Britain - The Official Thread

[Fezzik]

View attachment 1398122

To be fair to Gove he did acknowledge that

Kemi Badenoch: I would give JK Rowling a peerage

The Tory leadership candidate says ‘all sorts of oddballs and bad people’ are attacking sex-based rights activists

www.thetimes.com

Kemi going for the Mumsnet/Mail terf vote

 

[HenrySwanson]

"Envy of the world"

 

[XJ40]

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"Envy of the world"

I live in Scotland, less densely populated than South of the border. Getting a GP appointment is... awkward. Unless I'm dead or dying I tend to turn up at 5 to 8 and speak to the receptionists, amongst the ringing phones.

Over my life I've had several operations after speaking to the frankly awesome staff from initial GP to Consultants/specialists.

The NHS has always been there when I have needed it.

Now, devil's advocate: I think it would have been a different story if I had lived in bigger cities such as London or Birmingham. Even Glasgow or Edinburgh. So many more people requiring the same service.

Now let's imagine I live in the USA.

"Envy of the world"

Yes, very much so.

 

[HenrySwanson]

I live in Scotland, less densely populated than South of the border. Getting a GP appointment is... awkward. Unless I'm dead or dying I tend to turn up at 5 to 8 and speak to the receptionists, amongst the ringing phones.

Over my life I've had several operations after speaking to the frankly awesome staff from initial GP to Consultants/specialists.

The NHS has always been there when I have needed it.

Now, devil's advocate: I think it would have been a different story if I had lived in bigger cities such as London or Birmingham. Even Glasgow or Edinburgh. So many more people requiring the same service.

Now let's imagine I live in the USA.

"Envy of the world"

Yes, very much so.

This doesn't make sense. The world is not the UK and USA only.

The NHS needs both funding and reforming.

 

[Liquid]

In Slovakia, I went for a check up yesterday for my broken collar bone. I had checked carefully because I have to work:

"Is the clinic open in the afternoon?"
"Yes, until 5pm."
"And the X-ray department?"
"Yes, same times."

Okay, so I went there after work.

"Oh, the doctor's not here. He always leaves at 12."

Sure, the language barrier is one thing but why the radiology clinic and actual X-raying operations are open for four hours without attending doctors I do not know.

There's not a country in the world without a messed up healthcare system. The sheer scale of the operation guarantees it.

The NHS needs both funding and reforming.

I agree. But reform in the sense of modernising (old computers and wacky processes) rather than streamlining (cutting jobs and services in the name of efficiency).

 

[HenrySwanson]

There's not a country in the world without a messed up healthcare system. The sheer scale of the operation guarantees it.

There will be good and bad ones. I'm thinking more your South Koreas and Denmarks of the world.

I agree. But reform in the sense of modernising (old computers and wacky processes) rather than streamlining (cutting jobs and services in the name of efficiency).

Definitely both. The capital budget has been abysmal but things like this are ludicrous. Plus there's the complete shambles of the ARRS money and the MAP/ANP/etc cockup

EDIT: Jesus, why does that post comparing it to ONE country get so many likes?! It really is like a religion

 

[XJ40]

This doesn't make sense. The world is not the UK and USA only.

The NHS needs both funding and reforming.

In what way does it not make sense to you?

I have relayed my experience of the NHS from my corner of the UK, a positive one, been unsure about busier parts of the UK. And glad I am not in the USA as the costs involved (I do not know the dollar figure, but probably more than my house) would have been mind numbing to me.

Also regarding "The world is not the UK and the USA only", I am aware of that....

 

[HenrySwanson]

In what way does it not make sense to you?

I have relayed my experience of the NHS from my corner of the UK, a positive one, been unsure about busier parts of the UK. And glad I am not in the USA as the costs involved (I do not know the dollar figure, but probably more than my house) would have been mind numbing to me.

Also regarding "The world is not the UK and the USA only", I am aware of that....

Because someone could have an equally positive experience in any other country (including the USA) and conclude their health service is the envy of the world.

It's anecdotal.

I mean, I'm happy you've had that experience, but the reality is we have stories such as:

Leeds adult ADHD clinic shut for referrals due to 10-year wait

Thousands of adults are currently waiting for an assessment with the Leeds-based service.

www.bbc.co.uk

It goes to my point in another thread that this part of the board is kinda stuck in the 2000s-2010s for whatever reason.

