Nhs

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Originally Posted by Hibbyradge

I don't know if the talking down is partly deliberate, but there are countless examples of poor service.

Trying to get a GP appointment where I am is like going through hoops. Phone calls instead of F2F consultations, photographs rather than physical examination and what seems like a layered triage system before the Doctor is even consulted about your case.

I hurt my hand/wrist playing golf on 27 August (must have hit one of those notorious middle of the fairway tree roots 😁) and when it hadn't cleared up 10 days later, I called the doctor's surgery.

I didn't get past the receptionist. Go to A&E, I was told.

I knew York hospital was busy so I checked their website. It said not to go there, but to use another hospital's A&E!

I eventually went to another community hospital in Malton, 20 miles away, and was seen within 40 minutes. There was nothing they could do so I was advised to go back to my GP who might refer me for a scan.

I spoke to the receptionist who said she'd pass my case to the doctor and I'd hear back soon. I got a text the next morning giving me an appointment in 7 weeks, with a "Ist contact physio".

It's sub standard.

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We get free private healthcare through a family members employer. I don’t feel comfortable using it because I don’t believe in privilege, but I have gone private for an op before, because I knew I wouldn’t get on the NHS. It was at a soulless hospital where a coal mine and thriving community used to be when I was growing up. Almost too perfect a metaphor. I don’t know if not using that provision would have been a pointless act, and using NHS services is actually using their precious resources?

Maybe we’re at the point when these kind of consumer choices are irrelevant. I’ll just continue to vote for parties that are committed to keeping it free at the point of use and increasing NHS spending and recruitment.

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Originally Posted by hibsbollah

We get free private healthcare through a family members employer. I don’t feel comfortable using it because I don’t believe in privilege, but I have gone private for an op before, because I knew I wouldn’t get on the NHS. It was at a soulless hospital where a coal mine and thriving community used to be when I was growing up. Almost too perfect a metaphor. I don’t know if not using that provision would have been a pointless act, and using NHS services is actually using their precious resources?

Maybe we’re at the point when these kind of consumer choices are irrelevant. I’ll just continue to vote for parties that are committed to keeping it free at the point of use and increasing NHS spending and recruitment.

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I wouldn't class using an employee benefit as privilege and, in principle, I'm perfectly happy for people to go private as it does help free up NHS resources.

However, the NHS service should be much closer to the private provision in terms of quality and availability.

I might consider paying for a scan on my wrist, depending on what happens at my appointment, particularly if an NHS scan is either refused or if there's a lengthy wait.

Would I feel guilty about it? Possibly a bit, but is there really any point continuing to suffer unnecessarily?

:dunno:

I'm not sure what kind of scan I'd need, nor the cost so it may be academic regardless of what the physio says.

Was previously at Leith Links Surgery when I lived in Burns Street but since moving up to Abbeyhill I’m just a few hundred metres out of the catchment.

Cannot seem to join the Brunton Road Surgery as the website constantly says they are closed to new applicants. Perhaps a good thing as it’s got a terrible reputation.

Nothing else in the area so god knows what I can. Emailed NHS Scotland and they sent me a list of places to try but I’m out of their boundaries.

I've always wondered if more services could be opened up to self referral. It's something I've always found quite fascinating about the US system, people can in many instances just make an appointment with a particular specialism.

It's open for limited services here. Physio in some areas, podiatry in others and for procedures such as vasectomies in most. I had an in grown toe nail a few years back, obviously you know what that is so I self referred to podiatry, was seen within a couple of weeks and the required out patient procedure was done another week after that. All in it was 3 weeks from referral to resolution and no need for a GP appointment to confirm what was obvious. You can't argue with that. On the flip side I had a very suspicious looking mole on my arm in 2019, just about every red flag was present. Phoned my GP at 8am every morning for 5 days straight before even getting to speak to a receptionist, GP was supposed to phone me back that day but didn't, called for another 2 days before getting a receptionist again, got a call back that time then was asked to send a picture of the mole, GP then agreed I needed to be seen, went in, he looked at it for about a second and immediately agreed I needed a referral. Was placed on the cancer pathway which means a target of being seen by a dermatologist within 2 weeks, was 16 days so not bad. It was decided the mole had to be removed and biopsied. This was done on the NHS but by a private partner a couple of weeks later. I was told the results would be sent to my GP and they would contact me within 4 weeks. 5 weeks later there was nothing, called my GP, no results here, called dermatology, 'you need to speak to your GP', called them again and was told quite rudely they had nothing. This back and forward with no shortage of worry went on for another 5 days. Eventually I wrote a letter to dermatology who to their credit called me quickly, told me the results had definitely been sent to my GP 3 weeks before but confirmed over the phone that the mole was an early stage melanoma that required further surgery and follow up. To this day my GP still hasn't ever called and when seeing them about something else fairly recently there was no record of said diagnosis on my notes. Absolutely farcical and almost like a too many cooks scenario.

