PDA

View Full Version : Nhs



WeeMouse
07-10-2003, 11:20 PM
Ok I studied the NHS as part of my higher Modern Studies topic this year, and it seems to be getting worse and worse, so the question is - what do we do about it?

For those who don't know:

the NHS was founded in 1948 by a Labour Government, who beleived that health care should be free for everyone at point of use...they wanted to eradicate health divisions between social classes.

The theory was that if a National Health Service was set up, people would eventually become healthier and the NHS would not be needed as much....not the case tho! Costs, scandels and dirty hospitals have made Labour promise to reform it.....

Any ideas? Privatisation? Abolish the NHS? Raise taxes?

If any one has any questions about the NHS i'll try my best to answer :)

hobbes
07-10-2003, 11:29 PM
Undermining every Idealists' dream is a capitalists' scheme.

WeeMouse
07-10-2003, 11:41 PM
:rolleyes:

Hi Hobbes!

:D

you've always got an answer! :)

Rat Faced
07-10-2003, 11:44 PM
The NHS.....

Now that IS a can of worms.

Unfortunately every time you reform, you create more administration, and its the cost of the administration that precludes paying Nurses (etc) a decent wage.

As they cant recruite nurses (etc) for the crap wages (for what they do) then the whole hospital slows down, so they have to contract out to Private Hospitals (or even abroad) to try and get the waiting lists down to meet the governments targets (which costs more, and so causes more budget problems).

We had a Health Service that was the envy of the world, until Thatcher got her hands on it....

The Government ploughs money into it saying that this money cannot be used for staff wages....as its staff shortages which cause most of the problems, all of this extra money gets wasted in contracting out...which is slower and costs more.


Im sorry, I know the NHS has great problems....but 90% of them are CAUSED by the government of the day getting involved in reform.

I have every respect for the Junior Doctors and Nurses working in the service.



NB:
Not for the money grabbing Consultants using the NHS, as a way of refering patients to themselves in their Private Practices......leeching the money out of the service.

WeeMouse
07-10-2003, 11:49 PM
The government is always looking at how to cut costs....one of the problems is the drug bill in my opinion, as well as the government just generally mismanaging the whole system!

So we can't reform cos that costs money....but something had to be done otherwise our NHS goes down the plug anyway? Hmmm...glad I'm not Mr Blair!

Rat Faced
07-10-2003, 11:54 PM
I have yet to find any way to Invest by cutting costs.

Shame, could make a million by sharing that secret ;)

WeeMouse
07-10-2003, 11:56 PM
:lol:

We could think up a solution right now and sell it to the Government! :P

Maybe we should encourage private health treatment a bit more -
more people use Private treatment = less people use the NHS but still have to pay texes for i!

mogadishu
07-11-2003, 05:52 AM
I only wish that we americans could come up with something like National Healthcare. It just makes so much sense. I for one am always in favor of higher taxes, but right now I think that it would be better to rethink how America/Britain spend their money. I am not sure how much you guys spend on your military, but I bet it's way too much, just like us, we are the epitemy of overspending. Why not take half of what we spend on the military and put it into things like National Health Care. Sure, maybe some kid back home won't get to bomb the sh*t out of some terrorists with a remote control drone, but atleast your grandmother can get the healthcare she needs.

ilw
07-11-2003, 07:59 AM
Its not always the actual reforming that cause more money to be wasted its the -ing stupid people who want accountability for everything which leads to more paperwork and more manhours wasted. I reckon we should have a little more faith in medical practitioners. Obviously theres other factors like the aging population and the increasing cost and variety of drugs. And about the military, yes we probably spend too much, I think we had first or second highest % of GDP spent on arms (in developed countries) around 23billion a year. But we've got a nuclear fleet and a world class army to maintain.

Neil__
07-11-2003, 10:31 AM
WeeMouse

Do you think that it's the thatcherite years that screwed it over with 16 years of cronic underfunding and the development of an anti tax culture that makes this such a problem for Blair

The NHS needs billions now to turn it around and repair the damage that the tories did to it. massive infrostructure investment and huge increases in staffing are essential.
but with peoples pennypinching attitude to tax who is prepared to pay.

The answer seems simple
you pay your money you get your choice.

How does that equate to the research you have done WeeMouse
and what are the hidden issues with respect to this we don't hear about?

Neil

WeeMouse
07-11-2003, 10:47 AM
RIght....it was Thatcher's reign that screwed the NHS royally.....it needed funding and her solution was to introduce competative tendering - which basically meant things like cleaning were contracted to an outside firm. This was meant to save money as firms competed for the contracts, but it meant that the standards of service went down.....

