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So what to do with the NHS?

Discussion in 'Personal' started by dumpty, Nov 23, 2019.

  1. Kandahar

    Kandahar Lead commenter

    We should be actively discouraging families over 2 children. We are already overpopulated - and the enironment taking a a battering - there's that anthropogenic climate change we have to deal with too.
     
    BelleDuJour and border_walker like this.
  2. Duke of York

    Duke of York Star commenter

    I have long thought that hospitals often make poor decisions regarding their A&E depts. Many of them in my experience, are understaffed, resulting in long delays. Because they take in anyone in urgent need of treatment, hospitals never can tell whether they will get drunks and ruffians or yobs turning up, so they tend to be basically furnished. Then they've got screaming kids running about all over the place. Who wants that when they ain't feeling that clever?

    Yet for many people in middle age who have yet to acquire the diseases they are likely to require NHS treatment for as they age, but have injured themselves doing something daft like playing sport, the A&E dept is the impression they get of what the NHS as a whole is like.

    A simple question to ask, is whether anyone would enter a department store if the shop window was as unimpressive as an A&E dept?

    You see, A&E is the NHS shop window and if it was made as impressive as Harrod's, people would expect that what lie beyond the A&E dept is equally impressive.

    It can be done. A separate A&E dept for kids is brilliant, not just for the kids, but for the rest of us as well. A separate section for drunks, yobs and the dregs of humanity. How difficult is that?
     
    fraisier likes this.
  3. fraisier

    fraisier Established commenter

    You work in healthcare, is that right? I’ve got the impression that screening (across the board) has particularly improved in the UK in the last 20 yrs, am I right?

    Eg Cancer Research UK said improvements in cancer screening, surgery, radiotherapy and new drugs had all made an impact, adding that more cancers were being picked up earlier. About a quarter of breast cancer cases are diagnosed through the NHS breast screening programme.

    On the other hand, access to GP surgery (to see a GP I mean) has severely deteriorated in the last 10 years, and particularly so in the last 5.

    Yes, A&E waiting time is a huge prob.

    (same in France, my sister, a nurse in a general hospital, assures me that it's roughly the same as here, i.e 4 hours' wait are not uncommon. Yet, the French state health system, - although it's a very different system to the UK's so caution should be exercised when comparing the two - employs 1.2m people, so it's huge, both in terms of staffing levels and budget. I don't know, I imagine the structure leaves a lot to be desired, just like in teaching, and it's not so much a question of budget and money spent but more of structure, i.e an organisational problem, it's too bloated, too many managers, sub-managers, box-tickers, trusts, quangos etc. and not enough "doers", in short the same old story!).
     
  4. Duke of York

    Duke of York Star commenter

    Not now. I spent about twenty years in a famous teaching hospital doing medical physics and a further eleven in an associated business, so I know a fair bit about stuff that goes on in hospitals that the general public rarely get to see.

    Mind you, it's true to say that a lot was changing over the period I spent in the NHS and I doubt it's stopped changing.

    Something I meant to add regarding A&E depts was this. https://www.bbc.co.uk/news/uk-northern-ireland-50505731

    "One in five people in Northern Ireland receive their cancer diagnosis while attending an emergency department (ED), according to research by the NI Cancer Registry.

    The registry confirmed to BBC News NI that, at present, a quarter of bowel cancers are being diagnosed in EDs.

    It said mostly older patients are affected.

    Its research also found that a third of lung cancers in NI are diagnosed after a patient turns up at an ED.

    According to senior health professionals and some cancer charities patients having to wait lengthy times to see a consultant is contributing to the problem."



    OK, that's in NI, but I doubt it's that much different on the British mainland. It's often reported that people are visiting A&E because it's become more difficult to get a GP appointment.
     
  5. Jamvic

    Jamvic Star commenter

    If I thought the department store could save my life I wouldn’t give a sh*te what the shop window looked like.
     
  6. Jamvic

    Jamvic Star commenter

    Very difficult I would image considering the shortage of medical professionals.
     
    LondonCanary likes this.
  7. border_walker

    border_walker Lead commenter

    And some are not necessary. After a motor bike accident a surgeon wanted to put an implant in my wifes leg, luckily a consultant said that it was a stupid idea due to future issue that it could cause. Yes she still has the depression 30 odd years later, but it has not been an issue.
     
  8. border_walker

    border_walker Lead commenter

    So for those with a natural desire to eat too much, smoke or take drugs, I assume you also think that they should not be discouraging this?
     
    towncryer, Kandahar and needabreak like this.
  9. peter12171

    peter12171 Star commenter

    Of course, this is where it gets difficult. The cases you cite should be discouraged because they will have an adverse effect on the person’s health and thus discouraging them will help them (and the NHS). Discouraging people from having children might actually have the opposite effect, affecting their mental health, an area over which there is rightly a lot of concern at the moment. What the NHS should be encouraging, overall, is an appropriate, balanced approach to life and health.
     
    Kandahar and needabreak like this.
  10. needabreak

    needabreak Star commenter

    Bad for the world but good for the individual... an age old dilemma.
     