In an instance like the latter I really don't see why I couldn't self refer to dermatology. 7 days desperately trying to speak to a GP is ridiculous by any standard and needlessly stressful. Obviously there is a risk that people self refer when it isn't necessary and clog up specialisms when they don't need to be there but at the moment we seem to have a situation in which GPs are so unwilling or unable to see patients that in desperation many are clogging up A&E departments because they are either told 'if you are that worried go there' or they really don't know what else to do because the front line GP service is all but closed off to them.

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Originally Posted by Pretty Boy

I've always wondered if more services could be opened up to self referral. It's something I've always found quite fascinating about the US system, people can in many instances just make an appointment with a particular specialism.

It's open for limited services here. Physio in some areas, podiatry in others and for procedures such as vasectomies in most. I had an in grown toe nail a few years back, obviously you know what that is so I self referred to podiatry, was seen within a couple of weeks and the required out patient procedure was done another week after that. All in it was 3 weeks from referral to resolution and no need for a GP appointment to confirm what was obvious. You can't argue with that. On the flip side I had a very suspicious looking mole on my arm in 2019, just about every red flag was present. Phoned my GP at 8am every morning for 5 days straight before even getting to speak to a receptionist, GP was supposed to phone me back that day but didn't, called for another 2 days before getting a receptionist again, got a call back that time then was asked to send a picture of the mole, GP then agreed I needed to be seen, went in, he looked at it for about a second and immediately agreed I needed a referral. Was placed on the cancer pathway which means a target of being seen by a dermatologist within 2 weeks, was 16 days so not bad. It was decided the mole had to be removed and biopsied. This was done on the NHS but by a private partner a couple of weeks later. I was told the results would be sent to my GP and they would contact me within 4 weeks. 5 weeks later there was nothing, called my GP, no results here, called dermatology, 'you need to speak to your GP', called them again and was told quite rudely they had nothing. This back and forward with no shortage of worry went on for another 5 days. Eventually I wrote a letter to dermatology who to their credit called me quickly, told me the results had definitely been sent to my GP 3 weeks before but confirmed over the phone that the mole was an early stage melanoma that required further surgery and follow up. To this day my GP still hasn't ever called and when seeing them about something else fairly recently there was no record of said diagnosis on my notes. Absolutely farcical and almost like a too many cooks scenario.

In an instance like the latter I really don't see why I couldn't self refer to dermatology. 7 days desperately trying to speak to a GP is ridiculous by any standard and needlessly stressful. Obviously there is a risk that people self refer when it isn't necessary and clog up specialisms when they don't need to be there but at the moment we seem to have a situation in which GPs are so unwilling or unable to see patients that in desperation many are clogging up A&E departments because they are either told 'if you are that worried go there' or they really don't know what else to do because the front line GP service is all but closed off to them.

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That's really terrible.

My wrist is sore and it's frustrating not being able to golf etc, but I'm not particularly worried.

I'd have been worried sick in your situation.

https://www.private-eye.co.uk/issue-...BXODrcZFB_-htA

Profoundly depressing link here. Spire was the private hospital where I recently got treatment because I couldn’t get it on the nhs, carried out by the same surgeon who saw me a number of years ago as a NHS employee.

