FabSwingers.com forum: does the nhs need a rebuild from top to bottom

By *oxy j OP Woman
over a year ago

somerset

so the question is does the nhs need a rebuild from top to bottom its not a political question so its not about who you vote for its a general question to how to fix the nhs and to make sure those who save lives can get a decent wage from a system thats leaking millions every week ..

what would you do lets say there no more cash pay rise's has to be found from the cash leaks ..

i think the very first thing that needs to be fixed is agency this is a massive weekly bill thats just not substainable nurse's give up work to just work agency (dont blame them the money is better)

so what else should be done to get the nhs healthy or healthier please keep it non political just practical play nice .. different views is healthy not bad

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By (user no longer on site)
over a year ago

My best friend is a band 6 nurse who has just putting in her notice to go agency full time and the difference between the pay is shocking

Think she said on agency she gets around £40 per hour???

It's madness that the powers that be are happy to pay that to agency staff but won't give the NHS staff a pay rise

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By *uke olovingmanMan
over a year ago

Gravesend

I've just returned home from having a complicated appendectomy...I have nothing but praise for the way they handled my recovery ...the staffing was pretty intensive with a well ordered and disciplined team ...from a patient's point of view it is quite bewildering to start with..but the pure logic of how a ward works is like clockwork...the diagnostic machines are spectacularly modern ..so ..the NHS must be an expensive drain on our tax income...but worth every penny

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By *ansexualPandaMan
over a year ago

Near You

As an armchair expert, I'd argue that yes it does. Rebuild the hierarchy and invest more in frontline staff, doctors, nurses etc. Renationalise it fully and take away the contractors and subcontractors. Sounds obvious to me.

The trouble is I have no idea if that's possible or how it would actually work in practice. The NHS seemed to be in a lot better health (if you excuse the pun) when I was a kid to what it is now. Years of mismanagement, outsourcing and underfunding along with a rapidly growing population have got it to where it is. How to fix it? Honestly, I don't really know.

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By (user no longer on site)
over a year ago

"As an armchair expert, I'd argue that yes it does. Rebuild the hierarchy and invest more in frontline staff, doctors, nurses etc. Renationalise it fully and take away the contractors and subcontractors. Sounds obvious to me.

They can't take away subcontractors because they don't have enough of their own staff

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By (user no longer on site)
over a year ago

I would like a full non party review of the NHS in comparison with other public health systems in similar countries such as France and Germany; I feel we could learn a lot from them. I do find it strange how many take an insular, almost jingoistic, attitude towards the NHS, assuming it is the best health service in the world when anyone who has lived and worked elsewhere knows this is not true.

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By *penbicoupleCouple
over a year ago

Northampton

What it needs is decent funding and an end to all the privatisation.

(You might get more responses if this was in the politics thread.)

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By (user no longer on site)
over a year ago

Many of the contractors and suppliers are tied to long term and hugely expensive PFI deals. It is a complete rip off.

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By *penbicoupleCouple
over a year ago

Northampton

"I would like a full non party review of the NHS in comparison with other public health systems in similar countries such as France and Germany; I feel we could learn a lot from them. I do find it strange how many take an insular, almost jingoistic, attitude towards the NHS, assuming it is the best health service in the world when anyone who has lived and worked elsewhere knows this is not true."

Those comparisons already exist.

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By *ose and her beastCouple
over a year ago

Watford

Nope it just needs some actual attention to it's structure and support so many doctors and nurses stretched so thin

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By *oxy j OP Woman
over a year ago

somerset

"What it needs is decent funding and an end to all the privatisation.

(You might get more responses if this was in the politics thread.)"

but ive stated its not a political question hence its here its just a general question ..no politics needed

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By *ackandtheunicornCouple
over a year ago

liverpool

It's seems the main problem is a shortage of drs, nurses, consultants.

We should be paying people to train as these, not charging students ridiculous fees.

Won't have any immediate effect but would surely alleviate long term problems.

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By *oxy j OP Woman
over a year ago

somerset

"Nope it just needs some actual attention to it's structure and support so many doctors and nurses stretched so thin "

it simply cant have more money things need to be repaired and cash stopped bleeding to those who dont earn it if we stop that then all can have the pay rise deserved no to agency and total strip down of the managment and admin system its shocking how many office workers are in the nhs compared to 30 years ago there is a major problem with how cash is spent

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By (user no longer on site)
over a year ago

"What it needs is decent funding and an end to all the privatisation.

(You might get more responses if this was in the politics thread.)

but ive stated its not a political question hence its here its just a general question ..no politics needed

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By *oxy j OP Woman
over a year ago

somerset

"It's seems the main problem is a shortage of drs, nurses, consultants.

We should be paying people to train as these, not charging students ridiculous fees.

Won't have any immediate effect but would surely alleviate long term problems. "

totally totally agree with this training for nurse's should be free

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By (user no longer on site)
over a year ago

Get rid of this requirement for nurses only to come through Uni. Some people don't necessarily have the book smarts but would be fantastic at the job. I have met Nurses on all sides of the spectrum, some are unbelievably good, others mmm not so much. In house training would be ideal and hospitals can train people to the desired requirements, and asking as there is a clause saying that people are required to work in the hospital first (For x years) or pay back in full the training the hospitals would benefit.

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By *inaTitzTV/TS
over a year ago

Titz Towers, North Notts

It's a service that needs to be invested in, rather than have bits sold off to private contractors who just aim to milk it for dividends.

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By (user no longer on site)
over a year ago

"Get rid of this requirement for nurses only to come through Uni. Some people don't necessarily have the book smarts but would be fantastic at the job. I have met Nurses on all sides of the spectrum, some are unbelievably good, others mmm not so much. In house training would be ideal and hospitals can train people to the desired requirements, and asking as there is a clause saying that people are required to work in the hospital first (For x years) or pay back in full the training the hospitals would benefit."

No nurses absolutely need formal training.

