At last Ministers had something to say about getting waiting lists for treatment down and waiting times at A and E reduced. The fundamental principle of the NHS is free access to health care based on need. Rationing by delay is not part of the deal to taxpayers who are now paying very large sums for the service.
The NHS needs more medical capacity. It needs more GP surgery slots, more hospital beds and more operations performed. The backlogs are unacceptable. This is why I and others have been calling for a Manpower Plan. This needs to set out expectations of manageable workloads per employee and realistic targets for staff numbers needed to cope with likely demand. They also need extra to get rid of the oversized waiting lists.
This raises various questions over training, recruitment and retention. Could we introduce high standards of training in specific areas that take less time than a full doctor’s qualification to staff specialist centres for cataracts, knee surgery and the other high volume standard procedures for elective surgery? Can nurses and pharmacists have more authority over prescribing and providing medicines? Can medical tests be streamlined and be more efficient?
When it comes to retaining doctors that does highlight the general tax issue where people get taxed at 60% in the £100,000 to £125,000 range, and where the allowed level of savings for pension has bee cut back substantially. It would be good to ease these tax issues for all as doctors tell us they lead more to retire early when we still need their skills.
The Secretary of State yesterday announced more money to buy bedspaces in care homes to allow earlier discharge from hospital for some elderly patients. He also announced the equivalent of 7000 extra beds in the form of virtual wards where people are clinically supervised remotely by professionals whilst be in bed at home. he also announced some increase in capacity through adding modular units to allow more day care in A and E. He also proposed more work for pharmacies to cut the demands on GPs.
There is still no full workforce plan, nor stated plans to add beds with relevant staff to hospitals. As the population keeps on growing, and as an ageing population needs more hospital care the NHS does need to expand its core bed capacity.
January 10, 2023
You say “The fundamental principle of the NHS is free access to health care based on need. Rationing by delay is not part of the deal to taxpayers who are now paying very large sums for the service”
Once you have that free access principal then only way to ration demand is by delays and inconvenience in gaining access and so that is exactly what happens. GPs push patients to A&E and visa versa.
Everyone should pay something (with refunds for the very few who cannot afford to) and the NHS & GPs should only be paid when they offer a service of decent quality that the customer is happy with. As they have the money already in advance customers/patients are just a nuisance are are treated as such by the NHS. Perhaps left on the floor with broken hips for 24 hours or so. Or left to die in an ambulance outside a hospital as an elderly friend of mine was a couple of weeks back (this after waiting hours for the ambulance already).
When are the NHS and Gov. going to talk about and address the current levels of excess (non Covid related) deaths over 300 a day. So is it Vaccine damage or NHS incompetence/non treatment/delays or other and what is the mix of these causes?
The number of deaths registered in England in the week ending 23 December 2022 (Week 51) was 13,530; this was 20.2% above the five-year average (2,272 excess for the week).
January 10, 2023
Why does the rather silly Rishi not just admit and be proud of the fact that he uses private medical services? He and others in his position certainly should do so as to ease the pressures on the NHS and to make most efficient use of their time. Avoiding answering the question does not help him but then he has little political judgement. He should also point out that abolishing the Non Dom regime (as labour suggest with fund all sorts of things) will clearly decrease the tax take not increase it.
Alas he does not even do this. Will be be asked about when his wife actually stopped claiming Non Dom tax status, was it backdated and the back taxes paid. I suspect not? Perhaps he should prepare a sensible answer to this.
Bulk fossil fuel energy prices now below the level it was at the time of Putin’s invasion. The main cause of expensive energy in the UK is the net zero religion and the idiotic energy policies. So Sunak sort this out please it is not Putin but this government’s moronic energy policies.
January 10, 2023
Good morning.
So why are we having this crisis in the NHS now ? Is it because it is the time of year people get coughs and sneezes ? Some of which go on to become something more serious, alas.
And what value does 5,000 diversity managers bring to patients care and wellbeing ? There is a good half to one million pounds saved right there. That’ll get you a few nurses.
And as for this extra one million people your leader wants to bring into the country, not all of them are going to be doctors and nurses are they ?
Unbelievable.
January 10, 2023
Why now? Brexit robbed us of tens of thousands of dedicated health care workers, sent home because of the Conservatives’ scorched earth ideological fixation. Reality is now hitting – hard. And it’s hitting the NHS, the agricultural sector, care homes, delivery, truick drivers, etc etc, with high barriers to export trade too. Brexit, a calamity for us. As is now becoming visible day in, day out
January 10, 2023
Gary
I thought many of them went home because they wanted to be with their families during Covid.
Clearly I was wrong, but what made a minority of people who had a home and a job here leave, when really not much changed simply because of Brexit.
If Brexit made such a huge difference, why did the majority stay?
January 10, 2023
Tripe. Try again.
Is the EU still trying to find cash in its leaders houses?
January 10, 2023
JR, who do you think rocks up to minor injury clinics? Where do you think they live? Anyone check their identity? The one near me has most people seeing nurses not a doctor. The queues are huge.
Last year I went to minor injury clinic had an X-ray, told nothing broken, could not explain reason for pain and given a box of pain killers to fob me off. 2 weeks later I received a telephone call to say the x ray reviewed and my collar bone was broken. I was told to see my doctor, 3 weeks later, who referred me back to minor injury fracture clinic, two weeks later, who confirmed my collar bone was fractured because of length of time had passed nothing else could be done!!
January 10, 2023
Bringing 1 million plus annually into the country does nothing to help either the NHS, Schools , housing or any other service.
It is a disgrace that we can’t train enough British to staff the NHS but we’ve got to the state where there are so many foreign staff, they prefer to recruit their own.
We are paying ÂŁ960 ,per week for our mother’s care home so how many billions will 7000 beds cost the taxpayer.
The NHS is broken and needs root and branch reform but it will never happen whilst MPs kid themselves it’s the envy of the world.
January 10, 2023
Especially as few ever become tax-payers!
January 10, 2023
Indeed. The Consocialists keep importing people on minimum wages but maximum need of English taxpayer health, housing and public service top up benefits. Madness. Meanwhile 5 million on out of work benefits and 2 million more on in work benefits. We can’t afford you. Please go, we need Reform. When is the Home Office stopping the 40,000 EU applicants rights to live here, 18 months after the cut off? Another scam to keep freedom of movement by the back door or incompetence?
January 10, 2023
Mark, I wonder if they look at their peak times over the previous five years and use workforce planning to restrict holidays at the busiest times of the year and encourage holidays during lower demand?
January 10, 2023
That’s a good point. We all know certain times of the year, or certain days of the week can be extra busy, and yet . . . ?
January 10, 2023
The figures are out. Excess deaths in 2022 were around 9%, of the order of 50,000. Covid is only associated with about half of those.
This tallies very well with the news that on 1 January 2023, the president of the Royal College of Emergency Medicine suggested the crisis in urgent care could be causing “300-500 deaths a week”.
