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So....here we are... the future of the NHS

Discussion in 'Personal' started by HelenREMfan, Jun 16, 2019.

  1. needabreak

    needabreak Star commenter

    Fine for non post op plastic surgery I guess though perhaps free therapy for body dysmorphia would be very useful.
  2. florian gassmann

    florian gassmann Star commenter

    With the best will in the world, I am not going to listen to 28 minutes of radio just to try to work out what you seem to be grumbling about. Is it that you think the pharmacist concerned is not competent to prescribe or is it that you think he is illegally charging for his prescriptions?

    Pharmacists have been allowed to prescribe within their competence for as long as I can remember, as can dentists, some nurses, podiatrists and many other healthcare professionals.
  3. chelsea2

    chelsea2 Star commenter

    Thanks for that - though I can't get my head around 'available slots' actually being available. If they are, why are they being used for those who have decided to pay, rather than for those who are in great pain or unable to see?
    Surely theirs is the greater need?
    Wotton, FrankWolley and needabreak like this.
  4. Duke of York

    Duke of York Star commenter

    No the pharmacist is doing everything above board. The people he treats are desperate for medical help but can't get a GP appointment for love nor money.

    You don't need to listen to the whole 28 minutes. The relevant bit starts at 8 minutes in and you'll get the gist of my concern about this being privatisation through the back door within a few minutes.

    That's not to say I gained the impression that the phamacist intended to be doing anything other than providing a necessary service for people in need and the rate he charges for the medications and his consultancy is anything other than reasonable, but let's not forget, his patients are paying for the NHS on top of what he's charging them, but aren't getting the GP service they ought to be provided with.
    chelsea2 and slingshotsally like this.
  5. needabreak

    needabreak Star commenter

    Quite. Demand is high and supply low can't think why... though I do recall reading that it has never been adequate since inception so though greater need is perceived (perhaps we are getting sicker or think we deserve to be preserved/fixed and live longer) it appears we will never reach an equilibrium point in the public provision of healthcare.
    slingshotsally likes this.
  6. grumpydogwoman

    grumpydogwoman Star commenter

    Essentially it's means-testing.

    If you make the waiting-list long enough then people will beg, borrow, steal or bankrupt themselves to get treatment rather than wait.
  7. florian gassmann

    florian gassmann Star commenter

    The provision does seem so very uneven. Our surgery (a large one of about a dozen doctors, several nurses, manager, receptionists and other health professionals) always has a doctor on triage duty who will see patients within a few hours if necessary.They also do evening and weekend surgeries for people at work during the week.

    At the other extreme, I have known GPs working alone or in a simple partnership of two, who cannot possibly offer the range of services people expect these days.
  8. needabreak

    needabreak Star commenter

    Guess so, although the medics who are involved in devising the list must have an inclination as to those illnesses that require a speedy resolve as they are life threatening and those that are part of a vanity exercise or one that allows people to "fit in" to societies pre conceived ideas about how people should look at the cost of the mental illness caused and increase in public cost, at a net welfare loss to those who do indeed have life threatening ailments.

    Those I feel most for are those conditions who although are not necessarily life threatening but are extremely painful since those people will need to battle along with painkillers (sometimes licenced, addictive and expensive) while waiting for it to be resolved, sometimes this will have other costs like job losses due to incapacity etc... I don't know there are so many issues in the world and we pop sticking plasters on them and carry on.
    Lara mfl 05 and grumpydogwoman like this.
  9. florian gassmann

    florian gassmann Star commenter

    As I understand it, people in pain are being seen - but there are still vacant slots in the day which are being used for people who are not in pain but who wish to pay in the hope of getting their condition resolved before pain or incapacity set in.

    It isn't really much different to the fact that most NHS consultants do private work for one or two days a week - but the My Choice scheme means that the NHS rather than BUPA or AXA PPP gets the income stream.
    LondonCanary likes this.
  10. florian gassmann

    florian gassmann Star commenter

    The criteria for "free" NHS treatment are clearly set out in the trust's publication to which I linked in message #16.

