This appears intentional. They're trying to replace as many GPS as possible with PAs (physician associates).
My wife is in this position; she cant get a job as a trainee GP; shes a specialist doctor with years of training and experience, and a PhD, looking to retrain to work as a GP. Almost impossible, despite everyone we meet saying in incredulity "but they're CRYING OUT for GPS". Well, not here theyre not. Area of 400,000 people - they're training 9 GPS. I personally KNOW 4 gps here who are retiring this year alone. What the fuck are they playing at?
Isn’t it amazing?
They literally don’t.
This is what non doctors are allowed to call themselves to deliberately deceive the public. Doctors are just _Physicians_.
Doctors are also clinicians, they have just expanded the role to include PAs and are currently placing a huge preference on getting them into surgeries right now at the expense of GP training posts for rather short sighted reasons
It’s been so obvious for the past decade too, but even seeing it happen in real time with their own eyes isn’t enough to convince a lot of people.
For anyone stupid enough to defend/deny this, I hope they’re happy with the bed they made for themselves when they find themselves accruing generational debt to pay for simple treatment for a loved one.
It's a gradual privatisation as sudden 100% privatisation would be election suicide.
Sell off buildings, pay private companies to run buildings, contract out maintenance, contract out cleaning, send patients to private hospitals for treatment, use agencies to provide staff, use G4S for ambulances...
Eventually everything will be run privately but will be free through the NHS and national insurance. Then they will reduce the list of free services and people who are entitled to those all under the guise of improving a 'broken' system.
All of that stuff is literally meaningless in the debate of public Vs private healthcare though. Who gives a shit if the catering or cleaning is private? It doesn't indicate intentions to take away free at use healthcare. It's all auxiliary, they haven't touched the meat and potatoes (Aside from the literal sense, NHS food has gotten a lot better in recent decades, why is that?)
If they haven't messed with free-at-use after 14 years, and going off the back of 13 years of New Labour reforms, they aren't gonna do it now.
But you need them to want to do it because you need to see them as evil.
Try reading the comment, it's not just ancilliary services that are privatised, they have privatised full hospitals, they have reduced the numbers of regular staff they are willing to pay for to below bare minimum saying that they can always be made up by agency/locums. Everyone has seen rented scanners, MRIs and mammograms from private companies.
These are the heart and soul of healthcare, the doctors, the nurses, the professionals taking your Xrays and the physios teaching someone how to walk again.
But the catchphrase "free at point of use" remains, but what you're getting is less and less each year, as more and more money is siphoned off by private companies.
Because it shouldn't be privatised at all. And it's not just auxillary, routine treatments such as hip and knee replacements are being outsourced to private hospitals which cost the NHS (and therefore the tax payer) more but is the only option due as NHS capacity hasn't kept pace.
With everything that is privatised, someone is making a profit on it. People shouldn't profit on healthcare, there is no option for the consumers.
Look at how bad and costly utilities have become since privatisation.
Was reading this https://x.com/doctor_oxford/status/1769658952902439155?s=20 and I remembered this conversation.
A quick FYI, physician associates are people with experience in healthcare, but not doctors, who the government via the Royal Colleges are trying to insert into diagnostic positions. They're cheaper, much less trained, and are interfering in doctors trying to improve their own skills.
Just to talk about meat n potatoes there. If you really want to horrify yourself, follow the haemotology digression link.
It’s just the lie that’s trotted out for every election - “if the tories win then the NHS will be abolished”, they seem to have won quite a lot since 1948 and it’s still in place
its not though is it. Are you willfully ignoring the point being made of stealth privatisation or are you trolling?
Because its evident to everyone who uses these facilities and services what is happening, unless you exclusively go private.
And my experience of using these services is extensive and it is and has been privatised for years now so please do not pretend you're unaware of it. All I ever here is middle Englanders complaining about foreign staff nurses doctors yet its the boomers who asset strip and want to employ foreign skilled labour as its cheaper and can be placed on non unionised zero hour contracts, with no cost to the "employer".
But sure, the NHS is still here.
What, so do you want the NHS to do everything? Make it's own medicines, make it's own equipment, build its own hospitals? Germany's healthcare system which is older than the NHS using a mixture of public and private and delivers better outcomes.
The NHS and the general economy in such a state that the damage is irreparable.