You need to know alot of anatomy and physiology to be able to look after people properly

It's not just making beds and giving bed baths

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By (user no longer on site)
over a year ago

Demand is obviously an issue with huge population increases in the last couple of decades. I think people should pay an affordable fee for health insurance cover until they have permanent residency. Many European countries apply this already.

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By *penbicoupleCouple
over a year ago

Northampton

"(You might get more responses if this was in the politics thread.)

but ive stated its not a political question hence its here its just a general question ..no politics needed "

We probably mean something different by 'political.' But that's cool.

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By *penbicoupleCouple
over a year ago

Northampton

"it simply cant have more money..."

Um... of course it can.

I don't dispute the other options you list (which would also release more funds), but it can most certainly have more money.

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By *ackdaw52Man
over a year ago

Chesterfield

Agree 100% with the person who says the NHS needs an independent report producing which compares it to other countries.

The main problem is management. Our top managers are great, immediate managers are great but middle management is bloated, apathetic, ineffective, corrupt and entrenched.

They do pay themselves bonuses despite the rules against this. I also know that our Director is defrauding the NHS by submitting false staffing numbers.

Most of the staff who are under this umbrella are not even getting a national living wage, including me. We cannot recruit or retain new people because the wages are so low and we are forced to use agency staff to keep things functioning.

It's worth pointing out that healthcare is cheap but not free in most comuntries like Germany, France, Australia etc. I think paying for some of your treatment is fair, especially for A&E because we get people coming in with things that are completely self-inflicted simply because they were bored, d*unk etc.

Not everybody. Most of them are genuine emergencies, but it would cut down the time wasters.

The NHS cannot stay as it is. The country has changed a lot and it needs radical reform to survive.

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By (user no longer on site)
over a year ago

Problem is not the lack of money but rather the money spent in the wrong places which don’t improve neither the patient’s experience nor the worker’s satisfaction.

Stop paying so much to the people that don’t have patient contact and start paying more so people will actually want to go into the profession vocationally without questions.

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By (user no longer on site)
over a year ago

We clearly also need more preventive health measures to cut down the costs of treating obesity, drinking, addictions, etc. More support and advice outside the NHS to encourage healthier lifestyles as well as higher tax on unhealthy food and cheap booze for example. Long term it will save NHS billions.

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By (user no longer on site)
over a year ago

Give it another 20 years and it’ll probably collapse under the weight of the casual obesity time bomb anyway.

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By *r laidbackMan
over a year ago

London & New Brighton

Administration can be cut down, this would save millions and cut down managerial roles way too many managers and assistant managers in departments that dont need more than 1 manager, this is money that can be use towards better care

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By *eavenNhellCouple
over a year ago

carrbrook stalybridge

Those comparisons already exist. "
and 12 years ago they showed we had the best health care system in Europe now we are at the bottom .wonder what happened 12 years ago ?

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By *heDeliveryManMan
over a year ago

Leicester

The NHS is like a perfect woman...

On its knees.

It needs the top earners in the UK to pay extra funding into it, take a large amount of the middle managers out that earn way too much and invest in the nurses on the ground who are over worked and under paid.

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By (user no longer on site)
over a year ago

"The NHS is like a perfect woman...

On its knees.

As one of those top earners you can have my share of the poxy NHS.

I went private years ago to escape that train wreck.

Raise your required tax on sugar, lard and cheap booze.

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By *d59michelleTV/TS
over a year ago

walsall

Got to fix the care system 1st

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By *heGateKeeperMan
over a year ago

Stratford

IMO the system needs:

• Better public health awareness and training.

• Improved communication and system awareness with the public.

• Better recruitment, retention and training of GPs.

• Better recruitment, retention and training of nurses (i.e. brining back the bursary, a more NVQ type route for HCAs) and an opportunity for nurses to earn an excellent wage without having to step away from patients and into offices and boardrooms.

• To be better at handling patient complaints and PALS enquiries.

• One patient record system provider that covers primary and secondary care.

• Improved patient access to records and GP systems.

• Better integration with social care.

• More effective procurement systems and processes.

• Improved promotion of ‘system transformation’ better using real people and real examples.

• Better peer to peer learning between Trusts throughout the country around things like system transformation, serious incidents, fraud, cyber security, research and integrated care.

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By (user no longer on site)
over a year ago

Scrap the NHS, send everybody on a first aid at work course and just hope for the best

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By *ackandtheunicornCouple
over a year ago

liverpool

No nurses absolutely need formal training.

You need to know alot of anatomy and physiology to be able to look after people properly

It's not just making beds and giving bed baths "

Formal training doesn't mean you have to go to uni.

You can be highly skilled and never have set foot in a university and you can be unskilled and have spent years at uni.

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By *oxy j OP Woman
over a year ago

somerset

"Got to fix the care system 1st "

this is also a very good point

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By *ubal1Man
over a year ago

Newry Down

The UK's NHS, as it was originally intended to operate, will eventually collapse, and be replaced by a privatised system.

In the meantime, it will be tinkered with by various experts and its own management.

Currently structured and managed, it is becoming increasingly dysfunctional

Consultants, medical type were given too priviliged a role from the outset; health systems in other countries, such as France as more functional than the UK model, as currently constituted.

The NHS is simply too inefficient: staffing is a major problem; people need to be educated from an early age how to properly loom after themselves and not engage in behaviour that will cause problems decades down the line.

Diabetes, especially diet induced type 2, and related obesity have the potential to bankrupt the NHS within a decade.

Over-consumption of food that is cheap and of poor quality, through excessive processing is the elephant in the room, and needs to be addressed, educationally.

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By *isfits behaving badlyCouple
over a year ago

Coventry

What it needs is a government who truly stand by the founding principles of the NHS and the general values of those that created it. After the war people came out of the ashes asking for a new deal for all in our society. No more slums, better working conditions and rights, a certain guarantee of financial dignity no matter the hardship and universal health care. After all we were all supposed to be in it together durring the war, why not in it together after? Do we need to see this country in ruins again before ask for that deal to be renewed? Blame the Tories, Sure. But understand we the people both have the power and the responsibility to save our NHS. It's Ours after all. Our weapon the ballet paper, the battle ground the polling station. Stop arguing with a government that simply does not care, does not listen. Its fruitless. Take your power and mark the ballet paper correctly next election because I don't know how long the NHS will survive under this rotten lot.

