There are some people in need of treatment who are waiting too long. Despite the appointment of more than 200,000 extra staff since 2019, and putting in many billions more money the stated waiting lists have  risen. There are said to be 7.7 million waiting. The strikes have not helped. The NHS does need to ensure people in pain where treatment can help should get the treatment they need in a timely way.
There is also a large amount of duff data as in so much of the public sector. Talking to a recent NHS Minister I am told the rapidly rising numbers of executives and administrators have not managed to clean up the lists and produce meaningful figures.
The first problem with the waiting list figure is it includes many people who want to see a consultant to see if there is anything seriously wrong, with people awaiting test results, Â with those who are awaiting treatment after tests and diagnosis, with people who have completed treatment and may or may not need a follow up appointment.
Apparently if you are after treatment you may stay on a waiting list in case you need to come back, just as you are on a waiting list whilst awaiting test results or diagnosis.You need to say you are happy  with treatment and sign off.
There are people with more than one condition who may be on the waiting list more than once, waiting additionally for a second or third possible condition. There may even be people who have died of something else whilst registered as waiting under one or other of the categories of waiting.
It would help if all those extra  administrators got the lists into better shape and told us how many different people were waiting  for diagnosis, waiting for tests and waiting for treatment. That would help in the important task of getting different waiting times down.
December 16, 2023
Expansion of the Trust Boards with jobsworth roles
Lower down , too many recruited for useless diversity , equality, inclusivity, period officers, gay rights nonsense roles
Indecisive, backside protecting incompetents
December 16, 2023
Of that 200,000 how many are actual front line staff
We’ve just lost my mother in law in hospital and at weekends except for A&,E it eas like a ghost town
I worked in a power station, just imagine if we only had skeleton staff at weekends and holidays.
December 16, 2023
Condolences. Yes the hospital in Hexham is the same. In addition A&E is so well hidden that we almost gave up!
December 16, 2023
There are some people in need of treatment who are waiting too long. Indeed, expected to be circa 8 million by the summer next year.
Solution – give those who can pay about 50% of what the procedure will cost the NHS if they pay the other 50% and go privately. Saves the NHS 50% for these people and perhaps circa halves the waiting lists for the others and expands the private sector provision. A win, win surely? Also give tax breaks for people who choose not to use the NHS and insure and scrap the 12% IPT tax why should people going private pay four times over?
But then socialists Gove and Starmer want people using public schools to pay 4 times over too with VAT, tax for otherâs state school provision, tax on what they need to earn for the school fees, the fees and then VAT on top of the fees soon too. It will of course harm and close many good schools and not even raise any net tax and many will be force back on to the state system (and then use extra tutors perhaps). Perhaps the best way for Oxbridge and top universities as they now rather too heavily discriminate against private schools anyway.
December 16, 2023
Australia does something similar, although most Australians (55%) have private insurance compared with 10% in the UK. Australians can choose either a private or public hospital and, in a public hospital, public or private treatment. It’s very flexible, and if you go private the bill is split three ways between yourself, the insurer and the government (taxpayer). The usual reason to go private is to get treatment faster. Your GP can advise on the surgeon/specialist, the hospital and the waiting time in each case. If it’s an emrgency the ambiulance crew will find out whic ahospital can admit you fastest, allowing for travel times and take you there. After your emergency treatment you can send the bill to the govewrnment or your insurer. Last time this happened to me the hospital told me it would get more money from the insurer than from the government. Their treatment had been excellent so I sent it to my insurer.
December 16, 2023
I do think that health insurance available to all employees in any company should not be a taxable benefit and disapplying the 12% Insurance tax to health insurance could save more money than the revenue it loses.
December 16, 2023
Indeed and increase the total funding for healthcare. It was like this under Thatcher. Income tax and NI relief and no IPR on any insurance. Though in general it is actually usually rather better just to save up and pay as needed I find. Especially with 12% IPT.
December 16, 2023
Who does the work privately? Surprise surprise, the NHS doctors, consultants and surgeons use some of their working work as additional income to perform for those who are privileged or find the money from savings – I know several who have done that….so your idea merely takes staff away from the people in the queue, making it worse!
December 16, 2023
working work s/be working time
December 16, 2023
LL,
Some are taken off the list and put back on to help reduce figures when convenient.
December 16, 2023
Nick Fletcher MP Tory for Doncaster had the guts to speak up this week in Parliament about his town being full! Labour let their mask slip by the usual smears etc. However, Nick Fletcher is not alone, his councillors, of all political affiliation, ask where does this govt think they will house all these people.
No housing crisis this is a self- imposed mass immigration crisis deliberately caused by Sunak and Hunt. Everyone knows except the majority of cabinet and majority of Tory left wing MPs. Excessively encouraged by left wing Treasury, ONS and OBR under false narratives.
All public services are overwhelmed by Sunak and Huntâs mass immigration. Cameron back to help shore up the left wing socialists in the Uni party who is now on a mission to align UK to EU lock step so we cannot leave the EU or itâs courts, refs, and laws as we voted for.
JR,
Your party cannot be helped. It is simply untrustworthy. Sunak appointing pro EU left wing Cameron epitomises the situation graphically if anyone needed to be reminded.
December 16, 2023
So now the government is rigging the market not just in EV cars but also in Gas Boilers too to subsidise heat pumps. A technology that make not sense (even if the believe in the vastly exaggerated devil CO2 gas religion). This as we have no low carbon electricity to drive heat-pumps or charge EV cars with anyway. Using gas the generate electricity to drive heatpumps amd charge EV is idiotic.