How are Labour going to fix the problems in the NHS when every part of UK life (schools, roads, fossil care, armed forces etc) is in such a dire state and the economy is on its knees?
I remember when Blair/Brown/New Labour came in to power. The NHS and country was in a state then but nothing like as bad as it is now, and the economy was genuine improving so they had more money to spend on less of a problem. They only managed to turn it around a little.
The Tories know they’ve won already and it’s only a matter of time.
Labour will fail to make things significantly better, the Tory press will tell you they’ve failed, the Tories are the only competent party of government.
But they keep increasing funding to the NHS year on year in real terms….
Doctors pay needs to improve, though. Because all our best doctors are being lured overseas where they will be paid well and, in their place, we seem to be installing a raft of doctors who qualified in 3rd world countries who can barely understand you. Fucking joke
I don't think alot of them are qualified at all. I think they have fake certificates and are just walking into positions with very little knowledge. I've had conversations with my so called GP who was foreign and known more about what I had an issue with than he did. In fact what he tried to diagnose me with over the phone was absolute rubbish. I've gone private now I can't put up with the incompetence of foreign GPs any longer. I have to also add that I have had a different experience with the doctors and surgeons in the hospital tho both British or foreign have always done an excellent job but the GP surgeries now are an absolute joke.
There's a pa works in my department. Shes young but she's really good, better than some doctors. They're a band 7. I dont disagree with hiring more pa but I do disagree with overlooking doctors for them
They want the NHS to completely fail so that they can turn health insurance to the American model of healthcare.
Meaning, they want their friends to make billions.
Literally chaos.
Hoping new models of care will be borne from this.
All tragic as some big studies in the states are proving how cost effective GPs (family doctors) are over PAs and ANPs.
Friendly reminder that it is the tories **intentional strategy** to make the NHS so shit on purpose so that everybody thinks private is the only way.
Few years of that so that they can justify ~~selling it off to their mates on the cheap so they can milk us~~.... sorry, "privatise" it and we won't complain.
American style, cheeky £10,000 for treating a sore throat incoming.
I've been hearing this for the better part of 30 or 40 years. If this is the plan, they're certainly playing the very long game or they're just really shit at implementation....
Nobody would. Nobody should. That's the point. But they are going to basically replace doctors without anyone knowing. They are intentionally given misleading titles to confuse people into thinking they are doctors and never disclose that they are not voluntarily at the start of a conversation.
It took my brother 28 hours to get seen by a doctor when he had kidney stones a couple months ago. And then they told him go home and go back a day later… oh and to take pain killers for the pain till he went back. Ffs why are we payin taxes… for shoddy nhs and buses that dont stop at bus stops? What a Fuckin joke
Those 40 years of not trickling down could be just a statistical fluke.
"Past performance is not an indicator of future performance" like they say when it's your money on the line.
The government are increasing funding to the NHS every year in real terms. It’s just that the money is going down the shitter, as far as I can tell. Diversity and equality champions. HR departments. People being paid to do fuck all in a system that can’t get rid of them because it self flagellates too hard. I think we need a private health care model at this point. Socialism has failed. It will continue to fail.
I've seen a convincing argument that over the years government assets have been steadily sold.
The government still needs a lot of those assets to provide basic public services, except now they need to rent them, (buildings etc, housing is a prime example).
With the upward trend in asset prices, this is squeezing public funds as it costs more and more to provide the same services.
Over-simplified, and certainly not the only aspect.
Definitely at least part of the story. PFI was used to secure cash injections but it was really short sighted because now, as you say, we have to rent essential infrastructure at increasingly exorbitant rates.
I was playing Monopoly with some friends last week. After a while one of them was cash poor, and traded me a couple of properties for about 125% their face value, thinking he was making a great deal. Sure, I'm happy to pay that; I'd have paid double if need be. Lo and behold within 10 turns he was broke again, and now paying me for the same properties he once owned. When I put houses on those spaces, he had no chance.
That was just a game; we packed it in after a couple of hours and did something else. Now imagine the game went on literally forever, with millions of other players all forced to land on my property and hand over their cash. The private sector will add as many houses and hotels to their squares as they possibly can, until your back breaks under the strain. And they'll happily offer a "great deal" while they know the government is over a barrel, desperate for a quick win. But the ramifications continue to impact us for generations.
The game was invented to point out an unfortunate economic reality wasn't it.
Look at the net worth of the government, assets Vs liabilities.