Anyway....it's a problem....Mr Blair is stuck between a rock and a hard place here! He could raise taxes, but we never want that! British people already think they pay too much, although research does show that just under half or so would be prepared to pay more taxes....or he could introduce more prescription charges, but this would cause an uproar cos the NHS is meant to be "Free for all at the point of use"....

There's just all sorts of hidden problems here - our buildings are old and crumbly, so private firms basically pay the government and make the buildings pretty and clean, but that means our state-run hospital is in a private building! And sometimes the NHS beds are "rented" out to private patients, too.....

Neil__
07-11-2003, 11:35 AM
so basically the tories "Privatisation by stealt" of the NHS got too far progressed for any quick fixes.

Are these contracts with private industry watertight or can they be reversed?
And does the present government have the political will to do this?
and will it help?

What have you found.

Neil

WeeMouse
07-11-2003, 12:01 PM
I have found out more about PFI :


Labour ministers prefer to refer to the PFI using the more generic and less politically charged term "public-private partnership" or PPP.

The term PPP describes any private sector involvement in public services including the transfer of council homes to housing associations using private loans, and contracting out services like rubbish collection or hospital cleaning to a private companies.

The PFI, the most well-known form of PPP, refers to a strictly defined legal contract for involving private companies in the provision of public services, particularly public buildings.

Under a PFI scheme, a capital project such as a school, hospital or housing estate, has to be designed, built, financed and managed by a private sector consortium, under a contract that typically lasts for 30 years.

The private consortium will be regularly paid from public money depending on its performance throughout that period. If the consortium misses performance targets, it will be paid less.



People don't seem to like PPP/PFI - think it is a way of sneakily privatising everything!

ilw
07-11-2003, 12:09 PM
The problem with performance targets, is that they are really impossible to choose in a health setting because theres no real clear goal, other than to treat everyone to the best of your ability.

Edited punctuation

WeeMouse
07-11-2003, 12:14 PM
Originally posted by ilw@11 July 2003 - 13:09
The problem with performance targets, is that they are really impossible to choose in a health setting because theres no real clear goal, other than to treat everyone to the best of your ability.


Yup and it puts staff under increased pressure to reach those targets, so they cannot work to the best of their ability if they are overworked.

Health care should be about quality, not quantity! Perhaps we should send Mr Blair a link to this topic.......?

Neil__
07-11-2003, 12:24 PM
Originally posted by ilw@11 July 2003 - 13:09
The problem with performance targets, is that they are really impossible to choose in a health setting because theres no real clear goal, other than to treat everyone to the best of your ability.

Edited punctuation



the real problem with performance targets is that there being fiddled in order to pass the target.
One hospital transfered dozens of staff to A&E for the day/week of the testing and they passed.
also the fiddling of the waiting lists has become a science.
one hospital's management tean came in one night and cancelled all the follow up treatments for a couple of weeks and replaced the appointments with patients that were about to miss the targets
they did this without consulting the doctors and with no consideration for clinical need.
the only reason was to hit the governments rediculous targets just do Blair can say there is an improvement in performance

and when the punnishment for failure is dissmissal can you realy blame them.

The targets are there not to improve performance but to hide Blair's blushes

WeeMouse

So the privatisation still continues?

Neil

WeeMouse
07-11-2003, 12:33 PM
Basically, yeah - Tthe privitization still continues. Only in a sneaky and underhand way though so that most voters wouldn't realise.

ilw
07-11-2003, 12:37 PM
Its not just that they're fiddled, its also that u can't measure the right things, for instance some of the measures like % of AE patients treated within a certain time are just stupid because the people most in need of treatment are likely to take longer to treat and so tie up doctors and nurses for longer.

Neil__
07-11-2003, 12:38 PM
Originally posted by WeeMouse@11 July 2003 - 13:33
Basically, yeah - Tthe privitization still continues. Only in a sneaky and underhand way though so that most voters wouldn't realise.



That's what I think also.
Do you have any idea what to do about the fiddling of the figures.
considering the government isn't going to stop interfeering.

Neil

WeeMouse
07-11-2003, 12:54 PM
Originally posted by Neil__+11 July 2003 - 13:38--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Neil__ @ 11 July 2003 - 13:38)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-WeeMouse@11 July 2003 - 13:33
Basically, yeah - Tthe privitization still continues. Only in a sneaky and underhand way though so that most voters wouldn&#39;t realise.



That&#39;s what I think also.
Do you have any idea what to do about the fiddling of the figures.
considering the government isn&#39;t going to stop interfeering.

