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The NHS....Not Fit For Purpose?

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craigie b
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PostPosted: 18:04 - 13 Nov 2007    Post subject: Reply with quote
Quote:
As for the missing an ear infection . . . . does happen very very rarely.


It happened by four or so doctors in succession. That removes the chance of it being rare. However, it is a surgery that has a rotation of doctors every bloody week, which means no doctor is there long enough to suffer from malpractice or really be held accountable.

I'm not saying all doctors are crap, but I'm saying the general state of the NHS is not very good (shite would be an appropriate term, I think).

Its better than nothing but once you see how some other counties do it much better you actually realise that your original opinion of the NHS being good is marred by the fact it is the only health service most have ever experienced.
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syl
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PostPosted: 19:37 - 13 Nov 2007    Post subject: Reply with quote
Annabella wrote:
craigie b wrote:
Yeah they all work for BUPA though Laughing .


Most consultants work privately and for the NHS. I remember one proudly boasting that she earnt more working privately one day a week than she did the rest of the week for the NHS, so would recommend her patients went private (by overestimating the NHS waiting time and exaggerating how quickly they would be seen privately) as many of her NHS patients onto the private waiting list as possible - more money for her from people she would have to treat anyway.


Some consultants work privately and for the NHS. It's generally not worth the effort to do private work unless you do a reasonable amount of it, as you have to pay out for all the expenses such as rooms, secretary, accountant, stationary and (most expensive of all) insurance.

Patients chose to go privately for a number of reasons:

- there is no MRSA
- they get more attention
- they are seen quicker
- the rooms are nicer
- the food is nicer

One full day a week in the private sector would earn what it takes 40+ hours a week to earn in the NHS. It would be very rare for the doctor to bring up the issue of private work - it's the patient that tends to initiate that conversation. Lying about the NHS waiting time would be very dishonest - though the reality is that in the NHS you will probably get your routine operation done within 18 weeks these days (and it used to be much longer), privately you will probably get it done within four weeks, possibly within two weeks and maybe even later this week.

There is a plus side to private practice for the NHS too, of course. Every patient pays their taxes. If one chooses to pay AGAIN, and have his/her treatment done privately, this frees up a slot for someone else to move up the NHS waiting list into their free slot.
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J0Al1
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PostPosted: 20:02 - 13 Nov 2007    Post subject: Reply with quote
craigie b wrote:
I'm not saying all doctors are crap, but I'm saying the general state of the NHS is not very good (shite would be an appropriate term, I think).



It's the out of hours, I very much agree with that. There was a case on TV of a lady that died due to the out of hours service not diagnosing her. The reason being each 'new' doctor that saw her did not have any of the history of the problem, which is terrible, not the doctors fault, but a bad system.

Terrible shame, that lady clearly needed help, where as most of the punters are time wasters.

I have been lucky enough to always have had good Doctors wherever I have lived and to never have had to use out of hours.

We can not help but base our opinions on our own experiences.
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craigie b
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PostPosted: 04:14 - 14 Nov 2007    Post subject: Reply with quote
Thankfully I have never, ever had to use out of hours. Most docs these days don't even like going to visit patients out of hours.

I remember back home in Fraserburgh, a woman who had lost both brothers at sea (fishing incidents in the North Sea), took a handful of paracetamol.

She later told her parents. They called our then local Doc, who, rather than rush round and visit, advised she drink 'plenty of milk and other fluids'. She died a couple of hours later being rushed through to Aberdeen Hospital.
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J0Al1
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PostPosted: 08:17 - 14 Nov 2007    Post subject: Reply with quote
I have to say Craig thats terribly sad, but if I was told my a a member of my family that they had just tried to kill themself, I would call an ambulance or take them to AnE myself.

GP's are not on call paramedics.

Do GP's do OOO home visits anymore?

I have heard nothing but excellent reports about the OOO service at our local hospital (walk in centre).
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craigie b
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PostPosted: 08:57 - 14 Nov 2007    Post subject: Reply with quote
Quote:
I have to say Craig thats terribly sad, but if I was told my a a member of my family that they had just tried to kill themself, I would call an ambulance or take them to AnE myself.