January 10, 2023
we discussed on here quite often that the refusal of GPs to see patients, and the extreme process to keep trying to get through to surgeries, was bound to mean fewer referrals of a serious nature to specialists. Prediction was that thousands of people would eventually find out stage 3 or 4 cancers etc. And so it proved.
This abdication of responsibility for the patients on GPs roll merely meets with ‘but pension taxation causes early retirements’ – not our problem guv’.
January 12, 2023
the crisis in urgent care ‘could be’ causing 300 to 500 deaths per week, sounds very alarmist, isn’t the president sure? Are all 170 A&E (Major) emergency departments in crisis or individual hospitals and trusts? 2-3 excess deaths per week per hospital or do we have a problem at certain ones?
January 10, 2023
@Mark B +1 ‘what value does 5,000 diversity managers bring to patients care and wellbeing’ greater costs and less money to go around.
So called Diversity is a Political Statement that is interpreted by ones own Political Values – in reality political discrimination. Parliament is for Politics not the taxpayer funded health service.
January 12, 2023
These ‘diversity’ managers aren’t making people happy; workers in the NHS are getting more unhappy the more diverse they become. I’d put every single one of those 5,000 diversity managers on our wards and in our A&Es for a month to help with this ‘crisis’ in any way they can, at their level of qualification and pay grade they surely could make themselves most useful.
January 10, 2023
Grant Shapps on about a min. level of service on strike days. Can we have this on normal days please the current level of service is appalling.
He also wittered on about energy and Putins war. Energy prices builk for coal, oil, gas now well below the levels at tine of the invasion not Putin you dope but net zero and a mad government energy policy Grant please grow up and look at the figures. Look at the excess deathe for 2022 too 10% above 2019. So why it is not Covid?
January 10, 2023
Excess death rate 20% above normal last year according to ONS.
January 12, 2023
How do you know what the levels of staffing in each A&E are Ashley, do you have any links to any evidence because I’m trying to find it.
How many does each 170 (Major) Emergency departments employ each day, how many are off sick what % of the workforce, how many vacancies per 170 hospitals? Can you narrow it down because I’m struggling and I don’t trust the statements? The BBC had a chart last weekend and some trusts had very low figures for waits and some very high from 15% to 80%, shouldn’t our local media be drilling this down for us?
January 10, 2023
Politicians have known demand exceeds supply for many years and have deliberately allowed a managed decline rather than the fundamental reforms it needs. The lack of a recruitment and training plan is just the tip off of the lack of strategic management ice berg. They are not fit for purpose.
A serious amount of Doctor’s etc time is wasted because record keeping systems are appalling so there is no seamless management of patients as they move through the system slowing everything down and putting lives at risk.
The current initiative has been forced on an administration in political trouble and will merely stop the NHS sinking completely so sticking plaster even if it works and I have my doubts.
As ever they are responsible for the mess and are now claiming credit for sorting it. Boleaux.
January 10, 2023
Something I omitted, all medical training should be free to the student , subject to a signed contract on entry to give ten years, post graduation, to the NHS.
January 10, 2023
Absolutely agree, been banging the same drum for years, It’s an absolute no brainer, that is if we really want more home grown medical professionals.
Will the politicians ever wake up to the same polices which have been put in place with our armed forces, enrol and learn a skill that will also be useful when you leave, no debt and you have also been paid during training.
January 10, 2023
âThis is why I and others have been calling for a Manpower Plan. This needs to set out expectations of manageable workloads per employee and realistic targets for staff numbers needed to cope with likely demand. â
That could be turned into a huge exercise in itself. Dubious KPIs are set up, with monthly or weekly monitoring exercises, culminating in an annual report where a majority pass with flying colours. Bonuses all round!
Or you could simply decide that the NHS is now a top heavy bureaucracy and strip out several layers and multiple posts. Resources saved could then be allocated to patient-facing parts of the organisation – doctors, nurses, ambulances, beds etc.
It wonât happen of course.
January 12, 2023
Are the record systems ‘appalling’ Nigel. From what I see my GP has good recording systems, better than the old paper notes, his nurses have good systems of recording from the phlebotomist to women services. The new GP app works for reordering prescriptions and getting through to my GP which is a technological advancement.
The Spine connects A&E to your records so paper records don’t have to transfer. Which record systems have you seen that are appalling?
January 10, 2023
The ‘crisis’ is never ending but then of course that’s the objective of such a political strategy designed to extract the maximum amount of funding linked to minimal reform and zero change.
If the NHS was efficient it wouldn’t need such lavish amounts of financing but then the NHS is DESIGNED to be inefficient.
Tory MPS don’t help matters. For them the NHS is not a health service for the public but a political issue to be managed. For Labour the NHS is a political asset to be exploited. For the unions the public sector is their financing and power base.
The solution is simple
January 10, 2023
D,
In respect of health outcomes NHS is a talking shop for Westminster politicos where service delivery is an irrelevance other than scoring points between them each Wednesday.
January 10, 2023
@ DOM “For Labour the NHS is a political asset to be exploited” – I recall “weaponized” was the term used by one Labour leader.
January 10, 2023
Professor Karol Sikora has been offering more capacity for months now. Four state-of-the-art funded UK cancer centres lie empty because the decision maker (Equitix) refuses to accept his offer. The facilities could treat thousands a month, with world-class tech. Intransigence and bureaucracy are no doubt killing people – let them treat patients for goodness sake!
January 10, 2023
@ Nan T – more information reported last October @ https://www.dailymail.co.uk/health/article-11291215/Cancer-facilities-treat-thousands-Britons-month-gathering-dust.html
January 10, 2023
Indeed. Small testing laboratories with the skills and capacity to test thousands of Covid patients when the pandemic first started offered their services to MOH. After three months they got an acknowledgment from a bureaucrat.
The recently appointed head of a large drugs company stated that bureaucracy in the U.K. meant that it was many months behind compared with Germany and the US in approving new drugs, potentially to get worse as allegedly staff are being cut back.
Arguments in Whitehall are holding back the private sectors push for small nuclear reactors,
And so the WFH âcouldnât careâ mentality of our bureaucrats continues.
January 10, 2023
You ask âCould we introduce high standards of training in specific areas that take less time than a full doctorâs qualification to staff specialist centres for cataracts, knee surgery and the other high volume standard procedures for elective surgery?â
Of course we could do, an aircraft engineer does not have to study the whole aircraft for 10 years before he can adjust a seat, refuel the plane or top up the hydraulics. Where other medical conditions are relevant to the common procedure (knee, hip, cataract, toe nail, bunionâŠ) then other specialists can be consulted as maybe required.
But Doctors will obviously resist this agenda very strongly. The NHS is not an atractive place to work for doctors they are poorly paid and treated poorly. 25% leave in the first year after training for 5 or 6 years to do the job. Rather a waste of expensive training.
