NHS

You may recall
There were a series of junior doctors strikes last year

Which were effectively ended by government and media manipulation and pressure

They were silenced

The doctors had good public support engaged with people and presented their arguments

The government just denied them and forced through what they wanted
We have a health secretary with no medical training
Laughable
And who is happy to lie on a daily basis
Doctors can be struck off for this sort of conduct
But different rules apply for politicians

We run an NHS that we can afford

Or rather we run an NHS on the money provided by the government as opposed to the one people want or desire

This has always been the case

And it results in increasing rationing

The only realistic options are to start charging patients
This is the only way things work these days
Everything has a value and worth and cost

Or (preferably and) remove the NHS from out of the hands of the government

At the moment patients are unable to see the NHS as anything other than something serving their own individual needs and nothing is really practically done about this

Hence people think it's okay to attend A&E with a sore throat for less than a day
Because they are only doing it once

Along with hundreds of others all having the same idea and thought process

I don't think you actually realise most staff have given up
The system is in free fall and is a free for all
Most people are taking from it what they want

The government choose to ignore or deflect and deny

Whilst patients don't take notice of warnings and continue to flock to seek healthcare

I am sorry to say but your post shows a level of naivety and ignorance

Constant pleas and headlines fall on deaf governmental ears

We live in a country which went to war with Iraq despite best public opinion to the contrary
One million marched

And this has been clearly admitted as a gross error of misjudgment and misinformation

People don't care about strikes and protests

Just because we are allowed to express things doesn't mean anyone gives a sh*t about what we are saying

Government can change the goalposts and boundaries as and when they want and lie at whim
Without any real accountability

I think what you don't realise is that the current coverage of the NHS is a commentary on its last days in its current state

And most of the staff have given up trying or expecting change or improvement because they haven't the energy

I think you should watch Hospital
And see the look on the face of the patient and team when planned major surgery involving 10 or more consultants is cancelled due to lack of ITU beds
Surgery which has been planned months in advance
And for which patients have been cancelled and moved from clinics to allow the team to all be available for this major undertaking
And where this will occur all over again for the rescheduled operation once it goes ahead

You watch that and tell me that is acceptable for a modern developed country

By far the most frequent sorts of things I see in A&E are chronic problems which have been to their GP but they are waiting in pain for physio (up to 6 weeks) or for a scan (up to 3 months) or outpatient appointment (up to 6 months) or surgery (up to 18 months)
Sometimes the patients are shopping around often their condition has flared and they need advice or reassurance
What am I supposed to say to these patients?
I am sorry that's the system you have to wait, miss work and live in pain

But There is no point having arguments and debates when no one plans to take any action

The chasm between the government and NHS workers is so large nothing can be done

Most of my colleagues have stopped debating and accepted things as they come

The public are happy to watch a drama from a safe viewing distance
Try and educate and you get abuse or a complaint
"I didn't get what I wanted so I feel upset and distressed" But ask them to take action
Live healthily
Lose weight
Stop smoking
Stop to consider the wider effects of procreation

And you get screamed at for infringing human rights
Censored and told
"I pay my taxes now sort out my problem"

Patients are actively encouraged to fill forms with feedback like they have just been to Waitrose and are rating their shop
Complaints are encouraged but really no one takes them seriously because we can blame the system and increased demand


How can you succeed in this sort of climate?

This doesn't make it any easier on a daily basis when patients are left waiting for clinic appointments in pain or another community service has been taken away

We just apologise offer a sympathetic smile and refer to cuts and rationing

Secretly we are all hoping we don't fall ill anytime soon and pretend that we are immune to having to use these services

Once in a while a colleague will fall ill

And it might be their turn to face the system

Or they might have taken out health cover (most colleagues I know have private cover and this should be a telling sign) and can breathe a sigh of relief as they can have their treatment at their convenience


Most recently a good colleague in her 30s has gone through breast cancer treatment

She knows the limitations of the NHS as she works in it
There would have been a delay in her diagnosis in her first outpatient appointment and subsequent operation and chemotherapy

Privately she had an outpatient review and surgery within 5 days from referral via her GP

This is what the NHS tries to pretend to be able to do but simply cannot cope with demand

Many hospitals are so overwhelmed with 2 week cancer referrals (these are supposed to be seen within 2 weeks from referral to exclude a possible serious diagnosis) that they can just temporarily stop accepting referrals in extreme pressure

What's the point of having targets and aims if they are just rendered meaningless and are regularly breeched and exceeded


So what is my conclusion?

