| Non-motoring > NHS comme-ci comme-ça | Miscellaneous |
| Thread Author: Armel Coussine | Replies: 91 |
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New Sat 14 Mar 15 20:09
NHS comme-ci comme-ça - Armel Coussine
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Went to see the middle daughter today in a huge great enormous hospital in the Surrey/Sussex badlands, Farnham/Guildford, near where the then World Champion driver (why can't I remember his name... too proud to Google) was killed racing the classy car dealer Rob Walker on the public road, wrapping his 3.8 litre Jaguar (racing drivers drove cars in those days, not just inverted aircraft) round a tree... I saw the place, the dead straight 140mph skidmarks and the tree chopped off at ground level a day or so later, and passed it twice today. It was a single carriageway in those days, dual now. It felt as if we were driving or being driven all day, although it was hardly four or five hours all told. We waddled cross-country to the daughter's place, got into the S-I-L's Merc A class diesel, dropped a little angel at a friend's house and were driven to the hospital, where the daughter is briefly detained with a kidney infection (she's OK and will soon be released fingers crossed). The NHS is great if you need difficult treatment, or always has been with me. But it's really annoying in other ways. Nothing to do with medics and nurses who are fine: It's damn jumped-up managers making decisions to justify their inflated salaries. Herself had taken a few daffodils from the garden here, but they weren't allowed in. There's a new buzzphrase, infection control, which excluded a few garden flowers. What I don't understand is why they let us in, with in my case grotty shoes and frankly other clothes that could do with a wash. It's a mystery. Just as well the S-I-L was there because I would never have found the car again in the labyrinth of car parks. He's an excellent chap who cossets the daughter. An American lady in the next bed extolled the daughter's looks and said I looked Jewish, like her. Charming woman. |
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New Sat 14 Mar 15 20:23
NHS comme-ci comme-ça - Slidingpillar
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| Mike Hawthorn. |
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New Sat 14 Mar 15 21:00
NHS comme-ci comme-�§a - No FM2R
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>> It's damn jumped-up managers making decisions to justify their inflated salaries. Absolutely. There's nothing really wrong with the NHS insofar as medical care is concerned, it is the organisational management which is verging on the criminal. I contracted at the Wessex Trust at one stage trying to reorganise their management. We fell out quite significantly; There used to be a joke back in the early 80s about a boat race between IBM and Digital; IBM had 9 rowers and a cox. Digital had a cox, 3 rowing advisors, 3 rowing quality checkers, 3 rowing process experts an 1 rower. Digital got their butts kicked, even though they had invested far more money than IBM. This was immediately investigated by Digital's management and the conclusion reached was the the rower needed to work harder for less money. And old, not very funny, joke. But pretty much sums up the NHS management. And yet The Sun can't tell the difference between nurses, admin and cleaners. Even though the administrative and maintenance side is huge, every wage negotiation is reported as being solely for the nurses. Last edited by: No FM2R on Sat 14 Mar 15 at 21:01
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New Sat 14 Mar 15 21:24
NHS comme-ci comme-���§a - henry k
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>>There's nothing really wrong with the NHS insofar as medical care is concerned, it is the organisational management which is verging on the criminal. >> >>I contracted at the Wessex Trust at one stage trying to reorganise their management. We fell out quite significantly; >> My son is involved in trying to sort out various hospitals management etc. He is having some success but a long way to go. |
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New Sat 14 Mar 15 21:26
NHS comme-ci comme- - No FM2R
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>>He is having some success but a long way to go. He is clearly better at his job than I was. "some" is quite a bit more than I achieved. I'd be interested in more details of what he's up to though, if you're free to share. Last edited by: No FM2R on Sat 14 Mar 15 at 21:26
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New Mon 16 Mar 15 00:20
NHS comme-ci comme- - henry k
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>> >>He is having some success but a long way to go. >> >> He is clearly better at his job than I was. "some" is quite a bit more than I achieved. >> You cannot win them all. >> I'd be interested in more details of what he's up to though, if you're free to share. >> All I can say is that his company is a "Boutique Management Consultancy" that has been in existence for a few years and has had significant success with several large hospitals across the country. I think their size gives them an edge over the big companies and they get a better relationship with the CEOs and the top management. The government is taking a direct interest in the work he is doing. Management Consultants employed by the NHS are near the top of the list for praise by some of the press :-( For this reason he is usually vague about his job. |
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New Mon 16 Mar 15 01:18
NHS comme-ci comme- - No FM2R
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Fascinating Henry. Were I a bit younger and a bit more enthusiastic for hard work I would seek him out. |
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New Mon 16 Mar 15 10:20
NHS comme-ci comme- - henry k
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>> Fascinating Henry. Were I a bit younger and a bit more enthusiastic for hard work I would seek him out. >> Both my son and daughter have been head hunted several times and are in demand. We are obviously proud of them both. They are both bright in a nice way. At an early age we nurtured communication and confidence and no cockiness. I believe these skills opened wide many many opportunities at school and even more at the top Unis they have both attended. Both did not get three As but were still selected. Hard work plays its part of course. Both are doing their bit for the NHS. |
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New Sat 14 Mar 15 23:30
NHS comme-ci comme-���§a - WillDeBeest
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| Funnily I know the rowing joke with IBM as its overcoxed butt. Guess where I was working when I heard it. |
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New Sat 14 Mar 15 23:20
NHS comme-ci comme-�§a - Armel Coussine
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>> Mike Hawthorn. Thank you Sp. Herself, who isn't and never was interested in motor racing, came up with the name instantly. 'Of course!' I cried, and quickly forgot it again. Names are funny like that, especially well-known names. |
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New Sat 14 Mar 15 23:38
NHS comme-ci comme-ça - Armel Coussine
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>> An American lady in the next bed extolled the daughter's looks and said I looked Jewish, like her. That's ambiguous. The daughter doesn't look Jewish. The American lady said she herself was Jewish and that I looked Jewish. I said my mother came from Malta so I look a bit Mediterranean. The lady replied: 'Italian.' Spot on actually: my Maltese mother was Italian, or half-Italian. Apart from her though, I couldn't help remembering that mixed wards are a very mixed blessing. There was one who looked dead, another who moaned often and a third who kept calling for a nurse to no avail (she'd obviously been doing it every two minutes since admission). Mind you last time I was in a mixed ward I kept people awake half the night puking blue dye into a chamber pot. They were very nice about it though. |
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New Sun 15 Mar 15 07:08
NHS comme-ci comme-�§a - hjd
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>> >> >> Apart from her though, I couldn't help remembering that mixed wards are a very mixed >> blessing. There was one who looked dead, another who moaned often and a third who >> kept calling for a nurse to no avail (she'd obviously been doing it every two >> minutes since admission). >> I don't see what relevance that has to mixed wards though? Last time I was in hospital I was in a single sex ward and had the same sort of characters. Maybe they were from central casting? The one who looked dead was hoisted out of bed and onto a chair in the morning, then back into bed in the evening, and all with no visible signs of life. |
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New Sun 15 Mar 15 10:32
NHS comme-ci comme-���§a - Bromptonaut
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Are there still mixed wards in the man next bed to woman sense at all? My stay was in a mixed ward in sense that the Abington orthopaedic ward with dealt with both men and women. They were however in completely seperate bays with no line of sight even between them. Just shared staff that's all. |
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New Sun 15 Mar 15 08:47
NHS comme-ci comme-�§a - Roger.
