The NHS

BigT how do you think the A&E consultant maintains his suture skills if he don't practice on the simple cases? And not all nurses can suture and not all people in a nurse like uniform are staff nurses and considering A&E depts work on 12 hour shifts the staff are human and are allowed a coffee. Unfortunately they rarely get the time to go and get one away from the dept.

As for a 5 hour wait, is that such a bad thing? In America if you don't have the cash tough. Though I agree with your point about receptionists and despite being an NHS monkey myself if they ask why I need to see a doctor I refuse to tell them. Just state they don't need to know your issues and if you need triage ask to speak to a nurse.

As for the NHS being badly managed, yeah the government manages it badly but local management do the best they can with very little money. Care is suffering but if you leave 3 nurses to look after 32 patients on a ward then the best of nurses can't provide amazing care but that's the governments fault for cutting the budgets.

Either way I don't want the American model as money comes before a patients welfare. For example in the UK if you need a neck X-ray it's two exposures (two doses of radiation) in the USA you get 8 exposures, the extra 6 projections add no further useful info, add significant extra radiation dose BUT the hospital gets paid more so all is well!

As for private healthcare in this country, from my experience they buy cheaper equipment and source most of their work to the NHS.

Dave said:

BigT how do you think the A&E consultant maintains his suture skills if he don't practice on the simple cases?

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I'm sorry but simple cuts are completely beneath consultants and he shouldn't be touching them, complete bad case management, FYI the reason for the 5 hour wait was exactly the same reason, it wasn't busy, just the only person doing any work was the main man, if he was only dealing with more major cases then the waiting time would of been 30 minutes tops, like I said bad management.

Dave said:

As for the NHS being badly managed, yeah the government manages it badly

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Ah the government are to blame, thought you might say that seeing as they are finally getting to grips with the cash and making the NHS more accountable for its spending, and I'm sure the pay freeze has gone down well in your staff room.

Dave said:

As for private healthcare in this country, from my experience they buy cheaper equipment and source most of their work to the NHS.

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You obviously don't have much experience of private healthcare then because my local Private hospital doesn't source anything from the NHS they do it all themselves on the latest state of the art equipment, and you are seen by the top consultants who speak to you like a human rather than an inconvenience.


I make no bones about paying for private healthcare, it is the best care available and a hundred times better than the NHS.
I'm not rich but I don't smoke and rarely drink so I spend my hard earned money on that instead, it's my money I'll do what I like with it and as I already pay for the NHS anyway I'm actually doing you all a favor by not taking up a place in the waiting list.

The difference between the NHS and private is private healthcare has to make a profit (swear word on this site), which means that it is run efficiently, the NHS could learn a thing or two there.

I think when it comes to private health care, it depends where you live. From what I can tell, down South they have more Private facilities, where up north, they tend to use NHS facilities. Less demand up north for private facilities, so they use NHS I guess.

I don't think making a private health care making a profit is a bad thing, if the equipment is poor, the customer does not feel like they are getting value for money, they will go somewhere else, and that company will end up going out of business.

What ever you do, if you are successful, you deserve to be rewarded, whether that is offering a medical service, or whether its running a book shop. If you deliver a service that people keep coming back to, and paying what you are charging, then I do not see the problem.

I am a big fan of private business, I am a big fan that if you work hard, do a good job, you deserve to be rewarded for it, I am a big fan of the NHS as well, I just struggle to see how you fund something that needs more and more money every year.

Ian

My feelings on the NHS are mixed, but there's no way I would ever want to see it go.

When my mum had breast cancer a few years ago, the service she received was second to none. They got her in for an operation straight away, and afterward made sure she had all the best treatments going to make sure it wouldn't return. I don't think she would have received better treatment if she went private.

What has annoyed me with the NHS, though, is my treatment for gender dysphoria. I first went to my GP about it in September 2009, but didnt receive my first hormone prescription until June 2012. That's almost three years! It's disgracefully slow, and on top of that I haven't exactly had the best quality of care. I'm meant to be having regular blood tests, but I find them hard to organise.

Also, my current GP is terrible. You can only book appointments on the day, and all of them are gone by around 9 in the morning. There's always a huge queue outside as whole families get their whole family checked up, and there's no point in calling in as the phone line is usually jammed, and when you do get through the receptionist is a bitch.

Yea teachers work long hours my backside, none of the ones I know do. Has nothing to do with the NHS but teachers are not in the real world and everyone who isn't a teacher or student know that.

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My mum used to work fairly long hours.

BigT please source the medical journal that states the grading of cut a consultant should be banned from suturing as I'm intrigued as to what knowledge the NHS is missing out on.

As for the pay-freeze I took it as a necessary evil of the situation we are in, and I don't think anyone else has had issue with it (we don't have a staff room it's a cupboard with a kettle). We had issue with the pension as the government lied about its financial state to the nation but I and my colleagues have got on with life as you do.