We already have the poorest cancer survival rates of almost any modern western country

Perhaps we accept that the level of healthcare will just decline and tolerate it

This will have to be balanced off against constant headlines that someone slept on a chair or floor waiting for
treatment
But if that becomes the norm and they have no other choice then people will have to just get used to it

The government don't even think there is a problem
Most people have no or little respect for politicians
I wouldn't take advice on what to wear to bed from them let alone how to run a healthcare system and I don't know why people tolerate it
In many ways we are such a meek and subservient nation
The current excuse for a PM
Actually engaged in a dialogue comparing and defending the NHS against human disasters
Does she have a brain or any shame?


Perhaps we will all come round to the same conclusion if they ignore it for long enough

There was an interesting article recently which commented that humanitarian response teams are run with the sort of effort efficiency and organisation which the NHS can only dream about

I have increasingly contemplated leaving my work over the last 2 years because I am working in a system I don't trust anymore

Are you being sarcastic?

It feels like watching a relative slowly suffocating to death

In a glass box

Whilst being forced to watch tied to a chair

My previous post

Comparing the price of Hamilton tickets

To healthcare

Might have seemed stupid and obtuse

I think what people didn't realise is

That I actively save for ill health

If someone on the board had a stroke
And couldn't walk or look after themselves

What provision do they have other than banking on the NHS?

Just as you would not be able to live only off a state pension

I don't think people can assume the NHS can reliably look
after the range of health needs they might think it can for very much longer

And people might need to readjust their expectations

Or stump up some cash

Which might be savings or money they use for enjoying themselves going on holiday or to the theatre

This would show how much they really value health


I think people will have to start making financial sacrifices

In 10 years time
We might be posting

Should I see the new show for £500

Or shall I pay for my blood pressure medications for 2 years instead

Often they complain

And each and every complaint has to be addressed and answered

If the patient is not happy with the response

They can escalate to the ombudsman

Which is run by the government

And has the final say

You can't argue against them

Most of the time they favour patient choice and views

This leaves front line clinical staff in a precarious position and individuals are understandably not wanting to take the risk

E.g. A patient may ask for paracetamol to be prescribed

If a doctor refuses and the patient escalates this

Invariably the doctor will be found at fault and advised they should have prescribed it if it was indicated and the patient refused to buy it

The system does not support change

Although it's not nice to say it

The system is on the side of the patients

Which makes refusing anything on a case by case and face to face basis difficult

Although ironically overall services and treatments are being withdrawn and scaled down all the time

Please

I am not relying on the NHS pension

It is this sort of narrow minded Daily Mail comment which I find stunting

I don't even pay into an NHS pension

All the savvy people are buying up property in London

It offers a much better return

And pensions have nothing to do with poor patient care

It's a totally bizarre sour grapes comment

So doctors are supposed to offer patients rubbish care and do a bad job

And keep their mouths shut

Because they are going to get a pension at the end of it?

Many of my friends have left NHS work before the age of 35

Thereby forfeiting the NHS pension anyway

In order to have a better working environment and less stress
They don't want 45 years of misery for a pension
They aren't greedy and have more sense and resources


We aren't all sitting with our mouths open waiting for the government

Others have chosen to opt out of the pension contributions (as high as 14.5% anyway) and to invest this money in other assests

You need to get a financial advisor ASAP [br)

If you are so badly off ask yourself why and consider moving to a country with cheaper living costs and where the government don't treat grass roots workers like sh*t

But your own personal poor financial foreplanning has nothing to do with poor NHS funding

Theatremonkey, you're a doctor. 