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>> >> An American lady in the next bed extolled the daughter's looks and said I >> looked Jewish, like her. >> >> That's ambiguous. The daughter doesn't look Jewish. The American lady said she herself was Jewish >> and that I looked Jewish. I said my mother came from Malta so I look >> a bit Mediterranean. The lady replied: 'Italian.' Spot on actually: my Maltese mother was Italian, >> or half-Italian. I have a Maltese/English birth stickyfoot , my wife has a Welsh/English one; our daughter is the only one of us to have a solely English language one! Last edited by: Roger. on Sun 15 Mar 15 at 08:48
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New Sun 15 Mar 15 09:02
NHS comme-ci comme-�§a - Dog
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>>I said my mother came from Malta so I look a bit Mediterranean I look a bit Mediterranean too Sire. When I lived in Tenerife, I used to pretend to be a d*** (rhymes with dayglo) and, whenever I met a rosbif while out walking up in the hills above Los Cristianos, I would say, in purrfict Espanol "Hola! .. buenas dias amigos, como estas? (hehe!) - that used to really get 'em, like, but, when they had passed on by I would then say "turned out nice again, ain't it" in Formbyesque. A wind-up merchant to the bitter end I'm afraid, it's a wonder I haven't received a knuckle sandwich before now actually but ... it's the way I tell 'em I suppose :o} |
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New Sun 15 Mar 15 09:45
NHS comme-ci comme-���§a - Cliff Pope
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I've really only one grumble about the NHS and that's their chronic inability to understand the principles of running an appointments system. NHS-style is to book everyone in at 10.00 am, pretending to each patient that their appointment is at that time. Then you wait in a queue, possibly for 2 hours if you weren't smart enough to get in first at 9.30. If you ask how long the waiting time might be, they pretend it will only be a few minutes. If you go away and do some shopping for an hour, it will be exactly the same when you get back - another hour's wait. If you try to be clever and don't turn up until 11.30, they still get you because you are now at the back of another queue. All they need to do is allocate realistic slots throughout the day, and give people the appropriate appointments times. Then if they run a bit late they can appologise and say they are sorry, they are running 10 minutes late. But if they have some short consulations and they gain time they can ask if Mrs Jones is here and show her in a few minutes early. Any other organisation understands how to do it. |
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New Sun 15 Mar 15 09:59
NHS comme-ci comme-Ã���Ã�ï - Old Navy
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>> All they need to do is allocate realistic slots throughout the day, and give people >> the appropriate appointments times. Then if they run a bit late they can appologise and >> say they are sorry, they are running 10 minutes late. But if they have some >> short consulations and they gain time they can ask if Mrs Jones is here and >> show her in a few minutes early. >> Any other organisation understands how to do it. >> To reasons that I will not bore you with I have been a frequent user of NHS out patient services in three hospitals in my general area over the last couple of years. Your statement above is exactly how they work. I have only once had treatment late, the staff were most apologetic, explained why, told me to wait in the very comfortable cafe and they would come for me when they were ready. Also when I was receiving daily treatment I had to drive through a traffic choke point, (Forth Bridge) they gave me a direct line number and said that no matter how long I was delayed there would be someone to treat me when I arrived, even after working hours. I have no complaints whatsoever about the service that I received. |
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New Sun 15 Mar 15 10:08
NHS comme-ci comme-���� - Cliff Pope
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Gosh, you are so lucky then. It's nothing like that here (W Wales, if that's relevant). The GPs' waiting room is full of discontented people, all comparing notes about how many hours they had been waiting, busy spreading their diseases amongst each other. Last week I was bleakly reading the notices on the board, and my eye caught "Make sure you have renewed your prescription before running out". Running out, in panic and exasperation, was exactly what I felt like doing. |
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New Sun 15 Mar 15 10:45
NHS comme-ci - Bromptonaut
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What Cliff describes in either hospital or GP practice is unrecognisable to me too. Orthopaedic appointments are complicated by need to visit X ray which in turn had clients from A&E etc to deal with as well, some of them urgent. The X rays then need to be interpreted before seeing the man or one of his minions. Maybe 10 mins conversation with Doc, check I'm walking OK, check scar etc. Nonetheless I was usually in and out within an hour including all the above. GP runs a triage system on phone and you only get to see a Doc if you need to. They will even prescribe over the phone. Of course appointments run late, ask my friend Ian who's a GP in NE Wales about why that is, he could write a book on the subject. You might be 10 minutes late if you're unlucky - previous appt required a call to a consultant or patient presented with one complaint but consultation exposed rather more. Works as well as anywher else. Been kept waiting as long in a bank for an appt with an adviser. |
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New Sun 15 Mar 15 19:22
NHS comme-ci - PeterS
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It's certainly not how they work in West Sussex or Hampshire in our experience. Or St George's either for that matter. For renal or diabetic appointments in those areas the time you are seen only bears a passing resemblance to the appointment time you have. They are 'organised' in windows, exactly as the OP posted. Clearly run for the benefit of the staff. So you get a whole tranche of people who think they have a 10 o'clock appointment. An absolute shambles. And as we are there at least once a month its incredibly frustrating...more so as they won't listen to reason!! Without fail a 20 minute appointment with my partner takes at least half a day of my time, by the time we've got there, waited, been seen and got back. A normal appointment system would have that being an hour and a half, tops (bar St George's, which is further...) Now for me, bar the inconvenience, that doesn't matter. But for many people taking off half a day a month to accompany someone to hospital is just not sustainable... |
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New Sun 15 Mar 15 19:55
NHS comme-ci - sooty123