Still at least the Maths and Philosophy lass has cancelled the mad H2 instead of methane for gas boilers trials as no one wants them. That too saves now H2 if you do the maths correctly. So why was this insanity being pushed. We have no hydrogen mines and it takes loads of CO2 to and energy wasted to make H2 any way.
December 16, 2023
Nurses should not have to pay for their degrees. The NHS even uses them as free staff for 3 years.
Then to compound their problem foreign nurses are imported who have not had to pay to be qualified or do not need a degree. British nurses then have to take a salary whilst also paying back their student loan.
Then to compound the problem even more the shortage of nurses is made up by agency staff who get paid more.
Itâs all very simple (1) free degrees for nurses in return for free work (2) cancel all nurses student loans (3) phase out agency staff.
December 16, 2023
I’m partly with you. But the two ex-nurses in my family were trained in two years, and didn’t need a degree. I see that at one nursing college, in London, student nurses have to conclude their course by writing a lengthy dissertation.
December 16, 2023
Agency staff are provided by senior bodies from the NHS. We have one such neighbour whose husband is a consultant and she runs a nursing agency. Keep it in the house, it will never change.
December 16, 2023
Nurses do not need degrees.
December 16, 2023
They certainly wouldn’t if they had received a good education at school, but these days the curriculum covers little so they need the degree to learn what their (grand)parents learned at school before training as an SEN to become an SRN.
December 16, 2023
Agreed Everhopeful!
December 16, 2023
Javelin
Your point has been made before by many contributors including myself, but it would seem no one is listening.
Train Doctors and nurses for free as long as they preprepared to work for the NHS full time for 10 years, failure to do complete the 10 years results in a charge/payment for their training.
To avoid those absconding abroad after training, send them an account of their training costs every year, which is immediately payable if they leave.
December 16, 2023
J,
No need for degrees at all. Cameron took away bursaries! They should be given back. More nurses and doctors cut admin, diversity rot, race for equality schemes and tiers of useless management.
December 16, 2023
That should also apply to Junior Doctors who do not earn much more than nurses. Junior Doctors are leaving the NHS in their droves, overworked, underpaid, burnt out, under appreciated by this Government, morale at rock bottom. What many donât realise is Junior Doctors have to pay for their own equipment such as stethoscopes, membership fees at hundreds of pounds a year just to enable them to practice, courses etc. NHS staff should not be coming out of university with mind blowing amounts of debt hanging over them especially when this Government writes off 78% of all student debt, much of which is for Mickey Mouse degrees.
Junior Doctors in Scotland who donât have tuition fees have been offered around 3 times what the UK Government have offered Junior Doctors in England. Shows how little they think of them. But then again their solution is just to keep importing replacement staff from third world countries.
December 16, 2023
So itâs Free Degree for Free Work. So what does the Student Nurse live off? When I trained in the late 60âs each Student was employed, trained and paid for by a Hospital which had their own Teaching Staff and Training facilities. You had to sit a National Examination after 1 year then at the end of your 3rd year you had a Written Exam in your own Training School then, at a different Hospital, a Practical Exam plus an Oral Exam in front of a Panel consisting usually of a Senior Tutor, a Senior Nurse and a Doctor; all designed to assess quality under pressure. When qualified you would apply for a post at any Hospital of choice. It worked. Unfortunately the nature of the beast of Education is that Staff feel the need to change things, even when they are working fine. Thereâs no need for Degrees, (they are just ego busters) when State Registration suffices. Re-inventing the wheel and change for the sake of change is why we are in a mess now.
December 16, 2023
Even worse on student loans for doctors as 5 or 6 years training so just interest can be ÂŁ10K off take home pay often a low as ÂŁ23k so 13k for commuting. rent, council tax, heat, light, water, food, a holiday, fun… a new Dover boat arrivsl has more disposable pay & without 40 hours working and six years training. So about 50% the better ones often just leave.
December 16, 2023
Javelin,
You make good points.
Requiring nurses to have degrees has excluded a large number of potential great nurses from joining the profession. We need to consider a return to the old system of enrolled and registered nurses. The modern role of Health Care Assistant is the same as the old Auxiliary Grade.
Most, if not all, hospitals operates a Bank System for nursing staff. This enables a ward manager to call in at short notice, a replacement nurse to cover demand caused by staff absence or increased patient numbers. Calling in an agency nurse, should be a last resort.
December 16, 2023
Javelin, it suits nurses to do 3 days on NHS and 2 days on bank nursing for more pay less NI. The NHS just keeps making the same mistake on HR year after year. The nursing agencies must be making a lot of money so they wonât want this to change! Why isnât the bank nursing run internally by their own HR departments?
Nurses could have their 9% graduate tax bill paid by the NHS when they work over 37.5 hours per week for the NHS. If they leave the country their debt should go to an agency who can collect the graduate repayment abroad. Why should every other graduate job from teacher to accountant have to pay for their training and others not, its bad enough the Scots, Welsh and Northern Irish donât have the same debts of tuition that the English do. Itâs an English only tax even if the English grad works in Scotland, the Scottish grad working in England doesnât pay.
The Scottish NHS does no better with free tuition, still has recruitment problems and they go on strike all the time, its all just a mess the population paying for it keeps turning away from. Never mind they all think when Labour gets in next time theyâll boost the pay big.