Taxiiiiiiii!

Parsley on the one hand I can see that you really care, that you remember far longer the one patient you couldn’t help because of NHS limitations, than the 20-29 you send home happier each day. If you could turn that passion into positivity you might achieve something. Instead you radiate negativity (I bet you patents pick this up) and you spend your time with others who like you have given up and find it hopeless. I met people with your views in the NHS and Teaching 30 years ago and yet here we are. People are living longer and more people receive treatment than ever – SUCCESS. But we never did provide total healthcare to everyone and its more contentious when we fail.

Just reading this thread will remind you there are millions of people successfully being treated each and every day in the NHS. Don’t underestimate the great work you and your team do. Yes the no of limitations on you are growing and you find it intolerable, but saying its insolvable is no answer. Its nihilism. And get used to it, life is cruel, good people die and you just don’t like having to live within societies means.

And I do have a lifeteimes experience of living and socialising with employees of the NHS and its not my experience at all that “most staff have given up”. Just walking though a hospital the workers attitudes are really not that dissimilar to any large organisation. Perhaps you need to get out more.

The one thing we agree on is that it is a political football. There is no secret Tory plan to break up the NHS (come on Julian Assange show me that one!), they are s+++ scared of it and that prevents them taking big decisions like closing hospitals that don’t provide effective and efficient cover. They are just trying to keep the budgetary increases (and the facts show there are real increases every year) manageable. Just like Tony and Gordon did when it was their turn. Labour don’t want it to become apolitical because a Tory F up is the only thing they will have going for them at the next election. So they invent straw man arguments about what the Tories are going to do to the NHS. Well the Tories have had power for 28 of the last 40 years and the NHS is still here.

The same is true for lots of government expenditure, costs are rising and the tax take isn’t.

Somehow we need to get people to go back to read Beverage the ''architect of the welfare state”. He wanted the government to find ways of fighting the five 'Giant Evils' of 'Want, Disease, Ignorance, Squalor and Idleness. His report published in 1942 foresaw the dangers of a growth of dependency on a benefit culture and the waste that could come, but he though it worth the price to get the country back together after the war. These were problems that could be tackled later. He was against much that bedevils a free at he point of service provision. But to many people I am demonisng the 'working class', just by pointing this out.

But the budget remains key – there isn’t' enough money in the world to give everyone optimum treatment. Once that is set then hard choices can be made. The NHS cannot continue expanding its range of services to an ever ageing population unless robotiseation produces some huge economic boom. I'm not holding my breath and we are still borrowing money just to keep today’s government expenditure intact – a day of reckoning is due. So with Brexit to distract us all, how we get to an apolitical NHS is the real difficulty...but like a lot of political nettles it can be dealt with ...


PS Parsley please don’t call me ignorant of the situation when you know nothing about me. Also I'd like to point out that any target in an organisation like the NHS that isn't regularly breached is just not worth having. It sets no challenge. Targets have radically imporved waiting times. I bet you were against their introduction and now you use them as more evidence to support your viewpoint. . The breaches point us to the problems. This is basic management and I somehow get the feeling you just aren’t interested in that. You rather just moan about how hopeless it is.

I have said my piece. Thank you.

www.google.co.uk/amp/www.telegraph.co.uk/news/2017/01/19/sandwiches-salads-menu-nhs-battles-cash-crisis.

I'm not a doctor and am in a fairly low paid job. But I find this comment to be blind to reality and agree with Parsley's response to it.

How is it blind to reality, synchrony? Are you saying the pension isn't generous? Do you know what doctors get?

"I think it's really not that much. Certainly as a junior."

I'm not talking about their salary, as I think was clear.

"None of the NHS workers I know went in to it for the money"

Another straw man.

Lovely post

What is your role?

If you are happy to say?