How would you solve the NHS crisis?

It sure al adds up.

You are spot on. Big Pharmas are controlling the Doctors. Check out this site

When I was in Spain and developed a chest infection I visited a local Health Centre and received prompt and high quality care. I was asked for my EHIC card and once checked against my passport as ID the care and treatment I received was free. I only had to pay €5 for my antibiotics having walked to the chemist.

Yes jeanmark that's correct, even Spain have better sistem for health tourism. And why not. Their health service is much better, more efficient, very clean hospitals and the staff very polite nice.

Thanks mate, I'll follow through with my promise this evening when there's a little more time.

Got a 404 on that link.

Absolutely right nagonthenet, 99pc illegal.

Ain't that the truth!

Well said, and I so agree.

I have worked in NHS, the best solution is to give power to doctors and nurses who nows best what's needed. We have to many pen pushers and fat cats who spend to much money paying agency forgein staff instead of paying our own qualifying staff to do the work.

Oh yes, haven't we just become a so litigious society. A blame culture- he did this so I'll sue for hundreds of thousands, and get it.

Deplorable. For every pound of NHS money paid out in settlements there is at least a pound not devoted to patient care. But isn't patient care what the NHS is all about? Or am I mistaken here? Is little Jonnies finger nail, broken by an over worked A & E more important than someone in a ward needing surgery but sadly, theatres are so full, staff so over worked ...

I would say, ring fence the NHS. No further litigation after this night.

Sorry Lionel, the NHS like any organisation has to be held accountable for its action how ever distasteful that is. Thus legitimate litigation claims are an unfortunate necessity.

What should be stopped is legal companies eagerly seeking claims for little Johnnies finger nail and those people always looking for someone to blame when there is no blame, that is expensive.

I do agree with accountability Jean. Quite right. Just let me say while I am on the issue of an over burdened N H S , a simple enough problem that a G P could have fixed for a patient 20 years ago would have to be referred on to higher consultation now. That being the way numbers of consultations have risen dramatically. Scanning is now frequently used ( as we all know ). Maybe other little or larger problems appear with the diagnosis of a scan. All adds up. We are so lucky to have the N H S with it's ability to cover so much ground with healing so many speciality illness. May they work towards a remedy that will sort the N H S crisis ( the crisis of the original question put on by Silver Surfers)

Jeanmark, I don't disagree entirely with your views. But I hold the view NHS staff are human and fallible. We go to a doctor, enter hospital for treatment on the understanding those staff will do their best for us. And I sincerely believe they do just that.

If it doesn't work out quite as we expected; if the condition we have is too far advanced for present treatment levels ...

Let's just accept life, life as it is. Let's not sue the NHS because they were less than perfect, because a mistake occurred. Instead, let's just be grateful there are very hard pressed people in the NHS willing, and often, able, to help us.

Gratitude is something which has passed from our times. Instead we have 'rights,' which are not rights at all but privileges. If the NHS cannot restore us to a perfect 'me,' or there is a failure, let's be glad someone was in place to try for us.

Is that too simple a view? Perhaps.

Possibly Lionel because there are a small number of times when things can not be blamed on overworked staff. The skill is knowing when this is the case.

I agree the NHS is overburdened and a solution needs to be found. There have been many good ideas put forward, but you have identified one of the problems, we are now able to diagnose and treat so much more and not all with having to use a scanner. All of this advance in medicine comes with a cost. The NHS is no different to other organisations, businesses and our own homes, costs rise each year but income doesn't necessarily follow at the same level.

Absolutely right jeanmark.

I agree to all of it. Well done.

Marpo, I entirely agree with you. There is an obvious obsession with health and well being. In itself that is unhealthy. But, in my opinion much worse, is the scare-mongering in the press.

One of my few indulgences is reading the online press, most of it anyway. Last Spring, on one day, the Mailonline carried 11 health related articles, four of which were contradictions of others that day. Only this week an article stated crisp chips, toast and some crisps contain a carcinogen and therefore could cause cancer. It's not news! But what is news is that one would need to eat three tons of badly burned potatoes a week to be at a detectable risk. That was in the Mailonline the next day!