I think the solution in the NHS is training more men. Men demand better terms and conditions, are willing to work longer shifts and weekends and nights because they donât all have the same childcare obligations after a certain age (there are obviously some men that take over the role of the Mum) I know lots of working nurses that work just two night shifts for the better pay and to not have childcare costs and to spend more time with their kids, there is a room on a seven day per week service to accommodate lots of different work patterns, and unlike supermarkets, and warehouses and many other seven day businesses the extra pay for working those shifts is very generous.
Many men train as paramedics, I honestly think the word ânurseâ puts them off training for ward nursing. As a woman, I found it very difficult to work full-time 8am until 6pm but I did to give my family the lift we wanted from a poor backgrounds, we had to sell three businesses weâd built (we couldnât continue with the out of hours and weekend hours to oversee them and do the accounts) to concentrate on two other businesses.
I also think that teachers who want more pay should have the ability to run summer clubs on school premises for extra income levels, after school clubs and earn overtime. There are lots of people who have the capacity to work more they shouldnât be held back by others who donât want to (thatâs fine too).
December 16, 2023
Hopefully weight loss drugs will put an end to the obesity crisis in the UK.
All those hypocritical celebrities who celebrated their âdiversityâ with unhealthy bodies are now losing weight on the drugs and showing their new figures off. Hopefully the NHS will benefit.
Turns out being obese never was favourable to either the person or the NHS. It came down to self harm from having too little self control.
Letâs all hope the end of woke will save the NHS.
December 16, 2023
++
Bet thereâs a sting in the tail of those wonder drugs.
There usually is!
December 16, 2023
J,
No, we should not pay for obesity drugs exactly in exceptional cases. This is personal responsibility like smoking. NHS has managers and staff to cut smoking!!
What next advisors to help those with dangerous sports? NHS perhaps fund advance driving courses for the bad drivers? No, personal responsibility. Trans operation on NHS. No not without proper psychological assessment or unless you are one of a very small number who are born with both genitalia- ie hermaphradite.
December 16, 2023
hermaphrodite
December 16, 2023
how about you fund the NHS properly instead of calling for tax cuts?
Relly It is getting record levels of funding and staff numbers
December 16, 2023
Reply to reply.
Staff are leaving as fast as you are recruiting, exacerbating the immigrant influx and pressure on infrastructure. Moneywise you are transfusing a cadaver.
December 16, 2023
The NHS takes over 10% of our GDP. Within Europe, only Austria, Germany and Switzerland spend more. And I see that Wes Streeting wants the NHS to be more like Singapore’s – a country that spends less than 5% of its GDP on Health. The NHS is, clearly, not under-resourced.
December 16, 2023
How much might be enough for you.
More funding does not solve the problem just like more immigration doesn’t stop jobs not being filled.
Less is often more.
December 16, 2023
How about the NHS properly manages the many billions it is already given.
We could spend 100% of GDP on the NHS and it still wouldn’t be enough.
The NHS needs reform, not more billions chucked down the drain on it.
December 16, 2023
Both parties tell us that they have “given more than the other party” but it never seems to help
December 16, 2023
The huge rise in funding since covid has not led to a huge rise in productivity.
This isnât just the NHS. Our whole economy has seen anaemic growth of 1% for the past 15 years but taxes are now the highest ever in 70 years. The argument that raising taxes increases productivity has been proven 180 degrees wrong. Taxes above one third of GDP are unproductive.
Tax raising has been used to spend on unproductive benefits that have only encouraged more people to eat at the free trough. Woke concepts such as fat shaming, not negatively judging benefit takers, mass immigration of benefit recipients, and rights for every need to be met has been nothing but a godsend for grifters and scroungers.
December 16, 2023
Record spending on waste and numbers adds only worthlessness.
Efficiency counts.
December 16, 2023
And per Labour’s Streeting has to learn to live within its means, not use an annual winter crisis to extort more cash!
December 16, 2023
To reply – but not delivering is it. Too many people not paying in but using the NHS. People on benefit get more disposable income than 1st year junior dorctos get ater student loan int. rental and commuting costs
December 16, 2023
Lemming, how much do you want the NHS to have? What do you think the National Insurance premium should be to pay for it. 10% on every ÂŁ1 earned for everyone perhaps?
â Today, it consumes 8.2% of GDP, seven times more in real terms. REAL TERMS INCREASE 1 | The King’s Fund> Page 4 If the next 50 years of health spend follow the trajectory of the past 50, then the UK could be spending nearly one-fifth of its entire wealth on the NHS by 2062.â. The Kings Fund 2013 before covid. There is also extra healthcare funding on the ever increasing private healthcare provided by private dentists, optomistrists, chiropodists, private doctors and private hospitals.
20/09/23 Statista âPublic healthcare spending as share of GDP in the United Kingdom (UK) 2000-2022. In 2022, the annual spending on public healthcare in the United Kingdom (UK) accounted for 9.3 percent of GDP. This is a significant decrease from 10.3 percent in 2021 and the highest share in the reported time period.â
December 16, 2023
Lemming,
How about the NHS spend their budget sensibly instead of asking for ever larger tax hikes?
Concentrate on the core purpose of the NHS.. Treating and preventing illness and injury.