January 12, 2023
Has Modernising Medical Careers a lot to do with it, someone wrote “I doubt this many left before MMC was introduced.”
The 23% is for after F2 for a variety of reasons, this was on a blog with David Willets 12 years ago.
It said “Majority of these are people who take a gap year/work overseas for a year. Some pursue research jobs which are classed as “non-training”. Some people are overseas students who having trained in UK and completed foundation programme want to go “home”. Increasing numbers are on maternity leave, starting family etc. at this point in their career. So the numbers packing up and leaving altogether is rather low.”
If it is now 25% one year after graduating as you say, how many return a year later? If never, then we have a problem with who selects who will train.
January 10, 2023
the senior layer of the NHS clearly do not understand queuing theory, how to model constraints, etc. like other areas of useful substance they are completely clueless. without substance and skill at that level then pouring money in will not help.
January 10, 2023
I don’t think it’s that technical Iain – my experience is that they don’t even have basic management skills.
My Mother was in hospital (not RBH) for 10 weeks and I (or my sister) tried to visit every day. Food was delivered to the Ward via heated trollies. There were about 12 rooms, each with 4-6 patients, all spaced along a long, straight corridor. The trollies would be parked at one end of the corridor (by the door) and a nurse would go to one, collect a (named) tray and carry it to a single patient (in whatever random room they were in). So each nurse would make many trips up and down the corridor. I asked (several times) why the trollies weren’t moved room to room, with all patients in each room being served before they moved on to the next. I was told it wasn’t possible because the Kitchen didn’t ‘stack’ the trollies in any order. So quite often other patients would have finished their meals in Mum’s room, before her food was even delivered. By then it was usually cold so she had to be persuaded to eat it. Which is why we needed to go each day to make sure that she did, as the ‘Nurses’ certainly didn’t (“She didn’t want anything today”). Mum lost half her body weight in those 10 weeks and was discharged to a Nursing Home with “just a few weeks to live I’m afraid” (discharging Doctor). We were therefore delighted that after three weeks (in private care) she had clearly regained weight and was much more her old self. She also survived for another three years. Work Harder? No, just work a great deal Smarter!
January 12, 2023
I’ve not really thought about food logistics in hospitals, but as you say, some pre-planning would make improvements. My local hospital has 540 beds and 5000 staff. If you think about it, a long-haul flight can carry 450 people, and they serve 2-3 meals per flight. I wonder how costs and logistics compare; really ‘nursing’ staff shouldn’t be on food delivery, are they usually?
January 14, 2023
I was in hospital. After Covid but still with visitor restrictions.
No fresh fruit at all. No visitors to bring it as they normally would.
Massive doses of laxative for all the patients, which could have been significantly reduced if they had just given the patients some fresh fruit.
Madness.
January 10, 2023
Mrs Thatcher once said “The problem with today’s politicians is they make a speech and think they’ve achieved something. They haven’t; they’ve just made a speech.”
Sums up this Pretendy-CON Government to a T.
I’m tired of being told about the wonders they will do …… when they deliver NOTHING.
January 10, 2023
Years of neglect caused the backlog that now exists. When a backlog is removed near-instant treatment becomes routine. Leaving a backlog does not save costs unless the condition of those waiting changes, such as in death.
January 10, 2023
But whether nurses, train drivers, postmen or DVLA or Passport office – give out really high pay increases will magically solve the crisis!
January 10, 2023
+1
Per yesterday, Do not forget junior doctors debacle under Hunt in 2015. There was a petition of no confidence from public reaching over 220,000 signatures to be heard in parliament. Instead of promised debate on reaching 100,000, a debate over NHS contracts was instead made in parliament!!
It was clear then, as every winter, more capacity was required. 7 years on and JR is still talking good about a manpower plan! His party has kept its mass immigration policy without the infrastructure to support it! As for JRâs population growth deflection comment, again he does not say it is down to mass immigration. 1.2 million visas issued, where was the infrastructure to go with it? Obvious to anyone who plans an event, ie enough food, enough toilets, road management plan, etc etc. anyone allowing 46,000 illegal criminals into the country knows they need to be fed, watered, waste disposed of, housed and get health treatment!! Apparently they do not create extra carbon footprint for JRâs nutty net stupid!!
Hunt remained in place until 2018, recently rejected by his party and public as leader. Now chancellor when there are NHS strikes! I think the blame rests squarely with the useless Tory party and its repeated failed ministers, step forward one Jeremy Hunt. First step JR, get rid of Sunak and Hunt they are clueless pro EU fools.
January 10, 2023
Unfortunately, there are those in politics and the media, like Mr Parris in The Times last weekend, who relate good speech making with ability and leadership.
On this basis, with the skill to be able to enthuse with someone else’s words, every Thespian would make a great PM.
January 10, 2023
Prince Harry speaks well, and convincingly!
January 10, 2023
The Snake stating he’ll sort the boat people……….when?
January 10, 2023
@Donna +1
Parliament is becoming a hot bed of âprima donnasâ and needs some real Donnaâs (sorry, but you know what I mean)
January 10, 2023
+1
January 10, 2023
+1
January 10, 2023
Until the government accept that whether it be private or public procedures it is still relies predominantly on the same core of people and there is a limit before the burn themselves out doing the extra operations but also all the follow up check up procedures that are required and the trained staff to implement them.
My wife had two operations carried out privately and if it wasn’t for the NHS I would have lost her when complications set in after the operating surgeon had left the building and couldn’t be contacted.
The whole way the system works now is what my surgeon called a sticking plaster process where the priority is time, getting the operations done and getting them home. The after care sometimes needs medical supervision.
January 10, 2023
I had a survey from the (national) GP service yesterday⊠one of the questions asked if my last GP consultation had been satisfactory. No option to say yes, it was during lockdown and my treatment was done privately. The reason I ticked that the appointment was satisfactory was because my GP had seen me face to face. My point, what a pointless survey.
In your blog, JR, you say 7000 patients could be monitored remotely. Iâm not entirely convinced thatâs ideal eitherâŠin theory it sounds helpful, but in practice? Time will tell. At least something is being done, finally.
One last point, having met one of these âcanât doâ types, I think the decision making should be taken away from the NHS management- seriously!
January 10, 2023
John. I’m going to post something quite contraversial now. How many hospital beds and care home beds are taken up with people who have a terminal illness and simply do not want to be kept alive but have no choice? My mother was one who had enough of life and would have welcomed death earlier. Her last few months were hell. Patients should be given a choice. I am dreading a time where I may die a painful and prolonged death. I am unable to take opiods as I am very ill with them. I do not want to be taking a bed from someone else when there is no hope of life for me. I feel it’s time for a serious debate and perhaps more beds could be freed up then for people who need treatment and who can then move on with their life. I’ve seen first hand the suffering of many elderly and terminally ill people and it’s not nice. We don’t expect animals to go through what we put people through. It’s time for a rethink.
