The health Secretary has said a few bold and sensible things. He has said you do not just tip more money into the. NHS without reform. He has said maybe they need to buy in more private sector help to deliver more and better free care to patients.
More contentiously he has said the NHS is broken. Instead of getting on with mending it he now proposes a long and large consultation with staff and patients to see what to do. Itās like asking the audience on a quiz show if the contestant hasnāt a clue about the answer.
Patients will tell him they want less waiting time, easier access to GP appointments and better treatment when they need it. Staff will tell him they want more pay, better hours and better working conditions. No great need to go to consultation on that. Consultation with staff should start when he as their top boss decides what changes he wishes to make to working practices. Consultation with patients should start if he wants to change the way they access treatment.
His instinct that there needs to be change is a good one. History is littered with well intentioned Health Ministers who found guiding change was expensive and difficult. Wasting much of the first year on asking the obvious is not a good start. The NHS needs help now in spending its huge sums in the best way, and in hiring and motivating the right staff to get more work done. Firing the Chief Executive of NHS England would be a good beginning to underline the message that currently senior management are not boosting morale or productivity in the way we need.
October 22, 2024
Good morning.
Consultation means : Left boot – Tin can – Long grass.
If he does not know the problems with the NHS, then he should not be in his job. I can tell you one of the prime reasons the NHS is broken. Too many people accessing it. From the elderly, to those who should not even be in this country.
We do not need consultations. What we need is radical reform. I have mentioned here often enough that private companies and / or individuals should be allowed to have private medical insurance tax free. I believe MP’s get private medical insurance, so the concept and its advantages are not lost on them.
We also need to make sure that those that come here to visit and even work, do so once they have taken out private medical insurance. There are those who claim that the cost to the NHS of those claiming FREE healthcare from abroad is small, but it is not cost that is the prime issue. It is resources and the time taken up using them.
I do not expect things to improve not when those administering our affairs go largely uneffected by their poor performance.
And I have not touched on the number of FAKE healthcare (un)professionals that are in the system. That is another scandal that has been swept under the carpet š
Reply Yes, cut migration and require foreign visitors to pay for care are both important. MPs do not get private health care!
October 22, 2024
R to R
Thanks you Sir John. I was under the impression (from somewhere I read) that MP’s got BUPA Heathcare. Glad to be corrected.
October 22, 2024
MPs don’t get private health care but I bet loads of them have it, why wouldn’t you if you can afford it given the state of the NHS ?
October 22, 2024
The biggest issue is that the NHS is “free” at the point of use. Which means it is rationed by other means GP phone systems, delays, inconvenience, waiting lists… if you use the private system you pay four times over once for others, then tax/NI on the money you earn to pay you medical insurance, then the insurance premium then 12% IPT on top. A rigged system one Labour now want on private education too with VAT replacing IPT tax.
As I pointed out yesterday Wes Streeting is so daft he thinks that someone who could have been treated for Ā£40 at a GP costs Ā£400 for the same treatment at A&E so he is obviously rather dim. Are the A&Es 10 times less efficient than GPs for the same five minutes with a Doctor if so why Wes?
Why can they not get a GP appointment? Simple they are not paid for each appointment. If they were a dog or a cat no problem seeing someone the same day and getting MRI scans, e-rays, cancer tests…
Free at the point of use is the main problem, all who can afford to pay should pay something for appointments. People on waiting lists should get voucher for 30% of the cost if they can find the other 70%. The NHS saves 70% and it cuts the waiting times for other who cannot? But of course Labour cannot do anything sensible like that.
The net harm lockdowns, over medication & net harm Covid Vaccines have caused many health issue especially cardio vascular and blood clotting ones and have destroyed confidence in the profession. Especially as Sunak and the rest are still lying/pretending or misguided that the Covid Vaccines were safe when all the evidence say not. See the excellent film “Do No Pharm” – links on Dr John Campbell videos.
October 22, 2024
x-rays rather.
October 22, 2024
Stop the different arms of health care arguing with each other and pushing patients from pillar to post to try to get another department to pay. Social Care, GPs, the NHS – it is all the same tax payer money.
October 22, 2024
MPs do not get private health care and nor do doctors and nurses in the NHS. Bank of England employees do. My son an NHS junior doctor does not even get his exam frees paid or study leave. He has just had to pay out Ā£500 for one he needs to progress to his chosen field.
https://www.bankofengland.co.uk/careers/what-we-offer-you
If you look at the full package (as I have done, I know someone who works their) it is hugely generous. NHS staff get virtually nothing and many have very large student debts some Ā£100K to repay from their salaries too.
October 22, 2024
work “there” (the BoE) even sex changes I think or similar were covered.