 

[XJ40]

Because someone could have an equally positive experience in any other country (including the USA) and conclude their health service is the envy of the world.

It's anecdotal.

I mean, I'm happy you've had that experience, but the reality is we have stories such as:

Leeds adult ADHD clinic shut for referrals due to 10-year wait

Thousands of adults are currently waiting for an assessment with the Leeds-based service.

www.bbc.co.uk

It goes to my point in another thread that this part of the board is kinda stuck in the 2000s-2010s for whatever reason.

And if said someone had a positive experience of their health care in another country would that make no sense to you either?

Not to be too personal, but what is your own experience of the NHS? Or if outside the UK, wherever you live?

 

[HenrySwanson]

And if said someone had a positive experience of their health care in another country would that make no sense to you either?

It wouldn't make sense to conclude that their system is the envy of the world based on a sample size of one.

Not to be too personal, bit what is your own experience of the NHS? Or if outside the UK, wherever you live?

User of the NHS, worked and studied in it.

 

[XJ40]

It wouldn't make sense to conclude that their system is the envy of the world based on a sample size of one.

User of the NHS, worked and studied in it.

No, it wouldn't. The photo you supplied about a doctor having to do computer trickery to print out information (while a long winded way of doing things) then stating in quotes "Envy of the world", implies (to me) that the NHS is in the stone age (as per photo). It isn't.

The UK health service has skilled people who care.

Could we do better with efficency? Absolutely. But throwing money at the issue will not solve it. (I didn't say you said that)

"We will never have enough resource to do what we want to, so we must intelligently use what we have"

A quote I was taught as a student nurse, a very long time ago.

 

[HenrySwanson]

No, it wouldn't. The photo you supplied about a doctor having to do computer trickery to print out information (while a long winded way of doing things) then stating in quotes "Envy of the world", implies (to me) that the NHS is in the stone age (as per photo). It isn't.

The UK health service has skilled people who care.

Could we do better with efficency? Absolutely. But throwing money at the issue will not solve it. (I didn't say you said that)

"We will never have enough resource to do what we want to, so we must intelligently use what we have"

A quote I was taught as a student nurse, a very long time ago.

The NHS itself as a whole isn't in the Stone Age, but it isn't the envy of the world either. Parts of the NHS are seemingly stuck in the Stone Age, while parts of it are world-leading.

 

[XJ40]

The NHS itself as a whole isn't in the Stone Age, but it isn't the envy of the world either. Parts of the NHS are seemingly stuck in the Stone Age, while parts of it are world-leading.

Right, so how do you and I propose to sort it?

Given the area where I work, it has has a massive shock in the increase of social, elderly and youth care.

Not direct medical care, but more mental and social care not within a hospital building.

It seems to me that the responsibility of care has passed from parents to the state. At some point people must take responsibility for the care of their relatives. This will ease the financial burden on the NHS. Got an older relative that's a bit dottled? Look after them. They looked after you. My grandparents passed from dementia and cancer, and my mum and I did everything we could until the point where the NHS absolutely HAD to take over.

 

[XJ40]

@HenrySwanson I think the "Envy of the world" comes more from the model of the service, free of cost from the point of view of the service user, rather than the abilities of the personnel within.

 

[HenrySwanson]

Right, so how do you and I propose to sort it?

Given the area where I work, it has has a massive shock in the increase of social, elderly and youth care.

Not direct medical care, but more mental and social care not within a hospital building.

It seems to me that the responsibility of care has passed from parents to the state. At some point people must take responsibility for the care of their relatives. This will ease the financial burden on the NHS. Got an older relative that's a bit dottled? Look after them. They looked after you. My grandparents passed from dementia and cancer, and my mum and I did everything we could until the point where the NHS absolutely HAD to take over.

I can turn into the pub bore on this so I'll keep it to bullet points but am happy to discuss them in more depth if you want:

• Raise National Insurance. We can't expect world-class healthcare at bargain basement prices. The public needs to be realistic.
• Have a higher capital budget. Some hospitals are so bad that they're dangerous, and systems are outdated and differ between Trusts, leading to:
• Embrace digital healthcare. This is being done atm so I'm not worried about that.
• Improve social care. Easier said than done, but a lot of the problems come from an aging population with a care industry that has been chronically underfunded. Many patients are stuck in hospital mffd (medically fit for discharge) but because of the broken system they block beds.
• Long-term investment in training doctors. Divert the ARRS budget into paying for actual doctors rather than "noctors". Restructure the specialty training programmes so more places are available for doctors wishing to enter specialty training thereby reducing competition.
• Focus more on preventative medicine. Again, the NHS is moving in a good direction here so that's reassuring.
• Put clinicians in charge. I don't know much about management in hospital Trusts but key decisions need to be made by experienced healthcare workers not guys in suits.