I suggest you get a F.O.I request to your private hospital as there are very few who don't refer into the NHS and for good reason, its impractical for private hospitals to invest in certain treatments, and those consultants you are seing are NHS consultants, they supplement their NHS salaries by taking shifts in private hospitals as they would de-skill if they didn't work in the NHS. The only truly general exception to that rule is plastics and private GP's

As for the government getting to grips on spending they have done some good stuff (PFI was a terribly run idea) but they are cutting dramatically in areas of care and maintaining capacity for demand. This is having a huge knock on effect at basic level.

And as for profit, the NHS has to make one too, why do you think it takes the private patients. The actual difference between the private sector and the NHS is the private sector can refuse to provide treatments that don't make a profit even if it has benefit to the patient whilst the NHS can't.

I would quite happily see the NHS crumble, private hospitals pay better and give staff free private healthcare so I would be fine. But if someone I knew got some rare brain tumour requiring proton therapy then "ohh no sorry dear you can't afford that treatment but here's the address of your local hospice, we will claim the costs from your estate after you die"

The NHS will be missed when its gone...

BigT said:

I ring up my doctors 8:00 am in the morning and after a lengthy debate with the receptionist who somehow decides whether or not I'm ill enough to see a doctor even though she has no medical training whatsoever, I can normally get an appointment that day. So that's good and in general it works, I'm happy with that. (apart from the little hitlers)

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With all due respect, a receptionist's job is to prioritize patients to help clarify a schedule for the doctor. If she doesn't assess your condition, how do you expect her to do that? It'd be ludicrous for her to say "Yeah, sure, come in at any time with your cut and we'll wedge you in before that essential examination to decide whether to remove a kidney and the elderly gentleman with developed cancer". Calling these individuals fascist dictators for questioning the severity of your cut is not really a fair point.

BigT said:

Then the other week I cut my hand, not bad but deep enough it ain't going to heal on its own, 5 hours in A&E later...

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The NHS is an abused system, I feel. The five hour waits are stressful indeed, but patients tend to have this viewpoint that it's only a stress from their perspective; I'm pretty sure that the staff aren't exactly having a ball either.

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NastyPasty said:

BigT said:

I ring up my doctors 8:00 am in the morning and after a lengthy debate with the receptionist who somehow decides whether or not I'm ill enough to see a doctor even though she has no medical training whatsoever, I can normally get an appointment that day. So that's good and in general it works, I'm happy with that. (apart from the little hitlers)

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With all due respect, a receptionist's job is to prioritize patients to help clarify a schedule for the doctor. If she doesn't assess your condition, how do you expect her to do that? It'd be ludicrous for her to say "Yeah, sure, come in at any time with your cut and we'll wedge you in before that essential examination to decide whether to remove a kidney and the elderly gentleman with developed cancer". Calling these individuals fascist dictators for questioning the severity of your cut is not really a fair point.

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Actually it's not a receptionists job to triage patients as they are not clinical staff, some GP's try to use them as such (and Cameron wants GP's in charge... ohh my sides ache) but they shouldn't.

In A&E the cut would have been triaged by a nurse or doctor and if GP's want to see if you need to urgent appointment they need a better system than getting the receptionist to do it. The NHS is far from perfect though.

Sam said:

Maybe the teachers you know are just crap teachers...?

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Or good teachers if they only take 5 hours to do 5 hours work instead of taking 12, depends how you look at it.

Anyway I don't wish to derail this topic any more by talking about the work shy, let's keep on topic.

Dave, your right the cut to my hand was seen to by a triage, but why the hell couldn't she glue it. She took longer to bandage it up again than it would of taken to glue it and if she wasn't qualified too then what is she doing being a triage.

It's nice that at least we can agree about the little hitlers working in the doctors though.

Don't get me wrong I'm not saying abolish or shut down he NHS but it does need knocking into the 21st century, and if that means ruffling a few feathers then so be it.

Trouble is the wrong feathers are being ruffled, nothing the government is doing will change anything as the simple answer is there is not enough staff or equipment to do the job properly and Con/Dem have cut those even further. Then they wonder why patient care is going down the pan.

To answer your cut question it would depend on the size of the hospital you visited, but closing deep wounds is an extra skill to a nurse and if non where available then the Consultant would be needed. Despite what casualty suggests A&E's are not 24/7 pounding on peoples chests and removing bullets. Its mostly people who don't know what a GP is and you might have been the most complex case in so the consultant took it.

I've bit my tongue on this topic for quite a while, but as someone with a chronic medical condition, I have experienced both the good and the bad points of the NHS. In my experience if you find a good GP/Consultant/Nurse then you need to fight to see that particular person, because there are so many that are just not interested. It took them almost 5 years to diagnose my condition, when my age and symptoms should have been screaming at them what it actually was. My own GP (one of the good ones) actually diagnosed me, but because the consultant I got sent to at the hospital didn't see what he wanted to on the MRI scan I went for, wouldn't send me for any further tests that my GP had asked for. Consequently by the time I was diagnosed I was in a far worse state than I should have been.

Oh and I agree with the comments on the receptionists that some have made. I once had to make an emergency appointment, they asked me what for, so I had to tell them it was on the screen that I was being investigated (at the time) by the hospital. The response "You're not dying, it can wait". I know for a fact the surgery wasn't even that busy, as in the end someone ran back on my behalf and got me an appointment, when I got to the surgery there was only one other person there!