I believe far too many people, particularly in the younger generations, have become neurotic about health. Our postman's wife has WebMD site bookmarked. The slightest sign of a sniffle she's checking symptoms and running to her doctor.

In short, there's an excess of information. Information overload, in a limited sense.

Like you I was brought up not to fuss. Victorian grand parents raised me for the first eight years. Yes, I'm well familiar with hot wet crusty bread, as well as Kaolin Poultice and Friar's Balsam, to name but a few traditional remedies. Oh, let's not stop there ... Dr Collis Brown's stomach potion, (lovely), Indian Brandee, syrup of figs (why did that need to be given at night - always meant a midnight trip up the yard in the cold), and a bad gash in my left hand, well, white cotton soaked in Dettol and a needle. Granny did a neat blanket stitch! Still got the scar.

No WebMD, not a doctor for miles and an ambulance would take an hour to arrive from the nearest hospital. But we all survived, tough as old boots!

A very wise King of Israel in the Old Testament, Solomon, wrote, a time to build and a time to tear down. How true.

I believe it is true of the NHS as well. We can't tear it down in one go but piece by piece take down and re-build.

I have a deal of sympathy for your reasoning. And ...

My wife and I shared a similar A & E experience as you've related. Two years ago she was playing with our three Collies on a winter's Saturday evening. She made a mistake. One doesn't humiliate a masterful lead dog in front of his pack. She got bitten on the face. Blood poured. Late in the evening I raced fifteen miles to the nearest A & E only to find the others in waiting were drunks and crack heads. She was still pouring blood, faint and unsteady on her feet, but still they had their turn first.

Now, I'm not criticising the hospital here, no. There must be some order in their dealings at A & E, but an emergency patient pouring blood onto the floor warrants quicker attention than a drunk still slurping from a can and vomiting on the floor.

Agreed! And I would add, re-open cottage hospitals. Similarly, there was a nationwide outcry when almost all were closed - dire warnings issued but still the NHS closed them. Money.

Money? There is never a shortage of money in the UK Piggy Bank Lionel. It's just a matter of how you choose to spend it.

Ah, words of wisdom, and I could not disagree. But, most government departments are run by tight wads who would rather see money going to 'good causes,' than the NHS or Defence.

True!

That's authorative matrons as they once were. Perhaps not what Blair offered us as a sop.

Agreed.

This is an innovative approach and one I would subscribe to it could generate c.£250m per annum make it £5 and it is over a Bn.
Do not agree with charging for GP appts, but do agree with charges for missed appointments.

Perhaps a charge of £5 for GP appointment? That's only the price of two lattes in my part of the country! It might make people think twice about rushing off to the Surgery every time they sneeze, freeing up appointments for those who really need to see a doctor. We should all take more responsibility for our own health and stop abusing our pressurised NHS. Sadly many of the younger generation grew up in a Nanny State and their parents forgot to teach them common sense...

Hamlyn, some pensioners have more disposable income than the rest of society, but by no means all. We don't, things are quite tight.

Yes, I'm coming around to the way of thinking that says we must charge for missed appointments etc.

Yes, Hamlyn, the nanny state has done noone any favours.

Yes, money is tight for me too. However I would still gladly pay £24 per annum prescription charge and £5 or more to see my GP if it meant that the NHS would still be around in the future to treat my grandchildren when they are my age!

Hamlyn, I do so agree with you.

We don't mind paying a small surcharge for prescriptions, no not at all. And I so agree, the NHS must be around for our grand children, my step grand children whom I've raised, when they're our age. What better legacy may we leave them, better than money, what think you?

I understand your reasoning hamlyn but there are a number of people with a chronic condition who have no choice. They have to visit their GP on a very regular basis as a means of helping prevent hospital admission. They may not feel able to pay for every visit.

So those who need to visit more frequently could be given a discount in proportion to the number of visits needed per month say?Those in receipt of Benefits such as Universal Credit, Disability Living Allowance and Pension Credit would be exempt anyway from both fees to visit their doctor and prescription charges. We do have to get real in order to support our NHS.

Please leave pensioners alone, apart from the very rich I have paid into a sistem all my life, only to be disappointed with everything we stand for. Latest generation those nothing but life on benefits. Why oh why we have to foot everything for some lazy bones that have never contributed to the society.