Neil [/b][/quote]
Don&#39;t know what the govt is doing - will try to find out tho&#33;

I think that they try o discourage the fiddling of figures, but what can they actually do? THey could get people to check all of the figures but that would mean more cost&#33;

Neil__
07-11-2003, 01:09 PM
who do you get to audit the figures.
How about arthur andersen there trustworthy.

well Enron trusted them at least.

Neil

Rat Faced
07-11-2003, 04:09 PM
Im still totally confused as to how the Government can even claim that PFI (PPP if you want the new name) is value for money.

Instead of paying to Build a Hospital, School or and other building they get the Private Sector to build one Garanteeing a 25 year lease...the price they pay over 25 years is probably 2.5 times as much as they would pay if they Contracted to build the work themselves...(Generally 10yr lease covers the cost of building something)

If they dont need the building 10 years down the line, they are still stuck with a 15 year lease they cant get out of, instead of a building that has gone up in value and they can sell at a profit as is, or for redevelopment.

At the end of the 25 years they have nothing to show for it, and the building can literally be taken off them in an open market.


On top of all this, there are a load of the firms that have been caught out in trying to Bribe officials....

bigboab
07-11-2003, 07:29 PM
I think I may have an answer

Why doesn&#39;t the government pay part of our National Insurance Contributions to the likes of &#39;BUPA&#39;, then, when we become ill force &#39;BUPA&#39; to honour what it says in its adverts and brochures. Te remaining part of our insurance contributions could be used to tend to the less fortunate.

I Bet &#39;BUPA&#39; would like this idea(Like hell&#33;) :) :) :)

Neil__
07-11-2003, 08:58 PM
Originally posted by bigboab@11 July 2003 - 20:29
I think I may have an answer

Why doesn&#39;t the government pay part of our National Insurance Contributions to the likes of &#39;BUPA&#39;, then, when we become ill force &#39;BUPA&#39; to honour what it says in its adverts and brochures. Te remaining part of our insurance contributions could be used to tend to the less fortunate.

I Bet &#39;BUPA&#39; would like this idea(Like hell&#33;) :) :) :)



Or why doesn&#39;t the government say the likes of BUPA can only trade in Britain if the treat a percentage of NHS patients?

Neil.

WeeMouse
07-11-2003, 09:43 PM
Dunno if it could work - pay BUPA part of our NI? Could we afford to anyway? We need money for the NHS now and it may not be a good idea to give part of it to a private organisation.....

On the point of private medicine - d&#39;ya think it&#39;s good or bad for the NHS? On one hand you have people who pay NI contributions but get treated privately, and so do not use the NHS&#39;s resources....but private hospitals may "steal" NHS staff and do not always offer a great health care service&#33;

JUst my ramblings........ :)

Neil__
07-11-2003, 09:54 PM
Originally posted by WeeMouse@11 July 2003 - 22:43
Dunno if it could work - pay BUPA part of our NI? Could we afford to anyway? We need money for the NHS now and it may not be a good idea to give part of it to a private organisation.....

On the point of private medicine - d&#39;ya think it&#39;s good or bad for the NHS? On one hand you have people who pay NI contributions but get treated privately, and so do not use the NHS&#39;s resources....but private hospitals may "steal" NHS staff and do not always offer a great health care service&#33;

JUst my ramblings........ :)



WeeMouse

As long as the excuse isn&#39;t made that if we have large ammounts of private patients then it&#39;s a reason to cut back the NHS

I think you have a very good point
if many who can afford it pay for private medicine then the NHS will have less of a burden and be able to help the poorer in society
the danger is then that we end up with a second rate NHS with all the best doctors/nurses and others staff being headhunted with huge salaries (by private medical companies) that the NHS cannot afford.

and worse still we could end up with a system like america where only the poorest get free treatment and only the richest can afford private
then the ones in the middle just die in the gutter.
I know America isn&#39;t that bleak but it&#39;s not far

Neil

WeeMouse
07-11-2003, 09:58 PM
Originally posted by Neil__+11 July 2003 - 22:54--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Neil__ @ 11 July 2003 - 22:54)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-WeeMouse@11 July 2003 - 22:43
Dunno if it could work - pay BUPA part of our NI? Could we afford to anyway? We need money for the NHS now and it may not be a good idea to give part of it to a private organisation.....

