NHS

[Walker570]

Today I had to attend Leicester Ruyal Infirmary for an eye examination, it had taken their 'management since early October to arrange this simple half hour visit. I attended in trepidation but found out...as I believed from the start.... the sharp end are doing their best. From the moment I walked into the door I was met by polite smiling staff only too ready to help me navigate myself through this large building. Every time I hesitated a nurse would stop and give me directions. The staff dealing with my problem also where top hole.

It confirmed my belief that the problems with the NHS stem from appauling miss managementand there is a need for a root and branch cull, replaced by those who know how to run a business.

I have yet to hear of a Nationalised Industry which is actually succesful.  Just finance will NOT olve the problem.

Unfortunately the Police Service has gone down the sam route.

[Lloyd90]

A proper business increases their profit when they increase their efficiency. 
 

They get more done, and make more money. 
 

The NHS, and any other public service as such, increases their expenditure, for the more they get done. They do more operations, it costs more. The council does more Care Act assessments, it costs more to pay for and commission the services required. 
 

Having worked in such big organisations, and seen the work of the boots on the ground workers, as well as the work of the managers… and now being a manager… there is a MASSIVE amount of work being done behind the scenes, and the view that they can simply do away with the vast majority of managers, throw a load of nurses into hospitals and units and expect everything to run as it should without anyone doing all that stuff behind the scenes is beyond massively naive. 
 

 

The idea that managers are ruining the NHS seems to just be a way to blame the NHS for the massive reduction in funding it has experienced, whilst massively increasing the workload. 
 

The whole thing needs a huge overhaul. 

[ditchman]

2 minutes ago, Lloyd90 said:

A proper business increases their profit when they increase their efficiency. 
 

They get more done, and make more money. 
 

The NHS, and any other public service as such, increases their expenditure, for the more they get done. They do more operations, it costs more. The council does more Care Act assessments, it costs more to pay for and commission the services required. 
 

Having worked in such big organisations, and seen the work of the boots on the ground workers, as well as the work of the managers… and now being a manager… there is a MASSIVE amount of work being done behind the scenes, and the view that they can simply do away with the vast majority of managers, throw a load of nurses into hospitals and units and expect everything to run as it should without anyone doing all that stuff behind the scenes is beyond massively naive. 
 

 

The idea that managers are ruining the NHS seems to just be a way to blame the NHS for the massive reduction in funding it has experienced, whilst massively increasing the workload. 
 

The whole thing needs a huge overhaul. 

and what party has the kahonies to even think about that....................

[Cosmicblue]

The huge overhaul is required but no politician will want to touch it with an eye on being re-elected - political suicide to make the tough decisions required, making it two-tier with a large private medical insurance function (as happened with the Dentists) and focussing the efforts and money on those delivering hands-on-patient care.   There is no way on this earth that an NHS Hospital Chief Exec can justify a £300K+ salary - madness.   Turkeys don't generally vote for Christmas so the problem won't fix itself.

[bruno22rf]

I have experienced nothing but brilliant service both from various Hospitals and my local Dentist over the last 3 months (diagnosed with heart problems mid October, heart surgery mid November then same day service from my NHS Dentist).

[Cosmicblue]

Me too Bruno22rf - the NHS, its amazing care delivery and its future are worth fighting for.

[Charliedog]

May be a controversial one but having recently had my Dad pass away and been through the end of life process, the option to die with dignity (voluntarily) would surely solve the NHS budget issues overnight, my belief is we are spending huge sums of money keeping people alive when it would be better all round to let them go, not wanting to cause offence or get into heated arguments as still a bit raw for me.

[39TDS]

They didn't seem to do much at all to keep Mum alive this time last year. They didn't do much full stop tbh. It left me very bitter about the NHS in general. 

12 months later and they do seem to be trying very hard to keep me alive. It has changed my opinion of them. 

Luck of the draw?

[old man]

1 hour ago, Charliedog said:

May be a controversial one but having recently had my Dad pass away and been through the end of life process, the option to die with dignity (voluntarily) would surely solve the NHS budget issues overnight, my belief is we are spending huge sums of money keeping people alive when it would be better all round to let them go, not wanting to cause offence or get into heated arguments as still a bit raw for me.