Marigold 67, I'm sorry that you don't like my suggestion that Pensioners, who are not in receipt of Pension Credit, should pay £24 per year for their prescriptions, considerably less than non pensioners and a fee of perhaps £5 for a GP visit, which would also apply to working age patients. This would help the crumbling NHS enormously, as will charging non domiciled health tourists. I am a pensioner myself, but as I receive only a State Pension, I choose to work to top up my income instead of claiming Pension Credit and I would gladly pay all these suggested charges to help the NHS keep afloat for my grand children. Wouldn't you too?

Zelda I agree with all that you say but note the NHS is paid out of taxes. I think most Trusts do start discharge planning on admission, the problem is, as you have noted, there are insufficient resources in the community and that causes a very large problem with discharge. I would suggest politicians focus so much on the front door, as that is easier to measure, but ignore the back door because that costs money.

I think a number of us support the idea of the NHS being removed from the political sphere.

Oh, most definitely remove the NHS from the political sphere. To most politicians it seems common sense is not even a parallel universe.

I read on an SS forum on alcoholism that recognising there is a problem is the first step. When we recognise and indentify the problem areas with the entire healthcare system we will have taken a brave first step. Without that first step there is not going to be a realistic overhaul and expansion of the HNS services we need so badly.

Well said. But that must come after a complete review of NHS usage, staffing and expenditures.

Reading this back it sounds politician speak!

Perhaps I may put it this way: first, identify the enduring weaknesses and strengths, through the eyes of NHS staff and the public.

Rigorously search out anomolies in sound performance in every area.

Perform a brutal assessment of expenditure. View the present situation in the light of both known and estimated demographic changes and additional burdens through malnutrition, bad life style choices and any other factors.

Bring each part of this assessment into a cohesive whole and lay out a way forward, with realist expenditure.

Could all this be achieved in three months? I think it could if judges, politicians, accountants and other top management were not consulted.

It is then for government then to come up with the funds.

Lionel it would take years for the various parties involved to come up with a true budget: years that we do not have. So funds need to be found quickly whilst budgets are looked into and resolved.

I am instigating an e-mail petition to Parliament, and need five endorsers. I will not write more as this is not the place to publicise my petition without the agreement of the site moderators. Once I get the 5 endorsements my petition will get a website. If I get 100,00 signatories Parliament must debate the petition: this may be a way forward. My MP just sends a "template" reply.

nettap, if you contact Sally the Editor by going to the footer at the bottom of the page where it reads Contact Silver Surfers and give her the detail of what you propose then, knowing she is a very reasonable lady, and understanding, she may well allow publicity on SS.

Please, nettap, if you care to Private chat with me, I'll be very pleased to support you and endorse your petition. It is not a good idea to put private email addresses on a public forum, so, again, use chat. I'll look out for you.

Sorry JenB, not sure what you mean. Cutting nurses hours to 71/2 means you wouldn't save money, it would increase cost.

Soapbox, I entirely agree with your first paragraph.

In the West Norfolk area I came from we had a main hospital in Kings Lynn, about fourteen miles away. There was a doctor's surgery four miles away in the nearest market town with two doctors. They made home visits and one conducted a surgery in a village pub every Tuesday.

In that market town was a cottage hospital. Instead of blocking beds in the main hospital, elderly, and other patients, were taken there for rest and recuperation when unfit to be returned home. I spent a few days there after falling out of a tree into a shallow river at ten years old.

Sadly, a now long past review some wealthy bureaucrats found these cottage hospitals to be too expensive and without a defined purpose within the new framework they were putting forward. A Socialst government accepted that and very closed many.

These cottage hospitals freed up beds for patients needing urgent attention. I doubt a case of bed blocking for two years (recently in the press) could ever have occurred.

If it were left to me, and it won't be, I would establish cottage hospitals around the country; a dozen beds, supervision by local doctors and care staff could be used in place of so many highly qualified nurses. That would relieve bed blocking!

Miami, I totally agree with you with regard to PFI's, one of the biggest and expensive mistakes made by the government.