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By *ubal1Man
over a year ago

Newry Down

"IMO the system needs:

• Better public health awareness and training.

• Improved communication and system awareness with the public.

• Better recruitment, retention and training of GPs.

• To be better at handling patient complaints and PALS enquiries.

• One patient record system provider that covers primary and secondary care.

• Improved patient access to records and GP systems.

• Better integration with social care.

• More effective procurement systems and processes.

• Improved promotion of ‘system transformation’ better using real people and real examples.

• Better peer to peer learning between Trusts throughout the country around things like system transformation, serious incidents, fraud, cyber security, research and integrated care."

This gentleman has the entire situation summed up in a list of bullet points

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By (user no longer on site)
over a year ago

Top heavy with bureaucracy and managers, but the NHS is doomed to eventually fail even if it were a lean, mean efficient machine.

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By *rLothbrokMan
over a year ago

Lancs

"The NHS is like a perfect woman...

On its knees.

I agree regarding middle managers, currently 430 management staff earn at least £100k p.a.

As one of those top earners you can have my share of the poxy NHS.

I went private years ago to escape that train wreck.

Raise your required tax on sugar, lard and cheap booze. "

Why add additional tax to sugar, lard or cheap booze?

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By *ig1gaz1Man
over a year ago

bradford

" make sure those who save lives can get a decent wage from a system thats leaking millions every week ..

what would you do lets say there no more cash pay rise's has to be found from the cash leaks ..

i think the very first thing that needs to be fixed is agency this is a massive weekly bill thats just not substainable nurse's give up work to just work agency (dont blame them the money is better)

I kinda find the comment a little two faced.

You kinda speak about saving money and yet the people you know have run to a private system that is creaming money of the nhs.

I strongly believe we should have the nhs for everyone and keep private and america out of the nhs and there private insurance that they want here to cream the british public.

Whilst the gov are gifting our data for peanuts and yet billions can be made from it.

However our data shouldnt be within there data collection if the users refuse to be data collected.

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By *oxy j OP Woman
over a year ago

somerset

" make sure those who save lives can get a decent wage from a system thats leaking millions every week ..

what would you do lets say there no more cash pay rise's has to be found from the cash leaks ..

i think the very first thing that needs to be fixed is agency this is a massive weekly bill thats just not substainable nurse's give up work to just work agency (dont blame them the money is better)

I kinda find the comment a little two faced.

You kinda speak about saving money and yet the people you know have run to a private system that is creaming money of the nhs.

I strongly believe we should have the nhs for everyone and keep private and america out of the nhs and there private insurance that they want here to cream the british public.

Whilst the gov are gifting our data for peanuts and yet billions can be made from it.

However our data shouldnt be within there data collection if the users refuse to be data collected. "

nope not two faced at all its just how it is ..

i for one want a nhs free for all and without any private imput

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By *oxy j OP Woman
over a year ago

somerset

and as said on the original post no politics its just a friendly chit chat about what you would do to correct the nhs if no more money was available

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By *ig1gaz1Man
over a year ago

bradford

dont get me wrong i fully agree that the nurses should get a wage rise.

I find that many was very grateful in the covid situation for the many that stayed and cared for many of ill patients.

I find there response insulting of a clap for the nhs and yet refused to pay more for all the workers there.

as goes for money its there its just been flitted away into private companys that have gained a foot hold into the ics system to make the nhs more private .

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By *isfits behaving badlyCouple
over a year ago

Coventry

"and as said on the original post no politics its just a friendly chit chat about what you would do to correct the nhs if no more money was available "

I get that but politics and idiology have a lot to do with how funding is allocated, how management is approached and how its future (or planned demise) is envisioned. The very core of how the NHS is rebuild and/or restructured in reality depends on the idiology and values of the government in power. And arguably many of the funding, structural and future planning problems people are raising are symptomatic of the very nature of the successive government's and current one. So maybe we shouldn't be bitching as such but it's perfectly valid to the question to address the politics and idiology that effects policy, structure and funding.

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By *oxy j OP Woman
over a year ago

somerset

"and as said on the original post no politics its just a friendly chit chat about what you would do to correct the nhs if no more money was available

i dont see any bitching on this thread just normal comment without the political nastiness if people cant just for one question keep politics out of it then whats the point full stop ..

hence keep the politics out of this question its do able look above loads of great answers without a mention of politics ?

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By (user no longer on site)
over a year ago

"IMO the system needs:

• Better public health awareness and training.

• Improved communication and system awareness with the public.

• Better recruitment, retention and training of GPs.

• To be better at handling patient complaints and PALS enquiries.

• One patient record system provider that covers primary and secondary care.

• Improved patient access to records and GP systems.

• Better integration with social care.

• More effective procurement systems and processes.

• Improved promotion of ‘system transformation’ better using real people and real examples.

• Better peer to peer learning between Trusts throughout the country around things like system transformation, serious incidents, fraud, cyber security, research and integrated care.

This gentleman has the entire situation summed up in a list of bullet points"

Yes, fantastic informed and intelligent answer.

Had to check I was on Fab for a moment.

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By (user no longer on site)
over a year ago

"and as said on the original post no politics its just a friendly chit chat about what you would do to correct the nhs if no more money was available "

It's been a good thread with majority positive and thoughtful posts.

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By *arkgamesMan
over a year ago

UK wide

I agree, it needs a complete rebuild.

Scrapping the agency can only happen one way, make the current roles more sustainable and allow people breathing space and fulfilment so they don't look to do agency work.

The basic packages need to be scrapped and built so people take the role on for long term.

From my experience of using it, always found nurses exceptionally good but terribly exhausted, much as the doctors.

