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Old 11th January 2017, 20:37   #136
paulweaver
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If they did that I bet the NHS would be back claiming poverty and begging for more in less than two years.
The cost of healthcare is increasing as population ages. Unless we decide to cut off old people's funding (which would make economic sense as they cost the most and contribute the least to today's society), this problem isn't going away. When we're near the top of the "money spent per capita" tables I'll listen to arguments about waste.

The main reason not to change the NHS in any way is time and again successive governments have shown that they simply make it worse.
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Old 11th January 2017, 21:37   #137
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The cost of healthcare is increasing as population ages. Unless we decide to cut off old people's funding (which would make economic sense as they cost the most and contribute the least to today's society), this problem isn't going away. When we're near the top of the "money spent per capita" tables I'll listen to arguments about waste.
The main issue is the Conservative budget cutting, and not always in the NHS either. Repeated council funding cuts mean that there isn't the social care budget available. This means the vulnerable people don't get the care they need which, in turn, means they can't be discharged from hospital.

There is no slack anywhere in the system, none whatsoever, and it is purely thanks to the ability and dedication of NHS staff that the whole thing hasn't already blown over.

We can blame both Labour and the Conservatives, but the simple fact is that the NHS improved between 1997 and 2007, from an extremely dilapidated low in the early 90s. We're back there now already, and it is getting worse.

I see Theresa May has promised "more mental health funding". This is rich given her government has presided over massive cuts in the last seven years, to the extent that many trusts are not taking on permanent members of staff because they cannot guarantee the funding. In both my wife's current trust and her previous two, the majority of new clinical posts are 12-month temporary contracts and many other roles, such as CPNs, are simply not replaced when they leave, purely because of massive budget cuts and volatility caused by the competitive tendering of the 2012 Health and Social Care Act.

The NHS is failing, simply because of this government stretching things ever further. All the slack has gone in "efficiency saving". They've cut the fat right down to the bone. It makes me so angry.
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Old 12th January 2017, 10:05   #138
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I've never really looked at private cover; is the following right?
You could insure yourself with (any name) but if you are at home, break a leg, your ambulence is NHS and you are taken to A+E and treated there?
If so, when does the private part kick in?
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Old 12th January 2017, 10:10   #139
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I've never really looked at private cover; is the following right?
You could insure yourself with (any name) but if you are at home, break a leg, your ambulence is NHS and you are taken to A+E and treated there?
If so, when does the private part kick in?
Generally speaking, if your (NHS) GP refers you to a specialist/hospital for further treatment or testing, then you can take that referral to your insurer, and so get all treatment and testing for that condition from that point on done privately.
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Old 12th January 2017, 10:16   #140
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Generally speaking, if your (NHS) GP refers you to a specialist/hospital for further treatment or testing, then you can take that referral to your insurer, and so get all treatment and testing for that condition from that point on done privately.
I also believe, further to the above example, if after your broken leg you needed physiotherapy then your private insurance would kick in and get you private treatment rather than NHS treatment (with NHS waiting times).
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Old 12th January 2017, 10:30   #141
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Essentially as above. Generally in this country private healthcare is more for longer term treatments etc rather than A&E cases. Probably because of the fact that it is simply not viable to have different private A&E's around the place all competing with each other.
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Old 12th January 2017, 10:31   #142
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The NHS is top-heavy with Managers, many highly paid, but nobody in power seems to or wants to grasp that fact although it is obvious to people on the outside. Staffing levels should be determined at ground level, i.e. doctors, nurses etc. and then determine how many staff are required for the administration side of it.
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Old 12th January 2017, 11:33   #143
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Originally Posted by Howardh View Post
I've never really looked at private cover; is the following right?
You could insure yourself with (any name) but if you are at home, break a leg, your ambulence is NHS and you are taken to A+E and treated there?
If so, when does the private part kick in?
Another feature of private medicine is you can go into a private hospital for a routine operation. If it goes wrong and there are complications, they pack you into an ambulance and rush you round to the nearest NHS hospital to be sorted out.

IMO in such cases, yes, use the NHS for its specialities and quality, but the costs should be covered by the private insurance.
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Old 12th January 2017, 11:38   #144
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Originally Posted by PHILIPE View Post
The NHS is top-heavy with Managers, many highly paid, but nobody in power seems to or wants to grasp that fact although it is obvious to people on the outside. Staffing levels should be determined at ground level, i.e. doctors, nurses etc. and then determine how many staff are required for the administration side of it.
What evidence do you have for the bolded assertion? Several people here have said something similar, always without presenting any evidence.