GP's are not on call paramedics.


Rolling Eyes I get the distinct impression if I said black you would say white just because your old man's a GP. You think its fine a doctor would diagnose, over the phone, a suicide attempt as being 'nothing to worry about' or worst still not being his responsibility because he's not a paramedic?

Maybe had your first bit of advice been given by the doctor (i.e. call 999) then maybe the girl would still be here. [/quote]
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Annabella
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PostPosted: 13:09 - 14 Nov 2007    Post subject: Reply with quote
dmahon wrote:
Patients chose to go privately for a number of reasons:

- there is no MRSA


What?! You really believe that there are no cases of healthcare acquired infections within the private sector?

Mmmm, you've been reading the tabloids haven't you?

Here are the facts:- private providers don't have to report on their infection rates, so they don't. If they had a 0 rate of infection don't you think they'd be busy boasting about that?
The Healthcare Commission rates all providers on their ability to comply with a set of Standards, including one for patient safety which includes the minimisation of risk of HCAIs. A random dip from the many shows that Bupu Hospital Bristol isn't meeting this standard - I know I could find more.

In Ireland (ok, not the NHS) their private hospitals DO report their levels of infections and they are not that dissimilar to those of our NHS hospitals.



dmahon wrote:

One full day a week in the private sector would earn what it takes 40+ hours a week to earn in the NHS.

How do you make 40+ hours for someone who works only four days a week for the NHS?

dmahon wrote:

this frees up a slot for someone else to move up the NHS waiting list into their free slot.


Bear in mind there are a limited number of specialists and consultants. If they all chose to spend half their time working privately that would HALVE the number of 'slots' available within the NHS and hence double the waiting time.

There will always be greater demand for NHS treatment than private because, let's face it, most of us can't afford private treatment.
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J0Al1
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PostPosted: 14:49 - 14 Nov 2007    Post subject: Reply with quote
craigie b wrote:
Rolling Eyes I get the distinct impression if I said black you would say white just because your old man's a GP.


Nope, not at all. I'm sure there are some pants Doctors out there and bad stories out there. I just get to here a lot from the other side of the fence.

With this story . . . . whats the history? For all you know it was a weekly call that came from that family. It happens! Is the story even true? We all know that if you take an OD on pills the last thing you do it drink loads of fluid!!

My point is, don't be too coloured by all the stories we read/hear.

Razz
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J0Al1
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PostPosted: 14:52 - 14 Nov 2007    Post subject: Reply with quote
craigie b wrote:
You think its fine a doctor would diagnose, over the phone, a suicide attempt as being 'nothing to worry about'



Plus . . . I didn't say that Craig.
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craigie b
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PostPosted: 15:55 - 14 Nov 2007    Post subject: Reply with quote
Quote:
For all you know it was a weekly call that came from that family. It happens! Is the story even true? We all know that if you take an OD on pills the last thing you do it drink loads of fluid!!


I come from a small town. The family was well known (in fact their related), and coming from a small town, who's main source of income is fishing, its not the family's job to make the diagnosis. My point is not everyone is as blessed as us to have the common sense or intelligence to react accordingly, that's why we have services to react for us.

If you look at any chemical bottle which you shouldn't drink, it will say drink milk and plenty of fluid...why? To dilute the effects of the poison.

Quote:

Plus . . . I didn't say that Craig

No, you said Doctors were not paramedics as if to imply it is not a doctors responsibility to give a fuck.[/quote]
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craigie b
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PostPosted: 15:57 - 14 Nov 2007    Post subject: Reply with quote
Quote:
How do you make 40+ hours for someone who works only four days a week for the NHS?