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Clearly run for the benefit >> of the staff. So you get a whole tranche of people who think they have >> a 10 o'clock appointment. An absolute shambles. I would think so, mind you I wonder how many people being late or not turning up influnces setting a system up like that? |
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New Sun 15 Mar 15 20:08
NHS comme-ci - PeterS
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| I'm sure people turning up late is an problem. But then with a 'free at point of use' system that's always going to be an issue. What irritates me is how they're quick to bang on about how much no shows 'cost' the NHS ( I bet with some half decent analysis the % of no shows by day / department could be forecast...) without being willing to enter into any dialogue about how much waste their system causes for the rest of the UK. I reckon over the last 10 years I've probably spent 300 hours hanging around in NHS waiting rooms for the mythical 10am appointment. Multiple that by the number of appointments a day in a hospital, and the number of hospitals, and the number will mind boggling I'm sure. But in doctor speak that time is not as important as theirs - even if for a lot of people it's 'worth' more ;-) |
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New Sun 15 Mar 15 20:23
NHS comme-ci - Bromptonaut
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>> Clearly run for the benefit >> >> of the staff. So you get a whole tranche of people who think they >> have >> >> a 10 o'clock appointment. An absolute shambles. For the benefit of the staff or to meet imposed targets? It makes a difference. |
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New Sun 15 Mar 15 20:36
NHS comme-ci - PeterS
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>> For the benefit of the staff or to meet imposed targets? >> >> It makes a difference. >> Not to the customer it doesn't ;-) Though nothing has changed in the last 10 years or more, and I suspect targets change regularly. So I believe the former... |
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New Sun 15 Mar 15 20:52
NHS comme-ci - Bromptonaut
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>> Not to the customer it doesn't ;-) Appreciate that but if you're a staff member who told the bosses it wouldn't work and now you're getting abused by the punters it does. Actually we used to do same with Judges hearings in a small county court. He was there four days a month and we'd just list everything for 10:30. There's nothing like prospect of appointment with the man with a purple sash while counsel's taximeter running to focus minds. Something like 60% of cases would settle ahead of hearing with another 20% compromising at the courtroom door. Furthermore a case parties certified to take half a day all too often collapsed in 20 minutes. If the Judge was going to have an evens chance of a day's work you overbooked like billy oh. Most times you got it right. Just occasionally you had one Judge and three full day cases for him. Last edited by: Bromptonaut on Sun 15 Mar 15 at 20:53
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New Sun 15 Mar 15 10:46
NHS comme-ci comme-���� - sherlock47
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One of the problems is that individuals like to protect their own clinics and specialist skill centres, even within a specific hospital, let alone a hospital grouping. They then run them as their personal fiefdoms, paying lip-service to any centralised booking system. A good relationship with a consultants secretary or member of the medical staff can still work wonders. The 'managers' are not generally not of the highest quality, and the clinically qualified who have until fairly recently been used to making all the decisions without regard to £, can generally 'run rings' around the 'managers'. GPs practices are a rule to themselves. Our previous system worked well with timed appointments, but favoured the technically literate who could go on line at 07.58 when the new appointments for the day and next 10 days were released. They have now implemented a telephone call back triage system. Have not used it yet. My philosophy has always been to understand the system, and make it work for me. Selfish maybe , but has resulted in good service over the last 20 years of regular hospital dealings . |
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New Sun 15 Mar 15 11:38
NHS comme-ci comme-�§a - Armel Coussine
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>> mixed wards I was wrong, there were no men in the bay my daughter was in. But something else happened while we were there: they wheeled her out for an ultrasound scan. When they reached the equipment there was no techie to operate it, so she was offered a full CT scan instead. She refused to undergo that regarding it as harmful (I have no idea whether it is or not). The word is that she's likely to be discharged today, so that's all right then. A number of lives would be disrupted if she was crocked for long. Three nippers between 6 and 18 for a start, but the ripples go wide when someone so active is out of action. The children are charming but I don't fancy having to take them to school every morning. |
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New Sun 15 Mar 15 12:30
NHS comme-ci comme-���§a - Manatee
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>> >> mixed wards >> >> I was wrong, there were no men in the bay my daughter was in. But >> something else happened while we were there: they wheeled her out for an ultrasound scan. >> When they reached the equipment there was no techie to operate it, so she was >> offered a full CT scan instead. She refused to undergo that regarding it as harmful >> (I have no idea whether it is or not). It's an x-ray, and x-rays all increase risk of future cancers to some extent. As the same bits effectively get x-rayed from all directions in the plane of the cross section the x-ray dose is much higher than a single standard x-ray, but still low.* Modern x-ray machinery is much more efficient than the old stuff. As an older person, I'd be less concerned about this than for a child. And the benefits will generally far outweigh the risks I suppose, unless you start having CT scans for fun. *"low" is relative of course - a CT scan dose might be substantially less than what some of us got from those "floursoscope" machines in shoe shops as children. And that could be several times a year. |
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New Sun 15 Mar 15 12:40
NHS comme-ci comme-Ã���Ã�ïï - Old Navy
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At my GP surgery there is a self log in screen for appointments or a receptionist option. There is also a big sign saying "If you have been waiting for 20 minutes see the receptionist". I have never waited that long. Repeat perscriptions are ordered online and collected from the local chemist, or delivered if required. I think we get a very good service here.