On the point of private medicine - d&#39;ya think it&#39;s good or bad for the NHS? On one hand you have people who pay NI contributions but get treated privately, and so do not use the NHS&#39;s resources....but private hospitals may "steal" NHS staff and do not always offer a great health care service&#33;

JUst my ramblings........ :)



WeeMouse

As long as the excuse isn&#39;t made that if we have large ammounts of private patients then it&#39;s an excuse to cut back the NHS

I think you have a very good point
if many who can afford it pay for private medicine then the NHS will have less of a burden and be able to help the poorer in society
the danger is then that we end up with a second rate NHS with all the best doctors/nurses and others staff being headhunted with huge salaries that the NHS cannot afford.

and worse still we could end up with a system like america where only the poorest get free treatment and only the richest can afford private
then the ones in the middle just die in the gutter.

Neil [/b][/quote]
I definately wouldn&#39;t like to have an entirely privatized health care system&#33;

I think private medicine is getting more popular as employers offer BUPA packages and such like to employees - I myself have one&#33;

the NHS has been muddled with and screwed with for too many years now...it needds to be fixed, otherwise many more people will choose private medicine.

ilw
07-13-2003, 05:14 PM
Does anyone know roughly how much each of us pays each year for the NHS (or what the total NHS budget is) and how much we&#39;d have to pay to get medical insurance of an equivalent scope from say BUPA? That would be quite interesting to know.

ilw
07-22-2003, 01:48 PM
Just saw this report on some of the negative effects that setting targets can have:
http://news.bbc.co.uk/1/hi/uk_politics/3085105.stm

Though thinking about it, nobody ever mentions the positive effects of targets (and there must be some apart from cost cutting )

lynx
07-22-2003, 02:14 PM
I know that problems like this probably happen all over the country, but why is it that it almost always seems to be problems in Bristol which are reported in the news ?

ilw
07-22-2003, 02:35 PM
wasn&#39;t bristol the gay rape capital of Britain :o a few years back
Maybe its got something to do with that? ;)

lynx
07-22-2003, 02:54 PM
I would have thought that was Brighton, but don&#39;t take my word for it, I&#39;m not an authority on that sort of thing.

Maybe it&#39;s just that doctors in Bristol just can&#39;t keep their mouths shut.

Hmmm, maybe you were right about Bristol. ;)

Rat Faced
09-19-2003, 11:10 PM
No matter what you feel about the NHS...you have to wonder if the Americans are happy with their system....

Open Letter (http://congress.org/congressorg/bio/userletter/?letter_id=47364841&content_dir=congressorg) to Congress.org....



September 19, 2003

That remark about "open ended entitlements" coming from you OVERPAID BASTARDS, WHO JUST VOTED CONGRESS,THE OVERPAID FEDERAL WORKERS AND RETIREES WILL NEVER BE ENROLLED IN MEDICARE, KEEPING YOUR ROLLS ROYCE PLAN FOR YOURSELVES, is the height of ABSURDITY&#33;&#33;&#33;&#33;&#33; PLUS, WHAT ABOUT THE OPEN ENDED ENTITLEMENT OF CONGRESS&#39;S UNLIMITED POWER TO REWARD THEMSELVES WITH RAISE, AFTER RAISE, AFTER RAISE????? ARE YOU VOLUNTARILY GIVING THAT UP? BELIEVE ME WE ARE READY TO TAKE BACK YOUR DAMN PERKS THAT YOU GIVE YOURSELVES AND THEN PRESENT THE TAXPAYERS THE BILL&#33; LOOK AT THE MOOD OF THIS COUNTRY&#33; WE NEED TERM LIMITS BUT YOU GREEDY THIEVES HAVE IT ALL LOCKED UP SO NO HONEST PERSON NEED APPLY&#33;&#33;&#33;&#33;&#33;&#33; I DON&#39;T WANT OR NEED YOUR STUPID RX COVERAGE BILL YOU IDIOTS ARE TRYING TO RAM DOWN OUR THROATS&#33;&#33;&#33;YOUR ARE ALSO PROBABLY IN CAHOOTS WITH THE FORTUNE 500 COMPANIES AND OF COURSE THE INSURANCE INDUSTRY WHO SHOWER YOU THIEVES WITH READY CASH TO STAY IN CONGRESS IN PERPETUITY&#33; PUT US ALL ON CONGRESS&#39;S EXCELLENT HEALTH CARE PLAN AND SHUT UP ABOUT ENTITLEMENTS UNTIL YOU RELINQUISH YOU OWN&#33;&#33;&#33;&#33;&#33;&#33;

Charlotte , NC



I just found this site....love it.

If anyone ever had any doubt as to what Americans feel about their government..visit.

Its a hoot.

ilw
09-19-2003, 11:19 PM
Originally posted by Rat Faced@20 September 2003 - 00:10
I just found this site....love it.


It shows :rolleyes: :lol:

bigboab
09-22-2003, 03:15 AM
What are we talking about here?