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By *asterR and slut mayaMan
over a year ago

Bradford

Its a joke they need someone who can actually manage things people in ambulances in the hospital car park for hours AE a joke .for ffs they say there no beds .they simply need proper management of arrival and discharge patients not have them blocking beds.

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By (user no longer on site)
over a year ago

Do you know the reasons of bed blocking? I do because we have them on daily basis:

Not enough doctors to discharge patients home and attend to the rest of the patients and emergencies.

Social reasons why some people can be sent from hospital into proper care

Not enough staff to look after the people that would come in if the beds were open

I can keep going and going but the reason for bed blocking is no other than safety for patients because the lack of resources

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By *eavenNhellCouple
over a year ago

carrbrook stalybridge

"Its a joke they need someone who can actually manage things people in ambulances in the hospital car park for hours AE a joke .for ffs they say there no beds .they simply need proper management of arrival and discharge patients not have them blocking beds."
and where ate they going to discharge them to ? Social care is in an even worse state than the NHS this is where the money should be spent other than on wages for front line staff

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By *mateur100Man
over a year ago

nr faversham

The govt needs to ring fence the £6bn over the next 2 years to social care. That will, simplistically, ease problems across the board but since the money goes to the NHS it'll get wasted. The NHS isn't under funded, it's poorly managed

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By *ig1gaz1Man
over a year ago

bradford

"they simply need proper management of arrival and discharge patients not have them blocking beds.and where ate they going to discharge them to ? Social care is in an even worse state than the NHS this is where the money should be spent other than on wages for front line staff "

whilsty i agree with your comment on social care that would be done to your council tax being increased in the area for everyone.

as goes for your comment against the front line staff I strongly disagree

When its the higher ups that need sacking or a large pay cut from the managers to the accountants a good chunk of money is being spent that way.

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By *asterR and slut mayaMan
over a year ago

Bradford

blocking beds.and where ate they

going to discharge them to ? Social

care is in an even worse state than

the NHS this is where the money

should be spent other than on

wages for front line staff "

Its funny how they managed it at the beginning of covid once again social care the same bad management poor wages in all these things the money been spent. On agency staff where the agency make money .in stead of having enough trained staff and paying them properly . never mind clapping for them .

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By *heGateKeeperMan
over a year ago

Stratford

This gentleman has the entire situation summed up in a list of bullet points"

Thanks

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By *heGateKeeperMan
over a year ago

Stratford

"This gentleman has the entire situation summed up in a list of bullet points

Yes, fantastic informed and intelligent answer.

Had to check I was on Fab for a moment.

Haha sometimes we have good conversations on here

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By *mp411Man
over a year ago

chester

I don't think the thousands of diversity managers and thousands of equality managers and the thousands of directors of something or other all making millions same as local authorities (councils) the old saying springs to mind "too many chiefs not enough indians" get rid of the useless jobsworth management use the billions saved to pay the all the nurses who DIDN'T do the tic tok dances

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By *xhib12Man
over a year ago

Blyth

It needs a total rebuild but because it's so huge it's a challenge that looks overwhelming to all.

We need to look at basics and what's causing the problems....

Primarily the problem is the flow of patients through the system being too slow. This is mainly caused by a lack of beds due to bed blocking caused by the inefficiencies of the social care system. I'd like to see social care taken away from local council control and brought within NHS provision so it can be managed alongside basic and primary healthcare.

A&E departments need to be properly triaged and staff given the ability to redirect people who do not require urgent care. I.E. people who turn up at an A&E department with a spelk in a finger! It happens.

GP services, along with practice nurses to be expanded massively so that people can get appointments when required and minor treatments carried out at surgery or at home. Potentially open minor treatment centres within shopping centres for example.

Gp's given the power to reguse to prescribe simple medications such as paracetamol and direct people to purchase them at supermarkets etc. Paracetamol, ibuprofen, etc, costs approx 1p per tablet at a supermarket yet costs the NHS many more pounds to prescribe. The savings from this alone could be massive.

Charging people for not turning up to appointments should be brought in.

Procurement within the NHS is a joke. This needs to be centralized and all NHS authorities forced to purchase ftom it. The NHS is huge so could force down prices massively.

Management needs trimming down. Far too many 'non productive' people costing a fortune, most of which are unnecessary.

Reinstate the bursary for trainee nurses, make it worthwhile for them to undertake the gruelling study and work they have to do before they are qualified.

Work to minimise the use of agency staff. The use of agency staff costs money that could be better utilised elsewhere.

Streamline the IT systems and ensure they are compatible across different health authorities. It seems ludicrous that different authorities use different systems!

Think that's enough to start with. Lol

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By *oxy j OP Woman
over a year ago

somerset

social care is a even bigger mine field ...

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By (user no longer on site)
over a year ago

No nurses absolutely need formal training.

You need to know alot of anatomy and physiology to be able to look after people properly

It's not just making beds and giving bed baths

Formal training doesn't mean you have to go to uni.

You can be highly skilled and never have set foot in a university and you can be unskilled and have spent years at uni.

It's not just about skills it's also about knowledge....

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By *edfleetMan
over a year ago

covent garden

Nurses pay is an emotive subject. But anyone who trains to be a nurse knows how much they’ll earn for the rest of their working life.

There is a difference in pay between employed and agency but very little difference in the overall package. Employed nurses get significant pension contributions (but in turn have to pay in much the same each month) and have very generous sick pay too. Neither of these are offered to the same extent by agency workers.

It’s a calculation between money now or money tomorrow

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By *ust RachelTV/TS
over a year ago

Horsham

I found out recently that a new Liverpool hospital, doesn't have much office space.

Do you think they realised there is too many admin staff in a hospital?

I read somewhere that the NHS gives away an astronomical amount, to companies who let them use their ambulances and other services.

Maybe look to full these companies, there might be some more cash for the nurses

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By *oodmessMan
over a year ago

yumsville

As my late night thoughts go - the NHS is not a homogenous being.