    Kandahar likes this.
  11. Duke of York

    Duke of York Star commenter

    It was something they did at my hospital and it worked exceptionally well.

    Children frequently present at A&E with completely different healthcare needs to adults and respond far better to people skilled in dealing with kids. The environment in the childrens A&E was more akin to that of a nursery or primary school and equipped with things to keep the kids occupied. It was just less stressful for the kids, it was less stressful for their parents. Removing kids from the main A&E dept made it a less stressful experience for adult patients as well.

    Aside from dealing with emergencies, the childrens' A&E dept was used as a screening centre for conditions that develop in childhood and where early intervention is necessary if there's a chance of saving an early death.

    Among the things I designed was a device used to gather sweat samples for screening out patients who potentially had cystic fibrosis. I didn't invent the test, I designed a device that would enable it to be done safely and more reliably, after children were suffering burns from inept use of a crude device that had been used previously.

    Once it became known among GPs that any kid who presented with recurrent diarrhea and vomiting, which are among the symptoms of cystic fibrosis, GPs would arrange for them to have a sweat test and the best place to screen them was in an environment that was children friendly.

    For anyone interested, the sweat test provides confirmation of cystic fibrosis and eliminates the disease from other conditions that cause diarrhea and vomiting. It does so by measuring the concentrations of salts in the sweat sample.

    The test involves passing an electric current through a pad saturated with pilocarpine nitrate that is attached to the skin. This stimulates the sweat glands to artificially sweat. A piece of filter paper then gathers the sweat produced, which is then sent to the lab for analysis.

    There was nothing magical about the device I made, other than it eliminated user error and prevented any direct contact with the skin from the electrodes. To explain, children were getting burns from the previous device, because the current needs to be gradually ramped up to the rate required for maximum stimulation, held at that rate for a period then gradually ramped down. I just made a device that automated the process and a method of producing electrodes that made it impossible for them to make direct contact with the skin.

    Any idiot could have done the test after that, but since there had been an embarrassing case where a child had been badly burnt, hence the issue getting dumped on my desk to sort out, it was deemed appropriate that I conducted the tests myself for a while, so I would carry the blame if anything went wrong again.

    I didn't mind that. It gave me the chance to get away from pushing back the frontiers of medical technology for a few hours each week, to chat up the nurses etc... ;)
     
    Last edited: Nov 24, 2019
    Jamvic likes this.
  12. dumpty

    dumpty Star commenter

    An interesting read above, all.

    Something I would lobby for if an MP would be either a fee to see a doctor (say 3 quid for everyone, no exceptions) or - perhaps easier to agree to - a ten quid fine for anyone not cancelling an appointment and just no showing.

    OK, I know we would start saying lower incomes should not pay while others should (like the prescriptions) and many would not pay or be chased for the fine anyhow but it would help a bit, methinks.

    It would at least add some pressure to be a bit serious.
     
  13. LondonCanary

    LondonCanary Star commenter

    upload_2019-11-24_17-18-34.jpeg
     
    Kandahar likes this.
  14. ajrowing

    ajrowing Established commenter

    This is a truly excellent idea. What the NHS needs more than anything else, is more bean counters. Bean counters to collect the three quid off each patient. A bean counting manager to oversee the collection of each three quid. A bean counting target manager to set targets for the number of three quids collected and so on. All the while those most in need of the GPs support do not go to see them, but instead let their health deteriorate so much that they need an emergency admission and long stay in hospital.
     
  15. ajrowing

    ajrowing Established commenter

    I think we are now in agreement that cosmetic surgery should be a core part of the service of the NHS. Do you think it would be a good idea to have an increasing charge for the birth of each child, thus discouraging the poor from having large families?
    Also should euthanasia be encouraged as well in the fight against the environment?
     
    peter12171 and Burndenpark like this.
  16. needabreak

    needabreak Star commenter

    In principle a very good idea indeed but it requires updated tech to enable swift appt changes else you'd lose your tenner while waiting on the phone to cancel your appt.

    Or even allowed?
     
  17. lanokia

    lanokia Star commenter

    discouraging ''human beings'' ... why do you want to discourage the poor?

    Most people are 'for' the environment... except the ones who can't be "ar*ed"
     
    ajrowing likes this.
  18. Kandahar

    Kandahar Lead commenter

    No. There are occasions when it might be considered (massive disfigurement) - but routine cosmetic unessential procedures (e.g.removing minor skin tags) should be ceased
    You have already dismissed that above with your bean counters.
    It should be legalised first.
     
  19. ajrowing

    ajrowing Established commenter

    I don't want to discourage the poor. Was just suggesting a possible outcome of one way of discouraging large families. How would you suggest we discourage people from having large families?
     
    Burndenpark likes this.
  20. ajrowing

    ajrowing Established commenter

    I'll ask you again, because I am not clear of your answer. My daughter had cosmetic surgery to remove a flap of skin and fat when she was 2. Should the NHS not have done this?
     

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