Please vote Labour to save the NHS?

[JohnD]

All,

Forgive me for asking you to read an account of what's wrong with the NHS, and what can be done , to make it better in the original spirit.

Forgive me for heading this post in a political way, but that is the only way that I can see to achieve that recovery.

For after family, the NHS has been and is the most important thing in my life.

Please read: https://www.theguardian.com/society/2023/aug/24/voters-are-unhappier-with-the-nhs-than-theyve-been-for-30-years-as-a-gp-i-feel-the-same

John

Edited August 24, 2023 by JohnD

[Nick Jones]

I be voting for whichever not-Tory has the best chance of success in my constituency. Tactical voting is the way….

[thebrookster]

5 hours ago, Nick Jones said:

I be voting for whichever not-Tory has the best chance of success in my constituency

Given the current state of the English political scene these days, I can't help but think that leaves a very narrow range of candidates................

John, I feel for you. Fortunately my vote has no sway on such matters, as I don't think I could ever bring myself to vote Labour anymore. Not least because my local labour (albeit Scottish) candidate is a certain Ms Baillie, who would be perfectly capable of dooming the entire NHS simply by opening her mouth!!

[Nick Jones]

10 hours ago, thebrookster said:

Given the current state of the English political scene these days, I can't help but think that leaves a very narrow range of candidates................

This is true unfortunately. First past the post is a very poor substitute for actual democracy.
 

However, we are in what was Paddy Ashdown’s constituency, now held by one Marcus Fysh, who is about as useful as that Dorries creature, so there is a decent prospect of a Lib Dem return. Especially since the candidate (our local county councillor) is a very decent, hard-working man. Though I worry a bit whether he’s ready for the foul swamp that is Westminster.

[MilesA]

John 

I fear that your request that people vote for one party or another to 'save' the NHS is one of the key reasons why it will continue to suffer. Each political party will exploit its 'commitment' to the NHS to secure power and a few terms later all will change as a new party comes to power. I suspect the Labour party's 'credibility', appeal and difference to the Tories is too heavily invested in its historical association with the NHS for it to stop deploying it in the drive for and maintenance of power.

In my humble view, the first thing that needs to happen is that there must be an open and honest debate above the state, future and future funding mechanism of the NHS. Too often, any attempt to open such a debate whether on a national or private basis is howled down with allegations of wanting to destroy the NHS. At a national level, the debate needs to be removed from the party political ping pong in some way to neutral territory to which all parties are committed and which can provide a mechanism for agreed changes to be implemented. I do not know if such a process exists or whether the political parties would be honest enough to subscribe to one.

Such a debate must obviously address funding. The mechanism established in 1948 is in my view no longer viable in 2023. There are variants being deployed in other medically successful countries. So let's examine them. To be clear, from my perspective, this is not about privatisation.

As an addition, not a counterpoint, to your start of this debate, I found this article interesting :https://www.sajidjavid.com/news/sajid-javid-we-need-agree-new-nhs-future-or-1948-dream-dies I am not a cheerleader for Mr Javid and I do not agree with all that he asserts, but his article did seem to me to include some interesting information and proposals that are pertinent to the debate and change that must take place.

Miles

[iani]

It doesn’t matter who gets in, the economy is in a mess, way too much money was given away without any thought for the future. After being.a party member for some years, I have cancelled my Conservative membership and I certainly won’t be voting for Labour. My Chinese wife doesn’t understand why we get so excited by politics, we only ever complain about it, might as well have the Chinese system, at times I think she has a point.

Ian (politically very homeless)

[JohnD]

MIlesA,

in the same spirit as you posted it, I have read Javid's article, and I have to say he is wrong, when he says that "UK health spending is above the OECD average and countries known for impressive patient outcomes."   THis is the OECD's table for 2022:

It clearly shows that the UK spends LESS than countries with which we would like to be compared, eg Ireland, France, Australia etc.  Yes we spend more than  'average' but that average is brought down by the inclusion  of many developing countries, with grossly underfunded health services.   But look at where India and China are on the list!

America is the chart leader, by a country mile.   Wonderful medicine, but in the US, medical fees are the largest cause of bankruptcy (50-60%, depending on state).   I'm sure you would not argue for their system here, but recall that over 200,000 American families a year suffer serious disease AND financial disaster.

John

 

[RogerH]

I too am a political homeless soul.

I should identify with labour - but they have show,n all too often, how crazy they are.

I am  a reasonably well off retiree - so should identify with the Tories - but their mindless greed irritates me

I do agree with Miles - a non biased debate chaired by an engineer/Physicist  (as per the Feynman/Shuttle investigation) no holds barred.