January 10, 2023
FuS, donât expect too much from Sir John in that respect âŠ
January 10, 2023
In a perfect world I could not agree more. My Mum asked them to turn off my Dad after his stroke. “What’s the point?” she replied when asked if they wanted to keep him on life support.
But this world is full of sinners.
Where there’s a will, there’s a family…
“Doctor my boyfriend has just walked out and I feel so depressed”…
“Look, we need the bed”…
Doctors chatting and signing releases with their back turned on the medical form they are signing. I know a nurse who worked in an abortion clinic and she saw this quite often.
Have you read Soylent Green?
January 10, 2023
You touch on a topic that really should have a grown up discussion. I have been through a similar experience with my mother.
I have lived many years overseas and cultures differ, but dignity can be kept by allowing choice. (My learned solution, involves an old fashioned asian cooking charcoal burner, and a comfortable room with a bottle of port, when the time comes)
January 10, 2023
PW,
At least it’s not a bottle of whisky and a loaded revolver.
January 10, 2023
Agreed.+++
January 10, 2023
F U S
Couldn’t agree with you more.
You have said what so many people think.
Thank you SJR for posting it.
January 10, 2023
About an eighth of the population of the country are on an NHS waiting list. That number is too big.
January 12, 2023
They’re saying 10% now, 7 million + awaiting treatment
January 10, 2023
I visited a care home for the elderly a while back and was shocked by rows of completely silent and expressionless people sitting at tables waiting to be fed. I had expected some chatter and signs of life, but the staff told me everyone had dementia. What have we become when we think it is caring to prolong life in this way?How the staff remain motivated I can’t imagine, and I’ve worked in Homes myself.
January 10, 2023
FuS
Maximum respect to you for bringing that up. Like hefner I do not expect Sir John to answer but, I do think that it worthy of debate, if not here, then certainly elsewhere where the government may hear.
January 10, 2023
You do have options. But donât expect someone else to do your dirty work.
January 11, 2023
Lynn. I wouldn’t call it ‘dirty work’. I’d call it compassion or is there none in your book? If I were given a choice I’d like to be able to do it myself in the way it’s done at Dignitas. If someone is in a coma for a long time their life support gets turned off eventually. Do you call that dirty work? We should all have a choice and the ways of doing it would depend on circumstances.
January 10, 2023
How many operations are the result of lifestyle choices?
The cost to the system often highlighted when high profile celebrities have major operations and still don’t change their life style.
How many operations and the cost in time in bed occupancy to foreign hospital travellers?
The NHS has really got to think it’s whole operational policies through as the population increases and their capacity declines.
If people choose a pathway in life they have to understand there will always be consequences further down the travel path as a result of their decisions.
January 10, 2023
The things you highlight are peripheral, there are much greater challenges in the NHS.
January 10, 2023
Don’t blame the patients blame the poor NHS
January 10, 2023
If only we had had a party in office whose paramount concern was governing for the general benefit of the country, rather than preventing anyone else from doing exactly that, then these matters might be properly addressed.
January 10, 2023
NLH, do you honestly believe conservative MPs don’t want [the general benefit of the country]? Seriously?
January 10, 2023
then a question of competence is left, surely?
January 11, 2023
I know what I believe: look at what MPs do, not what they say. Look at what they have voted for, and you’ll see that again and again they have voted for policies that are ruining the country.
January 10, 2023
Well NLH, where would you find such a party- do NOT say Labour as they are as self-centred as most parties!
Time for Mr Farage and his mates I believe.
January 12, 2023
MFD, Farage is just a stirrer who ran at the first sign of change.
I honestly think he is just an agitator with no answers that can be carried out legally. Even if he got 10 MPs he couldn’t get any change the Lords would stop him, whether that should be the case is another question! He is also bigging up Labour on GBNews; he seems to be used by ‘the establishment’ to change the Tories’ fortunes.
January 10, 2023
NLH, try a vote for Reform at the next GE, no other party fulfills your desire.
January 10, 2023
@Nottingham Lad Himself +1
They know how to look after ego, and as @Donna above âThe problem with todayâs politicians is they make a speech and think theyâve achieved something. They havenât; theyâve just made a speech.â
January 10, 2023
That applies to all 3 legs of the Establishment’s Westminster Uni-Party.
Starmer’s off to Davos in a few days’ time ….. so we all know who he’ll be working for. And it ain’t us.
January 12, 2023
Oh Dear!
January 10, 2023
The NHS may need more of many things, but it could do with less patients. How about we relieve it of the obligation to treat illnesses the consequence of lifestyle. You get smoking, alcohol or over-eating disorders, you pay to get treated privately.
Someone was telling me 25% of A&E admissions were the consequence of alcohol abuse, so it’s not all old people with geriatric needs.
January 10, 2023
Dave Andrew’s
Spot on Dave I agree totally.
It is time for the old debit card machine in A&E. Swipe it on entry if the triage, or doctors after examination assessment find it is self inflicted then the charges are activated to that account to include all the admission and administrative costs as well as the treatment.
January 10, 2023
I think it time to separate A&E from the rest of the NHS. A&E Should be private and run /accessed via medical insurance, capped to a certain amount. If you don’t turn up with the mdeical insurance card, you could be charged the full fee, so bring your credit card instead.
January 10, 2023
We shouldn’t rely on ‘someone’ or gossip. It should be clear what each A&E are dealing with for each A&E department. Local people could then be given clear how to help yourself instructions on how to avoid some of the common visit reasons and alternatives on offer locally.
January 10, 2023
The problem is mainly not one of admissions but of discharges I read.
That is, many patients who should be in intermediate care are kept in hospital because the care sector has no capacity for them, in turn down to staff shortages, caused largely by b…
January 11, 2023
The care sector lost thousands of staff, lad, because of the over-the-top imposition of a Covid vaccine mandate in autumn 2021. The same would have happened to the NHS, but for the courage of a doctor who on live TV stood up to a government minister and told the truth: a lot of medical staff were worried about the mandate and were considering leaving. It is at least to the government’s credit that they listened on that occasion.
January 10, 2023
No Dave, do not dictate, but strongly advise. Government should be the target and through them the supermarkets , food industry, and advertising industry who are the root cause of obesity. Their heavy lobbying and party contributions are key. Next time you visit Spain take a walk through their supermarkets and observe the difference.
January 10, 2023
I agree in principle, Dave.
However, you have omitted a major category of self-inflicted health problems requiring treatment.
That is, sporting injuries.
No one, but no one, is obliged to play rugby, football, run marathons, nor do any of the other seriously damaging things done by millions.
January 10, 2023
Place a policeman with breathalyser kit, and popular drug testing kit outside A&E prior to triage. Either positive means the heavies are called to take them ‘somewhere else’. Friday and Saturday nights in particular.
January 12, 2023
Dave, aren’t most A&E visits lifestyle?