Trusts up and down the country operate differently, from the work they do to the budgets they have. Some are in good financial shape others are in huge amounts of debt. Some have good reports for can recruit staff easily others have poor reports and have difficulty. You could receive treatment at one practice/hospital that you couldn't 50 miles away simply because their budgets don't accommodate it or because their schemes are slightly different.

To think of the NHS as a single entity is wrong. It is the sum of its parts with some failing and some shining - it should offer a life saving service, it's simply some aren't capable.

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By (user no longer on site)
over a year ago

"Nurses pay is an emotive subject. But anyone who trains to be a nurse knows how much they’ll earn for the rest of their working life.

It’s a calculation between money now or money tomorrow "
I work in the health field in the US I find the pay scales in the UK for healthcare workers appalling. Yes you get health-care. But my health insurance is just as good. The health care workers there should be top tier payscales.

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By (user no longer on site)
over a year ago

If I worked there in the same field pay is 47k. Here I make 140 k. I dump 30 k in health insurance and my HSA to cover health costs. I still make 120 k literally 3 times as much. Pay them the same.

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By (user no longer on site)
over a year ago

Satff retention might be helped if many members of the public didn't have this sh1tty 'I pay your wages' mentality.

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By (user no longer on site)
over a year ago

"If I worked there in the same field pay is 47k. Here I make 140 k. I dump 30 k in health insurance and my HSA to cover health costs. I still make 120 k literally 3 times as much. Pay them the same. "
20 k my HSA covers everything emergency. Insurance covers the majority.

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By *oodmessMan
over a year ago

yumsville

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By (user no longer on site)
over a year ago

"If I worked there in the same field pay is 47k. Here I make 140 k. I dump 30 k in health insurance and my HSA to cover health costs. I still make 120 k literally 3 times as much. Pay them the same.

The difference in paying nurses £120k ($147k US), is that it would be paid by the government, and as a result the UK tax payer. The UK doesn't have the GDP to support pay of £120k as the NHS is the largest employer in the world. It is the difference between public sector pay and private sector pay and the difference between UK and US systems."
yet know you know the shortage of healthcare professionals. They can make more in the private sector. When it comes down to it people are going to choose a better comfort of living.

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By *ee And MikeCouple
over a year ago

Cannock

If the NHS is such a great model then why has no other country in the world copied it ?

The original model in 1946 was based on a population of around 30 million less than we have now and average age of death of 62, people are living into their 90’s on a regular basis now !

The NHS needs a severe overhaul, £10 billion on a IT system that never worked is a disgrace and there are far too many middle management pen pushers that need to be got rid of !

The NHS needs to get back to basics and start caring for sick people, doctors, nurses and support staff, instead of an employer to give people jobs, just for the sake of it !

It’s the 6th largest employer in the world, that’s some serious money needed to keep that ship afloat !

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By *unfriendly 123Man
over a year ago

boston

It's at a point of collapsing...from docs to ambulance not turning up to then no room for patients....at hospital

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By *ig1gaz1Man
over a year ago

bradford

"If I worked there in the same field pay is 47k. Here I make 140 k. I dump 30 k in health insurance and my HSA to cover health costs. I still make 120 k literally 3 times as much. Pay them the same. 20 k my HSA covers everything emergency. Insurance covers the majority."

from what ive read and seen your insurance health cover dosnt include everything

there is get out clasues where costs are are spiraling they can pull your cover and leave you in debt

there is many recorded cases where medical cover hasnt been enough and users have to sell there propertys and be left pennyless and still in debt up to there eyeballs

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By *TG3Man
over a year ago

Dorchester

"I've just returned home from having a complicated appendectomy...I have nothing but praise for the way they handled my recovery ...the staffing was pretty intensive with a well ordered and disciplined team ...from a patient's point of view it is quite bewildering to start with..but the pure logic of how a ward works is like clockwork...the diagnostic machines are spectacularly modern ..so ..the NHS must be an expensive drain on our tax income...but worth every penny

"
this

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By *instonandLadyAstorCouple
over a year ago

Not where we seem to be...

Put people in charge who know what they're doing and replace the bean counters.

My own experience, one my surgeon said is repeated day in, day out....

I needed a back operation. It took nearly 5 years of fannying around to get someone to actually agree.

In that time I met with 6 different consultants who all said "you need an operation".

In that time my condition worsened to the point I could barely walk.

Finally it was decided the operation was an emergency, but the waiting list was so long the NHS paid a private hospital to do the op.

Two operations available, 1 more likely to succeed, but more costly than the 1 with less chance of success.

Guess which one was authorised?

7 weeks after the op I'm in more pain than before.

Logic says clearly it didn't work so let's do the op we know will work, bean counter logic says the 1st one must have done some good, so let's do it again.

It didn't.

Finally the more expensive op is authorised and I've been pain free for 10 years.

So, 5 consultants time and expense after seeing the first one.

5 years of agony and a worsening condition.

3 operations, where one would have done the job.

3 operations the NHS paid to be done privately.

Not forgetting 3 months of physio, all at the private hospital that did my operations.

Scandalous waste of money.

Bean counters spending a fortune to try and save money, instead of listening to the experts.

Winston

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By (user no longer on site)
over a year ago

My view is that they need to bring in someone from the private sector to completely overhaul the whole system and run it as though it were a private business - no, I'm NOT suggesting it be privatised - but from the standpoint of making it more efficient and getting better value for money for tge taxpayer.

One of the biggest issues is things like pharmacutical companies that seem to charge the NHS whatever they like because they know the NHS will just pay it.

For example, in the automotive industry, supplier prices are usually dictated by the manufacturers. Often a component supplier will provide a price but the end manufacturer will tell them the price they need to be doing it at to get the contract.

A bit like the buying power that large retailers have.

If that makes any sense.