Sadly  no political party has the balls to go that route.

I feel going private is a backward step but the system is so broken it may be the only way to improve.  On this coming Monday I pay my final installment

for my Hip Op last September (£15K)  money well spent - but not every well meaning person can afford that.

Roger

[PaulAA]

It is interesting to see this microcosm of political position. Obviously, I've not voted in the UK for thirty years and it would be inappropriate to expound my political myopia here, but it is evident that democracy is facing an increasingly serious challenge everywhere in the 21st century.

We have a duty to vote, each and every one of us. Here in Poland, we are struggling with the dishonesty of Populism (doggedly reinforced by a religious hegemony that has progressively lost its purpose since the fall of communism) that most voters are comfortable to ignore, so long as they receive the monthly ex gratia payment that is now a feature of low-income life. Universal basic income pegged to procreation. Yet, for such a relatively young democracy, election frequency here is dismally low. Presidential elections struggle to reach 40%. GEs barely more than 60%. That's shameful.

Social media, soundbites, Populism, gangs, drugs... we're all up the Swanny River without a paddle. I'm only 59, but I dream of the halcyon days of the 80s and 90s, when content mattered far more than delivery.

For the NHS, John, it appears to me that the dreadful Lucy Letby affair has exposed the failures of tiers of management and their obsession with the smoke screen of good service and good publicity. Time for a serious look at how the NHS is managed, outsourced and financially administered, especially in relation to the involvement of the Big Four accountancy firms. Ten years ago (the most recent data I can find), the Big Four were collected nearly £700 million for 'accountancy services' from the NHS. How much would it be now, for their more extensive and avaricious services? Trouble is, I doubt any political party will tackle a potato as hot as that - it's easier to nibble at the low hanging fruit, and pay the Big Four yet more fees for spuriously analysing how savings can be made.

In parallel, I read recently that, by 2030, it is estimated that 10% of the UK working population will be employed by the NHS. Something wrong at t'mill, surely.

Paul

[JohnD]

Thank you, All!  Paul is quite right, and maybe I should have titled this thread "Please vote, to save the NHS", because even here in the UK, the turn out at the last GE was only 67%!   I will be honestly pleased, whatever the result at the next, if more than 70% of the electorate vote.   That's democracy.

JOhn

PS Paul, 14% of the US population is employed in healthcare, according to the US Gov Census.      While the Nuffield Trust estimated last year that less than  2.5% (1.5 million) of the UK population  was employed by the NHS, so we have a long way to go!  Where was the 10% projection seen?

[PaulAA]

John, embarrassingly, I can't find the article... always best to keep salacious material to hand when quoting it.

According to gov.uk, there were over 1.2m direct employees employed by NHS trusts and clinical commissioning groups in Oct last year. And according to latest Parliamentary figures, the UK working population is just under 34 million, so the employment ration would currently be 3.75% of direct employees, plus those indirectly employed through contractors and (business) consultants.

The Health Foundation anticipates that a further 314,000 full-time employees will be needed by 2030. Assuming a stable working population, this would bring the ratio to 4.75%... still well short of the figure I saw quoted. I'll keep looking...

[JohnD]

Yes, we keep getting told that the NHS is "on it's knees", but when 12% of nurse posts are unfilled and GP practices lack 6000 doctors, is it any wonder? (Kings Fund Report, "NHS staffing shortages.  Why do politicians struggle to give the NHS the staff it needs?")   That report, despite its title, avoids placing any political blame, but after 15 years in power, during which the service has been under funded and staff pay has been undermined, one can only conclude that the Tories are incapable of providing a solutiion.

John

[Escadrille Ecosse]

Every time there is a 'crisis' governments throw extra funding at the NHS. Unfortunately the patient throughput fails to respond.

There are likely a whole host of reasons,

an increasing percentage of agency staff

staff absences

the dilapidated state of the buildings and equipment due to funding being diverted away

'targets' and ever changing 'priorities'

lack of indigenous training

reliance on importing workers from abroad

competition from every other developed economy in the world for a limited supply of health workers to steal from undeveloped countries who really, really need them

incompetent and/or self serving management

Health trusts system and associated management structures

legal costs

fining NHS Trusts for failures which is self defeating rather than using laws like HSWA to go for individual managers

meddling by the courts imposing obligations on specific, small and dispropostionately expensive interest groups

a coherent concept of exactly what the NHS is and more importantly isn't for

 

As an example I have a friend who is an orthopeadic surgeon. When his hospital was transferred from the private to the public sector the accompanying NHS management system reduced the number of patients he treated in a year by about 30%.