Last edited by: Old Navy on Sun 15 Mar 15 at 12:43
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New Sun 15 Mar 15 13:06
NHS comme-ci comme-���� - Old Navy
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| What is the gobldegook in the subject box ? |
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New Sun 15 Mar 15 14:48
NHS comme-ci comme-ça - Slidingpillar
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What is the gobldegook in the subject box ? The forum software throws a fit if you are the second poster with the correct non Roman character. This post should be right, but any reply will need the title editing. |
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New Sun 15 Mar 15 14:50
NHS comme-ci comme-���� - Bromptonaut
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>> What is the gobldegook in the subject box ? It's some sort of oddity with this site/operating system/browser & fonts. In this case I think AC may have used accented characters but sometimes currency symbols are enough. Most of us see then but ISTR a few Win8/latest Internet Explorer users, Pat might be one of them do not. |
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New Sun 15 Mar 15 18:11
NHS comme-ci comme-���� - Duncan
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>> Most of us see then but ISTR a few Win8/latest Internet Explorer users, Pat might be one of them do not. >> I don't think Pat is talking to us, is she? Flouncette? |
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New Sun 15 Mar 15 14:01
NHS comme-ci comme-���� - Roger.
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Our log-in screens at the health centre are in English & Polish. No Polish doctors, though! |
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New Sun 15 Mar 15 14:53
NHS good an bad. - Old Navy
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Will that fix it? EDIT- Yes it did. :) Trust AC to be too clever and put the forum computer into a tantrum. Last edited by: Old Navy on Sun 15 Mar 15 at 14:55
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New Sun 15 Mar 15 17:50
NHS good and bad. - WillDeBeest
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But there should be a d in 'and', unless you're Whitesnake. };---) |
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New Sun 15 Mar 15 18:26
NHS good an bad. - Armel Coussine
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>> Trust AC to be too clever and put the forum computer into a tantrum. There's nothing clever about a sedilla. It's just correct. |
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New Sun 15 Mar 15 17:52
NHS comme-ci comme-���� - Zero
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>> Our log-in screens at the health centre are in English & Polish. >> No Polish doctors, though! Dont worry Nige wil fix that for you, you wont be able to afford the doctor- problem solved. |
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New Sun 15 Mar 15 18:11
NHS good and bad. - Old Navy
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| That OK ? |
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New Sun 15 Mar 15 23:25
NHS good and bad. - Ted
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My trick is to get to my appointments early. I've seen, over the years, thatas soon as you report to reception, your file is pulled from the day's box of files and put next in the queue of waiting files. There only may be three or four waiting whereas if you book in at you allotted time there may be 20 waiting.........look after no.1. Took SWM for a blood test last week, she likes my blue badge ! Her appointment was at 0905. We left home at about 0840. I waited in the car, she got dealt with and we walked back through our front door at 0909 ! |
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New Mon 16 Mar 15 07:52
NHS good and bad. - Old Navy
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>> >> My trick is to get to my appointments early. I've seen, over the years, thatas >> soon as you report to reception, your file......... >> That seems to be the system our hospitals and GPs use, only computerised. Keep the punters moving through, it uses the slack caused by no shows and late arrivals and keeps the good guys (majority) happy. On my last out patient visit ( last Wednesday ) I was done and out of the hospital ten minutes before my appointment time. Last edited by: Old Navy on Mon 16 Mar 15 at 07:55
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New Mon 16 Mar 15 08:08
NHS good and bad. - Westpig
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In my latter years of police service, I like many others had private health insurance (solely because the rules changed to cover the 'p' takers, so if you were ill/injured you could go on to half pay or no pay... and working in an environment where you could easily be injured, certainly more likely than the average job... it seemed sensible to cover the long NHS waiting list angle). To state the obvious, the difference between the two is absolutely unreal. Private health = be treated like a human being. NHS = at best, be treated like an inconvenience, at worst something on the bottom of their shoe. |
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New Mon 16 Mar 15 08:21
NHS good and bad. - Old Navy
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>> NHS = at best, be treated like an inconvenience, at worst something on the bottom >> of their shoe. >> You obviously live in the wrong place. I have had a totally different experience. |
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New Mon 16 Mar 15 08:33
NHS good and bad. - Westpig
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>> You obviously live in the wrong place. I have had a totally different experience. >> Devon is much better....London was bad. Luckily I didn't have to go very often. I forgot parking charges: Private health = park for free NHS = fleece them as much as you can. I can afford parking charges and accept them for what they are, another form of NHS funding, so being able to afford it and not going that often, it's acceptable... but what about the poor sods on very limited incomes who have to go in there all the time? |
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New Mon 16 Mar 15 09:00
NHS good and bad. - Dutchie
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Mine experience of the N.H.S. has been excellent regarding my operation and treatment.Not so good for my wife,she has severe nerve damage in her legs.We did see a consultant again for her. He was muttering something about what to do regarding a operation for her being above his pay grade.Strange comment from a consultant. The N.H.S can be a lottery you need luck with who is looking after you.Can't blame anybody going private if the money is there. |
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New Mon 16 Mar 15 09:03
NHS good and bad. - Old Navy
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>> but what about the poor sods on very limited incomes who have to go in >> there all the time? >> Where parking control is required a pay on exit barrier system should be used with a pass for patients but that would dent income. Most of our hospitals have free parking, with some having dedicated controlled parking for regular treatment (Cancer) patients, the few PFI ones have rip off parking charges. |
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New Mon 16 Mar 15 09:40
NHS good and bad. - henry k
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>> Where parking control is required a pay on exit barrier system should be used >> This is the system I prefer. No guessing how much to load the machine. No concern about a trek back to top up with another ticket. On a recent visit, the car park was a distance from my waiting area and it would have taken me ages to to re visit the ticket machine so of course I paid for an excessive parking period. The geography of the car parks does not permit pay on exit. >> Most of our hospitals have free parking, with some having dedicated controlled parking for regular treatment (Cancer) patients, the few PFI ones have rip off parking charges. >> I have not seen any of that, |
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New Mon 16 Mar 15 09:40
NHS good and bad. - Cliff Pope
