 2-4 working days away. If however we phone due to raised temperature, she will be seen within an hour, even though it is not an emergency as such.
 
According to this research recently published by London University, the UK resides 25th, 26th and 29th for five year survival rates of stomach, pancreatic and lung cancers. In no major cancer group does it sit in the top ten performers

Overall five year survival rates for all cancer diagnosed between 2010 and 2014 was half that of South Korea at 16%. Put that into perspective; of those diagnosed by the NHS with a cancer between 2010 and 2014, 84% are now dead.

One year survival rates are poor, which implies it’s taking too long for diagnosis and treatment. The target is I believe 62 days from diagnosis to treatment. But if it takes five weeks to see a GP and several more to get scans and see a specialist before diagnosis, then that 62 day target is meaningless.

I don’t want to bang on about Aus, but here you can usually get a same day GP appointment, be scanned the next day and into a specialist within a couple of weeks.

Thanks for your reply, but as I have posted before, there were no delays in the NHS response to my suspected skin cancer, sadly confirmed. But that is also down to being active in my care - speaking to the consultant's secretary, being flexible to come in at a moment's notice etc. Like so many faced with a potentially serious illness, I looked up the statistics on line and read widely; not altogether helpful as the outcome is multivariate. Most people who develop cancer to be +50 and often have multiple and dependent health issues (cardiac, obesity, T2 diabetes, etc), or respond adversely to the treatment and a consequentially slower recovery. Normal demographics also begin to play and this increases the apparent morbidity.

What was heart aching for me (I'm in my 50s) was seeing teens and young people at the cancer centre absolutely petrified with the prospect of treatment and an earlier death. But the advances in cancer care - especially in England - has had a dramatic and positive effect on morbidity in the last 10 years; Today's statistics are based on treatments of a decade ago, before immunotherapies were rolled out - often seen as the 'new penicillin'. Statistically for me, with my skin cancer, I have about a 10% chance of surviving beyond 5 years, based on the raw statistics. However, if I factor in my age, gender, lifestyle, general health, levels of activity, mental activity, active health monitoring etc...it's likely that I will have a normal life expectancy (ie about another 25 years!).

There's no reason to be complacent, however. The NHS needs constant transformation to meet the health demands of an ageing population and a recognition of the growing mental health problem; that will mean more money (and therefore fundamental questions on future funding and costs at point of delivery), and there needs to be a means by which healthy lifestyles are incentivised.

I have family in Australia (ACT and Sydney), and several suffer from a rare disease and they have fought for years to have funding for treatment that is available here. They have finally managed to get access to this treatment, but only after a high profile campaign.
 

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