I can see your point, for that to happen here would maybe require more sense of humanity and common sense than those in charge possess? 

[oldypigeonpopper]

Hello, I must say the Churchill have been very good this last 10 years with my PC , 2 PSA tests a year from a scan and biopsy , a recent scan, and 2 more PSA tests last year, all good so far 👍

[wymberley]

7 hours ago, bruno22rf said:

I have experienced nothing but brilliant service both from various Hospitals and my local Dentist over the last 3 months (diagnosed with heart problems mid October, heart surgery mid November then same day service from my NHS Dentist).

Plus one more.

First man collected from West Cornwall, second from Plymouth and then me from East Devon and driven in ambulance car to the Wellington Hospital London on a Wednesday. All three having a aortic valve replacement on Thursday and then the journey in reverse on Friday.

An old school friend who'd paid her way after leaving school which included service in HMFs until she met, married and moved to the USA with her husband, a university professor, when his time here was up. Coming over on an extended holiday when she noticed that something may not be right. It wasn't - same problem as me. They're now stuck as she's not now allowed to fly and by sea would not be on for her husband who is a good bit older than her and in the early/mid stages of dimensia. In spite of paying into the Nat. Ins. for a fair while, no help was forthcoming (Stateside the insurance would have covered it). She had the same operation by the same surgical team  as was the gang of three which is how I know that our three day jolly cost the the NHS £50k a day - OK, we may have got something off for bulk a bulk buy.

Edited February 8, 2023 by wymberley

[Vince Green]

3 hours ago, Charliedog said:

May be a controversial one but having recently had my Dad pass away and been through the end of life process, the option to die with dignity (voluntarily) would surely solve the NHS budget issues overnight, my belief is we are spending huge sums of money keeping people alive when it would be better all round to let them go, not wanting to cause offence or get into heated arguments as still a bit raw for me

I agree with this, my mother aged 90 had two difficult and invasive operations in the last year of her life when it was obvious to everyone that she was dying.

The cost must have been huge and it may have given her a few extra months.

Not happy or pain free months though

[udderlyoffroad]

13 hours ago, Lloyd90 said:

The NHS, and any other public service as such, increases their expenditure, for the more they get done. They do more operations, it costs more. The council does more Care Act assessments, it costs more to pay for and commission the services required. 

This place would run so much better if it wasn't for all those darn patients.

 

13 hours ago, Lloyd90 said:

Having worked in such big organisations, and seen the work of the boots on the ground workers, as well as the work of the managers… and now being a manager… there is a MASSIVE amount of work being done behind the scenes, and the view that they can simply do away with the vast majority of managers, throw a load of nurses into hospitals and units and expect everything to run as it should without anyone doing all that stuff behind the scenes is beyond massively naive. 
 

 

The idea that managers are ruining the NHS seems to just be a way to blame the NHS for the massive reduction in funding it has experienced, whilst massively increasing the workload. 

The healthcare systems...of literally any other civilised European country beg to differ.

The NHS is insane in its waste and profligacy, at the expense of patient 'outcomes', also known as treating eminently survivable conditions.  If we can't blame the management, or the front line, just who carries the can?  Oh that's right, no-one.

 

12 hours ago, Cosmicblue said:

The huge overhaul is required but no politician will want to touch it with an eye on being re-elected

I am slowly, but surely, seeing signs that the traditional paradigm is shifting.  People, finally,  are waking up to the fact that this "NHS or America" straw-man argument is hore****.

Can't come soon enough.

[old man]

Off on a tangent? How is it possible or expected that the NHS makes any sort of profit?

[Lloyd90]

16 minutes ago, old man said:

Off on a tangent? How is it possible or expected that the NHS makes any sort of profit?

It can’t, the better run it is, the more medicine it has to buy and give out, the more surgeries it has to do and pay for, etc etc. 

The better it runs, the more it costs. 
 

Yet people keep saying we should get in experts from private industry to run the NHS … then those same people say it’s obscene to pay those people with the skill and ability to run organisations of similar scale and responsibility a similar amount they would earn in private industry. 
 