Oh, and streamline management

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By *1bttmMan
over a year ago

Shoreditch east London

This has already started back in 2018/19. It's a Nursing apprenticeship scheme run by hospitals and uni's and the qualification is from more work based training and similar to the old Enrolled Nurse. Not all trusts have it but it is new and becoming more wide spread. The role is called Nursing Associate and once qualified they receive a "pin" number like registered nurses and similarly have to revalidate date every few yrs.

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By *ellhungvweMan
over a year ago

Cheltenham

I have zero insight into the _actual_ issues facing the NHS but I would observe that any organisation that is almost a hundred years old will be in need of regular overhaul and updating else it will become out of date and inefficient.

Any systemic review of the NHS would need to be taken with a much wider review of social care, elderly provision etc as they have all become very intertwined. I struggle to see how anyone would be able to pull off such a review in such a highly charged political environment.

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By (user no longer on site)
over a year ago

From bottom to top with front line care the priority, not targets and waiting lists

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By *waffham1102Man
over a year ago

King's Lynn, Norfolk

Sack all the Rota Meister's and it would work perfectly. Cut 400,000 people out who are clogging up the system and let the Doctor, surgeons and nurses run it. Plus stop using agencies

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By (user no longer on site)
over a year ago

It's not a Drain on resources it's an investment.

What is a drain is paying already very rich people £300 a day just to turn up and sign in at the House of Lords and subsidising MPs bar bills at the House of Commons. Its the political system that needs changing not the NHS.

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By *eard and BoobsCouple
over a year ago

Portstewart

Too many chiefs and department heads getting paid too much and instead of having extra money for extra nurses and the paperwork is terrible for everyone

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By (user no longer on site)
over a year ago

"My best friend is a band 6 nurse who has just putting in her notice to go agency full time and the difference between the pay is shocking

Think she said on agency she gets around £40 per hour???

It's madness that the powers that be are happy to pay that to agency staff but won't give the NHS staff a pay rise "

Agency staff get no sick pay, holiday pay, pension contributions or other benefits so their cost to NHS isn't as great as it seems compared to employed staff. Also easy to get rid of poor agency staff but very hard to sack poor NHS staff.

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By *RANDMRSJAECouple
over a year ago

chester

It’s the monumental wasting of money that needs an overhaul.

Admin is hugely inefficient - multiple letters about one appointment, all sent in no particular order that ends up with the ‘new’ appointment date letter sending before the ‘old’ appointment date had been cancelled.

The staff are superb - I can’t fault the care!

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By *RANDMRSJAECouple
over a year ago

chester

"My best friend is a band 6 nurse who has just putting in her notice to go agency full time and the difference between the pay is shocking

Think she said on agency she gets around £40 per hour???

It's madness that the powers that be are happy to pay that to agency staff but won't give the NHS staff a pay rise

Some like working for an agency, they pick and choose when they want to work and it suits them. A lady I know has a month off at Christmas and the summer… she uses the system to please her

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By *ife NinjaMan
over a year ago

Dunfermline

"It’s the monumental wasting of money that needs an overhaul.

The staff are superb - I can’t fault the care! "

Efficiency was better when it was the old health boards. This internal market bollocks just causes more paperwork than necessary

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By *inky_couple2020Couple
over a year ago

North West

"Demand is obviously an issue with huge population increases in the last couple of decades. I think people should pay an affordable fee for health insurance cover until they have permanent residency. Many European countries apply this already."

They already do. Incoming international students have to pay an NHS supplement (can't remember how much) and anyone acquiring a visa for longer stay also have to pay an NHS supplement, in addition to the cost of their visa.

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By (user no longer on site)
over a year ago

I dont know what it needs i think the tory want to make it such a mess to trick us into abandoning ship

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By *otsMan
over a year ago

Higham

"so the question is does the nhs need a rebuild from top to bottom its not a political question so its not about who you vote for its a general question to how to fix the nhs and to make sure those who save lives can get a decent wage from a system thats leaking millions every week ..

what would you do lets say there no more cash pay rise's has to be found from the cash leaks ..

i think the very first thing that needs to be fixed is agency this is a massive weekly bill thats just not substainable nurse's give up work to just work agency (dont blame them the money is better)

so what else should be done to get the nhs healthy or healthier please keep it non political just practical play nice .. different views is healthy not bad "

Yes it does!

Also how it does things to cut wastage.

So much money is just wasted.

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By *inky_couple2020Couple
over a year ago

North West

"It’s the monumental wasting of money that needs an overhaul.

The staff are superb - I can’t fault the care! "

Scrap the letters!!!! Have ONE online portal where all letters, appointments, correspondence goes on. If people don't 'do' technology, then they can request letters but they should be moving away from ridiculously burdensome admin. Manchester Royal Infirmary uses an excellent e-portal but it's specific ONLY to that NHS trust. Why not the same one across the NHS??

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By *ife NinjaMan
over a year ago

Dunfermline

"It’s the monumental wasting of money that needs an overhaul.

The staff are superb - I can’t fault the care!

Did they actually finish the last NHS IT portal? Remember it was suppose to link everything together

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By *inky_couple2020Couple
over a year ago

North West

"It’s the monumental wasting of money that needs an overhaul.

The staff are superb - I can’t fault the care!

Did they actually finish the last NHS IT portal? Remember it was suppose to link everything together

No, it got scrapped I think. Every GP surgery and hospital trust are commissioning and using different e-tools. It's ridiculous!

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By *otsMan
over a year ago

Higham

"I dont know what it needs i think the tory want to make it such a mess to trick us into abandoning ship"

I knew someone would get political!!!

It's no party that's the cause.

For decades politicals just keep throwing money at it, that doesn't fix the problems!!

Too many people taking out the system not paying in!,

Wastage of kit!

Too many managers not enough Indians,

Gp's off loading their patients on AE.

I could go on...

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By *otsMan
over a year ago

Higham

"It’s the monumental wasting of money that needs an overhaul.

The staff are superb - I can’t fault the care!

That's one great area of improvement

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By *ife NinjaMan
over a year ago

Dunfermline

"It’s the monumental wasting of money that needs an overhaul.

