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[NHS] Someone talks sense https://x404.co.uk/forum/viewtopic.php?f=19&t=23156 |
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Author: | cloaked_wolf [ Mon Jan 05, 2015 5:33 pm ] | |||||||||
Post subject: | [NHS] Someone talks sense | |||||||||
The ails of general practice and emergency medical care cannot be resolved by the doctors alone http://www.thesundaytimes.co.uk/sto/hom ... 6565c90140
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Author: | jonbwfc [ Mon Jan 05, 2015 7:18 pm ] | |||||||||
Post subject: | Re: [NHS] Someone talks sense | |||||||||
It's not free of charge at all for most of the population. It's free at the point of use. Those of us who are able do so pay taxation a fair chunk of which goes to the NHS every year. We have some right of expectation of getting a service for that taxation. The use of NHS services for trivial reasons may well have increased - I suspect that's an anecdotal statement but anyway I'm willing to accept that is true, or at least the perception is there amongst GPs, which has the same long term effect on GP recruitment and retention. His arguments that up to this date reforms have increased the burden on GPs and made the job less attractive, we have to accept that is true given the position he's in to observe it. However basing an argument on the logic of 'you don't pay for it, so you should be more careful how you use it' is a fallacy. We do pay for it. Just not directly by having a bill waved under our nose. Those of us who can pay accept the burden for those of us who can't. Either way, the people he's complaining about pretty much do pay his wages. Well, welcome to the real world, that's what rest of us have to deal with. Let's not forget why the NHS was created in the first place - because previously many people could not afford medical care and suffered pain or even died because of lack of wealth. "free medical care at the point of delivery" is possibly the greatest social innovation the UK has ever come up with. I accept the NHS front line needs reform and that people do need to be more self-reliant in general. But this article sounds very adversarial in a way that is not really helpful. |
Author: | cloaked_wolf [ Mon Jan 05, 2015 9:09 pm ] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Post subject: | Re: [NHS] Someone talks sense | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
In the medical world, we now refer to this as "free at the point of abuse" because you get a lot of people misusing the NHS services.
Firstly, the service isn't gonna be there for much longer if people keep misusing the services. Secondly, the amount of taxation isn't enough for running it properly. The amount of taxation required for what people want ("me me me" and "now now now") would be astronomical.
It's not just amongst GPs. I've worked in other areas such as surgical, medical, obstetrics & gynaecoloy, and A&E to name a few. A&E was often the worst where people would turn up and want treatment for (eg) an ingrowing toe nail - something A&E is not set up to do. Other times it would be for longstanding conditions that didn't warrant an attendance at A&E.
Ask GPs what they hate about their job and they'll tell you. I'll tell you (though I came in after the reforms had been made). Ask medical students about their opinion of General Practice. Surverys have been done.
He's trying to say the right thing albeit in the wrong way. Look at other systems where co-payment is based and look at how people utilise the services. Look at the past. I've spoken to GPs who worked under older systems. They were called maybe once or twice a night max, and sometimes not at all. Compare this to current demands and it becomes a struggle.
And it's something that will disappear within the next ten years. There needs to be a way of rationing what we have because the infrastructure just isn't there. Departments, wards, hospitals are being shut. Funding is being cut. The NHS is being strangled slowly. I was gonna post some stuff about the original article but I'll do tht another time. |
Author: | jonbwfc [ Mon Jan 05, 2015 10:09 pm ] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Post subject: | Re: [NHS] Someone talks sense | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Obviously, you've seen the sticky end of the idiot portion of the UK population and I don't actually disagree with you about the notion we have to do something about them. However dismantling the NHS is not the way to do that. Because you may get rid of the idiots - more likely you'll just move them on somewhere else - but you'll also harm many decent people who find themselves unable to manage whatever requirements come in. On the one extreme we have the idiots who go a see a GP after they stubbed their toe because it's free and on the other extreme we have the US nightmare of dying people refusing to get in ambulances because they don't want to burden their families with medical bills. There has to be a better way than either of these extremes. As far as I can see, the only way to decide this is hard numbers. What are the numbers in terms of wasted GPs appointment slots by complaints that could be easily self-treated? What percentage of A&E visits are for minor injuries that would heal of themselves within time? Do we keep these statistics? I'd imagine not, as some of that is pretty hard to quantify objectively. The article's problem is that because it's hard to objectively say when something is 'frivolous', it's based entirely on emotive arguments, it doesn't have the evidence to back it up. Anecdotally, I'm sure the stuff he's complain about happens. But is it really something that's costing us a vast fortune the NHS could better use for vital treatments and providing better front line care? We all have an opinion, but does anyone really know?