You’re joking, the BBC should have been reporting this crisis coming for 6 years but are turning a blind eye. This is privatisation. This brochure from a 2010 health corporations conference explains how it will be done (pages 10-13). The NHS is being underfunded and “the NHS will be shown no mercy". In fact the corporations have made billions , private healthcare spending has doubled. It's not foreigners, it's corporations and the politicians they have bought. http://www.apax.com/media/374179/apsax-healthcare-thought-leadership-2010.pdf

I don't disagree with your thoughts but unfortunately we live in a Parsonian culture (his Sick Role Theory) and thus people have to obtain a sick note for work. You have already noted self certification only covers 7 days and employers need to have some indication that someone is genuinely ill or unable to work such as after surgery.

Our culture also appears to suggest a number of people firmly believe there is a 'pill' for every ill. I have lost count of the number of people who have become verbally aggressive when not given antibiotics for their 'sniffle'.

Poppy rose, you and others have made some good points but some may be a little misguided. Nurses are not 'sent' away to do degrees, nursing and midwifery are now degree professions and thus are like other university students, they are no longer employed by NHS trusts. I agree with you about equipment but I know for experience that re-cycling certain equipment such as crutches etc. is not cost effective, it costs more to render them 'safe' for use than to throw them out. There are certain areas where the safety of patients has to be a priority even when it is the more expensive option.

No organisation as large as the NHS, the largest employer in the UK, can survive without layers of managers, and it is treated as a business that looks at all the areas you have mentioned. It is probably because it is treated as a business that layers of management have evolved. Plus all political parties use it and all public services as a bargaining tool and constantly set measurable, but not necessarily attainable, targets for their own purpose.

As a business the largest cost is drugs and yes they should be looked at, but pharmaceutical companies are profit making companies and thus not totally altruistic in their approach. The second largest cost is staff.

As for GP's I agree they should look at the service they provide but many do. I'm lucky, my practice is always reviewing its service and involve patient groups in that review but in general we, as patients, also have a responsibility. As an example, at the moment the practice I use has one GP on maternity leave and one on long term sick leave. They are unable to get locum cover because there are insufficient GP numbers out there. Add to that they receive approximately 140 'urgent' calls every day for a same day appointment but from the 1st January alone have had the equivalent of 4 days missed appointments, for either a doctor or nurse.

I suggest that next time the government announce the billions of pounds they have given to the NHS, we all ask the question "How much does that mean for every hospital and health centre in real terms"? It is estimated that Type 2 diabetes costs the NHS 1 million pounds per day and that is just one chronic health disorder without considering acute services.

If we want changes surely we, as the public, have to give our support to the NHS rather than constantly deriding them for not meeting our demands. You need more than doctors and nurses to run a health service.

The points I mentioned are all ideas to be looked at. What you have given in answer is a negative to each one but no alternative solutions. I do not deride the NHS but there must surely be measures that can be taken to make it more cost effective. What figure would solve the 'crisis'? Is it to be accepted that this giant of an organisation which is the biggest employer in Europe is able to just keep going receiving more and more without accountability? People within the health service cannot afford to be defensive but need to be more pro active in finding the solution. Every day, every winter there are the screaming headlines that the NHS is in 'crisis' so what would solve this continuing 'crisis'? The public are becoming numb to the continuous panic statements, fed up with the money constantly being poured in as in the proverbial bottomless pit. Remember Gordon Brown on one of his first budgets saying he would increase the tax on a packet of cigarettes by 25p thereby 'overnight' solving the NHS problem and here we are all these years later still having the same problems. That should give a hint that there needs to be change. The public do support the health service but that support should not be an open, never ending cheque.

I'm not disagreeing with what you have written Poppyrose just making points on some of the comments. The problem we have is that medical science has made more and more things possible that were once considered impossible and all with an additional cost. Something has to give and that may be considering things like rationing, something I wouldn't want to see having devoted 47 years of my life to the NHS. I am not being defensive just identifying how tiring it can be to constantly being told you have to be more efficient when you are struggling to make ends meet, being told you have to make savings but expected to expand the service you are accountable for.

I don't have an answer to the problems but do recognise it will get worse as more and more people use it. I agree that throwing more and more money at the service won't solve the problem because each year all costs increase. There is so much emphasis put on the front door without recognising it's the back door causing a problem.