The staff are superb - I can’t fault the care!

Did they actually finish the last NHS IT portal? Remember it was suppose to link everything together

No, it got scrapped I think. Every GP surgery and hospital trust are commissioning and using different e-tools. It's ridiculous!"

Not just the NHS who do that. Same in business. No joined up thinking

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By (user no longer on site)
over a year ago

Thanks

I guess the issue is the definition of permanent residence. In my experience this is defined and enforced much more rigorously in other European countries, for example asking for ID at any contact with health services.

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By *N4funCouple
over a year ago

Manchester

"It's seems the main problem is a shortage of drs, nurses, consultants.

We should be paying people to train as these, not charging students ridiculous fees.

Won't have any immediate effect but would surely alleviate long term problems. "

Son is currently doing medicine and there is no funding, the course is so intense we are going to cover his living expenses. His final 2 yrs they get no real living support and once out of medical school have to do 2yrs with the NHS to be signed off as a doctor on a pitiful salary.

Limits the number of people who want and can work in medicine

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By *RANDMRSJAECouple
over a year ago

chester

"It’s the monumental wasting of money that needs an overhaul.

The staff are superb - I can’t fault the care!

Spot on!

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By *RANDMRSJAECouple
over a year ago

chester

"It's seems the main problem is a shortage of drs, nurses, consultants.

We should be paying people to train as these, not charging students ridiculous fees.

Won't have any immediate effect but would surely alleviate long term problems.

Limits the number of people who want and can work in medicine

The only light at the end of the tunnel for them is the scope for career advancement. There’s job security and it doesn’t take a lifetime to climb the ladder and earn the salary they deserve.

It’s not ideal I agree.

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By *omesticflightMan
over a year ago

Burton-on-Trent

NHS worker, ask me anything

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By *omesticflightMan
over a year ago

Burton-on-Trent

What did all you **** voting for brexit think was going to happen?

I'm an NHSer. The backbone of it is foreign

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By *idnight RamblerMan
over a year ago

Pershore

Absolutely. It's morphed into a bureaucratic and inefficient dinosaur. The entire concept of healthcare delivery in the UK needs re-thinking for the 21st Century.

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By *ansexualPandaMan
over a year ago

Near You

"I don't think the thousands of diversity managers and thousands of equality managers and the thousands of directors of something or other all making millions same as local authorities (councils) the old saying springs to mind "too many chiefs not enough indians" get rid of the useless jobsworth management use the billions saved to pay the all the nurses who DIDN'T do the tic tok dances "

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By *ubal1Man
over a year ago

Newry Down

NHS is an organisational construct that has worked extremely well since it was devised after WW2, which is a long time ago; this construct needs to be modified and rebooted to reflect changed times and circumstances; people are generally living very much longer than was the case a lifetime ago.

Citizens need to be taught to manage their own health and not to depend on the NHS to rectify the damage they have wrought on their own bodies, through for example smoking, alcohol consumption and excessive consumption of cheap food, especially sugar that has lead to a type 2 diabetes pandemic, which will wreck the NHS within a decade.

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By *nabelle21Woman
over a year ago

B38

"My best friend is a band 6 nurse who has just putting in her notice to go agency full time and the difference between the pay is shocking

Think she said on agency she gets around £40 per hour???

It's madness that the powers that be are happy to pay that to agency staff but won't give the NHS staff a pay rise "

Absolutely agree

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By *rHotNottsMan
over a year ago

Dubai & Nottingham

It’s too big to try and manage centrally , bigism is a real thing and it’s why socialist governments failed. It has to be dismantled and de centralised and funded via insurance but not in the way our governments think. Problem is the real solutions would never win an election. Democracy doesn’t have a good track record of transformation projects

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By *JB1954Man
over a year ago

Reading

The NHS is a bottom less pit for money. For example if order a CT scanner . By time delivered / installed . There is a new version available. Same as d**gs. New life saving every year or month ? . Which keeps people alive longer. Which actually means more costs to NHS.

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By *penbicoupleCouple
over a year ago

Northampton

"Nurses pay is an emotive subject. But anyone who trains to be a nurse knows how much they’ll earn for the rest of their working life. "

That just doesn't make any sense at all. Does anyone take a job and know what their upcoming pension contributions and pay-rises will be for the rest of their working life?

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By *penbicoupleCouple
over a year ago

Northampton

"Absolutely. It's morphed into a bureaucratic and inefficient dinosaur. The entire concept of healthcare delivery in the UK needs re-thinking for the 21st Century. "

Why? It's looked on as an inspiration by much of the rest of the world.

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By *rHotNottsMan
over a year ago

Dubai & Nottingham

"Absolutely. It's morphed into a bureaucratic and inefficient dinosaur. The entire concept of healthcare delivery in the UK needs re-thinking for the 21st Century.

Why? It's looked on as an inspiration by much of the rest of the world."

Are you serious? Out of all the countries I work in , around 15, it’s by far the worst service. People are so stuck in the past in the uk thinking it’s acceptable health care , it’s abysmal in every way possible.

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By (user no longer on site)
over a year ago

"Absolutely. It's morphed into a bureaucratic and inefficient dinosaur. The entire concept of healthcare delivery in the UK needs re-thinking for the 21st Century.

Why? It's looked on as an inspiration by much of the rest of the world."

It really isn't. Not one country has copied the NHS model and they seem to do many things better. Time to look elsewhere for long overdue reforms.

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By *penbicoupleCouple
over a year ago

Northampton

"Why? It's looked on as an inspiration by much of the rest of the world.

Are you serious?"

Yes.

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By *penbicoupleCouple
over a year ago

Northampton

"Not one country has copied the NHS model and they seem to do many things better."

Italy, Spain, Portugal, New Zealand, Malta and Scandinavian countries have all been inspired by the NHS.

Countries like the US that almost pride themselves on taking an opposite approach have HUGE problems and personal medical debt is a national scandal there. Many of those looking for alternative health services are inspired by the NHS.