So all we need to do is get people with skill and ability to come and work for the NHS, for a fraction of what they would make for a similar level role in the private industry, whilst giving them a model which makes it impossible to run it like private industry runs. 

[Vince Green]

A ridiculously high part of the NHS's annual expenditure goes into paying pensions.

This is because, although they deducted pension money from the staff wages over the years they did not invest it in a pension scheme.

So now they don't have a pension pot to pay the pensions from and have to pay it instead from their annual budget.

 

[old man]

3 hours ago, Lloyd90 said:

It can’t, the better run it is, the more medicine it has to buy and give out, the more surgeries it has to do and pay for, etc etc. 

The better it runs, the more it costs. 
 

Yet people keep saying we should get in experts from private industry to run the NHS … then those same people say it’s obscene to pay those people with the skill and ability to run organisations of similar scale and responsibility a similar amount they would earn in private industry. 
 

So all we need to do is get people with skill and ability to come and work for the NHS, for a fraction of what they would make for a similar level role in the private industry, whilst giving them a model which makes it impossible to run it like private industry runs. 

Why then are large portions run by the likes of Virgin etc?

Presumably their altruistic interest is actually near zero?

[Lloyd90]

53 minutes ago, old man said:

Why then are large portions run by the likes of Virgin etc?

Presumably their altruistic interest is actually near zero?

 

Virgin for a time ran child protection services in Bath (and Virgin and many other companies have taken on similar roles in other local authorities).
 

They get given a set amount of money (less than the council was spending to run the service), and then they claim that they will provide the exact same or better service, whilst being more efficient. 
 

The theory being that they are so much more efficient, there will be loads of money left over after providing the services, so they can skim a profit off the top. 
 

They didn’t last long in Bath, and failed to make any profit because the services required were more than the funds allowed, so they pulled out. Some other company is running it now I think, but with a bigger budget. 
 

I imagine it is the same in the NHS sections they took on, the ones they could skim profits off the top, they have kept on, and the ones they saw as unviable they have packed in. 
 

There will be clinics or areas they are able to provide for less than the NHS I would imagine. 

[Vince Green]

The NHS wastes so much money on unnecessary things that they shouldn't even get involved in.

When my late mother had one of her many hospital appointments several times a car, ambulance or a taxi would turn up unannounced to take her to her appointment.

We never once requested this, a family member would always take her. Who booked these cars we have no idea.

[Bigbob]

I take my granddaughter twice a week to hospital 30 minutes away we have a local hospital but its closed to everything but minor emergency's  and the staff are great its just the parking you never get a proper spot so just dump the car anywhere and go in 

[Charliedog]

1 hour ago, Vince Green said:

A ridiculously high part of the NHS's annual expenditure goes into paying pensions.

This is because, although they deducted pension money from the staff wages over the years they did not invest it in a pension scheme.

So now they don't have a pension pot to pay the pensions from and have to pay it instead from their annual budget.

 

Is this really true, thought they would need trustees and annual statements to show how the scheme was performing, terrible if genuine

[Mungler]

When is enough money, enough money?

When can we objectively look at the NHS and properly weigh up if we’re getting any value - comparative costs of other systems in other countries, our own life expectancies and so on.

Anyone I know whose had treatment in France / Italy / Portugal under a hybrid system where the state pays the lions share and the patient makes a contribution can’t but help pass comment on how the queue was shorter, the hospital newer / cleaner and the treatment better. 

I can see us just tipping more money into the NHS leaky bucket and expecting some sort of change or better service. What did Einstein say about the definition of madness?

[Lloyd90]

2 hours ago, Charliedog said:

Is this really true, thought they would need trustees and annual statements to show how the scheme was performing, terrible if genuine

 

It's a defined benefit scheme, not a pot, therefore it doesn't matter how the scheme was performing.

It can't be a defined benefit if it doesn't pay out the defined amount. 

[Newbie to this]

8 hours ago, Lloyd90 said:

It can't be a defined benefit if it doesn't pay out the defined amount

So the Tax payer should just foot the bill 

[discobob]

14 hours ago, Mungler said:

the hospital newer / cleaner and the treatment better.

We do have new hospitals though - just they have been done under PFI and are taking a massive amount of budget to "rent" them from companies based in Guernsey