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>> >> Private health = be treated like a human being. >> >> NHS = at best, be treated like an inconvenience, at worst something on the bottom >> of their shoe. >> Some years ago I was waiting for a consultation, got worried, so jumped the queue and went private. £80 bought me an instant appointment, in a hospital that felt like a hotel. Greeted on arrival, conducted to the waiting room along carpeted corridors, and waited for a few minutes as Chopin played in the background. The consultant passed, greeted me, said I'd only be 5 minutes he was just finishing, and then apologised for the small delay. We chatted affably, he asked what I did, family, etc, did the examination, assured me all was well. and then talked more about this and that, nothing to do with my health. He showed me out, said he'd like to see me in a few months just as a chack, but as it was only routine there was no point in paying him again, I could see him at the NHS hospital. The contrast at my next NHS appointment was weird. Same bloke, but totally different manner. He barely recognised me, no polite chit-chat, just a brusque in and out, after a long wait with a dozen other people who all had the same appointment time. I suppose this kind of flipped personality comes naturally to them. I was feeling a bit miffed by this - I obviously didn't expect the same service, but some human recognition would have been nice. To force him to respond I remarked on leaving that he had the same surname as a famous Austrian singer of the 40s, 50s., and was he related? He very briefly became human, laughed and said, if he had a voice like that, did I think he would have become a surgeon ? and than instantly switched back to NHS mode. I was quite stunned by both performances, hard to say which was the more disillusioning. |
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New Mon 16 Mar 15 09:55
NHS good and bad. - henry k
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We are " self funded" which often causes some confusion in private hospitals as we seem to be the exception. We have been to four or five private hospitals ( of our choice) for various operations/ procedures. At Moorfields for SWMBO as an out patients evening operation we both had a hot meal there. At another hospital I stayed until past 11pm monitoring SWMBO as staff were not able to do so. I see my consultant on the NHS and privately. During my recent unplanned stay in the NHS he was just the same as my private consultations. Making more folks aware of the charges might improve understanding about overall costs of treatments.i Something has to pay for the better carpet etc :-) |
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New Mon 16 Mar 15 10:14
NHS good and bad. - sooty123
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>> We are " self funded" which often causes some confusion in private hospitals as we >> seem to be the exception. Self funded?I'm not surprised you're the exception! :) |
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New Mon 16 Mar 15 10:10
NHS good and bad. - sooty123
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| What a strange experience cliff, not sure what to make of it. Although that's the thing about better experience with private that it's often the same hospital same staff etc. All sounds very strange. |
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New Mon 16 Mar 15 17:57
NHS good and bad. - Bromptonaut
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My Mother had both cataracts and some other eye surgery at a major private hospital in Leicester. Self funded, as she was in third quarter of her eighties at time insurance cost is ridiculous. As above the consultant, working in evening after his NHS duties, was polite and customer focussed. Yes, the hospital was like a hotel in sense of having deep pile carpets, lots of pale wood and a fancy menu. OTOH the nurses and their auxiliaries were overworked and the wait for drugs from pharmacy was disgraceful. And, while free, the parking was utterly inadequate. More so when dealing with Mum who can only totter short distances on a frame. By contrast her treatment at Glenfield when her ticker was playing up was exemplary. Her only problem was her intolerance of other patients...... |
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New Mon 16 Mar 15 18:39
NHS good and bad. - Haywain
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"intolerance" Ah - so it's in the genes ;-) |
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New Mon 16 Mar 15 19:18
NHS good and bad. - Bromptonaut
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>> "intolerance" >> >> Ah - so it's in the genes ;-) Beeky Chugger!! |
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New Mon 16 Mar 15 09:28
NHS comme-ci comme-ça - Slidingpillar
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*"low" is relative of course - a CT scan dose might be substantially less than what some of us got from those "floursoscope" machines in shoe shops as children. And that could be several times a year. Those shoe shop machines were banned, and not without good reason. One look at a kids feet was equivalent to several X rays in hospital. And to be honest, they were just a sop to parents as one can feel a kids toes etc and unless the last was very strange, a measurement in length and width is all one needs to select the right size. Last edited by: Slidingpillar on Mon 16 Mar 15 at 09:29
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New Mon 16 Mar 15 09:44
NHS comme-ci comme-ça - Cliff Pope
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>> One look at a >> kids feet was equivalent to several X rays in hospital. >> One? We used to love going to Clarks and played with the machine for ages, watching skeletons. |
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New Mon 16 Mar 15 12:36
NHS comme-ci comme-�§a - Old Navy
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| Some years ago I needed serious abdominal surgery. Discussing the options with my GP he advised NHS, his view was private is good for the periferal routine stuff but you need the full scale backup of onsite intensive care and other specialist services for the serious stuff. |
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New Mon 16 Mar 15 13:06
NHS comme-ci comme-���§a - bathtub tom
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I'm sure many here will be familiar with the NHS bowel cancer screening programme (pop-a-poo-in-the-post). Why do they need to waste money sending a letter to let you know they're sending the test kit? |
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New Mon 16 Mar 15 13:26
NHS - Old Navy
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>> Why do they need to waste money sending a letter to let you know they're >> sending the test kit? >> I expect that some sensitive souls who have lead a sheltered life (Zero springs to mind) might go into shock at receiving a poo request kit on their doormat. Last edited by: Old Navy on Mon 16 Mar 15 at 13:27
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New Mon 16 Mar 15 13:32
NHS - Zero
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>> (Zero springs to >> mind) Oh good lord, someone has let Pats pet monkey out on a lead again. Throw him a banana someone |
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New Mon 16 Mar 15 13:40
NHS - Old Navy
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| Who has the fastest bite, you or your dog. :) |
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New Mon 16 Mar 15 13:59
NHS comme-ci comme-Ã���Ã�ï - Fursty Ferret
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>> *"low" is relative of course - a CT scan dose might be substantially less than what some >> of us got from those "floursoscope" machines in shoe shops as children. And that >> could be several times a year. Good on her to reject it. Low but statistically significant risk makes CT scans for routine health checks madness. Starting to see fewer of these "full body MOT" ads in the papers and about time, frankly. |
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New Mon 16 Mar 15 19:01
NHS comme-ci comme-���� - Lygonos
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Some CT scans have about a 1 in 1000 risk of causing a fatal cancer. A chest Xray has roughly 1 in 1,000,000 chance of death by cancer. (Of course the lifetime risk of a cancer death is about 1 in 4, so the extra risk from XR investigations is relatively small but not zero - the risks are cumulative for those who have multiple/recurring investigations though) |