 

[XJ40]

I can turn into the pub bore on this so I'll keep it to bullet points but am happy to discuss them in more depth if you want:

• Raise National Insurance. We can't expect world-class healthcare at bargain basement prices. The public needs to be realistic.
• Have a higher capital budget. Some hospitals are so bad that they're dangerous, and systems are outdated and differ between Trusts, leading to:
• Embrace digital healthcare. This is being done atm so I'm not worried about that.
• Improve social care. Easier said than done, but a lot of the problems come from an aging population with a care industry that has been chronically underfunded. Many patients are stuck in hospital mffd (medically fit for discharge) but because of the broken system they block beds.
• Long-term investment in training doctors. Divert the ARRS budget into paying for actual doctors rather than "noctors". Restructure the specialty training programmes so more places are available for doctors wishing to enter specialty training thereby reducing competition.
• Focus more on preventative medicine. Again, the NHS is moving in a good direction here so that's reassuring.
• Put clinicians in charge. I don't know much about management in hospital Trusts but key decisions need to be made by experienced healthcare workers not guys in suits.

Yup, I agree with all your points, more so the last one. Experience is crucial. A Professor (I'm not sure who is the highest ranking clinician in departments) moving up to a management role with decades of experience in his or her field, with a financial understanding of the costs involved would be beneficial to all.

My wife attends regular appointments to do with a liver thing, and the doctor she saw initially all those years ago is now a Professor. He is a brilliant bloke and when she describes issues, you can almost see the cogs whirring as he decides next steps.

Who knows, maybe we have such people in management roles just now?

Thanks for the insight 👍

 

[HenrySwanson]

Yup, I agree with all your points, more so the last one. Experience is crucial. A Professor (I'm not sure who is the highest ranking clinician in departments) moving up to a management role with decades of experience in his or her field, with a financial understanding of the costs involved would be beneficial to all.

My wife attends regular appointments to do with a liver thing, and the doctor she saw initially all those years ago is now a Professor. He is a brilliant bloke and when she describes issues, you can almost see the cogs whirring as he decides next steps.

Who knows, maybe we have such people in management roles just now?

Thanks for the insight 👍

We do, but not enough I think. Again, this is from lurking in forums and not actual experience in an NHS Trust (my last role was in primary care - hospitals are secondary/tertiary care).

If I were to be king of the NHS (ha) I would get rid of these stupid "values" things they get workers to learn and instead have monthly meetings with clinical staff from a range of wards - from HCAs up to consultants. Put people like your professor in charge of more decisions.

I have faith in Streeting (he can't be worse than the Tories), and we'll see if he does a reform as wide-reaching as Lansley did a decade ago.

In happier/sadder news depending on if you're glass half full or empty:

Unemployed Brits will receive free Ozempic-style weight-loss shots to help them get jobs

Britain has apparently found a solution to the global unemployment crisis: Weight loss shots.

fortune.com

 

[UKMikey]

Unemployed Brits will receive free Ozempic-style weight-loss shots to help them get jobs

Britain has apparently found a solution to the global unemployment crisis: Weight loss shots.

fortune.com

That must have been a speedy trial.

 

[HenrySwanson]

That must have been a speedy trial.

I'm not sure I understand?

It's a five-year trial so the results won't be available for many years. Isn't it a good thing that we are trialling this?? Attack two problems (unemployment and obesity) with a single intervention.

 

[UKMikey]

I'm not sure I understand?

It's a five-year trial so the results won't be available for many years. Isn't it a good thing that we are trialling this?? Attack two problems (unemployment and obesity) with a single intervention.

It is a good thing as far as I'm concerned.

I think I misread the Fortune headline but it made it sound if the unemployed are already receiving free Ozempic jabs to me.