For example, motorbike accidents, cyclists who come off their bikes, and DIY’ers; that’s why we pay the national health insurance and why smokers and drinkers pay lots of additional taxes (I say this as a none smoker, nor do I drink alcohol). The only people getting away with their vice visits are drug takers.
MT, I’d be interested in how many people would fail a breathalyser or drug test arriving at A&E.
January 10, 2023
Steve Barclay evidently proposed settling the strikes with pay increases subject to efficiency gains, as youâve been proposing. However, union leaders interviewed have rejected this as an outrage given that their members work 18 hour days, with no challenge from the interviewer. Government should respond by advocating efficiencies as a way of properly delivering core activities and improving the job satisfaction of core staff by reducing the barriers they currently face in service delivery – a key selling point. When working for a period in government some 20 years ago I took part in a âProductive Timeâ work stream, part of an overall change programme designed to achieve ÂŁ1 billion of savings. Itâs not clear whether this government has similar commitment to change which would benefit health service customers, or patients as they are called, and taxpayers.
January 12, 2023
I hope no-one works 18 hours a day straight through, certainly not in any important occupation. That would be from 8am in the morning to 2am the following day. I’m not even sure 12-hour shifts are safe for women as they seem to be struggling with them.
January 10, 2023
There has to be more than an element of responsibility from the population.
Smoking, drinking, obesity, drugs are all highlighted as potential life threatening life styles. It’s a personal choice and maybe operations and health care for the related illness should be outwith the NHS charter and be treated privately?
January 10, 2023
turboterrier:
Personal responsibility could be achieved. Instead of charging folk tax to pay for the NHS, give them an annual allowance to spend solely on their health. Theyâll then have a substantive budget to pay their own medical expenses.
January 10, 2023
Spot on! Like the BBC the adoration for the NHS should be tested.
January 10, 2023
@turboterrier
Smokers and drinkers pay high taxes on their tobacco and alcohol.
Does that mean it is fair for them to rely on the NHS for tobacco and alcohol related illnesses ?
January 10, 2023
Maybe the doctors and nurses charged with their treatment will say “Well you didn’t buy me”.
January 12, 2023
Turbo, an obese man, is a 5ft 10″ guy weighing more than 15 stones.
An obese woman is a 5ft 3″ woman weighing over 10 stone.
How much should they be charged per extra 1lb? per year?
January 10, 2023
At present the NHS is given money whether it sees patients or not. An empty hospital would attract the same funding as a busy one.
The only way to improve performance in the NHS is to pay for doing and not being. Funding should be awarded by invoice per procedure or appointment and not by grant.
January 10, 2023
Yes, they should be able to pay out staff bonus on efficiency and seeing people over and above cost targets on a per-hour worked/grade basis.
January 10, 2023
“Virtual wards” ?
January 10, 2023
Thereâs a lot of posts today talking about lifestyle choices, but what about the fact that medical staff call the NHS the International Health Service? Anyone from anywhere in the world, can get free treatment for free!
Remember the Nigerian doctors who were telling their pregnant patients to get themselves to Britain by a certain number of weeks to be delivered? Some women had had multiple births in England! This sort of thing should at least be considered as part of the reforms. Health Insurance for non-British patients and actually reclaim the monies!!!
January 12, 2023
Sharon from 2018 House of Lords report
13.According to the BMA, there were approximately 27 million active UK EHIC cards in circulation in September 2017.13 Of the 53 million visits made to the EU from the UK each year, and the 25 million visits from the EU to the UK, only around one per cent result in an EHIC claim, suggested the BHA.14 Hugh Savill, Director of Regulation at the Association of British Insurers (ABI), told us that estimated medical costs associated with the treatment of UK citizens under the EHIC added up to ÂŁ156 million per year.15 The BHA said that in return for these reimbursements, the UK recoups about ÂŁ70 million from other EU/EEA countries.16
So we make double the visits and recoup 45% the amount the EU recoup from the UK. I wonder if that includes travel insurance?
January 10, 2023
“There is still no full workforce plan, nor stated plans to add beds with relevant staff to hospitals.”
I looked up the figures and, rounded up slightly they look like this:
Half a million nurses and doctors in the NHS. Three quarters of a million others. 25,000 administrative staff. Almost half of these are “senior managers”.
No, the figures do not add up and there are a lot of gaps. What are these hundreds of thousands of other people actually doing apart from making work and making sure things remain exactly as they are?
It is a bit like “Oh What a Lovely War” with a lot of generals and HQ staff not having a clue what is going on at the front.
And we are losing the war, battle after battle.
But are we? My procedure at the (new) local hospital went off like clockwork, even though it turned out not to be necessary. The doctors seem to be working a sort of team ministry by telephone too. A friend’s broken arm was treated fairly well recently.
January 10, 2023
It seems it was only Therese Coffey that was interested in trying to do something about dentistry?
January 10, 2023
Several of your more prolific contributors to this site regularly imply about the perceived left wing leanings of schools, colleges and universities.
Could this perception be in some way instrumental in the number of younger faces on the picket lines?
January 10, 2023
Give me teenagers in the prison of the classroom for a few years and I’ll give you a bunch of idealist possible extremists at the end.
January 10, 2023
Making the NHS, as an employee attractive has to be a priority – staff are certainly not doing their best because they are frustrated with constant changes and dictats, amongst other things Plus of course those things highlighted by our host.
Training of new doctors and a more streamlined career line should be at the top of any list — I’m tired of hearing that we just simply throw money at the NHS with no plans in place to spend it wisely.
….and when are we going to stop employing worthless diversity managers?
January 10, 2023
Sir John
Some good logical questions, although thinking about the whole spectrum of Government as it now stands we need a revolution, a real revolution as the top management doesnât even understand their true purpose. We have gone through 12 years of failed Conservative playing at âlook-at-meâ Iâm a minister! This is on top of the mismanagement of the Blair/Brown years.
Even yourself Sir John one of the more enlightened in Parliament is suggesting tinkering and tweaking things around the edges. That wont achieve a proper purpose just an easement today â kicking things further down the road while waiting proper management. We need a Government that can manage and a Parliament that can hold them to account â we need a full blown real Democracy. The appearance at the moment is we have a crowd of careerist that are along for the self-esteem and preening themselves. They appear not able to comprehend management and the purpose of managing UK Plc.
The tweaks you suggest today on top of what you have said before do not solve what is really lacking a commitment to the UK.
January 10, 2023
Any extra money should just be given as cheques to individual patients to take to any provider they choose. Let the market fix things in the way a state enterprise will never be able.
January 10, 2023
Your government keep doffing out lots of extra holidays to the public sector is causing losses in productivity. Two days extra last year, one day extra this year on top of an already very generous package of time off.
Now your government is getting ready to backdate next year’s pay increase to this month and attempt to keep them quiet with a one-off cost of living payments (have any of those been given in the last three years on top of normal salaries or would this be the first time ever?