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New Mon 16 Mar 15 20:34
NHS comme-ci comme-���� - Crankcase
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>> Some CT scans have about a 1 in 1000 risk of causing a fatal cancer. Crikey. I've had two in the last couple of months, and another planned in August, apparently, and nobody mentioned that! I'll not post my admin side of the hospital experience though, as it's long, involved and not actually all that positive. |
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New Tue 17 Mar 15 08:49
NHS comme-ci comme-���� - Fursty Ferret
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>> Crikey. I've had two in the last couple of months, and another planned in August, >> apparently, and nobody mentioned that! >> Probably not full body scans. |
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New Tue 17 Mar 15 11:23
NHS comme-ci comme-���� - Ambo
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>> It's damn jumped-up managers making decisions to justify their inflated salaries. Quite, Armel, and endemic in the NHS. My wife spent her career in the NHS, lately in charge of a service for our entire county, and suffered greatly from interference from a highly paid CEO of the relevant trust whose only qualifications were in office practice. I suffered something of this in higher education and there is an article in the current London Review of Books by Maria Warner, showing the horrifying extent of it there now. But I guess every large organisation has the same problem presently, Met, National Trust, RSPB etc. God save it doesn't apply to the Army (but I expect someone will tell me it does). The puzzling question is why? The philosophy behind it seems to be that business is better at running things than consultants, teachers or other specialists. This is surely an argument derived from the practices of market capitalism, which would make it a Tory brainchild although it is cockeyed enough to be Labour's. |
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New Tue 17 Mar 15 11:42
NHS comme-ci comme-ca - No FM2R
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>>The puzzling question is why? The philosophy behind it seems to be that business is better >> at running things than consultants, teachers or other specialists Well, not so puzzling really. We have a Health Service where pretty much all the metrics, measures and reports are administration or finance based. Consequently there for we have financial and administration managers running the NHS ( / police / education / etc.). If we had medically oriented metrics and reports, although I wouldn't know what they might be, then we would have a Health Service run by medical professionals ( / police / education / etc.). People want an NHS which is free (at the point of use) and unlimited for any and all needs. But that's expensive, more than we want to pay, so we get financial people into manage it. We want as to have as much time from medical staff as we feel that we need at that moment. The trouble is, that's difficult and variable. So we bring in administrators to try and schedule everything. Etc. etc. b***** obvious, b***** annoying. But as Roger said, you can have the best you want, but you will have to pay for it - and people don't want to. Lets see how many Sun and Daily Mail readers would actually dip in their own pockets to pay for the nurses' pay increase. Around about none, I should think. |
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New Tue 17 Mar 15 16:05
NHS comme-ci comme-ca - Westpig
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>> Well, not so puzzling really. >> >> We have a Health Service where pretty much all the metrics, measures and reports are >> administration or finance based. Consequently there for we have financial and administration managers running the >> NHS ( / police / education / etc.). >> >> If we had medically oriented metrics and reports, although I wouldn't know what they might >> be, then we would have a Health Service run by medical professionals ( / police >> / education / etc.). Well IMO it is an experiment gone horribly wrong. You cannot really argue about the theory of a manager managing in the examples you've listed above.. (as opposed to the medical professional / police / education etc)... but... .... the reality is the management system becomes dreadfully bureaucratic and empire builds, so that the new management system itself becomes more important than the main aim of that particular organisation. Multiply that by each new management dept e.g. HR, IT, Finance, Fleet Management, whatever... and you have Frankenstein. The old omni-competent medical professional / police / education etc would in fact be much better, because although their HR work or Finance as examples might not be quite as good... they'd still very much focus on the main aim of the organisation as well or at least prioritise that. I'd guess this is more a real problem in State funded outfits rather than those who need to make a profit... however.. having spoken to senior people in profit runs companies, they also have such moments. |
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New Tue 17 Mar 15 16:19
NHS comme-ci comme-ca - No FM2R
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>>Well IMO it is an experiment gone horribly wrong. Well, I'm not sure it was an experiment, but it has most certainly gone wrong. However, the alternatives are not obvious. Let us say that my some magical wand I can double the Police budget overnight. Ignore the issue of where the money is actually coming from. However, I want to make sure that the extra money is well spent; and by "well spent" I mean effective. What metrics could I use to make sure that was so? e.g. Number of criminals successfully prosecuted? But that might discourage the police from attending events such as parades where they are concerned with safety, not crime. Number of policemen? But that might encourage the force to recruit as many as possible as cheaply as possible without worrying about quality? etc. etc. And these metrics are expected by the general population and set by politicians and administrators - NONE of who have the slightest idea about effective policing. So what do you do? Frankly I have no idea. Its easy to say that Police Chiefs should be elected, but approach hardly ensures we get competent politicians so I can't quite see how it would mean that we got competent police chiefs. >>I'd guess this is more a real problem in State funded outfits rather than those who need to make a profit Pretty much. But mostly because its much easier to measure whether or not a commercial operation is successful. |
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New Tue 17 Mar 15 17:05
NHS comme-ci comme-ca - Bromptonaut
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The other issue for the current health service is contracting and then managing the let contracts. Huge growth industry under the coalition's reforms but they only expanded on what was there before. Trouble is when something goes wrong massive amounts of energy are devoted to allocating blame and cost accross all involved contracts. You might have though that the precedent of rail franchising would have shown the error of this route but apparently not. |
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New Tue 17 Mar 15 20:43
NHS comme-ci comme-ca - Westpig