It seems obvious to me that most people outside the NHS are going to have no detailed knowledge of the internal structure of the NHS, and therefore no way to judge whether or not the management structure is unnecessarily bureaucratic. Maybe it is, maybe it isn't, but without some hard evidence, making assertions either way doesn't seem a very clever thing to do.
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Old 12th January 2017, 11:41   #145
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Originally Posted by DynamicSpirit View Post
Generally speaking, if your (NHS) GP refers you to a specialist/hospital for further treatment or testing, then you can take that referral to your insurer, and so get all treatment and testing for that condition from that point on done privately.
If you do not have private insurance, you can also pay out of your own pocket for a specialist consultation, thus jumping the queue.

Having then discovered you have a treatable condition, you can then slot back into the NHS queue for treatment, but at a much higher level thus avoiding delay.
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Old 12th January 2017, 11:57   #146
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What evidence do you have for the bolded assertion? Several people here have said something similar, always without presenting any evidence.

It seems obvious to me that most people outside the NHS are going to have no detailed knowledge of the internal structure of the NHS, and therefore no way to judge whether or not the management structure is unnecessarily bureaucratic. Maybe it is, maybe it isn't, but without some hard evidence, making assertions either way doesn't seem a very clever thing to do.
Just compare with the situation in the past
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Old 12th January 2017, 12:08   #147
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Just compare with the situation in the past
Sorry, but you'd need to elaborate a lot more on that. By itself that sentence doesn't - so far as I can see - tell me anything of significance.
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Old 12th January 2017, 12:08   #148
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From my own experiences of working in the NHS in Wales, there are too many roles that are involved with managing the administration side of things. I think that this is at least partly due to the increased bureaucracy that exists in every aspect of modern life. There have to be policies on privacy, freedom of information, data protection, disabilities and all sort of other things.

Life is certainly not as simple as it was when the NHS was founded, but I don't think the majority of people would say that the things I've listed above are bad things. They do have to be organised and paid for, though, so I can't see how the increase in managers and other admin could have been avoided.

Similarly, on the medical side there are a lot more clerical based processes now that doctors, nurses and health care assistants must follow. All of this has massively complicated the provision of medical care, and I've no doubt that this has been compounded by additional, and probably unnecessary internal processes.

Certainly, where I worked there was a real fear of litigation with meant that a lot of processes were introduced in order to try and safeguard against legal action. I'm not convinced that they were all good decisions, as some of the stuff that was brought in would have cost more than the sum total of what it was trying o prevent.
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Old 12th January 2017, 12:13   #149
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I agree with what Greenback has said and now understand further regarding the increased bureaucracy and the reasons behind it. Unfortunately, bureaucracy can increase more bureaucracy.
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Old 12th January 2017, 12:18   #150
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Originally Posted by Howardh View Post
I've never really looked at private cover; is the following right?
You could insure yourself with (any name) but if you are at home, break a leg, your ambulence is NHS and you are taken to A+E and treated there?
correct - emergency care, including if your elective surgery goes wrong - You will be collected by an NHS ambulance and taken to an NHS hosipital where NHS staff will patch you up

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Originally Posted by Howardh View Post
If so, when does the private part kick in?
Outpatient services
--- old post above --- --- new post below ---
Quote:
Originally Posted by Greenback View Post
From my own experiences of working in the NHS in Wales, there are too many roles that are involved with managing the administration side of things. I think that this is at least partly due to the increased bureaucracy that exists in every aspect of modern life. There have to be policies on privacy, freedom of information, data protection, disabilities and all sort of other things.

Life is certainly not as simple as it was when the NHS was founded, but I don't think the majority of people would say that the things I've listed above are bad things. They do have to be organised and paid for, though, so I can't see how the increase in managers and other admin could have been avoided.

Similarly, on the medical side there are a lot more clerical based processes now that doctors, nurses and health care assistants must follow. All of this has massively complicated the provision of medical care, and I've no doubt that this has been compounded by additional, and probably unnecessary internal processes.

Certainly, where I worked there was a real fear of litigation with meant that a lot of processes were introduced in order to try and safeguard against legal action. I'm not convinced that they were all good decisions, as some of the stuff that was brought in would have cost more than the sum total of what it was trying o prevent.
but the frustrating thing for coal face staff ( at least those i know ) is that the cuts in back room staff have come to those who actually support clinical delivery.

This means clinical staff are tied up on what are essentially admin tasks for increasing parts of their day. That means less time "on the tools" making people better.
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Last edited by DarloRich; 12th January 2017 at 12:18. Reason: Double post prevention system
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