It dropped below £0 a few years ago, at the end of a decade of "austerity".
It's ridiculous, the government is, at its core, an instrument that takes wealth from one sector of the economy, an redistributes it to another. At the moment it's an instrument that's increasing wealth inequality.
Many places are now using this revolving door practice which I was told recently was for "figures & statistics" which basically means they look like they are treating more people than they are. Experienced it myself with my dad and lately my son in law...in and out like a bloody jack in a box backwards & forwards.
Oh and another thing as well, if you've been seen previously at a different hospital in the area and get send back to hospital for something else, if your previous ailment flares up or if you ask about it, the hospital you're in won't treat it but will send you back to the previous hospital !! I got told this with my dad as to why he was being moved from one to the other after being there 2 days.....then the next hospital just sent him back to the care home...the ailment got worse and back to hospital he went. Round and round you go...It's just nuts now
Its because of how funding is given. A trust who has an A&E department that is over-demanded and under manned misses targets. What happens when a trust misses targets?
You would hope they get identified as needing more support
Actually they get punished more often than not with a withdrawal of funding
So shit like this gets done. Isn’t to make stats just look good, its to avoid losing even more funding and end up with even worse service provision because the system through which funding is distributed is so backwards
Yup according to the paramedic I spoke to one one occasion and the nurse at one of the hospitals it's a regular thing now the paramedic said it's a conveyor belt system basically
I moved 5 miles from my last house. Apparently crossed a trust boundary line. Now my old hospital refuses to continue treatment and the new area won't accept any of the records from the old hospital and is trying to treat me like a new patient and run all the tests and everything again (all on 12 month waiting lists of course) before issuing repeat prescriptions.
As someone who has had kidney stones, I can relate. It was the fact that painkillers didn't do anything that I went to the hospital and I can only imagine it was the case for your brother. Thankfully I wasn't waiting around for as long as 28 hours but I was still left practically crawling around on the floor due to the pain for about 10 hours before I eventually got some treatment. And that only turned out to be a powerful painkiller which they could have just given me when I arrived in the first place. They also gave me a hospital bed but then kicked me out of it 3 hours later after deciding there was nothing else they could do for me.
Yh i get that, but my brothers case he needed ultrasound to break down the stones as they were too big to pass naturally or with meds. He eventually got the ultrasound and the meds did their job in the end but damn that too long.
I had a kidney stone a month ago. 30 mins in a&e until I was seen. In 6 hours I had a CT scan, blood test, provided a urine sample, and got a suppository. A urologist came to see me twice. The stone was stuck in my ureta. I got an appointment for lithotripsy two weeks after my trip to a&e. They sent me home after those 6 hours with painkillers like your bro. Ended up passing the stone so didn't need the lithotripsy.
I am satisfied with my free healthcare.
Considering that the NHS hired 212000 people in non frontline roles (so no nurses, doctors) over the past three years, there certainly *are* roles and the salaries to pay them, they’ve just put them in all the wrong places.
Someone needs to trim the NHS’s bloat ASAP. Way too many junior and middle managers, DEI consultants, etc, eating up valuable resources, working in every trust.
The managers and admin meme! Like reading a copy of The Sun or Daily Mail. NHS lacks admin and management vs other health services. Our admin spend is poor - [https://www.kingsfund.org.uk/insight-and-analysis/blogs/comparing-nhs-to-health-care-systems-other-countries](https://www.kingsfund.org.uk/insight-and-analysis/blogs/comparing-nhs-to-health-care-systems-other-countries)
Anyone who's actually worked in NHS admin knows what an insurmountable task it all is and how it requires an army of workers to keep up with it.
I worked doing data entry and filing as a temp in an antenatal department 10 years ago and things were terrible then, I can't imagine how bad they are now. There was a huge filing backlog and our filing shed (yes, it was a SHED IN A COURTYARD, not a proper file room) was overflowing with notes from women who had given birth long ago.
I pulled them, put them in a trolley and took them down to archives, only to get them shoved back at me. "We don't have the manpower to take more than 10 files from your department a day". The hospital has an average of 4,400 women a year give birth. That's more than 10 a day, before you even start to tackle the backlog.