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Originally Posted by hibsbollah

https://www.private-eye.co.uk/issue-...BXODrcZFB_-htA

Profoundly depressing link here. Spire was the private hospital where I recently got treatment because I couldn’t get it on the nhs, carried out by the same surgeon who saw me a number of years ago as a NHS employee.

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A lot of Consultants and Surgeons run private clinics. When I had my shoulder injections many moons ago in Ultrasound at RIE it was done by a Dr Begg who works between RIE and Murrayfield hospital, my hip injections were done by a different Consultant who also worked between the two hospitals

https://uploads.tapatalk-cdn.com/202...dc142c2311.jpg

UK now has worst access to healthcare in Europe.


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https://scontent.fman1-1.fna.fbcdn.n...1w&oe=637919CC

“This is a national emergency and requires tough decisions. To help us out of this difficult situation we need to bring in the private sector for a limited time until the back log is cleared.”
How long till we hear something like that from Sunak?[emoji115]


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Originally Posted by Stairway 2 7

Uk has one of the highest health funding as a % of gdp in the world. But we've less Dr's and hospital beds than loads bellow us. Funding isn't the problem it's where is the money going
https://mobile.twitter.com/cjsnowdon...18322999517186

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Much of that will be going on PFI and other stealth privatisation. I suspect if the NHS was, as it should be, fully public there would be far more value for money and better outcomes. Much of the money going into the NHS goes straight into the hands of the wealthy without touching the needs of the ill.

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Originally Posted by wookie70

Much of that will be going on PFI and other stealth privatisation. I suspect if the NHS was, as it should be, fully public there would be far more value for money and better outcomes. Much of the money going into the NHS goes straight into the hands of the wealthy without touching the needs of the ill.

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But most on the list have much more privatised health care than the UK. Most of Europe has already sold of their NHS as it were. These graphs are total spending on health including private.

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Originally Posted by wookie70

Much of that will be going on PFI and other stealth privatisation. I suspect if the NHS was, as it should be, fully public there would be far more value for money and better outcomes. Much of the money going into the NHS goes straight into the hands of the wealthy without touching the needs of the ill.

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https://www.kingsfund.org.uk/publica...-england-myths


The NHS is being privatised.

The facts:

Private companies have always played a role in the NHS, with services such as dentistry, optical care and community pharmacy being provided by the private sector for decades, and most GP practices are private partnerships. The NHS and the private sector have also established partnerships for the delivery of clinical services such as radiology and pathology and non-clinical services such as car parking and management of buildings and the estate, while independent hospitals have been used under successive governments to provide additional capacity in response to pressures on NHS services.

Identifying how much the NHS spends on the private sector is not straightforward but estimates can be made using data from the annual accounts of the Department of Health and Social Care.

...spending by NHS commissioners on services delivered by the private sector increased to £12.2 billion in 2020/21. However... this again represents only around 7 per cent of the total Department of Health and Social Care revenue budget.

Following the Health and Social Care Act 2012, which extended market-based principles and introduced more competition into the NHS, the number of contracts awarded to private providers increased. However, this did not lead to an increase in the proportion of the NHS budget spent on private providers, in large part because the majority of contracts tended to be smaller than those awarded to NHS providers. In 2019/20, before the pandemic, NHS commissioners spent £9.7 billion, or 7.2 per cent of the Department of Health and Social Care revenue budget on services delivered by the private sector. This proportion has remained largely unchanged since 2012.

Throughout the Covid-19 pandemic, the Department of Health and Social Care and the NHS entered into new contractual arrangements with the independent hospital sector to increase capacity. These arrangements provided access to additional beds, staff and equipment to treat patients during the peak of the pandemic and are being used now in some places to support efforts to reduce how long people wait for routine care. As a result, spending by NHS commissioners on services delivered by the private sector increased to £12.2 billion in 2020/21. However, in the context of the significant additional funding provided in response to the pandemic, this again represents only around 7 per cent of the total Department of Health and Social Care revenue budget.

The Health and Care Act 2022 removed the competition and market-based approaches introduced by the 2012 Act. This gives commissioners greater flexibility over when to use competitive procurement processes, reducing the frequency with which clinical services are put out to tender and allowing contracts to be rolled over where the existing provider, most likely to be an NHS provider, is doing a good job.