 

[RYAN]

For an example of how useless this country is getting. My dear mother is waiting for an ambulance... Since 2PM yesterday. Out of respect for her I wont go into detail but its not nice the way she is being left and she is very upset. She has MS, Compressed spine among other things and because its not "Life threatening" she isn't a priority. I understand emergencies, accidents and life threatening cases come first. That's the way it should be. The state she is being left in however is unacceptable and this isn't the first time. First it was 4-6 hrs than 2 to 4. Now we have given up on getting updates.

I feel so powerless and useless. There's nothing I can do. She's too disabled to get into my car and then there would be other issues even if she could. I don't know. Only thing is to sell the car and somehow get a disabled access van as South Wales Ambulance Services can't be relied on. I would like to say that I have the utmost respect for the paramedics and other health workers, Every single one has always treated my mother amazingly. Its not the people, There's literally not enough money put into the NHS (Especially in Wales) for it to actually function properly.

If there was a life threating issue for my family or anyone who lives around me we have been told the primary Hospital would be The Grange Hospital in Cwmbran. To put that in perspective I live in Caerphilly, That's 24 miles away. I don't fancy our chances much.

Sorry for the rant, But after a day of waiting with her and keeping her company, I feel so sorry for her that I have to vent somehow.

 

[HenrySwanson]

For an example of how useless this country is getting. My dear mother is waiting for an ambulance... Since 2PM yesterday. Out of respect for her I wont go into detail but its not nice the way she is being left and she is very upset. She has MS, Compressed spine among other things and because its not "Life threatening" she isn't a priority. I understand emergencies, accidents and life threatening cases come first. That's the way it should be. The state she is being left in however is unacceptable and this isn't the first time. First it was 4-6 hrs than 2 to 4. Now we have given up on getting updates.

I feel so powerless and useless. There's nothing I can do. She's too disabled to get into my car and then there would be other issues even if she could. I don't know. Only thing is to sell the car and somehow get a disabled access van as South Wales Ambulance Services can't be relied on. I would like to say that I have the utmost respect for the paramedics and other health workers, Every single one has always treated my mother amazingly. Its not the people, There's literally not enough money put into the NHS (Especially in Wales) for it to actually function properly.

If there was a life threating issue for my family or anyone who lives around me we have been told the primary Hospital would be The Grange Hospital in Cwmbran. To put that in perspective I live in Caerphilly, That's 24 miles away. I don't fancy our chances much.

Sorry for the rant, But after a day of waiting with her and keeping her company, I feel so sorry for her that I have to vent somehow.

Sorry to hear this. Is a private ambulance an option (I'm not sure of the costs involved)?

If it's been since 2pm yesterday, am I right in thinking that's over 24 hours you've been waiting for an ambulance? Do you know which response category her call is under?

 

[HenrySwanson]

As you can see, it's much more than it just being underfunded. The model is broken:

I am a doctor who has just moved from England to Scotland, and have had the most awful couple of days trying to get simple abx for a simple problem. The way I have been treated as a patient has been an absolute joke, so I thought I would post about it here to get some thoughts.

Day 1

On Tuesday I ring my local primary care to register and ask for a same day appointment to get some abx. They initially say sure thing, but then phone me back and say because my problem can be solved by a pharmacy, they will process my registration at normal speed (5 working days) and I should attend pharmacy instead for my medical issue.

During my very limited lunch break at work I attend two pharmacies, neither of which have prescribing pharmacists, who say no abx for me. Unfortunately I finish work late and can't check any more pharmacies.

Day 2

Show up to a pharmacy with a prescribing pharmacist, who say I haven’t lived in Scotland long enough to qualify for this service. Tell me to go back to my GP

Phone my GP who tell me to go back to the pharmacy.

Go back to pharmacy - no luck

Phone 111- They say the best pathway is via primary care or the pharmacy prescription service.

Day 3 - symptoms worsening

Check into the SDEC in my own hospital seeing as I’m at work anyway, after checking with the nurse in charge if this is allowed, she says yes and adds me to the list to be seen.

After waiting two hours I get an angry phone call from an ANP who has the following points to make (before I have had any triage, history taken, physical examination etc).

1- I can’t treat my employer like a walk in antibiotic dispenser 2- plenty of sick people attend the walk in centre so I can’t just take up queue space wanting antibiotics 3- this is what primary care is for. 4- they are taking me off the list to be seen.