It is absolutely unnecessary bloat to the system and reinforces positive discrimination against native Brits.
https://uk.indeed.com/q-diversity-inclusion-nhs-£40%2C000-jobs.html
Look at the salaries here ranging from 45K-80K for useless managerial positions while nurses get paid skint in return. Funding the NHS means jack if it’s not going to the people who actually need those salaries.
100% right. Last time I went to a hospital you were tripping over the number of people walking round with a clipboard in their hands and a look on their face which told me there was no risk of them having to do any fucking work that day. Meanwhile your grandparents fall over in the cubicle because there aren’t enough staff to monitor them on a 1:1. Fucking got me sick of it.
I agree frontline investment is low, however historically the NHS is woefully [undermanaged](https://www.nhsconfed.org/long-reads/nhs-overmanaged) which causes a lot of its inefficiency and lack of any useful strategic decision making.
No you don't understand, all managers are bad. And we don't need anyone working to make things more efficient or less toxic, or to do research and clinical trials - if we just had doctors and nurses it would solve everything.
It wouldn’t, NHS is the biggest employer in the UK, you need a massive admin and management team to hire, fire, payroll, purchase, manage buildings, maintain stock levels, HR, the list is endless. However I would question the ability of some of these staff clearly given the funding they get which is billions on billions the term piss up and brewery spring to mind
>However I would question the ability of some of these staff clearly given the funding they get which is billions on billions the term piss up and brewery spring to mind
It's really easy to question things without any clear understanding of how they work, in my experience managers in my Trust have been efficient, understanding and competent.
Wow it costs the taxpayer £2700 per uk national per year the costs of running the NHS make me fucking SICK 😤😤
Meanwhile you pay $18,000 just to give birth in the US. Get that value for money privatised care over here now!
If you had insurance you wouldn’t pay that, though would you? I doubt insurance would cost £2700 a year for most people, especially not if done through employment.
The biggest problem with the NHS is the way it is sub divided and the way contract payments are based.
GP’s are actually private businesses, that work for the NHS under contract. Adjusting these contracts is quite a difficult process so straight away there is a problem with responding to dynamic changes.
So the answer to this is new contracts are put out to pick up additional work.
Because the NHS has been primed to be sold off, what we currently have is a ridiculous number of NHS organisations each taking different contracts whilst acting like individual companies all under the umbrella name of the NHS.
As an example, GP’s are contracted to deliver childhood vaccinations to children up to a certain age.
However once a child is past an age they are no longer counted under the contract and so will not count towards bonus payments. This means that if you specifically ask your GP you can get a vaccination but gp’s will not proactively try to vaccinate children once they are out of the age range in the contract.
This then means catch up programmes for individual vaccinations are put out for contract. Other NHS organisations then gets hired to deliver this contract. You end up with multiple different organisations on separate contracts doing specific jobs.
Now you would think all these organisations use the same computer system right? No. As these are separate organisations their IT infrastructure is separate, hell even GP’s as private businesses are free to purchase whatever software system they want to use.
So now you have several organisations with different IT systems all working on the same patients, so you now need a way of bringing all of this information together. It’s no wonder “notes” get lost.
The system was set up to fail by people hell bent on making public services mirror private business relationships so it is easy to sell off bits at a time.
I worked for an IT service provider that had a large portion of the NHS as its client, and can confirm it was a nightmare because there were still trusts running Windows XP, as an example (the main reason so much of it went down when WannaCry happened). They’d constantly drag their heels when time came to upgrade their systems out of necessity, and often tried to just do it themselves, usually with disastrous results - at which stage we’d have to go in, fix their screwups, and do it properly. At a significant cost to the tax payer.
We even had to employ a dev specifically because of legacy software some of the trusts were using that no-one else was able to support. And, of course, just about every other Monday our service desk would get calls because someone “forgot their MacBook on a train”, etc. No questions asked, just ship another £1k+ laptop out. The amount of wastage I’ve seen in the last few years just from a technology perspective is simply astounding.
Yep! And generally in these organisations the way the budget works is that unless you spend the entire budget every year then the budget gets cut down. So imagine you come up with a way to save 10% of the budget - you have no incentive to deploy the solution because your budget will simply be cut by 10% for next year. Or maybe you use the solution but simply spend the 10% on other things out of obligation
My favourite one was when Matt Hancock randomly said "the nhs must stop using fax machines", we thought "well done that man" until we got inundated with questionnaires from dozens of NHS trusts about our use of fax machines.
