British hospitals at breaking point


(Barbara Deane) #1

Why?

What can be done?


(Timothy Cole) #2

Pump more money in or have a cull of the old, fat, drink and drug dependent.


(David Martin) #3

Higher taxes. Not politically popular but if the money has to be raised so be it.


(Chris Kite) #4

In the last few years I’ve seen elderly relatives in hospital in what I would consider poor conditions. A&E patients left in corridors for hours. Staff stressed to excess. Throwing money at a problem isn’t always the answer, but I would be surprised if people aren’t paying for healthcare in the not too distant future.


(Véronique Langlands) #5

Public service, public money; TAXES.


(Ann Coe) #6

Hi Tim
Don’t forget that we are all going to get old one day, the other 3 we can at least avoid with a bit of care :wink:


(Trevor Hunton) #7

The UK government’s have been cutting back on healthcare since the seventies. When I was a lad, we had cottage hospitals, maternity homes, convalescent homes, psychiatric units, large hospitals with plenty of bed’s. NHS dentists, state enrolled nurse’s, state registered nurse’s, nursing auxiliaries, all cut back. Funding cut back annually, healthcare on a budget.
The French spend eighteen billion a year more on healthcare, have a state backed insurance scheme for social care, have the best health system in the world. The NHS is the best cheap health system in the world. Plenty of people have harped on since the year dot about mismanagement in the NHS, but at the end of the day its underfunded. Doesn’t matter how good the manager is if he ain’t got no cash.


(Barbara Deane) #8

I remember when I was young thinking how safe it was being in hospital.
I remembered hating being there away from home but I did feel sure
that all would turn out fine…and it did.
Staff were trained to show compassion and care.
But not now.
Perhaps UK should realise that the most important thing in life is good health
and knowing that if you feel unwell that you can find proper help.
Now the focus is on making money.
And in turn that creates an “exhausted” population which leads to more illness.
Once again I will say that I do not look at figures…but I can tell that the French
system is working.
I have seen my neighbours in their eighties spend time working on the vines when
it so pleases them. I know that my electrician will have finished his work around 4 and
will stop for some lunch and enjoy his week end with his family and when he retires he
will be contented.
Yes more taxes but also, perhaps better recruitment, better training not just in the study
of human biology, anatomy but also in how to talk to patients and show care.
Not just for medical staff but for those who deal with administration and management.


(Jane Williamson) #9

Years of under investment, poor procurement with authorities not coming together sufficiently to get bargaining terms.
Best practice not being followed throughout the UK.
Fraud.
Over demanding patients, wanting to see the doctor when they could see a pharmacist, drunks on the weekend.
Oh, and lack of good leadership.


(Paul Flinders) #10

I’d love to know if you have any hard data to back that statement up - because it is simply not true.

UK healthcare in the 1970’s was pretty dire, in fact up to the late 1980’s when we started to turn the NHS around with considerable improvements in organisation and manpower, but spending on healthcare and the numbers employed within the NHS have gone up consistently (even adjusted for general inflation) since its inception.

As a %age of GDP spending is being reduced at present - it peaked in about 2010 and I am concerned that the target of less than 7% of GDP is too little. We also have the problem that “healthcare inflation” runs much higher than general inflation because modern drugs, especially for cancer, can be extraordinarily expensive. But t is a fallacy that the NHS has been consistently cut since the 70’s

All those cottage hospitals etc disappeared because they are simply inefficient, if not outright appalling providers of care, not because overall funding was being cut back. Bed numbers decreased because we recognised that long hospital stays are actually bad for people’s health (though probably by too much). Where there has been too little development is in “social care” so that bed blocking has re-emerged as a problem (and with fewer beds it can become an acute problem very quickly) but I remember it being a significant problem in UK hositals in the mid 80’s despite all those “wonderful” cottage hopitals.

See https://www.ifs.org.uk/uploads/publications/bns/BN201.pdf for some data.


(Barbara Deane) #11

Oh dear here come the facts and figures!!!
But it all went wrong somewhere.
And it continues to do so.
Just about every one I know in UK has had a story of wow
relating to the attention and service received in medical care.
14 years ago I spent hours parked on a trolly in a lonely
corridor before going to a ward for treatment for Septesemia.
Not a comforting experience …to think of spending your last
hours in Hammersmith on your own.