If you don’t pay, people will die, so you are over a barrel. The day after you pay, you will have to pay the same deal to every other public sector worker, they can’t promise us we’ll die if you don’t do it, but they can delay people’s driving tests, licences, travel, teaching, and on and on.
It is then incumbent on your government to stop flapping around and set targets and ensure they happen by holding the Managers of these organisations to proper account and remove the incapable.
January 10, 2023
Back in the mid nineties I was a member of a quality forum in London.
One of the members gave a presentation about the trials of being a medical centre manager. Having collected the necessary data she could prove the percentage of patients consuming the most time of the doctors.
She proposed that they employed a triage system that everytime the targeted patients turned up (every other day) the nurse would do the whole triage gambit. BP, Weight, ECG, Temperature etc. The reasoning was after three months the doctor had the evidence to call them out.
Then there was mayhem. Doctors saying they couldn’t afford to lose patients even though she proved they were the ones costing them the most money and they didn’t need them.
End result nothing changed.
That was a lesson for the learning but ignored. The cost of the triage nurse would have been paid for by the changes. Her final comment before questions was “We have got to learn to start saying no to patients”
January 10, 2023
For sure the NHS is short of medically trained people across the disciplines, but I would suggest grossly over administered and in many cases incompetently at that. Because of the working pressure on medics the attrition rate is high. I suspect that though pay is important, lack of it causing other pressures, having time to do the job to their own satisfaction is even more important.
I therefore think that arranging the structure of the NHS, the function of each element in it, and how these elements interlink is supremely important. Most of medical personel are highly trained and some are specialists. As we have both intimated there are pharmacists and nurses who could prescribe. I would take issue with you when it comes to surgery. There may be many elderly hips and knees that need attention, but they are still the work of specialists and personally I would be picky about who I chose to rebuild me from among the consultants on offer. You have a point to a degree. I can tell you from personal experience that if you need blood extracting from old veins or bone marrow from your pelvis then a specialist nurse who does it all day and every day is a better bet than a more highly qualified doctor. Best avoided are the mountain rescue or battlefield necessities if you have the full medical panorama available. I would put in a plea that the first contact between patient and NHS should be medically astute. Young well meaning receptionists are not the answer.
I would also suggest that each unit within the NHS adapts Kaizen, a japanese industrial practice of continuous improvement at all levels, that ensures your Honda Civic is so reliable. Involvement makes for a happy ship.
When I talk of all elements of the NHS I include Hospices, Dentistry, Midwifery, Care Homes and Air Ambulances. None should be left to charity. I have no hang ups as to whether elements are private or state run. Nye Bevan created a great concept, it is up to us to ensure it works well seventyfive years later.
I am far too old for this to be a job application, but I must admitt I would quite like the challenge.
January 11, 2023
Well get on and moderate it.
January 10, 2023
Are there any NHS shortages on starter grade in Hemel Hempstead, Doncaster and Gourock, in the west of Scotland? Perhaps the NHS managers of those trusts could liaise with Amazon about re-training opportunities for porters, HCA, cooks and other grade 2 occupations locally to start people off. People who perhaps wouldn’t normally consider the NHS could sample trial and observe the positions on loan from Amazon as they’re about to be cut.
January 10, 2023
Do doctors and nurse trainees work in the NHS for some of the weeks they are not in university at the moment? Do they go through Agencies or does the NHS employ them directly if they do?
University weeks are 30 per year (usually 3 10-week terms) so if they take 6-8 weeks off, that would leave nearly 3 weeks of work availability to cover wards and help them to fund their studies.
January 11, 2023
Up to nearly 14 weeks of work time available that should be not 3.
January 10, 2023
Sir John
Your tax comments while valid, are not the real issue. Tax is paid unequally between all sections of society not just Doctors. The Doctors beef is that they now only get the same tax kickback on their pension contributions as the majority of the Country. Instead of receiving a greater contribution from the taxpayer under the previous system.
Their headline thinking is disingenuous. Their pay is from the taxpayer so then to assume more contributions from the taxpayer than the average taxpayer, gets just to top up their pension even more is at odds with fairness.
What is actually wrong is the âwholeâ tax system, as a general rule no one is paying their fair share. Yet everyone wishes to benefit from our infrastructure, education health and welfare, along with everything else. The reason it is unfair the Government wonât âManageâ everyone has to cut back but them. So we get more tax applied and as the process is not thought through it means one sector is finding it more difficult than another. So we then get subsidies and handouts to ease the pressure on some, that means the shortfall requires even more tax to be paid by others, leading to more giveaways then more tax needed to pay for those.
I clearly donât know, but a good guess would be 50% of tax collected is actually wasted in the subsidies and handouts because the tax system itself is overbearing and over burdening the whole country. It is the Countries crippling handicap from the continuation of Governments that wont just get on and do their proper job â manage
January 10, 2023
Most folk believe the NHS (in whatever country of the [dis]UK they reside) is a wonderful institution, and indeed the whole idea is.
Unfortunately it has become far too easy to access treatments that are far from essential. eg. turning up at A&E because you have a cough/splinter in your finger/ a bit of a headache.
Throw in health tourism. I once saw a documentary on the subject in which a woman from the Philippines came to London on holiday and the next day presented at A&E complaining of chest pain. She ended up having a heart operation (bypass I think) on the English NHS at a cost to you and me. Upon discharge she was presented with a bill, which she took back to the Philippines a few days later. We’re still waiting for the payment.
And of course 50,000 more illegal immigrants, this year, with many and varied medical issues, all treated for free (and it really is free for them)
Oh! and as an aside. Why is it still the case that only residents of England pay prescription charges/hospital parking charges/eye test charges etc.
The NHS needs not some treatment, but a major operation.
January 11, 2023
so why are people turning to A & E? First call should be GPs.
January 12, 2023
Old Albion, people turning up at A&E with just a cough or splinter, do they even get past the receptionist when triaged? Don’t most A&E’s now have a minor injuries clinic because Doctors are now closed after 6:30pm? Wasn’t the point of them that most are a 15 to 40 minute drive away for people so it stopped people going with minor ailments. Blame Labours 2005 GP contract.
January 10, 2023
The whole operation of the NHS needs a complete overhaul . The fault is in its management and its inability to control . It should be in the hands of people who understand and have experience of medical practice . The direct and indirect costs are enormous and to date the politicians who make noises have failed . There is little incentive for anyone who may seek a career in medicine – no wonder that Australia attracts the newly qualified .
January 10, 2023
OT:
JR, we read today Cleverelly has sold out our nation for nothing in return to give EU access to our IT systems which could be commercially sensitive with no reciprocation!! No wonder his oppo is laughing like a Cheshire Cat. I suspect he cannot believe the treachery to our nation. We voted leave. What are you and other leave MPs doing?
January 10, 2023
@Hope: Custom officers are civil servants with no “commercial” interest in flows of goods, just like when they ask you to open your suitcase or handbag they are only interested in “forbidden goods”.