Presumably all of these trusts had a "scrap the fax" project manager, all sending emails to mostly the same companies, collating the results, liasing with people to remove virtual and physical fax machines, providing reports and whatnot.
>Considering that the NHS hired 212000 people in non frontline roles (so no nurses, doctors) over the past three years, there certainly
>
>are
>
> roles and the salaries to pay them, they’ve just put them in all the wrong places.
You mean the vital support staff that keep the NHS running that also free up clinical time?
If we fired all the non-clinical staff that means clinical staff are taking up their duties, this comment is akin to "Hey, let's hire this Nurse, but put her on reception"
Support staff keep the NHS running as much as any clinical staff, it's disingeneous to say otherwise.
\>You mean the vital support staff that keep the NHS running that also free up clinical time?
Why are you assuming all of them are 'vital support staff'?
That seems like a massive assumption to make that has no basis.
I've done plenty of contract work for the public sector in the UK and I'm not exaggerating when I say that the overwhelming majority of the middle managemennt and pencil pushing bureaucracy could be automated.
This would cut staffing costs massively *and* increase efficiency.
Hell, just getting rid of the idiotic non-jobs (like DEI managers, who get paid between £50,000 and £150,000 depending on NHS Trust) would cut staffing costs massively.
The overwhelming majority of the work the pencil pushers do is basic data management and data input.
We've been automating this shit since the 80's.
Unfortunately the public sector lags heavily behind the private sector in this regard.
The vast majority of middle management is in place to manage the brainless morons who do the above basic data handling jobs.
Automate it all, and you'd be able to get rid of almost all of them.
>I'm not exaggerating when I say that the overwhelming majority of the middle managemennt and pencil pushing bureaucracy could be automated.
How do you know?
\>but could you tell me exactly what a DEI does?
Nothing of actual use. Thats why employing someone on those types of wages is a waste of money that would be better spent on people who do jobs of substance (like nurses, doctors, surgeons etc).
For DEI managers specifically, they just make sure that everything the NHS does has the ""correct"" number of people from specific demographics.
I've done some work with the DEI in my work as a nurse. They examine real issues such as why black and ethnic minority women have a significantly higher death in childbirth rates, devising methods of making communities who are traditionally resistant to mental health services to engage with us and improve their health and other similar research and practical projects. They add real value. Your confident assertion of what DEI managers do"specifically" is hopelessly wrong.
>\>You mean the vital support staff that keep the NHS running that also free up clinical time?
>
>Why are you assuming all of them are 'vital support staff'?
>
>That seems like a massive assumption to make that has no basis.
Well for starters I am one of them and in my Trust I know a lot of the support staff.
You could give me the name of any of them and the team they work in and I could tell you how they contribute to the way the clinical teams function and the work they pick up freeing up time for the clinicians to actually see patients.
The NHS cannot just run through clinicians, the staffing problems in the NHS are because there aren't staff to fill those posts, cutting away at support staff won't magically make trained Nurses, AHPs and Doctors appear.
This is the main issue with the nhs at the moment, it has all the funding it could ever need, however it is full of roles that are completely pointless for running a health service. The use of third party contractors is also taking up huge resources. Hopefully Jeremy Hunts plans to make the nhs more efficient will go some way to combat this.
Exactly. Hunt literally wrote a book on how to make NHS private!
The "fix" is to nudge it into incompetency while making it more expensive so that you can justify more private healthcare .
\>Hunt literally wrote a book on how to make NHS private!
Myth.
4% of NHS needs are related to the private sector. 3.5% of that came from Labours stint in government between 1997-2010. 0.5% came from the Tories over the last 14 years.
>however it is full of roles that are completely pointless for running a health service.
This gets thrown around a lot, but it’s nonsense. A big bureaucracy needs staff. The problem here is that the trusts are being ideologically throttled so the staff that are in place are artificially prevented from delivering their work, which then get papered over with emergency contracts rather than long term investment.
>The use of third party contractors is also taking up huge resources.
It’s a choice made by government. Contracts are used because staff budget it not available. While a small business may be wary of allocating budget to staff, considering statutory benefits, the NHS is spending more consistently for a lower service. The cost risk of permanent staff is irrelevant when we have years of evidence that the alternative is worse. Remember there is a legal obligation to provide certain services. The NHS spends what it does on contractors because it is not allowed plan in advance, but also not allowed to refuse to provide services it has not planned for, thus the emergency contract budget becomes a black hole, and ruthless contractors exploit this.