(Paul Flinders) #12

Not just “facts and figures” but personal experience - I work in the NHS and, though I took a fairly long sabbatical from 1988 to 2004, I worked in the NHS in the mid 80’s. There is simply no comparison in the levels of service today compared with back then. Do not forget the 3+ year waiting lists for (e.g.) hip replacements - it was not uncommon for patients to simply drop dead before getting to their surgery. Attitudes to quality of care have simply changed completely - back then you got what you were given and had to like it or lump it. Today we really try to learn from mistakes and prevent similar problems in future. I also dread to think how the service would have coped with modern levels of demand - it would just have collapsed completely.

Yes there are problems and the service does not always work for everyone, no organisation the size of the NHS is ever 100% perfect and there are certainly challenges - our emergency departments are struggling to cope with workloads created by the current underinvestment in general practice and the fact that people seem to be less self reliant/have higher expectations of support then they used to. Personally I would say that it is never acceptable to have someone on a trolley in a corridor but sadly this has become commonplace.

The NHS is not perfect, it needs more funds and more people. Just please do not kid yourself that the NHS of the 1970’s was somehow wonderful and perfect. It was not and the NHS of today is massively better, despite the problems.


(Mat Davies) #13

My recent experience of the NHS was ridiculously inefficient.

My daughter occupied a bed for 2 nights as there was nobody available to release her, the nursing staff although slightly sympathetic didnt do anything about it.

Apparently the cost to NHS of each overnight stay was approx £300 to sleep in a 6 person bay. I am slightly puzzled about how I can stay in a Travelodge for £40 with an ensuite etc - why is the difference £260 per night - I am aware that there are differences in that you would not have the nursing care - but does this really cost £260 per night per patient?

I am not convinced it is simply a case of allocating more money to NHS, I also dont think that it is also entirely the managements fault.

I am aware that this may be a little controversial - but what is a discussion without a series of opinions!


(Paul Flinders) #14

Gosh, where to start - what an apples to onions comparison.

£300 per 24 hours - well, yes there is nursing care but there are also the doctors, pharmacists, radiographers, porters, physiotherapists, occupational therapists, delivery of medical oxygen and vacuum to the bedside, patient monitoring equipment, catering, ward clerks, administrative staff, secretaries and probably half a dozen professions and expenditures that I have left off the list supporting that hospital bed.

If you really think that a hospital bed is in any way comparable to a Travelodge bed you are woefully misinformed.


(Barbara Deane) #15

Yes I get that Paul…
but t not every patient gets to a pharmacist, a porter, a physiotherapist, occupational therapist, receives oxygen!
And a shared ward…obviously …perhaps finances are not well planned?
now when it comes to the catering I can tell you a thing or 2 about that…
I knew someone who was in management at Hammersmith hospital and
we discussed the costs…you may not believe it.
I did offer my advise and I still believe that nutrition is key to recovery.
Simple foods close to being vegetarian rather than trying to adapt to religions.
I had his attention …after all he was one of my regular clients…but I think that
Jamie Oliver was brought in to consult.
My advise was free,
I think that some people in the medical world are paid far too much and others
far too little and the balance and the interest in work virsus income is not balanced.
Medication and oxygen is financed at source…and drug companies entice doctors to
recommend their products…or at least they did when I lived in UK.
I always look beyond the facts and figures and go much deeper in so that I can understand.


(Paul Flinders) #16

No, but the cost per bed day is averaged and these clinical specialists have to be provided and paid for and available to all patients according to need.

Can any organisation claim to use resources with 100% efficiency?

Oh, yes - I forgot dieticians. Hospital food quality (or lack thereof) is something that annoys me as well but from what I hear of French hospitals the NHS is not bad.

Not sure what you mean by “Medication and oxygen is financed at source” - delivery of medical gasses to the bedside is an infrastructure cost and almost certainly included in the bed-day costs (I’m not in NHS finance so don’t know but it would seem logical). Drug costs should not be included in the bed costs.

that is to be commended but making sure you are working with reliable facts and figures is also important.


(Graham Lees) #17

Did the rot not start when they got rid of all the ‘old style’ Matrons? They ruled the roost with a rod of iron - absolutely fearless - and would tell Surgeons, Doctors and administrators where to get off…


(Barbara Deane) #18

There is No excuse for the terrible hospital food which sits on trollies in the ward for hours.
And no staying in hospital is not comparable to fine dining but it needs to be assisting with recovery.


(Paul Flinders) #19

Total agreement there!


(Chris Kite) #20

From what I’ve seen some people feed their animals more enticing and nutritious food. I don’t have anything good to say about the present state of the NHS but then neither do I have the answers.