Ā£100K of student debt for a doctor (plus interest) takes about Ā£25K off your gross salary for 10 years to repay. They start on about Ā£34k in London and it rise to about Ā£80K so average for the first 10 years is circa 50K less this Ā£25K leaves them about Ā£20K take home to live on. Less rent on a room say Ā£14K and commuting, council tax lunches – so negative net pay! Yet they (or parents) have to pay for their exams!
October 22, 2024
I would ask myself a number of questions.
1. What is the size of the task, is it geographical, how is it defined by speciality.
2. Do we have sufficient capital capacity, beds, theatres, CT, MRI, PROTON, scanners, and the professionals to use them 24 hours 7/7 , for as long as the demand is therre.
3. Is 47% of the NHS being none medical the right ratio. Could better computerisation and AI replace many.
4. To what extent is the NHS medical service blocked by having an inadequate after care and end of life service. Should this be free to the patient if and when required.
5. How effective is the NHS procurement service, and is waste monitored and controlled.
6. Is the balance of GPs, Medical Centres, Local Hospitals, A&E, and Specialist Hospitals, the right one, and is it all working for the benefit of the patient.
7. Is our laisse faire attitude to what we put in our mouths and the lack of early exercise in schools totally inadequate. To what extent should the food industry be regulated. The Nazis regulated UK food intake during WW2, why can’t we achieve it ourselves now.
8. Should so many vital services be in the charity sector, hospices, air ambulances etc. Is it to make us feel good in giving to charity . The service they offer is excellent, but are government avoiding financial responsibility.
9. Can the NHS be funded by a better financial system as would appeare to be the case in other countries.
10. Are we financially burdining and restricting those who might wish to join the medical services of the NHS.
Those are just some of the questions that need answers. Answers on which a reborn NHS can be based. My personal experience is that once the NHS takes you in the service is compassionate and effective. Getting through the door is the problem that leads to unnscessary failure for many. Curable becomes terminal. I give you a personal example. I have to wait one month to get a GP appointment for a letter to a private consultant for a knee problem here in the UK. In 2022 while resident in Spain I saw my GP in two days, was referred to my local hospital, had blood tests, a CT scan, a colonoscopy under anaesthetic removing a pollip, and a final clearance, all within two weeks. That is a health service performance we should aim for. Anything less is failure.
October 22, 2024
A good list and your last section suggests an initial direction – look around for the world for systems that already work well – perhaps France, Spain, Germany, Poland ..
Also look at what aspects they do not get involved in ..
October 22, 2024
The main trouble with the NHS is that thereās far to many Chiefs and not enough (workers Ed)
October 22, 2024
To be fair to Wes Streeting I saw him interviewed yesterday and he did answer all the questions put to him. I think he is well intentioned, but the fact is that the consultation and future changes will only amount to a revised status quo based on the existing model of healthcare. Thereāll be no fundamental review taking into account the better health outcomes achieved in other (EU) countries and their financing and insurance based delivery models.
October 22, 2024
Unsurprisingly, this ‘national conversation’ reminds me very much of a similar campaign which ended very badly for those who believed in the goodness of their political leaders. The mention of a ’10-year-plan’ was a dead give-away.
I’m referring to communist China in the 1950s, where Mao ‘asked the people’ in the infamous ‘Let a thousand flowers blossom’ campaign. Most of those who dared to offer their opinion ended up in ‘re-education’ camps.
Nowadays, we recall Lockdowns, with Prof Ferguson allegedly wondering at a SAGE meeting if ‘we’ could get away with Chinese methods. And surely, the Chinese Social Credit System doesn’t need to be mentioned.
My verdict: it’ll all end in tears, with Labour telling us that ‘you wanted it, you demanded it’ …
October 22, 2024
He is just stalling. And his earlier saying that the system is broken is just giving himself an excuse that the next few years of problems not solved are not his fault.
Labour have had years in opposition to work out what is needed and what ought to be done and to tell us.
They will take no notice of the people they don’t like in this bluff.
Time for the Tories to work out and say what they will do, and tell us what they failed on before. Can’t criticise Labour without better practical solutions. General ideal statements are no use.
October 22, 2024
A bigger problem is that the NHS is no longer a health service.
It is Labour’s shield. It is Labour’s replacement for the working class that it has abandoned.
The NHS is now the reason to put up taxes whenever Labour likes “To save the NHS !” to justify mass immigration and ‘bring in doctors and nurses’ “To save the NHS !” and sometimes to put us under restrictions including house arrest “To save the NHS !”
Britain is the NHS with a nation of taxpayers attached to it.
Until that changes it can never be fixed. What is the point of a fixed NHS to Labour ?
October 22, 2024
Back in 1946 or whenever the NHS was created the civil servants and politicians started with a blank sheet. The NHS is far more complex now but essentially that is what I believe should be done now. Itās no good trying to modify the existing organisation, that would only bring temporary benefits. An insurance based system should be part of the solution. That would relieve the NHS from some of the most routine problems and leave the most complex for serious healthcare. Also increasing care in the community should be a long term aim.