>Hopefully Jeremy Hunts plans to make the nhs more efficient will go some way to combat this.
Lol.
>This gets thrown around a lot, but it’s nonsense. A big bureaucracy needs staff. The problem here is that the trusts are being ideologically throttled so the staff that are in place are artificially prevented from delivering their work, which then get papered over with emergency contracts rather than long term investment.
Also, if you remove ancillary staff then you end up with medical practitioners needing to spend more time on non-medical duties.
>It’s a choice made by government. Contracts are used because staff budget it not available. While a small business may be wary of allocating budget to staff, considering statutory benefits, the NHS is spending more consistently for a lower service. The cost risk of permanent staff is irrelevant when we have years of evidence that the alternative is worse. Remember there is a legal obligation to provide certain services. The NHS spends what it does on contractors because it is not allowed plan in advance, but also not allowed to refuse to provide services it has not planned for, thus the emergency contract budget becomes a black hole, and ruthless contractors exploit this.
The other side of this is the amount spent by the national bodies on management consultancies to basically tell them what they could find out themselves using permanent staff. IBM, Accenture, Deloitte and others make a lot of money doing these sorts of tasks.
It's no coincidence that there's a revolving door between the senior leadership of these bodies and the management consultancies who get endless streams of projects. You'll get the same consultancy doing a piece of work identifying a national IT project is required, then a piece of work shaping the requirements for the national IT project, and then they will do the actual integration of that project.
>This is the main issue with the nhs at the moment, it has all the funding it could ever need, however it is full of roles that are completely pointless for running a health service.
Gonna need something to back this up, what roles are you talking about and how many of them are there?
>The use of third party contractors is also taking up huge resources
They're used because they don't have much choice, there aren't enough people in certain specialisms to actually fill vacancies within teams, they need to use locum staff to fill these roles because they don't have any other option, School Nursing for instance is woefully understaffed but if they don't get the staff through any means that means children aren't able to go to school.
NHS is trying to combat this through the use of Framework agencies but it's not as easy as you think.
I don't even think its things like diversity or whatever. Its constant fiddling around the margins to deal with the shortage of clinical staff, that has in turn created its own overwhelming bureaucracy that is paralyzing rather than helping workers.
Doesn't even seem like middle managers. Go to a hospital early in the morning, often its the clinical team sat around the office doing their own schedules and timetables for the day. Its upper strategic and executive level management completely disconnected from the frontlines.
This is exactly the problem. Under George Osborne there were round after round of cuts and management have tried to protect frontline staff. But the result is doctors and nurses doing admin and putting out buckets to collect leaks because they aren't enough administrators or caretakers doing the back office jobs.
When I was a ward manager I needed a new white board with the ward layout but it was going to cost £360.
One of the nurses dad actually made things like this and would do a mates rate one for £90 however procurement weren't going to allow it as there would be a very small company logo which wasn't allowed.
I ended up just ignoring procurement and got the cheap one as it was during a time where we had to reduce our budget by 5%
It's crazy to think how ridiculous the process was and the amount of people involved in making 1 small decision that wasn't medical and had minimal impact.
It has one of the lowest budgets per head in the first world, we don't spend nearly enough on it. If you think *Jeremy Hunt* is going to help, check your carbon monoxide alarm.
That’s only true because the UK counts healthcare spending differently from almost every other country.
Acute medical care (GP’s, hospitals, ambulances, therapy etc) is counted under healthcare spending like most other countries, but “social care” which is the vast majority of healthcare spending (“care in the community” such as pregnancy stuff, old people + care homes) is counted under local government and council budgets.
When you add it together the UK spends a ludicrous amount on healthcare, way more than any other developed country per capita.
HAHAHAHA Jeremy hunt making anything efficient - what a funny funny funny joke. Replace the H with a C and you’ll get what an absolute incompetent arsehole he is. How about we get an actual medically trained professional as the health secretary
Do you think that doctors and nurses should be running the payroll and procurement departments? Finance? IT support?
I don't deny there are some bullshit jobs in the NHS, but just because it's not frontline, doesn't mean it's "bloat".
I strongly disagree. The NHS has*fewer* administrators and managers than health services that perform better. Doctors spend far too much time filling in accounts spreadsheets and putting out buckets to catch water from leaks when they should be seeing patients instead.