We don’t need rainbow pedestrian crossings nor rainbow railings in hospital carparks. It doesn’t matter which race, sexuality or gender a service user is, so there is no need to take that data nor therefore to coalate that data
December 16, 2023
Off topic, this is interesting:
https://theloadstar.com/bid-to-cut-through-post-brexit-red-tape-tying-up-uk-trade-with-flanders/
“Bid to cut through post-Brexit red tape tying up UK trade with Flanders”
“GatewayÂČBritain, described as âan innovative digital application that will bring visibility and transparency for trading with Flanders into one placeâ, derives from a partnership between Port of Antwerp-Bruges, Flanders Innovation & Entrepreneurship (VLAIO), Flanders Investment and Trade and Deloitte.”
The sort of thing that the EU liked to dismiss as “magical thinking”:
https://www.theguardian.com/uk-news/2017/aug/25/uk-accused-of-magical-thinking-over-brexit-plan-for-irish-border
to help Theresa May keep at least part of the UK under their thumb.
December 16, 2023
an ill chosen subject for PMQ type responses.
Too many , 47% admin jobs, on irrelevant diversity/racist subjects.
Insufficient medics who are leaving as fast as you recruit, due to poor pay and working conditions.
Stop charging for training medical personnel in exchange for 10 year contracts tied to the NHS.
When in ten years you begin to benefit from the above, restructure the way you handle patient throughput for more productive use of capital facilities.
Rethink post hospital care so that there is sufficient of it to unblock hospitals.
Rethink the way the NHS is financed.
For those who cannot wait ten years, get private health insurance or move abroad where you will get treated with speed, compassion and efficiency.
December 16, 2023
During lockdown, because admin staff were all working from home, a consultant took over the running of a hospital unit (in one of the London hospitals.) Staff said the unit had never been run so efficiently!
I do think many of the points you raise SJR are very pertinent – too many chiefs and not enough (others. ed)The chiefs not being terribly competent either!
December 16, 2023
One of my family members was in hospital recently. It took more than three weeks for the result of a biopsy to get to her.
December 17, 2023
They play a ‘keep it to ourselves game’. – should heaven forbid the patient knowing they might ask ‘ what types of treatment could be given?’ it might mean discussion on what the patient would like, when it might be performed and who do they sue when care is inadequate.
December 16, 2023
Sad to say the least that the NHS failed to feature within the top 20 in a recent league table analysis by Imperial College of 38 countries. More than a little sad also that far from being “the envy of the world” they appear to be incapable of even producing list data with any degree of accuracy.
December 16, 2023
Importing hundreds of people every day, cannot have improved the waiting lists.
The same applies to housing. Why doesn’t the Government admit what is contributing to the problems of shortage of services, paid for by the taxpayer.
December 16, 2023
Too many managers in the NHS add nothing.
However I suspect that the problems you identify with the data has always been the case so proportionally the waiting lists remain much higher despite more staff.
A private organisation would not have so much admin and processes would be designed to get patients through the system to generate revenue rather than leave them waiting.
December 16, 2023
Nobody can manage anything if all the data they have is erroneous. So all Managers can go and the management would be no worse, because their jobs are impossible to do.
December 16, 2023
What I also find ludicrous is the populations of Wokingham and Bracknell have grown somewhat in the last 10 years, with all the new housing developments on the outskirts. Yet there is no proper Hospital to cater for these areas. Wokingham residents are directed towards the already overstretched Royal Berks in Reading, an area that has also seem big population growth. Bracknell residents to Frimley Park, or Wexham in Slough.
If the Government is determined to keep increasing the population (against the will of an increasing number), then it needs to provide the adequate resources. That doesn’t mean the average taxpayer is prepared to fork out more in taxes to do so!
December 16, 2023
The change in the NHS is just too terrible and distressing to contemplate.
It didnât have to happen.
But it did. And all because of governments and their mad obsessions.
December 16, 2023
Look on the positive side Sir John, I bet the Equality Diversity and Inclusion Managers on their 6 figure salaries and their cohorts of administrators know exactly how many trans, wanna-be-trans, gay, disabled, male and female members of staff they have plus the ethnic minority breakdown of both their staff and every patient who comes through the doors of their NHS Trust.
And along with every other public sector institutions (and those in the private sector who have been infected by Woke) they’ll be working extremely hard to ensure that any straight white males are put on the bottom of the pile when it comes to recruitment and treatment.
The Not-a-Conservative-Party has created this clusterf…. by REFUSING to take on and reverse Labour’s Cultural Marxist Agenda.
December 16, 2023
‘It would help… told us how many different people were waiting for diagnosis, waiting for tests and waiting for treatment.’
A private-sector healthcare company would soon fail without such a basic breakdown, freeing its resources for other companies to use.âCentrally-planned rationing is a poor method of supply.âThe NHS shows this applies to healthcare.âUnfortunately for its patients, the NHS isn’t allowed to fail.
December 16, 2023
It is incredible that no politician of any party has been able to face up to the fact that just chucking more money and people at the NHS without further thought as to what is needed has done anything to solve its systemic problems. The NHS clearly needs root and branch reform of the way it operates and is funded. At least it does appear that the Labour party are at last looking at the way funding, in particular, is done in other countries, but will they follow it through?
You refer to extra administrators, and we know these have been recruited in large numbers, but how many of them are employed to manage the system, and how many of them spend their time dealing with such things as ‘Diversity’ and other areas of wokeness?