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but it has most certainly gone wrong. >> However, the alternatives are not obvious. >> >> Let us say that my some magical wand I can double the Police budget overnight. >> Ignore the issue of where the money is actually coming from. Chucking more money at everything isn't the answer...(and I know that's not what you are advocating). An example: 30 odd years ago, if you arrested someone for a criminal offence that needed to go to Magistrates Court, you prosecuted it yourself... and soon learnt not to 'p' off a Stipendiary Magistrate (District Judge) and got a lot better at court presentation. If it was a good criminal job, you either persuaded CID to take it on or you had to do a 'legal aid' which was an extensive file preparation which went off to police solicitors for them to assign a police funded solicitor to prosecute... it was a PITA...so you didn't do that, you did it yourself and got even better at court presentation... and most of the time your prosecutions were done by yourself and were not too time consuming. Then someone invented a Criminal Justice Unit, an internal police civilian crewed outfit that was designed as a support for police officers so that they could stay on the streets and the CJU would do all the court preparation stuff... only, that never happened... because the police created civilian management posts... who had demands... and who decided the very police officers who were meant to be freed up to police, should do all the running around to create the files to a certain standard so the CJU could then deal...and the CJU numbers became vast. ........then someone created the CPS..... who did likewise (and some). So fast forward 30 years, unbelievable bureaucracy, the coal face workers now have to run around the back room people for EVERY CASE, rather than the odd one or two out of a hundred that it was 30 years ago...and, the modern police officer gets sod all experience in court, so becomes a considerably less professional witness. That example is valid for many other areas as well. It certainly isn't progress. Last edited by: Westpig on Tue 17 Mar 15 at 20:46
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New Thu 19 Mar 15 17:18
NHS comme-ci comme-ca - Armel Coussine
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I just took Herself to the station in time to catch a train to Chichester for a long-standing medical appointment. When I got back from the station, Herself being by then on the train, saw that there was a message left on the phone. It seems that owing to 'an emergency' all the standing appointments have been cancelled for the rest of the day. Yeah, yeah. She told me not to try telephoning her and I haven't. I look forward with interest to what she'll say when we do speak. How thoughtful of the management to work it like that. They have our best interests at heart obviously. Think we need to be kept busy at all costs, the screaming idiots. |
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New Thu 19 Mar 15 17:59
NHS comme-ci comme-ca - Bromptonaut
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>> How thoughtful of the management to work it like that. They have our best interests >> at heart obviously. Think we need to be kept busy at all costs, the screaming >> idiots. What was the nature of the emergency? Flood? Absence of critical staff? A crisis elsewhere in the hospital? Without that information it's a bit hard to criticise the staff. Lots of stuff these days depends on IT. Miss B works in the collection side of blood transfusion. No IT means all patients have to be treated as new/returning donors; questionnaires to fill in etc. PITA for all concerned and slows things to a crawl. |
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New Thu 19 Mar 15 18:16
NHS comme-ci comme-ca - Armel Coussine
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>> Without that information it's a bit hard to criticise the staff. Yes, I posted that in a temper. Can't remember what the emergency was. The message was hurried and pretty faffing, hard to make out what was important in it and what wasn't. These things can happen... but the timing was spectacularly inconvenient. Herself has just called. She wanted to know why I hadn't rung her. Apparently I got that wrong too. Anyway she'll be back an hour earlier than scheduled. Our plan was to get fish and chips for supper from the place by the station, but it'll be a bit early now. Faff faff... there's no escape from faff today. Last edited by: Armel Coussine on Thu 19 Mar 15 at 18:17
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New Thu 19 Mar 15 18:33
NHS comme-ci comme-ca - Bromptonaut
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>> Herself has just called. She wanted to know why I hadn't rung her. Apparently I >> got that wrong too. Can't do right for doing wrong? Welcome to the club!!! |
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New Thu 19 Mar 15 20:26
NHS comme-ci comme-ca - Armel Coussine
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I hope Lygonos hasn't got bored or annoyed and is just a bit busy. I'll try to tempt him back with this: Drinks on the way out of town on Tuesday evening with Herself's well-connected college friend. The other person present was a journalizing doctor whose column appears in my comic, and I had skimmed it that morning. The item I remembered was about foot cramp. Both Herself and I get it sometimes. Probably normal at our ages. We discussed the virtues of water and quinine as specific treatments. Very nice cat he seemed. Takes me back a bit, talking about the day's comics with the people who have scribbled and cobbled them together in a desperate hurry. Did it all the time when I still did stuff. And in those days you didn't have to worry that the lousy subs would make you look an utter t***, the anonymous carphounds. |
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New Thu 19 Mar 15 21:41
NHS comme-ci comme-ca - Runfer D'Hills
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| It's those shoes AC. Keep telling you. |
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New Thu 19 Mar 15 23:02
NHS comme-ci comme-ca - Armel Coussine
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| You can knock me down, Humph, tread on my face, slander my name all over the place, do any thing that you want to do, but oh never mind... |
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New Fri 20 Mar 15 07:57
NHS comme-ci comme-ca - Roger.
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>> You can knock me down, Humph, tread on my face, slander my name all over >> the place, do any thing that you want to do, but oh never mind... >> Oh, Lordy - tell me they are not blue suede! |
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New Fri 20 Mar 15 16:03
NHS comme-ci comme-ca - Armel Coussine
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>> Oh, Lordy - tell me they are not blue suede! No, they are white Rastaman, or used to be. But I did have some blue blue, blue suede shoes a few years ago, and very elegant they were. Didn't stand up well to mud though. 'You can do anythang but lay offa mah blue suede shoes'... even the King couldn't protect them from mud. |
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New Thu 19 Mar 15 21:56
NHS comme-ci comme-ca - Lygonos
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>>I hope Lygonos hasn't got bored or annoyed and is just a bit busy The real problem in the NHS is about to kick off (although any fule noes it has been coming for about 15 years). GP numbers are struggling - very badly in some places. 4 practices in Forth Valley have collapsed due to inability to recruit (nearly 30,000 patients affected), and every other region has practices that are quietly being supported by their Health Boards. 5 years of falling income and increasing demand and workload is now coming home to roost: for many GPs life is far easier and at least as financially rewarding as a locum, with partnerships increasingly not being worth the hassle. Or they have moved to Australia where they are actively being recruited. The big issue isn't the money (although it's important) ~ it's the lack of GP numbers. Hospital specialist numbers (Scotland - I expect the other nations will mimic this) have far outstripped GP numbers - in 2009 there were around 3700 full time equivalent GPs - in 2013 there were 3730. Over the same period hospital doctor numbers increased over 20%. There are usually around 20 unfilled GP training posts each year in Scotland (out of around 300) - last year there were over 30 unfilled, and this year it is going to be around 60 unfilled posts. Retirement rates are rising, especially as pension changes and seniority payments are making it less attractive to work on past 60. About 70% of trainee GPs are women - on average they work less hours than men, have longer career breaks, and are less likely to take on partnerships. Wait til you see A&E and Hospital waiting times explode when 10% or more of the country can't access GPs, or only ever see locum doctors who are paid by the Health Board. Health Boards cannot run Practices as well as partnerships - not even close. Last edited by: Lygonos on Thu 19 Mar 15 at 21:58