I've done that in two days....not suggesting doctors use speed, just making an observation Laughing
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Annabella
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PostPosted: 16:10 - 14 Nov 2007    Post subject: Reply with quote
craigie b wrote:
I've done that in two days....not suggesting doctors use speed, just making an observation Laughing


You said yourself Doctors don't like working out of office hours.
4 x 7.5 = 30hrs Wink
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craigie b
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PostPosted: 16:12 - 14 Nov 2007    Post subject: Reply with quote
Damn, my mistake. I do apologise. I'm using myself as a yardstick and missing the point completely Wink Very observant of you Laughing Thumbs Up
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J0Al1
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PostPosted: 20:55 - 14 Nov 2007    Post subject: Reply with quote
craigie b wrote:
If you look at any chemical bottle which you shouldn't drink, it will say drink milk and plenty of fluid...why? To dilute the effects of the poison.


Chemical, like beech, yep. Pills no, it breaks them down and gets them into your blood stream quicker - meaning a stomach pump will be less effective.

That Doctor made a bad judgment call on that one. Was he struck off?
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syl
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PostPosted: 01:40 - 19 Nov 2007    Post subject: Reply with quote
Annabella wrote:
Kickstart wrote:
Maybe their budgets should be far larger


Shocked

Sadly, from experience, most GPs would struggle to manage the budget for a church fete....


Funnly enough, many doctors seem to think along similar lines with regard to the PCT:

a doctor wrote:
to be fair my pregnant Belgian Sheperd could do a better job of managing a large budget than most of the muppets you find running PCTs

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syl
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PostPosted: 02:14 - 19 Nov 2007    Post subject: Reply with quote
Annabella wrote:
dmahon wrote:
Patients chose to go privately for a number of reasons:

- there is no MRSA


What?! You really believe that there are no cases of healthcare acquired infections within the private sector?


Of course there is the occasional case, but on a completely different scale to the NHS. This is because:

    Patients are screened for MRSA prior to admission. If they carry MRSA, they are treated (at home) prior to admission.

    Private hospitals generally take elective patients. They rarely admit unscreened emergencies.

    All patients are housed in single rooms. Bed occupancy is not pushing 100%.


Annabella wrote:
Here are the facts:- private providers don't have to report on their infection rates, so they don't. If they had a 0 rate of infection don't you think they'd be busy boasting about that?


They do (some of these quotes may be a year or two old, so I can't say that any ZERO is still ZERO, but the numbers are definately much lower than in the NHS)! Here are a few:

Quote:
The numbers of recorded MRSA infections within Nuffield Hospitals is extremely low.


Quote:
The hospital boasts a zero rate of hospital acquired MRSA in the last twelve months (July 2006).


Quote:
Fears over catching MRSA are leading people to take out private medical insurance, reveals healthcare provider BUPA as it launches a new ad campaign highlighting private hospital hygiene.


Quote:
Dr Natalie-Jane Macdonald, BUPA Insurance medical director, said: “We have noticed that more and more of our customers are giving MRSA as a reason for calling to enquire about buying private medical insurance because they know the MRSA rate in private hospitals is much lower than in the NHS.”


Quote:
BMI Healthcare is one of the biggest private hospital groups in the UK, with 47 hospitals. During the course of a year, the group has a quarter of a million in-patients and three-quarters of a million out-patient visits. How many patients in BMI hospitals have acquired MRSA in the blood? None. In fact, over the years, the company has "never" had such a case.


Annabella wrote:
In Ireland (ok, not the NHS) their private hospitals DO report their levels of infections and they are not that dissimilar to those of our NHS hospitals.


50% of the population in Ireland are insured and treated privately - therefore the private healthcare system there is completely different to the private healthcare system in the UK.

Annabella wrote:
dmahon wrote:

One full day a week in the private sector would earn what it takes 40+ hours a week to earn in the NHS.

How do you make 40+ hours for someone who works only four days a week for the NHS?


0800-1800 four days a week = 40 hours.
One night every other week.
One complete weekend (Fri/Sat/Sun) every 8 weeks.
Some paperwork done at home.

The NHS hours add up fast.

Of course, the private work might be done in the evening or at the weekend.

