NHS - I want to love them but it is hard.

[Wuffle]

Sibling took a telephone consultation from an NHS consultant today about a scan our mom had.
Dad took her.
He's been dead 18 months.

W.

[XFool]

...?

XFool

[bungeejumper]

We hear a lot these days about how the NHS is focusing too much on the oldies, who have only short prospective life spans (and yadda yadda yadda), and how it's not leaving enough hospital resources for everybody else. Thank you for reminding us that we are all feeling the pressures from the NHS's problems at the moment.

I am a year overdue for a scheduled cancer follow-up check, which isn't a very comforting feeling. (I'm 70, BTW.) But I don't have any trouble loving the NHS, because I see every day how hard those people are working, and how few other options they have. Heroes, all of them. That won't help you in your present grief, of course, but one day I hope it'll all make sense. As somebody said, we are all in this together.

BJ

[dealtn]

We hear a lot these days about how the NHS is focusing too much on the oldies, who have only short prospective life spans (and yadda yadda yadda), and how it's not leaving enough hospital resources for everybody else. Thank you for reminding us that we are all feeling the pressures from the NHS's problems at the moment.

I am a year overdue for a scheduled cancer follow-up check, which isn't a very comforting feeling. (I'm 70, BTW.) But I don't have any trouble loving the NHS, because I see every day how hard those people are working, and how few other options they have. Heroes, all of them. That won't help you in your present grief, of course, but one day I hope it'll all make sense. As somebody said, we are all in this together.

BJ

Would your view change if the NHS adopted best working practice as evidenced elsewhere, and those hard working people could work more effectively, reducing the waiting list for cancer follow-up checks so they weren't a year overdue?

[bungeejumper]

Would your view change if the NHS adopted best working practice as evidenced elsewhere, and those hard working people could work more effectively, reducing the waiting list for cancer follow-up checks so they weren't a year overdue?

I have no idea what you mean, unless you're saying that the NHS deserves better management? That might be correct, of course, but I doubt that it would make more than a small impact on the gargantuan size of the challenge that staffs are all facing at the moment.

IIRC, your wife is in the health sector? What does she say? Is it any less enigmatic and woolly than your own post just now?

BJ

[dealtn]

Would your view change if the NHS adopted best working practice as evidenced elsewhere, and those hard working people could work more effectively, reducing the waiting list for cancer follow-up checks so they weren't a year overdue?

I have no idea what you mean, unless you're saying that the NHS deserves better management? That might be correct, of course, but I doubt that it would make more than a small impact on the gargantuan size of the challenge that staffs are all facing at the moment.

IIRC, your wife is in the health sector? What does she say? Is it any less enigmatic and woolly than your own post just now?

BJ

There is huge resistance to change in the NHS. Even where that change is to adopt practices that appear to work well in other countries.

Some of that resistance is political (We don't want to charge - it must be free - yet we charge for prescriptions, dentistry etc.)

Some is from the unions (it will lead to job losses - highly unlikely, there is huge demand and freed resource can be used easily elsewhere - what we are hearing about shortages at the moment in non-Covid care, as nurses are moved to Covid etc.)

Some is just sheer exhaustion and inertia as every time there is a reorganisation it is changed again before many of the benefits kick in.

With less resistance to change, and adoption of best practice (the profit motive that might drive this in the private sector is mainly absent despite internal market mechanisms), things might improve noticeably. For the "customers" that might mean (much) shorter waiting lists.

My wife hated a lot about the NHS, and loved other bits just as ferociously. Having moved to the (private) education sector she is amazed how "treacle-like" the NHS can be in terms of change, or even decision making, and is still amazed at some of the ludicrous stuff she hears when she meets up with her (now-ex) colleagues.

She loves the NHS, perhaps more than me, but like a wayward relative that love is mixed with a number of other emotions.

[Lootman]

Would your view change if the NHS adopted best working practice as evidenced elsewhere, and those hard working people could work more effectively, reducing the waiting list for cancer follow-up checks so they weren't a year overdue?

I have no idea what you mean, unless you're saying that the NHS deserves better management? That might be correct, of course, but I doubt that it would make more than a small impact on the gargantuan size of the challenge that staffs are all facing at the moment.

IIRC, your wife is in the health sector? What does she say? Is it any less enigmatic and woolly than your own post just now?

There is huge resistance to change in the NHS. Even where that change is to adopt practices that appear to work well in other countries.

With less resistance to change, and adoption of best practice (the profit motive that might drive this in the private sector is mainly absent despite internal market mechanisms), things might improve noticeably. For the "customers" that might mean (much) shorter waiting lists.

My wife hated a lot about the NHS, and loved other bits just as ferociously. Having moved to the (private) education sector she is amazed how "treacle-like" the NHS can be in terms of change, or even decision making, and is still amazed at some of the ludicrous stuff she hears when she meets up with her (now-ex) colleagues.

She loves the NHS, perhaps more than me, but like a wayward relative that love is mixed with a number of other emotions.

My first job after University, in 1975, was as a hospital administrator in a London University teaching hospital. Although such facilities are the very best within the NHS, and we had our own independent board of governors, the bureaucracy was still stunning. It really was run like a government department and not like a vibrant enterprise. Our House Governor was tight with then PM Jim Callaghan. We were civil servants in all but name, with dozens of memos a day from the (as was then) DHSS.