A Conservative Minister has been in charge of the NHS since 2005, and none of them have done anything effective to address its huge problems. Perhaps it really is time to let someone else have a go?
December 16, 2023
I can confirm the waiting lists are beyond a joke, it is now 8 months since I was told I needed an operation, confirmed by specialists and the surgeon and nothing is happening.
In the mean time I can barely get around and instead of being very active with daily exercise I can hardly get out of the house. How long does one have to get punished like this?
December 16, 2023
Gordon Brown ( 6 week wait for ops by 2008).
Macroeconomics.
Globalised Healthcare.
The Wanless Report.
Do these all play into the utter, utter misery and chaos we now have?
And of course we now know why this non con govt. did not IMMEDIATELY change Labour policies upon coming into power.
December 16, 2023
Seems like we need to qualify what actually waiting list figures are made up from.
Certainly from experience of family and friends, waiting times appear to be lengthening before you can even get to see a Consultant to even get a proper diagnosis.
Many times a Consultants time appears to be wasted, as requested test/scan results fail to arrive on time, so a further appointment needs to be made.
Management and admin seem to always be the problem !
December 16, 2023
Yes – administration of the NHS need to catch up with reality.
The NHS is currently rolling out ‘another’ new all encompassing system to record what happens to patients, their readings and other details. It is called EPIC, but so far all I’ve seen is that it increases the workload of nurses using it.
It is, I am told, intended to eventually take in data automatically from various machines, but as you’d expect with the NHS teething problems and poor instruction have only increased the stress.
The NHS shows once again their level of professionalism, which unfortunately is still at the level of amateur.
December 16, 2023
O/T for which I apologise, but-
I knew Sir Kneel had a special pension which broke the laws brought in by Gordon Brown but to discover The Pensions Increase (Pension Scheme for Keir Starmer QC) Regulations 2013 was a bit of a shock. A special law created to give one man a pension that nobody else in Great Britain could dream of!
All pigs are equal, eh?
Disappointed as I am with the Tory Party I know Labour will be even worse so surely this fact will tip the balance?
December 16, 2023
Hey …. Starmer is just the son of an ordinary working class bloke … a toolmaker don’cha know. And he certainly knew how to make a tool.
December 16, 2023
Hi sir John
A fast growing populations,
to many free loaders ,
free tourist heath care,
Free in house treatment for some that haven’t paid into the system,
who don’t have to wait for doctors appointment
Pay every thing get nothing
Pay nothing get everything
Thank you John
December 16, 2023
Waiting should barely exist at all. Treatments performed immediately incur less time and cost than doing the same work 3 years later. If a massive effort is made to eliminate waiting, only patients would choose to wait with other patience.
Some people improve without treatment, but most worsen and cost far more. Those who die waiting cut medical costs, yet that should not be the Conservative way to control the NHS budget. What would a once-off elimination of waiting cost? It must be worth it.
December 16, 2023
So whatâs the reason and how/when will it be resolved? The Minister told you an appalling fact but you didnât follow up with the two obvious questions.
I canât believe a few hours of a small working group canât identify sub categories as you have done to be added to a patients history and fed into data base.
As for the bigger picture what you are confirming yet again is weak Government/senior civil servants failing totally to performance manage.
We saw Sunak in Parliament, yet again, praising the appalling OBR. He wants to improve maths in schools. He should start with them
December 16, 2023
the month to see a GP should be added onto the cancer wait times.
the time from GP referral to 1st hospital appointment should be added back onto the cancer wait times, like it used to be before they started more fiddling of the figures.
a first hospital appointment which does nothing but repeat the GP appointment should be ridiculed.
far more cancer patients should be getting proton beam therapy like the rest of the developed world, we are massively behind on this. and there are many proton beam machines in the country not being used which the NHS could use.
the poor children so let down by the Covid response should be getting far more mental health support.
hand buying power to patients, get the state out of owning and operating providers of healthcare.
stop rationing healthcare randomly, and instead have a written policy of what a patient is and is not entitled to.
cut immigration to reduce the burden on all our services.
sack NHS execs when they fail to deliver.
stop nonsense IT programmes like the Palantir waste of money.
December 16, 2023
âIt would help if all those extra administratorsâ The problem is that when you throw masses of money at those that manage, but donât do, worry they know they need to spend it otherwise it wonât be there later as part of the budget. That is what has given us the HR contrived Discrimination Departments, no longer recruiting the best of the best to deliver a great service but there to build great empires to protect those at the top of the administration. Would Government dare to ask for redundancies in these purely periphery people?
All these situations fold back into having a weak ineffective Government, everywhere taxpayer money is thrown they just want to mirror the âmanagementâ of the top table. If the Government wont control expenditure, spend for a return, why should those that hold their hand out and say give us more care either.
December 16, 2023
Re “Apparently if you are after treatment you may stay on a waiting list in case you need to come back, just as you are on a waiting list whilst awaiting test results or diagnosis.You need to say you are happy with treatment and sign off.” sure if you have potential cancer you will 1st get on a waiting list for examination, then waiting list for biopsy, then waiting list for treatment (say an op), then waiting list to test if the op managed to remove it all, and repeat tests in case it comes back if op failed to get it all out repeated through time, and if it does come back you need further treatment. that’s the real world. many conditions are not neat cures which need no follow up.