[Wolfrace.]

On 9/1/2023 at 5:59 PM, Escadrille Ecosse said:

As an example I have a friend who is an orthopeadic surgeon. When his hospital was transferred from the private to the public sector the accompanying NHS management system reduced the number of patients he treated in a year by about 30%.

Targets - the Commissioning group authorizes ‘x’ number of say hips.

once you hit let’s say 2,000 hip operations, you stop. You might finish those 2,000 hips after 8 months, but you don’t carry on doing hips for the next 4 months, you stop. Some trusts will rent out the spare theatre time for private operations, some just close up shop until the next financial year.
So, there is no incentive to improve efficiency, you have a year to do 2,000 procedures, You take a year to do 2,000 procedures.

 

see also the insane NHS operational model - you are only allowed to be really I’ll 8.30-5.00 Monday to Friday - hospitals run around the office hours, not the patient hours. When I had a bad ticker, my Cardiologist expressly warned me to avoid a blues and twos to the hospital Friday night or over the weekend, wait until Monday! Your chances of pulling through rise dramatically after 08.30 Monday when all the systems spin back up.

[Nick Jones]

Unfortunately entirely true about Friday nights and weekends in my experience. Bank holiday weekends even worse.

[JohnD]

8 hours ago, Wolfrace. said:

Targets - the Commissioning group authorizes ‘x’ number of say hips.

once you hit let’s say 2,000 hip operations, you stop. You might finish those 2,000 hips after 8 months, but you don’t carry on doing hips for the next 4 months, you stop. Some trusts will rent out the spare theatre time for private operations, some just close up shop until the next financial year.
So, there is no incentive to improve efficiency, you have a year to do 2,000 procedures, You take a year to do 2,000 procedures.

 

see also the insane NHS operational model - you are only allowed to be really I’ll 8.30-5.00 Monday to Friday - hospitals run around the office hours, not the patient hours. When I had a bad ticker, my Cardiologist expressly warned me to avoid a blues and twos to the hospital Friday night or over the weekend, wait until Monday! Your chances of pulling through rise dramatically after 08.30 Monday when all the systems spin back up.

You make me furious, Wolfrace!    " hospitals run around the office hours" indeed!   Hospitals provide staff and facilities for emergency cover right around the clock and week.    Is it their fault that the incontinent and inebriated throng to A&E on a Friday night, when the thin resources available after 15 years of Tories 'economies'  are overwhelmed?  

I'll bet you vote Tory!

Disgusted, of Lancaster

[Nick Jones]

Ah, John, though hospitals certainly operate outside normal working hours (have an on-call person in the house right now), the 24/7, 7 day service that politicians have occasionally promised is also very far from reality.

Our experience at Yeovil is that if you get admitted on a Friday night, once they’ve decided you are not actually about to die(!), you just get put in storage to join the queue on Monday, so best not get sick(er) over the weekend as they may not notice. They can’t even access the (paper) medical records until Monday.

Other hospitals may be different, better or worse….

I’ll be voting for whichever non-Tory party stands the best chance of winning in my constituency.

[Wolfrace.]

Problem is Nick, no amount of money will fix the basic truth, the NHS is no longer fit for purpose.

The whole model on which it was founded was built on a foundation of sand. The population the NHS inherited in 1945 was fundamentally very healthy and fit, years of enforced rationing and overseas adventure for millions fighting the beastly foreigners saw to that. If you read the original discussion documents, Beveridge and co actually forsaw the NHS budget dropping after a decade when all want had been disposed of, and underlying health conditions treated. Well that vision worked out well…

The NHS is as near as damnit the UKs state religion, any suggestion is is less that perfect and formed as some immaculate conception results in a spectacular political Bunfight and nothing gets done. But it’s the worlds 3rd largest employer and a model of quasi Stalinist inefficiency. It’s trying to do everything, and doing too much, too much of it badly.
It’s hysterical institutional fear of the private sector is simply perverse. You have a waiting list? Book 400 procedures with a private provider and clear it, works a treat - see my recent YAG laser treatment, Thanx Optilaze! Paid for by the NHS, treated at a time of my convenience in only a couple of weeks.

The NHS is not the envy of the world - far from it, you want an envied health service, bonjour mes amies en France. A hybrid private-public health system leveraging the advantages of both. Public systems excel at basic primary healthcare, the screening, vaccinating , the legwork to find the illnesses, but the private sector is very efficient at processing patients through theatre's.