Verdict:
There is no evidence of widespread privatisation of NHS services. The proportion of the NHS budget spent on services delivered by the private sector has remained broadly stable over the past decade

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Originally Posted by Stairway 2 7

But most on the list have much more privatised health care than the UK. Most of Europe has already sold of their NHS as it were. These graphs are total spending on health including private.

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There is private and private. I suspect other countries will be looking for value whereas the UK is looking to syphon funds to the rich. Is it all the easy bits of healthcare that are privatised in other countries.

There is also an apples to oranges factor in that the UK population as a whole has terrible eating habits, drug use and drinking are a big issue, and we couldn't care less about the poor or less able. The systems for care, health and well being are broken so it isn't a surprise that the NHS will are struggling as they are the end of the line for care and the least effective and costly way to deal with many citizens who should be home and being helped by another service. I also think the lack of prevention plays a part too as our FPTP system means no government looks beyond their next electoral success and that is all that matters to them. Health and Care need joined up medium and long term strategy. We will never get that in the UK under the current electoral system.

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Originally Posted by wookie70

There is private and private. I suspect other countries will be looking for value whereas the UK is looking to syphon funds to the rich. Is it all the easy bits of healthcare that are privatised in other countries.

There is also an apples to oranges factor in that the UK population as a whole has terrible eating habits, drug use and drinking are a big issue, and we couldn't care less about the poor or less able. The systems for care, health and well being are broken so it isn't a surprise that the NHS will are struggling as they are the end of the line for care and the least effective and costly way to deal with many citizens who should be home and being helped by another service. I also think the lack of prevention plays a part too as our FPTP system means no government looks beyond their next electoral success and that is all that matters to them. Health and Care need joined up medium and long term strategy. We will never get that in the UK under the current electoral system.

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We've got one of the highest life expectancies in Europe so we are fortunate in many ways, 10 years on average longer than Eastern Europe. The amount we put in health care should definitely be better spent. Nhs spending has went up every year in the last 10 I read, but nurses wages have went down. There is corruption somewhere and it begins at Westminster.

Attachment 26290

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Originally Posted by James310

https://www.kingsfund.org.uk/publica...-england-myths


The NHS is being privatised.

The facts:

Private companies have always played a role in the NHS, with services such as dentistry, optical care and community pharmacy being provided by the private sector for decades, and most GP practices are private partnerships. The NHS and the private sector have also established partnerships for the delivery of clinical services such as radiology and pathology and non-clinical services such as car parking and management of buildings and the estate, while independent hospitals have been used under successive governments to provide additional capacity in response to pressures on NHS services.

Identifying how much the NHS spends on the private sector is not straightforward but estimates can be made using data from the annual accounts of the Department of Health and Social Care.

...spending by NHS commissioners on services delivered by the private sector increased to £12.2 billion in 2020/21. However... this again represents only around 7 per cent of the total Department of Health and Social Care revenue budget.

Following the Health and Social Care Act 2012, which extended market-based principles and introduced more competition into the NHS, the number of contracts awarded to private providers increased. However, this did not lead to an increase in the proportion of the NHS budget spent on private providers, in large part because the majority of contracts tended to be smaller than those awarded to NHS providers. In 2019/20, before the pandemic, NHS commissioners spent £9.7 billion, or 7.2 per cent of the Department of Health and Social Care revenue budget on services delivered by the private sector. This proportion has remained largely unchanged since 2012.

Throughout the Covid-19 pandemic, the Department of Health and Social Care and the NHS entered into new contractual arrangements with the independent hospital sector to increase capacity. These arrangements provided access to additional beds, staff and equipment to treat patients during the peak of the pandemic and are being used now in some places to support efforts to reduce how long people wait for routine care. As a result, spending by NHS commissioners on services delivered by the private sector increased to £12.2 billion in 2020/21. However, in the context of the significant additional funding provided in response to the pandemic, this again represents only around 7 per cent of the total Department of Health and Social Care revenue budget.