OK, this was 45 years ago, and some things might have changed (I left after one year). But I can believe from your statements that the NHS is still sclerotic, and my wife has the same view as she is on the periphery of the NHS although she is paid privately.

To my mind the real problem is that there is no competition for the NHS. Because the NHS gives its product away for free, competing with it is hard and so the UK has not developed a viable alternative to the NHS. Whereas a good few European countries utilise private providers and hospitals far more than we do, which is why the NHS is the biggest employer in Europe.

Our collective love affair with the NHS seems to revolve around the fact that it is free at the point of use. To my mind that rather misses the bigger picture.

[AleisterCrowley]

I think the NHS has become a sacred cow - politicians are scared to enact the radical changes needed because "the NHS" and "free healthcare at the point of delivery" have become interchangeable. In other words there's the assumption/ false dichotomy that ending the NHS as we know it means US-style 'pay or die' healthcare, and hence no debate about whether the NHS is the best way to deliver care.
The majority, possibly all, Western European countries provide health care to all who need it regardless of their ability to pay. The German system is a mixture of public and private insurance schemes (from memory) and it works very well.

[nimnarb]

Slightly OT but heard today from a friend who's son is an administrator and runs a large department of a well known London Hospital that it's horrific whats going on as he was late returning to his house this evening due to sorting out body bags plus the oldest at present in the ITU was 61 as the more elderly are not being given beds there and effectively not receiving treatment. She told me that a lot of stuff, the public don't get to hear or read about. He had a 35 yer old pregnant Lady in itu for 4 weeks before they could deliver the baby and then died. The baby lived. Very sad indeed. In March/April you may recall seeing the body bags lined up in New York and now the same happening in the UK. Lets hope this is short lived.

[JamesMuenchen]

I think the NHS has become a sacred cow - politicians are scared to enact the radical changes needed because "the NHS" and "free healthcare at the point of delivery" have become interchangeable. In other words there's the assumption/ false dichotomy that ending the NHS as we know it means US-style 'pay or die' healthcare, and hence no debate about whether the NHS is the best way to deliver care.
The majority, possibly all, Western European countries provide health care to all who need it regardless of their ability to pay. The German system is a mixture of public and private insurance schemes (from memory) and it works very well.

The thing is everyone in the UK seems to mix up the health insurance with the health provision.

Actually in German system the majority of people use the public insurers, not private. But the majority of health care providers are private practice, not public. Only the large teaching hospitals are state run.

So you go to a GP of your choice with, say, a dodgy knee. They tell you you need a CAT scan and give you a list of CAT scan clinics in the area, and you choose the one you want. Then you take your CAT scan back to the GP and they maybe give you a list of surgical clinics to choose.

Competition, as Lootman said.

In the German system competition exists at all levels and the patient always has a choice. Not just those who 'can afford to go private'. There's even a choice of public insurers.

Not saying that it's perfect, there's a lot wrong with the private insurance system actually. But it's way better than the Uks NI+NHS.

[AsleepInYorkshire]

Sibling took a telephone consultation from an NHS consultant today about a scan our mom had.
Dad took her.
He's been dead 18 months.

W.

Some short comments that may help?

AiY

[Mike4]

Sibling took a telephone consultation from an NHS consultant today about a scan our mom had.
Dad took her.
He's been dead 18 months.

W.

I don't understand.

Ae you saying Dad took her before he died, and it has taken 18 months for the consultant to respond?

Or are you saying the consultant mistakenly thought the person who took Her was your Dad?

Or are you complaining that the response was a telephone conversation not a face-to-face appointment to discuss the results of the scan?

Or something else?

[GrahamPlatt]

A quote from my ex, who’s in the NHS “I’m stepping over the bodies to get to meetings about paper clips”.

[Wuffle]

Too brief, fair enough.

Timescales and the irony that a lot can happen. As it did to my father who had plenty of time to go from fine to be diagnosed and pass from lung cancer.
The scan was actually in 2018, so they had 2019 (all of it) to respond to the broad question of 'you may be poorly so let's have a look and see what we can find' with respect to my mom.
And that efficiency doesn't equip them for a crisis.

R.

[JohnB]

There has long been calls to have fewer administrators in the NHS and more nurses, when what we actually need is better administration. I'm sure we all have examples of good staff using bad systems so errors that balloon into wasting far more effort overall. I don't have a problem with the medical staff at mum's GP, but I loathe the practice manager. If latter role could attract better candidates the former could get so much more done.

[AleisterCrowley]

My (limited) experience is that the frontline staff are generally dedicated and excellent, and the admin is very poor

[servodude]

My (limited) experience is that the frontline staff are generally dedicated and excellent, and the admin is very poor

I reckon you could fix it by building 3 arks (to be honest though you'd only need one )

-sd

[AleisterCrowley]

Telephone sanitisers are probably quite useful in these viral times...

[bluedonkey]

I agree with the earlier comment about conflating (i)free public medical insurance and (ii)public sector health service. It is a mistake surely to think that privatising (ii) leads to the end of (i).

[Mike4]

I agree with the earlier comment about conflating (i)free public medical insurance and (ii)public sector health service. It is a mistake surely to think that privatising (ii) leads to the end of (i).

But a very convenient mistake, deliberate even, for those with a party political axe to grind.