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By *idnight RamblerMan
over a year ago

Pershore

"Absolutely. It's morphed into a bureaucratic and inefficient dinosaur. The entire concept of healthcare delivery in the UK needs re-thinking for the 21st Century.

Why? It's looked on as an inspiration by much of the rest of the world."

Well I've worked all over the world as an ex-pat and never heard the NHS described as an inspiration. The truth is, we talk it up as a 'national treasure' when in fact it delivers mediocre service at huge expense.

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By *penbicoupleCouple
over a year ago

Northampton

"Well I've worked all over the world as an ex-pat and never heard the NHS described as an inspiration. The truth is, we talk it up as a 'national treasure' when in fact it delivers mediocre service at huge expense. "

The NHS is currently ranked 10th in the world.

worldpopulationreview .com /country-rankings/best-healthcare-in-the-world

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By *idnight RamblerMan
over a year ago

Pershore

The NHS is currently ranked 10th in the world.

worldpopulationreview .com /country-rankings/best-healthcare-in-the-world"

Depends how it's measured and who you believe. The NHS is ranked 30th in Europe alone by The Lancet.

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By *penbicoupleCouple
over a year ago

Northampton

"Depends how it's measured and who you believe. The NHS is ranked 30th in Europe alone by The Lancet."

Obviously it will change based on how it's measured. I don't know if you followed the link above, but a number of factors were taken into consideration.

Until fairly recently, the NHS ranked best in the world for 7 years in a row. So, although it dropped to 4th in 2021, I was simply responding to those who question whether other countries respect, or find inspiration in the NHS.

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By (user no longer on site)
over a year ago

"Not one country has copied the NHS model and they seem to do many things better.

Italy, Spain, Portugal, New Zealand, Malta and Scandinavian countries have all been inspired by the NHS.

Inspired by ? You mean establishing public health systems with different models ? Its just a nationalist fantasy that the world looks to the NHS - live and work abroad and you'll soon see its not so.

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By *penbicoupleCouple
over a year ago

Northampton

"Depends how it's measured and who you believe. The NHS is ranked 30th in Europe alone by The Lancet."

Additionally, I believe the Lancet ranked it 30th globally, not just in Europe.

(Massive room for improvement, obviously, but even within that ranking it would be one of the best in the world.)

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By *penbicoupleCouple
over a year ago

Northampton

"Its just a nationalist fantasy that the world looks to the NHS - live and work abroad and you'll soon see its not so."

I have lived and worked abroad.

The 'nationalist fantasy' you perceive is quite funny. I'd rather go with facts and historical record, but you do you.

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By (user no longer on site)
over a year ago

"I'd rather go with facts and historical record, but you do you."

A few facts, from the 2022 Civitas report on 19 comparable countries, based on OECD data. UK ranked 2nd last.

Between 2020-2021 the UK saw the biggest increase in health spending as a proportion of GDP than any other country in a global 19 nation league table.

Britain become the THIRD biggest health spender in Europe as a percentage of GDP.Brits saw health spending go up by 14% on a per person measure – in a single year – breaking the £4,000 per person barrier – the largest increase of all 19 comparable countries and up by 43% since 2011.

New figures for avoidable deaths show that Brits are more likely to die of treatable diseases at the hands of the health system than any other country apart from America.If the UK health system matched the average performance for health outcomes, over 9,000 lives a year would be saved.

British life expectancy has plummeted – among 19 similar countries only Americans die sooner. Life expectancy went up by an average of 9.6 months across other countries but fell by 2.4 months in the UK.

Aross 16 major health care outcomes the UK comes bottom of the league four times – more than any other country – and is in the bottom three for 8 out of 16 measures. No other comparable country has such a poor record.

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By *abs..Woman
over a year ago

Overall, I feel that people need to be educated on when to use the NHS, first and foremost. Change needs to happen from pharmacies, to doctors, to triage before you get to hospitals.

It needs reform, it wasn’t created for the numbers that use it or the types of treatments it provides.

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By *penbicoupleCouple
over a year ago

Northampton

"I'd rather go with facts and historical record, but you do you.

...

A few facts, from the 2022 Civitas report on 19 comparable countries, based on OECD data. UK ranked 2nd last."

You've changed the goal post there. The points of discussion were 1) whether the NHS (as envisioned by Bevan) has been an inspiration to other Health Services across the world - which it has and 2) whether the NHS is still respected by many countries across the globe - which it is.

I don't see anyone here denying that there is room for improvement within the NHS. However, what Tim Knox's sumary of the International Health Care Outcomes Index 2022 fails to highlight is how or why the UK has dipped where it has, or areas where the NHS excels.

And the areas where the UK does not rank as well as it did just a few years ago have specific causes. And that cause is not associated with the nature or notion of the NHS.

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By *ovelifelovefuntimesMan
over a year ago

Where ever I lay my hat

Yes, not fit for purpose and failing in many areas. That's not to say the staff aren't doing a sterling job.

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By *idnight RamblerMan
over a year ago

Pershore

"Depends how it's measured and who you believe. The NHS is ranked 30th in Europe alone by The Lancet.

Obviously it will change based on how it's measured. I don't know if you followed the link above, but a number of factors were taken into consideration.

Well at the end of the day it comes down to personal experience I suppose. Mine isn't great - I had far better diagnosis and treatment overseas. Faster, more efficient.

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By *moothshaftMan
over a year ago

Coventry

Get rid of all management, and bring back the good old fashioned matron.

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By *ove2pleaseseukMan
over a year ago

Hastings

"Get rid of all management, and bring back the good old fashioned matron. "

We have Modern Matron's

1. Rebuilding lots of property hospital's are to old impractical for modern medicine.

2. Need to stop government games with the NHS. Long term plan on a cross party collaborative approach.

3. Agency think the ship has sailed but it needs to be raind in better pay would be the start. Bank overtime at at least time and a half. More if need be 1 person use to a ward is better then 2 that are over paid and don't know the ward

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