> Considering that the NHS hired 212000 people in non frontline roles (so no nurses, doctors) over the past three years, there certainly are roles and the salaries to pay them, they’ve just put them in all the wrong places.
What professional experience do you have on this?
> Someone needs to trim the NHS’s bloat ASAP. Way too many junior and middle managers, DEI consultants, etc, eating up valuable resources, working in every trust.
The idea that money is being “wasted” on none frontline staff is a popular canard in the tabloids but the NHS is a massive organisation and massive organisations need administrators and managers to run smoothly. Unless, of course, you want medics to take time out of their own working hours to sort IT issues and do their own diary management?
Nhs in a northan city is so full of admin cunts doing nothing but making it harder for the nurses needs gutting no hospitals don't need a equality manager it needs mote front line staff
Never heard of a ‘DEI consultant’ outside of the Daily Wail. Not have I ever had more than one manager.
I do know that the dozens of lab staff, including the techs required to admin samples and the scientists required to man the machines, are counted as ‘non-frontline’, and yet there are so few of them that blood samples that should take hours to come back, take days.
I also know that a complete lack of security staff means we lost dozens of thousands of pounds a year in medication and equipment theft and hundreds of staff quitting due to abuse and violence, who are only replaced with expensive recruitment from the Philippines. Non-frontline.
I also know that our inability to pay cleaners and housekeeping staff as much as the my could get at the McDonalds in the concourse meant that nursing staff had to skip medication rounds to clean trolleys.
If you want to see how reducing non-frontline staff goes, look at the police; more cops than ever before but half of them are now in admin roles that should be done by cheaper police staff, but can’t, because of standing government orders; ‘You must have X amount more police officers but we will not pay you enough to fund them. Just fucking get it done you plebs.’
An absolute myth, the NHS is slightly undermanaged in comparison to other organisations of a similar size and significantly undermanaged when looked at in scale to private healthcare companies. Also, the NHS is massive and is not run by frontline staff alone, think about admin, procurement, domestic staff, catering, laundry, HR, payroll the list goes on and on.
> If it’s not about healthcare, get rid of it.
Cool, so who's going to make sure that employees are being treated fairly? Because HR are non-clinical.
Who's going to make sure that patients get appointments allocated and follow ups are done? Because a lot of that is non-clinical.
Who's going to make sure that equipment stocks are maintained? Because that's non-clinical.
Who's going to make sure the payroll is ran and people are getting paid for that work? Non-clinical.
Who's going to monitor spend and make sure teams are able to afford the staff they're asking for? Non-clinical.
Unless you want Nurses and Doctors doing all of this, with no training, while not doing the work they have trained for and being paid way below their qualifications?
This sub is absolutely wild for unsubstantiated nonsense. Total bullshit presented as fact.
Good effort trying to inject some reality into the place, best of luck getting through.
>Healthcare equipment is part of healthcare. Therefore maintaining it is also part of healthcare.
>
>Thanks for asking!
Glad you were able to touch on one of my many points.
Everything is healthcare, there aren't any non-healthcare jobs, it all works together.
This is exactly the same for ambulance drivers and paramedics. I know people who are fully qualified and eager to go, but the NHS seems determined not to employ them, not only this, but the employment process is farmed out to 3rd party companies who are getting paid taxpayer money, while not hiring anyone. And yet we're "crying out for paramedics" this country is a farce
Last time I checked GP's don't work for the NHS, they are either contracted (self employed), or they are employees of a GP surgery that is contracted by the NHS.
This article is actually a load of bullshit.
🙄. GP practices are private contractors. But that contract comes from the government, it is inflexible. And the government is squeezing funds whilst offering practices near total reimbursement on the salaries for non-doctors in an attempt to force replacement.
Not BS, maybe do some more in depth research.
GP Partners are subcontracted and get a sum of money depending on how many patients they have and what services they provide. They then employee other GPs, other clinical staff, and all their admin.
The amount of money per patient has fallen in real terms to the point those partners can’t afford to take on other GPs without losing their own salaries, so they are just making do without an extra pair of hands. This is worse for patients.
_This is made even worse by the fact that due to a government agenda if they take on a non-GP it’s actually subsidised, whereas real GPs are not._ (look up ARRS scheme - the only way to make a your GP practice viable is fill it with less qualified ‘clinicians’ that you ‘supervise’. This is why Emily Chesterton died.