Re “There are people with more than one condition who may be on the waiting list more than once, waiting additionally for a second or third possible condition.” sure of course there are. eg diabetics will be on lists to see the diabetes consultant, will be on lists for eye exams, possible laser eye treatment from time to time, trigger finger surgery from time to time, treatment for foot problems from time to time (which the NHS in many parts of the country is very poor at actually delivering), etc. So yes many people have multiple simultaneous waits ongoing, but still with good care can expect many happy decades of life if the healthcare system does the basics like the rest of the developed world. Needing multiple parallel treatments is not the patients fault, and other healthcare systems deal with it far better than the NHS.
December 16, 2023
“The NHS does need to ensure people in pain where treatment can help should get the treatment they need in a timely way” – and surely also those whose condition may materially worsen even to the point of being untreatable.
” There may even be people who have died of something else whilst registered as waiting…” – or died of that for which they were awaiting treatment!
If getting list numbers down is sought, forget NHS administrators and let the not fit for purpose Home Office have the task for it is extremely good at under-counting. How come the NHS has not needed informatively constructed lists at any time in the last c. 75 years?
December 16, 2023
I would comment but as the moderation process takes so long there is little point.
Is this a common problem or is it just me?
December 16, 2023
The NHS suffers from over-population , poor management and direction . Years go I was asked to join the Board of the District Hospital and at the time I asked if I could first meet some of the other members – this request was agreed . I was shocked at the subsequent session ; the level and inconsequential chit chat that took place frankly was beyond description and , as a result , I declined the invitation explaining my disgust and reasoning . The Board continued its membership for several years longer and during this time some of its most Senior Medics left for various different reasons . Subsequent to this in my professional consultancy role I was asked to comment on the structure and composition of the National NHS Board and in doing so I examined the background of its existing members ; some of the criticisms and comments that emerged illustrated its inadequacy . As far as I know my observations never got beyond the Cabinet Office and changes did not occur .
December 16, 2023
What a mess! Only computerisation could have created such a complete mess on such a huge scale. Letâs have more of it !
December 16, 2023
My local health authority wasted over 100k changing all their literature to make it more inclusive by removing the word WOMEN and other gender terminology. The NHS along with other government bodies has lost the plot. Only the government can stop all this nonsense but we all know they are the ones pushing it.
December 17, 2023
On the contrary government can never optimise healthcare better than an empowered market can. It’s handing over of real power to individual patients which is the only way to transform the thing. And allow proper competition for staff by allowing different terms from different competing healthcare providers.
Top down state control can never produce success like the free market, no matter how well meaning.
State backed insurance for patients, not state owned, run, and rationed healthcare providers.
December 16, 2023
The old saying âPrevention is better than cureâ should be followed. More money should be put into genetic testing. This would screen for life-threatening and disabling conditions allowing early treatment and reduced waiting lists and benefit payments down the line. Use all the redundant Covid testing facilities for this purpose.
December 16, 2023
OK moderations seems to be a little quicker today. So here goes.
The NHS is a broken institution. It was founded with the right intentions and my eldest brother probably owes his entire existence to there being an NHS to call on back at the end of the 1940s.
Equally my younger brother was treated for Leukaemia successfully by the NHS so we as a family have a lot to thank the institution for.
However while everyone has positive stories such as mine there are endless horror stories to counter the feel good factor. The NHS has become the go to funding sump channelling tax payers money into Labour and also into big pharma. That has to stop. Common Purpose training diversity and inclusivity nonsense has no place in health care.
The need to get back to what the NHS was originally established to do might be worth thinking about.
Over the past NHS period of existence, we have evolved treatments for conditions that were once terminal, we have seen the nations population increase from 50 million to 75 million and the obesity of that increased population literally balloon.
The loss of GPs from society which is a real happening despite what they might say different is a problem. They acted as a triage function, sadly now people just present to A&E and are told by their local GP receptionist to do that.
The whole NHS needs radical reconstructive surgery.
December 16, 2023
Politicians have no control over the NHS. Giving money to unaccountable managers is ridiculous – “unaccountable” in that they are not obliged to provide details of what they will do with the money before they get it or to justify what they have done with it after they have spent it.
The policy that emerged a few years ago of diversifying locations has meant putting major NHS sites in tiny villages. Once there, they are treated in the same way as a pit village treated its mine – it’s the village’s source of employment which they exploit and defend as if their lives depend on it – which, in a sense, they do.
So they work together in an unseen pact to make sure that everyone gets a job and a nice pension – whether that job needs to be done or not.
I have seen an army of people whose “job” is correcting errors in IT systems – errors which would never be allowed to occur if done properly. The private sector would never allow it, but in the public sector the rules are different.
December 16, 2023
NHS is suffering from a crippling illness. It’s defined in the medical textbooks as Artsgraduatitic Sclerosis. This condition arises when intelligent doctors trained over seven years become beholden to the pathological incompetence of Arts graduates whose degrees confer neither relevant knowledge nor the hallmark of intelligence.
Look across the Channel where there are well functioning health systems which cost no more than ours which just happen to be run by the medically qualified.
There is not much time left to unravel the monstrosity created by Bliar before the next election when his lot will be back.
December 16, 2023
August 2023 âAmong the 7.7 million, in 396,643 cases the patient was waiting more than 52 weeks,
in 109,523 cases they were waiting more than 65 weeks, in 8,998 cases they were waiting more than 78 weeks, and in 265 cases they were waiting more than 104 weeks. In 58.0% of cases the patient had been waiting up to 18 weeks, thus not meeting the 92% standardâ NHS England.