Annabella wrote:
dmahon wrote:

this frees up a slot for someone else to move up the NHS waiting list into their free slot.

Bear in mind there are a limited number of specialists and consultants. If they all chose to spend half their time working privately that would HALVE the number of 'slots' available within the NHS and hence double the waiting time.


The vast majority of consultants who do private work, do it in their spare time. There are very few consultants, mainly in London, who work less than full time for the NHS because they have so much private work to do.
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cestrian
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PostPosted: 02:41 - 19 Nov 2007    Post subject: Reply with quote
"The NHS....Not Fit For Purpose?"

The reason for this has been presented to me. It's available via PM, all you have to do is ask Wink
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craigie b
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PostPosted: 06:29 - 03 Dec 2007    Post subject: Reply with quote
I was watching Micheal Moores flick 'Sicko' yesterday. Now, I like Micheal Moore, however he does paint a very one sided tale which is as bad as the other side, with the exception that Moore tends to be on the side of the common man.

His film shows the health care that is received in America and more importantly how it is funded. To this extent, he shows how Health insurance companies are interested in nothing other than profit and to this extent will quite often deny people medication due to one of a million ludicrous reasons.

Now, without proper research I would take what he says with a pinch of salt (especially when he paints the NHS as a heavenly health service where no aliment goes uncured), however I do find it credible that insurance companies would put profit before peoples life. Its not like we don't see this everyday with the likes of car insurance.

Based on that alone, I would rather keep the health service nationalised and simply improve the infrastructure instead. The thought of being refused health care at all because you ticked the wrong box or failed to meet the specific criteria is appalling.
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Annabella
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PostPosted: 17:28 - 03 Dec 2007    Post subject: Reply with quote
craigie b wrote:
I do find it credible that insurance companies would put profit before peoples life.

Thumbs Up Good point.
Try getting travel insurance if you have had cancer at any point in your life, try getting life insurance (at a reasonable rate) if you have had cancer, a back injury or any major surgery at any point in your life.

It's possible, but it will be near enough unaffordable. Insurance companies are all the same regardless of what they are supplying.


Dhamon, in response to your points regarding MRSA and private hospitals. Can you imagine the uproar in the press if a patient were turned away because they were carrying MRSA? Can you imagine the backlash if, in addition to the usual waits at A&E, people had to wait for blood tests to come back stating whether they're positive for MRSA or not?
It simply wouldn't work. The system has to provide care quickly and in emergency situations to those that need it.


You state that private hospitals do report their MRSA rates. That is not the case. The numbers of MRSA recorded are very low... yup, if it wasn't a legal requirement to record them here then there would be a very low rate recorded because only those that weren't sucessfully treated would be reported - do you want to hazard a guess how many that is for my local Trust? Ahh, yes, ZERO!
Your second quote states "Hospital Acquired MRSA" - again, that would be ZERO, however we have to report on ALL cases of MRSA regardless of source.

Read between the lines, it starts making far more sense then Wink
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syl
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PostPosted: 14:36 - 04 Dec 2007    Post subject: Reply with quote
Annabella wrote:
Dhamon, in response to your points regarding MRSA and private hospitals. Can you imagine the uproar in the press if a patient were turned away because they were carrying MRSA? Can you imagine the backlash if, in addition to the usual waits at A&E, people had to wait for blood tests to come back stating whether they're positive for MRSA or not?


It's nasal (and axilla/groin) swabs generally. These are done on elective (non-urgent) patients and this does occur in some NHS hospitals already. Positive patients can be treated at home prior to admission. Emergency patients are different - of course they cannot be turned away simply because of MRSA. Having hospitals open to all-comers without screening, running at almost 100% capacity and having shared facilities does not help control infection. This is the reason why the NHS hospitals suffer significantly compared to private hospitals.

Annabella wrote:
You state that private hospitals do report their MRSA rates.


No I didn't. My "They do" was in response to your "If they had a 0 rate of infection don't you think they'd be busy boasting about that?"

If cost were not a factor, where would you choose to have an elective operation?
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