The Health and Care Act 2022 removed the competition and market-based approaches introduced by the 2012 Act. This gives commissioners greater flexibility over when to use competitive procurement processes, reducing the frequency with which clinical services are put out to tender and allowing contracts to be rolled over where the existing provider, most likely to be an NHS provider, is doing a good job.

Verdict:
There is no evidence of widespread privatisation of NHS services. The proportion of the NHS budget spent on services delivered by the private sector has remained broadly stable over the past decade

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The King's Fund is a GSK-partnered think tank who have previously advocated for NHS privatisation. Not the best source.

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Originally Posted by Diclonius

The King's Fund is a GSK-partnered think tank who have previously advocated for NHS privatisation. Not the best source.

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So the numbers used are wrong? Which ones?

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Originally Posted by Diclonius

The King's Fund is a GSK-partnered think tank who have previously advocated for NHS privatisation. Not the best source.

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I’ve read through the article and it doesn’t read like something that is consciously or otherwise advocating the need for further privatisation of the NHS.

An excellent new way of working to begin in England to help with quicker cancer diagnosis. Hopefully we see the same direct GP referrals rolled out across all RoUK health services soon.

https://www.theguardian.com/society/...directly-tests

https://www.bbc.co.uk/news/uk-scotla...r_name=twitter

They’ll get slated for this but new thinking is needed.


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Originally Posted by Ozyhibby

https://www.bbc.co.uk/news/uk-scotla...r_name=twitter

They’ll get slated for this but new thinking is needed.


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No new thinking should involve anyone paying for nhs services. Uk healthcare funding is in line with western European countries. We need to sort out the waste and mismanagement, the funds are there

Many already pay for dental services. And if you don't then it can be difficult to find a NHS dentist as a new patient. So there is already a two tier system there.

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Originally Posted by Stairway 2 7

We need to sort out the waste and mismanagement, the funds are there

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Definitely. Even something simple like sending out appointment letters must cost hundreds of millions of pounds.

An app based system could eradicate this. And for the 20% or so who need or want a letter then that could continue.

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Originally Posted by Hibby Bairn

Many already pay for dental services. And if you don't then it can be difficult to find a NHS dentist as a new patient. So there is already a two tier system there.

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Not just dental services. Private healthcare is booming in the UK just now as people can’t be waiting up to two years for treatment.


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Originally Posted by Ozyhibby

Not just dental services. Private healthcare is booming in the UK just now as people can’t be waiting up to two years for treatment.


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Yes. But I think dental insurance is now quite common amongst a large part of the population. Private health insurance not so much...yet.

I know someone who was told it was 3 years for a hip replacement on NHS. They were in pain. Had the means. So paid £14k to get it done almost immediately.

The capacity is there. The finances not so much.but something needs to change.

There's already a two-tier system. People who can afford it, and some who can't, are considering shelling out in order to end their pain and discomfort sooner rather than later. What's the point of being in pain for ages when you can end it now, especially in your declining years?

Commentators are scapegoating middle management and bureaucracy but that sounds like Tory talk. Cut out the paper shufflers. Unfortunately you need bureaucracy to run a monster like the NHS!

Hospital beds have halved in the last 30 years, but the NHS budget has doubled in real terms

https://mobile.twitter.com/cjsnowdon...48634883092480

In the last 20 years the ministry of health's staff has doubled but nurses only up 7%. Where the money going, mostly on wages

We definitely underspend compared to gdp but we perform worse than we should

A key driver for the bed reductions was modern methods and medicine, example being my wife's shoulder replacement op, 1st one years ago she was in almost a week, last time she was out the following evening.

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Originally Posted by Just Alf

A key driver for the bed reductions was modern methods and medicine, example being my wife's shoulder replacement op, 1st one years ago she was in almost a week, last time she was out the following evening.

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And maternity wards/beds. Not even time nowadays for a post birth cuppa and plate of toast (as a supportive dad 🙂)

I have a friend in London who’s son had sickness and diahorrea for 2 weeks, couldn’t get an NHS GP appointment for two weeks, told the receptionist finally she was willing to pay, she got an appointment that afternoon.

Nobody seems to have noticed or is talking about it but the NHS as we knew it is already history. Beveridge would be turning in his grave.