NHS Crisis, do the French have the solution?!

[Supermofo]

So daughter is ill, hacking cough, rattly chest, sounds like darth vader, been going on for a few days.

Call doctor who say no appointments call 111. Call 111 who say call GP as they have a duty of care to see her, we ask what happens when they say no appointments - they say they've put a note on the system and call GP. Call GP who say no appointments and no note go to hospital or call 111. Call 111 and they have no way of referring to the call we'd made an hour before so they won't do anything unless we go back through all the questions, so we do that and they say we'll get a clinician to call you and they'll let you know if you need to go to hospital. No idea how long that might take and then we might end up sitting at the hospital anyway.

System is fucked.

[Ant]

Get back in touch and say you want a sex change and diversity training. You'll get seen right away,

[Dodgy69]

So daughter is ill, hacking cough, rattly chest, sounds like darth vader, been going on for a few days.

Call doctor who say no appointments call 111. Call 111 who say call GP as they have a duty of care to see her, we ask what happens when they say no appointments - they say they've put a note on the system and call GP. Call GP who say no appointments and no note go to hospital or call 111. Call 111 and they have no way of referring to the call we'd made an hour before so they won't do anything unless we go back through all the questions, so we do that and they say we'll get a clinician to call you and they'll let you know if you need to go to hospital. No idea how long that might take and then we might end up sitting at the hospital anyway.

System is fucked.

The country is fcuked. Too many tossers in charge, for too many years. We're doooooomed.

[Pirahna]

Little sis, who knows about things (she's a senior civil servant and statistician) has explained in easy to understand phrases the problem with the NHS. Apparently half the beds are taken up by people who should be being cared for at home, similarly ambulances are full of these people as well. The hospitals can't discharge them because they can't manage on their own and there's nobody to look after them.

Where have the carers gone? The problem has been brewing for a while. The Labour Party were given an oportunity to take action in 2009 and passed up the chance, things have got a lot worse under the Tories. The staff shortages were dealt a blow with Brexit when lots left and went back to Eastern Europe, and remember the bit where Matt Hancock said that anyone working in the care sector that wasn't fully vacinated would be out of a job? 40,000 staff left over that one. So according little sis, sort out social care and you'll be a good way to sorting out the NHS.

[DefTrap]

I'm very surprised that 40k staff have left as a direct result of not being (presumably covid) vaccinated. Seems an odd stat to be able to correlate - did they all quote it in their exit interview or summink?

[Pirahna]

I'm very surprised that 40k staff have left as a direct result of not being (presumably covid) vaccinated. Seems an odd stat to be able to correlate - did they all quote it in their exit interview or summink?

A good question. I've sort of done the obvious (sorry) and Googled "did 40000 people leave the care sector". The search throws up numerous articles, I think the Matt Hancock comment is just one of many factors, not the main one. This is the first article on the search:

https://www.cityam.com/pandemic-exodus- ... ths-alone/

This article links the 40k staff leaving to compulsory vaccinations:

https://www.communitycare.co.uk/2021/07 ... ns-policy/

[Count Steer]

A quite good summary of the issues here. https://www.bbc.co.uk/news/health-64190440

PS. I don't believe for one minute that they lost 40,000 because of their unjabbed status in the care sector. That just looks like a handy hook to hang the losses on to avoid looking too deeply at the other reasons.

[DefTrap]

Yeah I thought that.
If I was a nurse, I wouldn't shout about that as a reason.

[demographic]

Pretty sure were not heading in the French direction, our glorious leaders seem far more keen on using the American model.
Can't say I'm blown away by that idea at alll.

[Cousin Jack]

The real problem is not with the NHS, it is with society and economics.

Economic theory says demand is asymptotic to infinity if cost is zero.
And society say "I demand", rather than "Please can you help me".

I have no idea how to sort out societies problems, but economics is easy.