    Sorry, how do you work that out? If a patient fulfills the criteria for "free" NHS treatment, they get it. Nobody is being deprived if the trust is filling spare slots in the day when staff would otherwise be twiddling their fingers waiting for the next patient.
    needabreak likes this.
  11. needabreak

    needabreak Star commenter

    I was talking about life and death situations with specialist staff who are I dare say rarely sitting about twiddling their fingers waiting for the next patient. Costs incurred for pinning your ears back could be used to treat other more life threatening illnesses or invested in research on say congenital heart defects... (other illnesses are available).
  12. chelsea2

    chelsea2 Star commenter

    That still makes no sense, though.

    If there are vacant slots in the day, with NHS doctors (i.e. on the days when they do NHS work) available - as seems to be indicated by your reply that the NHS gets the money - then surely they should be reducing the waiting list of those in pain etc. Because there IS a waiting list of those in pain, even if the more pain you're in, the more quickly you may be seen. Maybe then the waiting time for everyone would be less?

    People buying NHS time & expertise surely impacts on the waiting time of those in chronic pain?
    needabreak likes this.
  13. Duke of York

    Duke of York Star commenter

    One of the reasons might be that GPs are having to deal with unprecedented numbers of patients complaining of stress and depression. Something I recently read told me that 50% of GP time is being spent on conditions associated with poor mental health. A symptom of the times we live in?
    needabreak likes this.
  14. florian gassmann

    florian gassmann Star commenter

    Well, all we know is that the trust have stated in their literature:
    • MY Choice treatments do not impact on NHS activity – they fill under-utilised capacity which, if unfilled, may have to be reduced or removed
    If that is not the case, I have little doubt that the doctors concerned would not have hesitated in the six years the scheme has been running to make it known that patients in life and death situations have been ignored in order to undertake MY Choice work. I am not aware of any such claims. Are you?
  15. needabreak

    needabreak Star commenter

    Yes and they used to offer short term counselling and pills, I guess now it's just pills and maybe advice but I am not sure to be honest. You can manage some MH issues with pills but not all, peoples lives/circumstances/feelings/chemicals(quotes Rac) aren't really changed with them... only the perception and often it's slight amendments to perception.
  16. florian gassmann

    florian gassmann Star commenter

    Not according to the trust. They are totally clear in saying that they only use empty slots. By all means challenge the trust in court of you think they are lying. Here's what the Trust says in its information booklet about MY Choice:

    • WHH My Choice patients are scheduled for procedures on lists that are already running and simply occupy what would have been lost theatre slots.
    • WHH My Choice patients, after being referred, are treated as NHS patients – they do not jump the queue, they do not receive any special privileges and they are not prioritised over NHS patients.
    Last edited: Jun 16, 2019
  17. needabreak

    needabreak Star commenter

    To be honest I wasn't really aware of the fees till this post. Thing is though their statement appears to be sound business judgment we all also know that NHS buildings, theatres, staff and resources are rarely under utilised in any meaningful way for long periods of time (especially since restructuring which leaves people travelling further for their expert NHS treatment), these services aren't airplanes or football pitches they are specialist fields where work levels may fluctuate but on the whole not under utilised. If they are then yes they need to be closed and money diverted to areas of most need. I may be wrong as I am no health service administrator but isn't that how all organisations work these days they respond to changes in demand, provide what is required and do not provide what is not.
  18. BelleDuJour

    BelleDuJour Star commenter

    We have this in our local hospital.
    You are not obliged to use it, but you can if you wish.
    Any profits are ploughed back into the NHS side of the hospital trust.
    It works as it allows those who can afford to pay to subsidise those who can't.
  19. needabreak

    needabreak Star commenter

    Are there good profit margins then?
  20. florian gassmann

    florian gassmann Star commenter

    Do we? There have been countless studies of the under-utilisation of hospital operating theatres. One of the recent ones pointed out that 61% of lists start late and 45% finish early:

    I know from my own experience of an eye operation for a detached retina, that the entire theatre staff were kept waiting for five hours for a report on blood tests. When I complained about the wait and asked what was wrong, the consultant said his PA could not contact my GP for the results. I told him that if he had asked, I could have said that Tuesdays is her day off and that he needed to ask the practice manager, not the GP. The inefficiencies in the NHS are legion.

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