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New Thu 19 Mar 15 23:17
NHS comme-ci comme-ca - Armel Coussine
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>> There are usually around 20 unfilled GP training posts each year in Scotland (out of around 300) - last year there were over 30 unfilled, and this year it is going to be around 60 unfilled posts. Wow Lygonos, proper answer, thanks. My sister and her husband are both GPs. They met at Edinburgh when they were students there. Went off to New Zealand, unpatriotically but sensibly from the personal angle. I find it puzzling that students aren't keen to be GPs any more. It's a good and worthy profession after all. But I suppose specialists get better pay for shorter hours, plus more kudos? One of the subjects of conversation with the journalising doctor on Tuesday was Harold Shipman and his estimated 300 victims. Mad doctors aren't as unusual as you might hope... Indeed I knew one, a near-contemporary who'd been at my last school before my time, a real fruitcake. No Shipman of course but pretty nutty all the same. Topped himself in a fit of depression (he was appalling in manic phases). His suicide made me feel very guilty although there was nothing I could have done about it. I felt I should have given the barmpot more attention. Last edited by: Armel Coussine on Thu 19 Mar 15 at 23:20
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New Thu 19 Mar 15 23:26
NHS comme-ci comme-ca - Lygonos
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>>I find it puzzling that students aren't keen to be GPs any more. It's always been around 25% (figures going back nearly 100 years are pretty much the same proportion) want to do GP at the qualification stage - one issue in the past 10 years or so is the difficulty to switch from a hospital programme to a GP one compared to the 'old days'. If you start, for example, wanting to be an orthopaedic surgeon and realise that the old adage "as strong as an ox, and almost as smart" is actually true, it's harder to divert into GP land. Also, the training and examination regime for GP is tougher and more involved than previously - if you're not going to make it as a consultant I guess you're more likely to stay in hospital as a salaried non-consultant than try your hand in GP. |
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New Thu 19 Mar 15 23:30
NHS comme-ci comme-ca - No FM2R
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| Without asking anything personal, how do the different medical roles compare from a financial perspective? |
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New Thu 19 Mar 15 23:42
NHS comme-ci comme-ca - Dutchie
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Not that good F.M.Doctors had excellent pay rises.Nurses poor.Care workers on the bottom. Daughter is a qualified Mental health nurse (Degree educated) I think she is now on about 27 Grand a year.1% pay rises for the last five years. |
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New Fri 20 Mar 15 00:59
NHS comme-ci comme-ca - No FM2R
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>> I think she is now on about 27 Grand a year.1% pay rises for the last five years. Doesn't sound a lot for a 30yr old in a difficult and qualified profession. |
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New Thu 19 Mar 15 23:54
NHS comme-ci comme-ca - Lygonos
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Consultant starts on £76k, rising to £102k by 19 years experience. They can be awarded discretionary amounts up to around £20k on top of this for exceptional research/performance. (Basic salary for a newly qualified doc is £23k - was just under £16k when I qualified in mid-90s) Salaried GPs earn a minimum of £55k (for 40 hours) but most will earn £65-80k depending upon experience/demand. GP partners get a share of the money left after the practice pays its expenses - typically a GP would earn around £120k if they had a list of around 1600 patients - this would be a gross amount subject to both employee and employer superannuation (approx. 30%) so would have a realistic salary equivalent around £105k (ie. around £90k + £15k that would be the employee's pension contribution). Mileage varies quite substantially depending upon list size, practice size, private income (such as medicals) and so forth, but they'd be a fair guesstimate. I suppose that means a typical GP earns about £65 per year to provide each of his/her patients with general medical services (with an average of 6 contacts per patient per year, so a tenner per appointment) - know any lawyers that charge £10 per appointment? ;-) Last edited by: Lygonos on Thu 19 Mar 15 at 23:56
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New Fri 20 Mar 15 00:01
NHS comme-ci comme-ca - Lygonos
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bma.org.uk/news-views-analysis/news/2014/september/gp-income-continues-to-fall-finds-report This suggests around £90k before tax, so presumably is a figure after pension payments have been deducted. |
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New Fri 20 Mar 15 00:58
NHS comme-ci comme-ca - No FM2R
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£65k - £80k sounds reasonable, £35 per hour, or something I suppose, but then considering what one can occur in other, somewhat less important, walks of life puts it in perspective somewhat. Having said that, on the occasions I am working full time I'd sell my soul for a 40hr week. Still, its not the bread line, albeit probably worth substantially more. I realise that serious studying and underpaid early years are involved, although that's true of lots of us. Equally I realise that people don't die if I make a wrong decision, well its not likely anyway, whereas their life may well be in your hands. Is it a "pleasant" job overall? I mean, would you still decide to go into it if you had the decision to make again? |
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New Fri 20 Mar 15 01:26
NHS comme-ci comme-ca - Lygonos
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>>Is it a "pleasant" job overall? I mean, would you still decide to go into it if you had the decision to make again? It's a very rewarding job, but the expectation and workload (especially targets of dubious importance to an individual) are increasing over time. Think about the variety of what is seen: nowhere else in medicine can a single practitioner deal with coughs, sneezes, diarrhoea, rare genetic complaints, suicidal depression, heart attacks, cancer, drug overdoses, bereavements, recuperation from surgery, skin complaints, eye problems, 900 pages of prescribable medications and devices, dealing with social work, arranging blood tests and radiological investigations, etc, etc. Competence in most fields, mastery of one or two is the norm. Would I be a doctor again? - sure. Would I be a GP? - probably - if I was a hospital doc it would likely be in cardiology or rheumatology but I think I'd get bored of the specialties after a decade. |
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New Fri 20 Mar 15 16:14
NHS comme-ci comme-ca - Armel Coussine
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>> "as strong as an ox, and almost as smart" Heh heh... but it's surprising how many people think of surgeons as being high intellectuals, when what they need is a very steady hand and not too much compassion (they do need some of course). Anyone too tender will be afraid to cut and their hand will shake. I'm not knocking surgeons, far from it. They've saved my life twice at least. In Chad I used to drink with a lot of doctors, MSF, and surgeons, Médecins du Monde. The MSF people noted jealously that the surgeons were 'very rich'. But they were paying their dues, or some of them, by giving their services free to repair wounded troops, guerillas and so on, using their holiday time to do it and getting travel expenses only. |
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New Thu 19 Mar 15 21:50
NHS comme-ci comme-ca - Runfer D'Hills
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Nah, no need for club membership, it's a bit like staff, if you make it clear that the previous incumbent was dismissed for inefficiency and insubordination the newer model usually shapes up all right. ;-) |
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