January 11, 2023
An independent sovereign nation does not allow another foreign body to checks
Goods from one part of the country to another. Do not be an idiot. RoI should only be interested in goods entering RoI. This is about control power and trying to humiliate UK for leaving.
UK needs to stop buying RoI products and stop supplying it gas. We do not need inferior products entering our markets.
January 10, 2023
Hope
Can you imagine any other Nation allowing this, Take back control my backside !
January 10, 2023
There are specialist units for eye problems springing up in England, private eye health providers in partnership with NHS; elected via your optician. I was lucky enough to have a cataract operation just before Covid reared its head. Excellent service. I was able to chose what day suited me to have the operation and very patient friendly through the whole procedure.
January 10, 2023
We have such a Unit in Wokingham, family member very pleased with the outcome.
January 10, 2023
Thanks Sir John, you make valid points. Why on earth did they dismantle Nightingale Hospitals? Who made this insane decision? Buying bed space may slightly ease the logjam but this crisis has been years in the making and an extra few thousand beds will hardly affect the 7 million people on waiting lists! The NHS is unfit for purpose in 2023, there are not enough medically trained doctors and nurses and not enough hospitals to support our towns, cities and villages. Where thousands of new homes have been built around the country insufficient thought has been given to the provision of additional GP surgeries and hospitals. Allowing Hospital consultants to work privately and GPâs to work part time only exacerbates the problem. The concept of devoting oneself completely to working full time in medicine (and other vital services eg Police, Fire, Trains) needs to return. Politicians and media raised NHS status to quasi religious levels with âSave our NHSâ and âThursday eveningâ clapping nonsense during lockdown. Fundamentally the model âFree at the point of deliveryâ is broken and until politicians realise a 1940âs concept is unsuitable for the 21st century nothing will change. We need a hybrid system, those on benefits and low incomes do not pay and those who can afford to pay should pay, through an insurance based scheme and get tax relief for their payments. Unless and until government accept this stark reality the problem will only get worse, just like the disaster they have created with our broken energy policy.
January 11, 2023
They say 7 million people waiting for treatment, how many treatments are done per day by the NHS?
January 10, 2023
I see Kenneth Clarke QC MP has today proposed âthat the rich pay to see a GPâ. I mention it because you chose him as your running mate when you stood in the leadership election JR. It is the reason I could not vote for you!
If the ârichâ pay to see GPâs then they will get priority. Does this ex-Chancellor not understand that?
Of course we pay already – but that contribution is discounted by the warmongering globalist neo-cons.
Reply Clarke is no longer an MP. I did not chose him as va running mate when I stood for leader!
January 10, 2023
Claire Perry another former MP coming out for Starmer. Tories definitely showing their true co.ours. Perry the one who called true conservatives righty tighties!
January 10, 2023
Well, you supported Clarke over Hague, and there was an arrangement. Hobsonâs Choice I admit.
Clarke can command coverage for his opinions, apparently an ex-Chancellor who still has no idea of the repercussions of actions.
Reply For all of two days. the deal was his agreement to keep the pound, my main campaign at the time
January 10, 2023
Off topic, I have sent a little letter to the Times:
“Having checked the joint statement from James Cleverly and MaroĆĄ Ć efÄoviÄ I can confirm that yesterday’s breakthrough deal consists in the UK giving EU officials access to data on a flow of goods between two parts of the UK, Great Britain and Northern Ireland, a flow of goods in which the EU has no legitimate interest, and without UK officials being given any reciprocal access to data on flows of goods within the EU.
Insofar as this arrangement can even be described as “data sharing”, (“Data sharing agreement hailed as way forward for Brexit deal”), is it not a very one-sided form of sharing?”
I’m not expecting them to print it, but you never know, maybe they will.
January 10, 2023
Denis, it’s all good news I would say if it puts th protocol business to bed.
Also would think any agreement on access to data is to also allow for better relations with the EU which we badly need furthermore news is that president Biden is going on visit to the ROI and NI in April I think for belfast agreement celebration 25 years on. All very important for the Americans as well – so I don’t think Sunak or Cleverly could dismiss this very easily.
January 11, 2023
On the contrary, it will be very bad news if the unionists are foolish enough to accept it as a solution.
The DUP have nailed their colours to their Seven Tests, which will obviously not met by this deal.
January 11, 2023
Here is the concluding part of an email I circulated yesterday evening:
“… the unionists in NI would be very foolish indeed if they accepted this so-called breakthrough deal as a solution to the problem when the correct solution must be to pass this trade-related problem to the trade department where it belongs, and direct them to set up a system of UK export controls administered by their Export Control Joint Unit, which once established could completely replace both the EU controls on imported goods and the EU Single Market controls on locally produced goods. Which could be easily and quickly done by trade secretary Kemi Badenoch on the legal basis of secondary legislation under Section 12 of the Export Control Act 2002, permitting extension of the existing system of export controls to “All goods to be carried across the land border into the Irish Republic”, with SPIRE export licences easily available online.”
January 11, 2023
And here is an email that I have sent in the direction of James Cleverly, Chris Heaton-Harris and Steve Baker this morning and blind carbon copied fairly widely, headed “Another day starting badly”:
“Gentlemen
Do you really think that this rubbish will cut the mustard with unionists in Northern Ireland?
https://www.gov.uk/government/news/foreign-secretary-in-belfast-as-progress-is-made-on-ni-protocol
How does it help to restore Northern Ireland’s position within the United Kingdom, and the integrity of the United Kingdom and its internal market, to allow EU officials to scrutinise the flow of goods between two parts of the United Kingdom, a flow of goods in which they have no legitimate interest, and moreover without any reciprocity so that UK officials could scrutinise any flow of goods within the EU?
It is more of an insult than a solution, and I would be rather disappointed in my loyal fellow citizens in Northern Ireland if they allowed you to get away with it.
Whose side are you on? It became clear that Theresa May was at least as much on the side of the EU as on our side, are you suffering from the same affliction?
You must try harder, and I suggest you start by taking a look at this:
https://www.legislation.gov.uk/ukpga/2002/28/contents
and this:
https://www.gov.uk/government/publications/spire-online-export-licensing-guidance/using-spire-to-get-an-export-licence
Dr D R Cooper”
January 10, 2023
+1 I agree as above.
Well said Dennis. Cleverely has shown himself to be an utter fool or treacherous. I think the former.
Sunak and Hunt are winding GB closer to the EU by the day. Why not give data to other countries of the world as well! No borders no checks Johnson promised the country! Tories are selling out N.Ireland and GB. Disgraceful.
January 10, 2023
was the Heading ‘ More white flag waving’ ?
January 11, 2023
It could have been, if they had printed it.
January 11, 2023
But brave talk when it comes to Ukraine!!