The NHS needs reform, and it’s needs that reform to be fundamental at the hands of an apolitical Royal Commission.

And You can be sure said Commission will bring an end to the do it all, free at the point of delivery model. 

[JohnD]

Wolfrace,

Forgive my impassioned previous, and thank you for your reasoned reply, to Nick, but maybe partly intended for me.

Reasoned, but WR, quoting you, "Book 400 procedures with a private provider and clear it, works a treat - see my recent YAG laser treatment, Thanx Optilaze! Paid for by the NHS, treated at a time of my convenience in only a couple of weeks."   (my emphasis)  

You are happy to accept free treatment from the NHS, while criticising it as "a model of quasi Stalinist inefficiency"! ).    No gratitude, and I suppose we should not expect  respect from you for "From each according to his ability, to each according to his needs."?

John

[Wolfrace.]

NHS treatment isn’t free, that’s the fundamental lie at the heart of the NHS - everything costs and is paid for. 
 

The fiction the NHS is ‘free’ means many of the public are extremely careless about the way they waste the NHS’s time - see the astonishingly high % of missed appointment and procedures - it also fosters a toxic culture within the NHS that waste doesn’t cost anything.

if Yiu want a truly searing indictment of NHS waste? The drop out rate in breast cancer treatment at my local hospital, only 70% of patients bother to complete the full course of radio and/or chemo. Well, ‘it’s my choice and it’s free, innit’ - no, it’s cost the Trust an eye watering amount if wasted time avd money, you’ll probably be back in a year with Stage 4 cancer complaining it’s not fair, and the 30% drop out rate represents a large number of people who never got the chance to live as they didn’t get the treatment.

‘From each according to their ability, to each according to their needs’?

that’s the anodyne socialist mantra that sees my Orthopedic Surgeon required to give hip replacement to housebound people in the 80’s who she knows will never benefit from it, while required to chin off a hip reversion for a still full time employed 60 year old who’s had his hip in for 33 years.

matters not BTW, the very same NHS trust that won’t do a reversion on the NHS, will happily do said reversion as a private procedure - in the same NHS hospital, with the NHS staff - waiting time? In fur surgery the Same week.

[Wolfrace.]

And vote Labour to ‘save’ the NHS?

https://www.independent.co.uk/news/uk/politics/tony-blair-nhs-anniversary-barclay-b2369616.html

 

[JohnD]

17 hours ago, Wolfrace. said:

NHS treatment isn’t free, that’s the fundamental lie at the heart of the NHS - everything costs and is paid for. 
 

The fiction the NHS is ‘free’ means many of the public are extremely careless about the way they waste the NHS’s time - see the astonishingly high % of missed appointment and procedures - it also fosters a toxic culture within the NHS that waste doesn’t cost anything.

if Yiu want a truly searing indictment of NHS waste? The drop out rate in breast cancer treatment at my local hospital, only 70% of patients bother to complete the full course of radio and/or chemo. Well, ‘it’s my choice and it’s free, innit’ - no, it’s cost the Trust an eye watering amount if wasted time avd money, you’ll probably be back in a year with Stage 4 cancer complaining it’s not fair, and the 30% drop out rate represents a large number of people who never got the chance to live as they didn’t get the treatment.

‘From each according to their ability, to each according to their needs’?

that’s the anodyne socialist mantra that sees my Orthopedic Surgeon required to give hip replacement to housebound people in the 80’s who she knows will never benefit from it, while required to chin off a hip reversion for a still full time employed 60 year old who’s had his hip in for 33 years.

matters not BTW, the very same NHS trust that won’t do a reversion on the NHS, will happily do said reversion as a private procedure - in the same NHS hospital, with the NHS staff - waiting time? In fur surgery the Same week.

That does it, Wolfrace. You are the lowest of the low.

  Have you ANY idea of the side effects of chemo or radiotherapy?    The sickness, the vomiting, the skin burns from radiation, the hair loss,  that make anyone undergoing them view their next dose with dread.    And "people in their 80s who will never benefit" from a hip replacement?  Clearly, you do not care about the dragging pain of a severely arthritic hip, made worse with every movement, even turning over in bed, that persists even if you lie still, so dreading the moment when your full bladder forces you to move that you soil yourself.   Of course "house bound people in their 80s" are not worth treating, far better to repair the hip of a potentially productive worker.   You worm, you uncaring Tory.  May you never be in that position, you or your parents.

John

PS It's a "revision". 

 

PPS. Please will the monitors close this thread?     

Edited October 2, 2023 by JohnD

[Nick Jones]

Enough I think….