These figures are all too big to truly see where the blockages are. There are 7 NHS England Regions are they all equally backlogged? Are any successful? Tell us NHS England of the 265 cases waiting more than two years why are they waiting? What service are they waiting for? Why havenât they been referred elsewhere ie. Private is their condition complicated, stalled by their health, stalled by their weight? What are the excuses?
Can any trust be held up as good or outstanding?
This week Victoria Atkins put out a tweet that waiting lists DOWN by 60,000 in October, so 7.1 million down from 7.7 million!
December 17, 2023
7.7 – 0.06 = 7.64
December 17, 2023
arithmetic wins again!
December 17, 2023
Actually its 6.5m patients I conflated two reports where people claimed it was now 7.1m, but fact checker did a review and its better than claimed by Labour:
https://fullfact.org/health/nhs-pathways-patients-waiting-list-labour/
Claims corrected
Politicians and the media must take care to use the best evidence available and describe it accurately, so people are not misled about the state of public services.
Following contact from Full Fact, Ms Siddiqâs office said it would ask Parliament to correct the record. Ms Maskell said she was happy to talk about episodes of care in future. As weâve mentioned above, the Independent and the Times also corrected their articles.
The Royal College of Surgeons told us: â[NHS England] published the multiple pathways data for the first time in November, showing that the number of unique patients is estimated to be around 6.5 million. We did include this information in notes to editors in our press release and will be including the breakdown in future communications.
December 16, 2023
The Times today reports that some people have to wait for a month for a GP appointment. Why does the government maintain the cap on medical school places at 7,500 a year when the population has increased significantly since that cap was set ? Why is there any cap at all ? Why do we import doctors from overseas when we could train more here by raising the cap ? Of course the doctorâs union the BMA also agree with the cap as it keeps GP salaries higher than in the rest of Europe.
December 16, 2023
John, could you ask to see the waiting list for your local trust and analyse what the problem is. If your local trust added a day per week of out-patient surgeries for certain conditions and paid the medical staff overtime to staff it would they be able to bring the list forward? How many people are waiting because there arenât enough beds? Couldnât two more beds be added to every ward to improve productivity? Could they start nurse/medical training again at the age of 16 day release at medical college near to the hospital to obtain the certificates to move on to the next stage. Itâs never worked right since government stopped that sort of training in the UK and started just importing more and more staff, no charge for that training up to degree level over five years as an offset for vocational on the job work.
December 16, 2023
and now for something Rishi doesn’t want to talk about – small boats.
Almost 300 people crossed the English Channel in small boats on the day one person died and another was seriously injured off the French coast. The Home Office said 292 migrants crossed to the UK in seven boats on Friday. They are the first recorded arrivals since 3 December when 118 people made the crossing.
So far this year 29,382 people have made the journey. Last year 45,774 migrants crossed in small boats.
On Friday more than 60 people were on board a boat which got into trouble about 8km (5 miles) from the French coast when it partially deflated, according to the French coastguard.
One person died and another was taken to a Calais hospital in a life-threatening condition.
The first group of people were pulled from the water at 01.15 local time (00.15 GMT) in the French-led operation, with a total of 66 rescued within an hour, the French coastguard said.
December 16, 2023
not just Rishi – you too!
December 16, 2023
Apparently the NHS now boasts an employee total of around 1.5 million. That puts it in the top five world’s largest employers. Just behind China and the USA. That in itself is amazing for China has a population of 1.4 Billion and the USA 334 Million. The UK stands at 67.7 Million. I wonder just how many of the 1.5 Million NHS employees are of direct benefit to the UK patients, for that employee total is more than those in the Health services of those two much larger Nations.
It seems to me, the NHS requires “modernisation” to become managed and run as though a private hospital service when the non-medical empire builders and their empires are dismantled and the resultant savings allocated to practical nursing, to vastly reduce and much improve those long waiting lists.
December 16, 2023
I can only write from personal experience. Both my wife and I have had Ambulance call outs this year and gone into RBH. The Paramedics turned up within about 20 minutes in both cases. I wasn’t kept overnight but my wife was and had an operation the next day. I am an out-patient at RBH as well as having regular tests at Bracknell Health Centre. We have absolutely no complaints about the treatment we have received which has been excellent.
I’ve also had close contact with other NHS Trusts and I’m pretty certain that we would not be as happy living within their areas. When my mother went into in hospital for ten weeks after a fall (the Ambulance took six hours to arrive – the Hospital being two miles away ) I had every opportuniity to see how poorly managed her Trust appeared to be. For example, It was very clear early on that whilst some of the Nurses were excellent, others were (shall we say) ‘indifferent’. “Has Mum had anything to eat today?” A shrug “The tray was put in front of her” and that was it, the neccessay ‘box’ had been ticked.
Frankly we stopped trusting the nursing staff to feed her (after she had lost half her body weight in the first five weeks). My Sister and myself (neither of us lived locally) decided one of us had to be there every afternoon just to make sure that she’d had enough nurishment, even if it was just from protein drinks. When she was eventually discharged, the Hospital told us she had one or two weeks to live. The Nursing Home had her back to nearly her old self within a month and she survived for another three years.
So when I listen to all the problems the NHS seems to have, I often reflect how one Trust can do a pretty good job, whilst another apparently cannot. The only reason I can think for this difference is the Trust’s Senior Management. We seem to be very fortunate with our local Trust but clearly others are not.