GP appointment £10
A&E visit £100
Ambulance £250
Unwarranted ambulance call £1,000

[Mr. Dazzle]

Who gets to decide if the call is unwarranted?

For some people a £250 ambulance ride is a throwaway cost, for others it would mean not having the heating on for a few months.

Some people are so tight they'd avoid the £10 GP bill until they have a £250 ambulance ride forced on them.

Etc.

That's why it's free at the point of service right?

[DefTrap]

The real problem is not with the NHS, it is with society and economics.

Economic theory says demand is asymptotic to infinity if cost is zero.
And society say "I demand", rather than "Please can you help me".

I have no idea how to sort out societies problems, but economics is easy.

GP appointment £10
A&E visit £100
Ambulance £250
Unwarranted ambulance call £1,000

Or based upon 'ability to pay'. But we know that won't work because society has decided everyone else is a scrounger.

[Mr. Dazzle]

Just been through a financial assessment for a family member needing social care. Took 6 months and umpteen million bits of paper.

Bollox to doing that every time someone needs a plaster cast!

[DefTrap]

Well over here they just treat you and bill you.

[Mussels]

Well over here they just treat you and bill you.

Does that go for everyone, what about people on benefits?

[Count Steer]

It seems that one of the key issues of social care is that the ever rising costs fall on the increasingly squeezed local councils (which is one of the reasons less and less gets spent on all those other things that are constantly moaned about, like road repairs).

You could save ambulance crews and A&E departments huge amounts of work if the emergency contacts could send local community care, first response teams to assess stuff like 'I've fallen off the commode and can't get up for the 3rd time this week' or the mental health 'I've taken 5 paracetamol' calls to either resolve or triage cases. ('I've just chainsawed my leg off' calls get ambulance first response teams still, obvs).

Will the NHS cough up for that? No. Have local authorities got the money? No. Will government let Council Tax go up to pay for it? No.

There seems to be no will to even address the key structural issue. It also means that social care is a postcode lottery.

[Mr. Dazzle]

They can/do use social care to 'rescue' people off the floor etc., I've been through all this with family. However a lot of the time the answer is "we can't get to you, call an Ambulance". There is also a whole raft of HSE/legislation about picking people up, handling people with certain conditions etc. as you might imagine.

You almost need B tier Ambulances or something like that.

[Gregor]

It seems that one of the key issues of social care is that the ever rising costs fall on the increasingly squeezed local councils (which is one of the reasons less and less gets spent on all those other things that are constantly moaned about, like road repairs).

You could save ambulance crews and A&E departments huge amounts of work if the emergency contacts could send local community care, first response teams to assess stuff like 'I've fallen off the commode and can't get up for the 3rd time this week' or the mental health 'I've taken 5 paracetamol' calls to either resolve or triage cases. ('I've just chainsawed my leg off' calls get ambulance first response teams still, obvs).

Will the NHS cough up for that? No. Have local authorities got the money? No. Will government let Council Tax go up to pay for it? No.

There seems to be no will to even address the key structural issue. It also means that social care is a postcode lottery.

We as a society don’t seem keen to take responsibility for our sick and elderly, preferring in some instances to ship them off to granny farms rather than care for them ourselves when they lose their independence.

That’s a conversation you don’t hear very often.

[Gregor]

They can/do use social care to 'rescue' people off the floor etc., I've been through all this with family. However a lot of the time the answer is "we can't get to you, call an Ambulance". There is also a whole raft of HSE/legislation about picking people up, handling people with certain conditions etc. as you might imagine.

You almost need B tier Ambulances or something like that.

They used to exist, that was how my missus started with the ambulance service, dealing with non life threatening but urgent calls for help.

It was called A&E support back then.

[DefTrap]

Does that go for everyone, what about people on benefits?

I think they are 100% covered.
Everyone else pays at least a percentage, you can take out insurance to cover. Lots of caveats.

But you do get oversight of the full cost of hospitalistion, procedures etc. Loadsa money.