January 10, 2023
Hello Sir John,
I can give you both excellent stories of NHS treatment & also stories of utter incompetence, as I suspect most people can. Your article is right but who is listening? We need a Royal Commission on the NHS to look at how it should be in 2023, not leave it as it was in 1948. Our current Chancellor spent six years as Health Minister but did not achieve much.
The NHS suffers from poor management from top to bottom & nothing will change or improve until someone has the guts to tackle that. It would also help to control & reduce legal & illegal immigration, since free health care is a real incentive.
January 10, 2023
You are unfair to Jeremy Hunt he was quite good at saying sorry for the endless deaths and disasters caused by the dire NHS not so good at anything to sort thess disasterd out though.
January 10, 2023
Not only do we have Patricia Hewitt trouble shooting the NHS for the government, I also note Dom Cummings is asking all-sorts of relevant questions, so presumably his advice is being sought.
Seems like the senior NHS management have not got a clue, so others are being asked.
January 10, 2023
Put the doctors in charge not dire history and PPE graduates like the last few minosters and CEOs perhaps.
January 11, 2023
IG – Patricia Hewitt!!!!!!! The Globalist WEF plan will be fully instigated.
January 10, 2023
Surgery should be performed by highly qualified, English trained, doctors. A friend of mine was almost blinded in one eye by a third worlder armed with a laser and now can’t drive. He was operating in a specialist private centre contracted to the NHS all of whose staff appear to be third worlders, so how many others had he injured? There are no short cuts; letting third world trained people on the unsuspecting public is not the solution; it causes the need for more remediation and is the reason for poor outcomes in this country compared to Germany and France.
The NHS is a shambles because it is understaffed by English medically qualified staff and overstaffed by useless Arts graduate types who run it at every level.
January 10, 2023
All very sensible, very obvious, and long overdue.
Only one question please :
If the extra ÂŁ200m on top of the ÂŁ500m to solve the urgent problems is not additional money, but money that was already available to the NHS, why did NHS Management not do everything just announced through the summer ?
If 500 people a week are dying unnecessarily, the blame must rest on the most senior managers in the NHS.
Why have they not been summarily dismissed and charged with corporate manslaughter ?
January 10, 2023
I see labour are guaranteeing access to mental health care within a month of needing it if they get into power. Ah the freedom being in opposition gives to make promises you cannot keep.
January 11, 2023
IG – not just being in opposition either.
January 10, 2023
Donât forget that there are 13000 patients medically ready for discharge but unable to leave because there are inadequate numbers of staffed care home beds. Letâs not forget which idiot insisted that 40000 Care workers had to be sacked in Autumn 2021!!
Clue. It wasnât an NHS bureaucrat or a member of the Labour Party.
January 11, 2023
and a lot of people couldn’t see relatives in the Home or attend a loved one’s funeral due to Covid transmitted.
January 10, 2023
Sir John, on a different but linked subject.
A pan around the chamber by a tv camera showed almost all MP âs with their heads in their mobile phone while Grant Shapps was speaking about an important subject.
They are like kids so should be treated as such, make them leave their mobiles in a rack at the entrance to the chamber
January 11, 2023
Fully agree- No cell phones in the chamber and close down the alcoholic beverage facility.
January 11, 2023
MFD – I forgot to mention, we have 650 of them.
January 10, 2023
I would like to know the Governmentâs definition of âunvaccinated peopleâ. Are those everyone who has not had the full suite of jabs – 4 or is it 5?
It is claimed that the âunvaccinatedâ constitute the majority of the excess deaths.
January 11, 2023
Sadly the reverse is true. This is why the Honourable Member for N.W. Leics, who has a relevant degree, has made multiple speeches on this and has now been deprived of the Whip. It’s his critics who’ve generally been spreading lies, aided by fake ‘philanthropists’ who seem to part-fund all the MSM including even the BBC.
40 years ago I moaned at my (Tory) MP that people badly needed help and advice to take more responsibility for their own health. He agreed. Instead, after decades of Tory policies – note, we’ve had no ‘Old Labour’ governments since 1979 – the NHS is more ‘Soviet’ than it’s ever been and more top-heavy with layers of management.
Luckily I looked after my own health so at ~70 I’m on no medication. The many doctors who oppose the pharma takeover are mostly near or past retirement, yet they’re the ones with a track record of improving their patients’ health while saving NHS money.
Don’t we want that? Apparently not. These doctors regularly get victimised, even removed from the register by the GMC. (See Dr. Sarah Myhill’s article on The Conservative Woman website.)
January 10, 2023
as a side issue, why are the Competition Commission not looking at the event ticketing agents?
since both the rock stars and the fans are complaining about the monopoly position the big ticket agents are in you would have thought it was screaming out for action
but seems like another part of the public sector who dont actually do the job we pay them for
January 10, 2023
Yes, and clearly the law of supply and demand is indicating that we need to pay doctors and nurses more to get better rates of retention. Delegation to nurses and pharmacists is also a good idea, as is the concept of auxiliary nurses trained in particular specialities. Taxing pensions less to stop doctors retiring early is also good.
We have to recognise that most of the public are reluctant to pay higher taxes to finance the NHS, so we must also look for economies. There are too many would be strategic managers – the politicians, the Civil Servants, NHS England, NHS Confederation, NHS Service Providers – and we should reduce their number. NHS Confederation and NHS Service Providers should not be taxpayer financed at all. A lot of Woke jobs in HR relating to diversity and staff mental health can be scrapped. And the NHS does not need to translate English documents into 28 other languages. There should be more checks to ensure that foreigners are not freeloading. I have had the experience in a hospital X-ray reception area of an articulate American woman (aren’t they all) saying how wonderful the NHS was for treating her shinbone injury for free following a skiing accident.
I myself am treated generously by the NHS. I have three 4-hour dialysis sessions, transport to site and back or parking, tea and biscuits twice per session, and television, all free. I’m grateful but is that optimum use of the nation’s resources?
Let’s face it: there are probably lots of economies the NHS could make in order to secure better medical care within the existing cost envelope. NHS management and staff should get into the right frame of mind; they should replace the word ‘patient’ by ‘customer’ and recognise that the value of time – yes, even pensioners’ time – is of the order of ÂŁ10 per hour. Then they might not waste so much of it.
January 11, 2023
Sorry, John – much as I respect you I think you are in a fantasy world here. If capacity was so good that there was no rationing by delay, the system would be vast with the world and his wife arriving here for free treatment. There is no checking for eligibility, remember. Or is anyone eligible as long as they can make it to this country?
What is wrong is the iron grip of the unions meaning that no efficiency gains can be made and no changes in working practices resulting from technology development. In fact, some technology developments will make the system less efficient as working practices must remain as required by previous technology.
The second problem is that no-one has any financial incentive to provide a good, efficient service. GPs are paid whatever level of service is provided. When was the last time a Trust went bust and was replaced by a different contractor? A profit motive is needed for a good efficient service. Most MPs will not criticise the NHS and so long as that persists, we must seek private provision if we possibly can.