The past is not always the place we remember it being. GPs were called out less often and there were less idiots to be sure but maybe more genuinely ill people suffered in silence as well. We can't get back to where we were, we have to make the best of where we are now.
Sadly I agree, but I think this has less to do with increasing demand as other factors.
See above.
Sorry if I derailed your train of thought. But I am a firm believer in the idea that the NHS is one of the things that shows us to be an enlightened, civilised nation and binning it because there are a percentage of us who will always look a gift horse in the mouth would be national tragedy of unprecedented proportions. |
Author: | cloaked_wolf [ Mon Jan 05, 2015 10:30 pm ] | |||||||||
Post subject: | Re: [NHS] Someone talks sense | |||||||||
I completely support the NHS, and when it's properly funded, properly staffed, properly resourced and well run, it's fantastic.
There are a few problems here. Knowing what would have healed/settled by itself is almost a retrospective affair. Coding is another issue. Most of the time, when I write up a patient's notes, I don't always code "sore throat" or "viral infection". Sometimes I don't know what the diagnosis is but I know it's not immediately life-threatening or serious. Ditto in other departments. If you had accurate coding, you could run audits. The easiest thing to do is rock up to A&E on Christmas morning. On the times I've covered this shift, I've found A&E to be very quiet. The last time, I recall about seven patients in A&E. All of them had something serious eg stroke, heart attack. These were people who were genuine and needed to be there. It wasn't until late afternoon that it started crowding up. It was over Christmas time that I recall seeing a 20 year old (or thereabouts) who had queued for four hours to be seen with a sore throat. The look on her face when I told her it was just a sore throat that didn't require treatment was priceless. But at the same time, she'd taken up NHS resources for what was ultimately a self-limiting illness. |
Author: | TheFrenchun [ Mon Jan 05, 2015 10:45 pm ] |
Post subject: | Re: [NHS] Someone talks sense |
How much of the breakdown is due to people living longer, but not healthier and needing an incredible amount of care and meds? Sent from my iPhone using Tapatalk |
Author: | pcernie [ Mon Jan 05, 2015 10:51 pm ] |
Post subject: | Re: [NHS] Someone talks sense |
'Major incidents' declared at English hospitals http://www.bbc.co.uk/news/uk-england-yo ... e-30687347 This happens continually now in Belfast. |
Author: | big_D [ Tue Jan 06, 2015 5:11 am ] |
Post subject: | Re: [NHS] Someone talks sense |
I think in the past, a lot of people would have pain over night and think "I'll go to the doctor's in the morning," but a lot of people will now just call. I know that the first time I had a gout attack, I waited over the weekend to attend the doctor's surgery on Monday morning as an emergency. That was 2 excrutiating days, but I could limp by, literally. On the other hand, a friend of mine, who is an asthma sufferer came to visit and had a bad attack and his spray wasn't any use, so we called the emergency on call doctor at 2 on a Sunday morning. In Germany, I certainly feel pushed to go to the doctor's sooner. In England I could self-certify for the first 4 days, here I need to provide a medical certificate to my employer by first post on the second day of illness, or bring it with me, if I go back to work on the second day. That means that I have used the doctor's services a lot more than I used to. Also, as in the article, when I was a kid in the 70s and 80s, my mother would provide first level care and only when it was beyond her expertise (cleaning wounds, administering cough syrup etc.) did we get taken to the doctor's for a diagnosis or to A&E for treatment - in fact I got a right good telling off for going to A&E after falling off my bike, when I was 12, because I was outside the hospital when it happened, I "shouldn't have wasted there time with something so trivial," which was a cut arm, which just needed cleaning and a gauze bandage over it. |
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