Agreed. While working in the NHS I could not understand how a foreign patient, referred by the GP, was not asked for any documentation but WAS asked if they needed an interpreter for their appointment with the Consultant. The cost of an interpreter is very high - and if they could explain to the GP what was wrong with them, why an interpreter now? Surely they could have brought an English speaking friend.

Yep! That's about right David. I'm with you on that one.

I'll go with most of that. But may I add ...

There's been a serious misconception about the NHS. Under Blair they were pushed into running themselves as a business. Too many private contractors were brought in. They offered inferior services and made a profit. There cannot be a profit in the NHS! Simply, it is not a profit making concern.

A close look at the entire set up is needed, from Hospitals, A & E, G.P.'s and care services. A close look at supply companies and their rpices, Big Pharma and what it is charging. There must be a tight integration of the NHS with care services. I was in the care industry for some years and know first hand how disjointed the entire system is.

I would suggest the review be conducted not by judges, Civil Servants and the like, all of whom have a vested interest, no, not them, but a body of ordinary people, well used to the work place. Afterall, the NHS serves mostly ordinary people, like me.

And funding? What are your thoughts Ginntonic?

Right on Lionel. I think it was Blair who cut GP hours and increased their pay at the same time. Also extending pub opening hours and adding to the problems caused by alcohol in A&E.
I think MPs should take themselves into local pubs etc., and just listen to the world being put right by the general public. Among the rubbish talked after a few beers - there are a few gems.
I agree with you that the problems in the care industry are causing a bottleneck in the NHS, and old people are getting the blame for living too long!! Let's keep going.

I lived in Eire for a long while and know how the system works. Actually, it works very well.

Picking up a point you made, over many years I've been sickened by the young mums crowding waiting rooms because little Jimmy has a sniffle, They feel the need to see a doctor when common sense and their mother's experience would serve them better.

You are quite right. Health tourists must not be treated unless they have provable means of payment, and perhaps a significant deposit should be taken at reception?

Not to all it seems my grandaughter still at school was advised by a teacher to seek medical advice about pain and tingling in her arm when she is writing for any length of time. From previous experience of the same symptoms it was suggested that physio therapy would help. My daughter took her to see the GP who said oh no we can't do that you will have to pay for physio, This is for a young person who is still in full time education. This is so wrong.

Thank you Pam. I absolutely agree with you.

We live in a time when people think so much is free when it is not. Nothing is free. Someone must pay.

To walk into A & E and get free treatment ... it's not free.

I have three Collies here. They're lively to say the least. About five years ago they were barking at the postman, a friend of mine. My face got too close to my lead dog and he savaged it. Made a bit of a mess.

It was my fault. Having had Collies for then forty years I should have known better. But, so much blood, it was pouring out of me. My wife took me to a minor injuries unit thirteen miles away. No waiting, straight in for treatment. Thirty stitches and getting home made peace with my lead dog. He's down beside me now.

We must pay for that service, yet so many people moan about taxation and still use the NHS.

Yes, absolutely!

I don't disagree in principle but maybe the winter fuel allowance should be means tested, I know a number of elderly people who rely on it to keep warm. Also are all pensions in a position to make a monitory contribution once they retired if they only receive the state benefit?

I think thats quite a good idea but you may get a lot of arguments at A&E if people are turned away and I could see a lot of bureaucracy

I don't think taxing the working population is biased as they will reap the benefits on retirement when they will probably require the NHS more. People of working age who are on benefits could always pay a nominal sum which is deducted from their payments. We have to find a way to keep this wonderful service. Maybe another option is only cases which include life or death cases, broken bones, victimsof crimes and major accidents will be seen at A&E unless referred from walk in centres where they have been assessed first of all. If people turn up at A&E with non urgent issues they will be charged for treatment

I think you are right Pam1960 about having a separate tax for the NHS that is totally transparent and the fact that we are in an ageing society makes matters worse. I have an old Aunty who was 95 when she died and the last year she was always in and out of hospital understandably when you are that age. If we all age another 10 years thats about 10% more people using hospitals. the figures don't seem to add up. Also why doesn't the government make all this information about the NHS more transparent...I will look on the internet to see if I can find anything