I explain very nicely that I have tried all other avenues and I am not able to get an appointment to see anyone, and all I need is a simple appointment and some treatment. I also ask him if he even knows what my presenting complaint is, and whether it’s routine practice to take someone off the list without triaging or assessing them in any way. He insists that he would do the same to any member of the public who walks in off the street asking for abx.

Eventually that evening I went through 111 again, who this time sorted me a GP appointment (at the same hospital I work at…) for 2300 that evening, and luckily I now have antibiotics.

I have been reflecting on it and I am still outraged about this whole situation. I’ve seen my fair share of patients coming to ED with minor primary care style issues and have always felt a bit exasperated, but honestly no wonder why. I was this close to just prescribing myself some meds and risking the GMC.

(Abx = antibiotics)

In Mother Russia we have great and glorious healthcare system

 

[RYAN]

Sorry to hear this. Is a private ambulance an option (I'm not sure of the costs involved)?

If it's been since 2pm yesterday, am I right in thinking that's over 24 hours you've been waiting for an ambulance? Do you know which response category her call is under?

Yes over 24 hours and like I said it's not the first time. As she is bed-bound she needs to go on a stretcher. I'm unaware of any private services that offer to accommodate this. Although I admittedly haven't researched.

We had district nurses come out to change a medical device and they couldn't install the replacement properly. Admittedly not an emergency straight away but after 30 hours something has to be done. She has the implement half in, Its sore and causing great discomfort. It's causing incontinence which obviously makes her bed incredibly uncomfortable not even 5 minutes after changing it everytime.

Anyway its has been updated to an emergency in the last hour or so. Let's hope they arrive soon.

 

[HenrySwanson]

Yes over 24 hours and like I said it's not the first time. As she is bed-bound she needs to go on a stretcher. I'm unaware of any private services that offer to accommodate this. Although I admittedly haven't researched.

We had district nurses come out to change a medical device and they couldn't install the replacement properly. Admittedly not an emergency straight away but after 30 hours something has to be done. She has the implement half in, Its sore and causing great discomfort. It's causing incontinence which obviously makes her bed incredibly uncomfortable not even 5 minutes after changing it everytime.

Anyway its has been updated to an emergency in the last hour or so. Let's hope they arrive soon.

I would look into it in preparing for the future. My sister has MS and we're lucky to have access to great care but even still the ambulance times here can be atrocious.

 

[DG_Silva]

From my personal experience, I can only think of a couple of times I've experienced poor treatment in hospital - once where I had an operation cancelled while I was in the hospital and no one has told me for 6 hours, and a second after having crushing pains in my chest/shoulder I was waiting in Accident & Emergency for hours. However, most of my experiences have only ever been positive so I guess I can call myself lucky.

In no way am I making light of the issues you guys (and loved ones) have been having, but I believe this fairly accurately reflects the cause of the issues (even from 40 years ago).

 

[RYAN]

From my personal experience, I can only think of a couple of times I've experienced poor treatment in hospital - once where I had an operation cancelled while I was in the hospital and no one has told me for 6 hours, and a second after having crushing pains in my chest/shoulder I was waiting in Accident & Emergency for hours. However, most of my experiences have only ever been positive so I guess I can call myself lucky.

In no way am I making light of the issues you guys (and loved ones) have been having, but I believe this fairly accurately reflects the cause of the issues (even from 40 years ago).

The best thing to do in these situations is try and make a joke and have a laugh. Otherwise the experience would be made even worse.

Anyway, I got my mum a bag of chips in the meantime so that's cheered her up a bit 😄👍

 

[HenrySwanson]

but I believe this fairly accurately reflects the cause of the issues (even from 40 years ago).

With time I'd love to explore how it's got to this stage. I've used this as a primer, and there's definitely stuff I recognise (PFI, Lansley reforms, hello)

https://www.opendemocracy.net/en/nhs-crisis-rishi-sunak-conservative-labour-austerity-privatisation/

I'm also curious about this from the BBC:

Of course, that is when a Conservative-led government came into power, although it is worth bearing in mind Labour were also signed up to this squeeze following the 2008 financial crash.

Labour - despite previous big increases in funding - were promising less for the health service than the Tories in the 2010 election, while in 2015 there was little between the two parties.

The NHS crisis - decades in the making

Hospitals are having their worst winter in a generation, with doctors warning lives are being lost. How did the NHS get here?

www.bbc.co.uk

And the real differences between the parties:

There's also the elephant in the room of the large population increase: