Why is the NHS failing us?

[@alansouthall8221]

Thank you for this. We need to shed our xenophobic view of other country's health services and let go of the idea that the NHS is the envy of the world

[@OrganisedPauper]

For decades working class Brits have been terrified from an early age by the spectre of the American health care system. It's held up to us as a bogie man at every opportunity. We've been steeped in the fear of either having the NHS or total healthcare insecurity. That's the only two options ever shown in mainstream media, or anywhere else, other than here that I have seen. The only reason I know about other European health systems is because I actively looked. Bizarrely the most hardcore NHS supporters seem to be the most hardcore rejoin the EU supporters. This makes no sense to me at all. Surely someone who wants to be part of the EU would see the benefits of EU members' different forms of health provision? As someone with little choice in healthcare, some years ago I started seeing the NHS as a sort of Eastern European provider. In that I get what I'm given and be grateful. It's been much less stressful since I gave up expecting to have any agency whatsoever over my healthcare.

[@batcollins3714]

So to expect the fools to believe you're willing to pay American prices for insulin at $600 per month? And if you can't pay, you just die. My brother in law is a doctor in Chicago and can't believe how lucky the British people are with the NHS

[@OrganisedPauper]

@@batcollins3714 You just proved my point here because you had a knee jerk reaction and assumed I was pro an American system, which I absolutely oppose. You clearly didn't read what I'd said fully because I talk about other European countries' health care systems. Other European countries do much better than we do. That's where we should be looking for ideas for something that works better than the NHS.

[@michaelgilday]

One simple example of waste is when an elderly person is discharged from hospital and requires continuing attendance by district nurses. They initially provide a box full of dressings and other items that may or may not be needed for the future care of the person discharged. Most of what is provided is never used and eventually thrown away. I estimated I threw away at least £300 (when my father died,) of items, multiply this across the NHS against all those discharged and it is a vast amount of money wasted, just in one simple aspect of the overall service. I am now in the same position presently with my mother. What would make far more sense is for district nurses to carry a kit for what they require therefore reducing costs and wastage. But this is only a tiny example, I was at a hospital recently for the third time this year and I counted four people surplus to requirements in this particular department, compared to previous visits. Wage cost are the biggest cost to any business how many departments does one hospital have and then consider this across the NHS. When my father would leave hospital, he would have lost two stone in weight, due to poor care. The community matron would then be horrified, and he would be put on additional supplements to increase his weight rapidly, again an unnecessary but common problem incurring additional costs to the NHS. So, you cannot tell someone who has experienced the NHS for a number of years first-hand that the NHS does not waste resources and money. The Open University did a programme years ago on how not to set up a computer system and cited the NHS. Doctors have told me every time you move to a different area you have to learn a new system. This area where I am presently has four systems, which from what I can tell are not properly integrated. It is not a National Health Service but a localised service. Due to Covid I have been stuck where I am for almost 2 years and not been able to return home. This means I cannot access (for instance,) free eye tests as this is only covered in my own NHS area. A blood test taken elsewhere can take up to twelve months and numerous phone calls and interventions to get the results to a doctor in another area who requested them. This should be a simple result search on unified system, but as nothing is unified then it cannot happen. You might have five ward areas one above another in the same hospital. The care and service can vary dramatically from one ward to another even in the same hospital. Why because each ward has its own manager and team of nursing staff. This leads to inconsistent standards and how you might respond to the care given is a direct result of what you receive from basic to excellent. Return something to Physiotherapy and they don't keep a record of what has been issued so have no idea if it is returned. You could easily sell on NHS equipment, and no one would be any the wiser. I do not consider private enterprises replacing the NHS to create something similar to which exists in the USA. But it could be possible to have large Community Interest Company PLC (CIC’s) formed to replace the NHS. This would allow for investment from both shareholders and stakeholders with a cap on share dividends. The profits being ploughed back into the NHS services. If the NHS was profit orientated, then it would be less wasteful and more concerned with efficient service delivery. It should be possible to set high standards for such a structure to adhere. This is the debate that should be had to ensure that health provision meets the needs of a 21st Century service and the needs of everyone in society.

[@paulcassidy8130]

Nice to see the cameo appearance by Kristian's cat! Cataracts and hip replacements are surely two very routine operations that would benefit from the factory production line style of delivery; if outsourced to, say, Tesco Healthcare, it would be the model of efficiency.

[@OrganisedPauper]

Cataracts would be a great candidate for it. Getting more operations done would significantly improve people's lives and function. It's likely to cut down on other costs too, as having cataracts can lead to falls and accidents in the home and at work.

[@WATCHINGTHEWATCHERS999]

6:45 It is SUCH a MASSIVE breath of fresh air to hear you guys say this… so often I feel like the boy in The Emperor’s New Clothes! 🙈

[@morgste]

As a NHS GP for the last 30 years I would suggest the reason there are regular winter and other crises is that this is the best way to obtain further resources directed to your organisation. On the other hand if you work more efficiently with what you have and thus avoid a crisis the central NHS is highly unlikely to think your innovation deserve further funding or encouragement. This institutional tendency to reward failure or underperformance is visible at every level and seriously degrades the overall NHS performance. In the last 5 years or so the previous modest 'market reforms' in the NHS have largely been undone and already this is having a further negative effect on NHS efficiency and quality. The success of the vaccination programme rollout I would suggest is down to the fact that hospitals were barely involved and GP practices and pharmacists who did most of the work have a significant private sector approach to their work.

[@Combatwombat-sn7ng]

That reminds me somewhat of the way the management of the Soviet economy worked- if you failed to achieve targets one year you'd get given more resources the next year so failure became ideal

[@TheSunlight74]

Very interesting conversation

[@adamadamant5061]

Because the NHS is not about health, nor bodily integrity. Cleared that up for you?

[@Combatwombat-sn7ng]

Very interesting to hear two non-natives discussing this issue because they have experiences of health care systems in other countries

[@raymondbedborough8522]

Any organisation that willfully retain it's poor performing staff at best it's doomed to mediocrity . The NHS is a clear example of this. A dreadful performing institution

[@WATCHINGTHEWATCHERS999]

40:26 But it is in the sense that so many parts of it are subcontracted.

[@raymondbedborough8522]

If you have to retain your sociopathic staff because of poor recruitment you are doomed to mediocrity at best. I have seen to many deaths do to criminal negligence. It breaks my heart to see so much NHS corruption. Read John England's book

[@IanParker]

Very good... can we put Dr Niemietz in charge of the nhs please.. perhaps it might do what the Billions, upon Billions of £'s suggest it ought too.

[@lawrencebishton9071]

money laun dry