December 16, 2023
ALL part of the Globalist UK Establishment NWO plan. Wake up people you have been fooled for TOO long.
December 16, 2023
‘The Home Office said 292 migrants crossed to the UK in seven boats on Friday’ BBC reporting
Thats enough to fill one aeroplace to Rwanda or twenty NHS wards
December 16, 2023
Dear Sir John,
Your proposal makes sense in the very short run. Looking ahead, however, it ratifies the need for more administrators and form-filling and tends to increase the monolithic top-down approach to the NHS.
Ex-Covid, the NHS makes up about 9.5 per cent of GDP, which is the same as the entire UK manufacturing sector. Treating it as a consolidated command unit rather than as an organic system ( as in France or Germany) makes about as much sense as having a chief executive for UK manufacturing, monitoring the state of all the orders.
First, we need a national debate on how much of GDP we should spend on the NHS : not more than 10 per cent I would suggest. Growth in total resources would then be fixed in advance for all to see, perhaps on a smoothed rolling average of GDP growth.
Improvement in services would then depend on allocation , productivity growth and the scope of what the NHS does. Better perhaps, as in much of government, to do less but do it better.
The focus now needs to be on the collapse of GP surgeries. Once the central relationship beween people and health care, many are now little more than a triage centre with an add-on receptionist triage even to contact a doctor.
Messrs Blair and Brown improved the hospital sector with more money, but started the degradation of family doctors into GP practices, about 20 per cent of which have merged or closed since NHS England started 10 years ago , largely eliminating any competition through patient choice. Whitehall now wants to abolish GPs’ independence altogether by making them all NHS employees. Mr Javid, in his brief tenure as Health Secretary, seemed to back this Soviet-era reform. It may appeal to Labour’s Mr Streeting.
Could you, Sir John, please remind your fellow MPs how long people had to wait for a telephone line, or how many people were on the waiting list for a new phone, when British Telecom was a full state monopoly.
December 17, 2023
I wonder how much of GDP we spend in the UK if you add all private services, insurances, private doctors and hospital tests and treatments, etc.
December 16, 2023
I commented here once before that c. fifteen years ago I heard of an NHS consultant working in East Anglia who exceptionally for his specialism had no waiting list. This was explained by him always running two theatres contemporaneously, leaving his colleagues to perform preparations and immediate aftercare whilst he confined his time to only his expert procedures.
Such an approach, accepted by his health authority, his colleagues and profession surely should find wide application, even if not all specialisms could make it work?
December 16, 2023
Another aspect of management failure seems to be the procurement of drugs and medications. Following on the debacle with PPE and medications over covid it seems no lessons have been learned. I am aware of a number of instances of acute shortages of common drugs and medications in recent months, even those with near substitutes and alternative manufacturers. It is being left to the patient to discover if they can track down supply: I am faced with a 50-60 mile round trip to try to collect medication – and in diametrically opposite directions if the first choice turns out to be out of stock by the time I get there. Gaps in supply last months at a time.
December 16, 2023
Robert Tombs in the Telegraph this evening is beyond parody. Having agitated at length for this country to leave the European Union, he now wails pathetically about the absence of influence that this country has on defence and security decisions in Europe. As those of us who advocated Remain argued at length before the referendum, voluntarily leaving the decision-making councils for Europe was always going to result in a diminishment of British influence. Now he rages impotently from the side lines. He is pathetic.
December 16, 2023
That Sir John can and found it necessary to list the content failings of the list is a disgrace. The fact that nothing can be done about it is a matter of government and administration shame. I seem to recall he has written on this matter before too.
Another example of how this country is going down the pan because our leaders are unable and often unwilling to solve problems.
December 16, 2023
So here we are approaching the beginning of the next General Election year. Who knows how many words will be written and column inches printed about the likely outcome, whenever Mr Sunak decides that will be. For all our sakes, despite our disagreements, let’s hope that he decides not to ignore democratic norms and the Parliament Act by simply perpetuating his government. It wouldn’t surprise me if some members of the Conservative Party and some Tory MPs – inspired by the Republicans in the United States – encourage him to do so.
Reply Baseless allegations which you should withdraw.
December 17, 2023
If you want to get waiting lists down, a series of simple steps will do the trick for now:
– Award doctors and nurses a 15% pay rise
– Remove restrictions on their pension pots
– Sack ALL Equality and Diversity Officers
– Reduce the number of Senior Managers from more than 50% of the number of managers to 20%
– Minimise the number of non-clinical staff that do not support clinical staff
– Reduce the number of NHS vested interests and would be policy makers financed by taxpayers
– Get the doctors union to delegate many of their tasks to nurses and pharmacies
– Stop expensive drugs that extend the fag end of life by a few months being free
In the long run, demand management will be needed. “From each according to his ability, to each according to his need” is a Communist/Socialist slogan. It doesn’t work for any other industry. Why expect it to work for health?
December 17, 2023
Many are under the misapprehension that the NHS exists to treat the sick. Nothing could be further than the truth. The NHS exists to provide employment for women who wish to return to the workforce after having children. They do not want low-paid cleaning jobs etc – they want senior level administration posts on huge salaries so they can afford a new Tesla. Not to mention the cougars who are after a junior doctor toyboy
December 17, 2023
Really? That certainly explains everything. (Imagine a Smiley here).