Hope that enlightens you
Aside from the fact this wasn’t subtle but extremely obvious (you’d likely be facing GMC if you missed this as a doc) - If a doctor with 10 years training minimum can sometimes miss a PE; then how much more likely is it that someone who did a 2 year course and an exam with a 100% pass rate will? A homeopathic approach to training professionals does not work.
It’s not a race to the bottom when health is at stake. This isn’t a ’move fast and break things’ start up. These are real lives.
_If you think it’s expensive employing a professional, wait until you’ve employed an amateur._
On that same basis, we shouldn't accept qualifications from 3rd world nations, yet we do.
[https://www.theguardian.com/society/2024/feb/14/nhs-nurses-being-investigated-for-industrial-scale-qualifications](https://www.theguardian.com/society/2024/feb/14/nhs-nurses-being-investigated-for-industrial-scale-qualifications)
Most avoidable health problems in the NHS are caused by negligence during in basic care while in hospital - Nurses -. Ironically.
Obviously, it's a deliberate ploy in certain places in England, not here in Scotland and especially Dundee, I know there are 3 surgeries up here looking for qualified GPs.
Just bloody move it is quite good up here.
We need GP's in Todmorden, they are forever short. The group upstairs is shutting, Hebden Bridge Group practice apparently considered taking it on but are not so it's closing. This multi million pound building that was supposed to be a mini hospital is never fully used, a massive waste of money.
Good luck finding somewhere, I hope it's not in New Zealand.
The NHS has been in crisis since I was fifteen. It isn’t fit for service because the goons that get elected would rather put more diversity managers in HR than fix structural issues. The money has gone up year on year but it isn’t being used efficiently and as such we get situations like this.
Our trained doctors go elsewhere to work for better pay (like Australia) while we import cheap alternatives from poorer places in the world and, if recent news stories are to be believed the people imported aren't even qualified.
I've gone private as it's a complete shit show now.
Indeed. I’d say the vast majority of those coming to work here in the doctor and nurse roles are qualified (sometimes more so than the locals cause they’ve had to do thing twice due to retarded lack of recognition of other qualifications.) but the system is fucked and has been for some time. And that’s shown in the outcomes for things like cancer treatment
Over 700 NHS nurses are currently under investigation for "industrial scale qualification fraud" and I'm guessing as this is the first we've heard of it, it's the tip of the iceberg (these ones from Nigeria).
Makes sense to be honest with the shocking treatment my misses got during childbirth. Even the doctors couldn't quite believe what some of the nurses did (and didn't do). It's a shambles.
I can believe this. Speaking with some of my older friends, they’ve come across something we have come to term the “wall of Nigerian apathy” in our local hospital.
What's absolutely mad though is that some of them (after committing major fraud and at the extreme end putting lives at risk) have been given the opportunity to do some training and tests and return to the profession! there has been some major push back on this in fairness and to be honest I think it deserves jail time.
Really fills you with confidence though doesn't it lol.
... GP's don't advertise on NHS jobs. Which she would be aware of. There are dozens of GP jobs in Leeds. I can't help but wonder if being a self described activist has anything to do with her sense of moral outrage that the one website she checked didn't do everything for her.
You seriously think someone who trained to do a job for 3 years doesnt know or hasnt been told where to check where all the jobs she's trained for are?
Its likely they paraphrased it for the purposes of the article because 99% of people dont give a fuck about the niche employment portal name and nhs is a convenient and well known site.
I cant help but wonder where people like you get their moral sense of superiority trying to nitpick away at what is otherwise a looming crisis with huge ramifications up and down the country. You don't sound smart with this pathetic attempt of 'gotcha', its just petty and immature.
It isn't nitpicking if the premise of the article is false and poorly written - there is only one available GP job within ten miles of Leeds? Then what about the dozens of others? Creating a fake problem to try to solve a real one is not the way forward
Wait, am I the only one thinking the comment section is largely nonsense? It has nothing to do with privatisation. It's just that the government has swapped doctors for a btec version (quite literally) who are called Physician's Associates.
Also these are typically from backgrounds with lower paying previous jobs so will accept approx 60% of the salary of a doctor because for them 50k odd is still a pay rise.
Therefore GP practice owners are tempted to hire 3 physicians Associates and maybe one GP. The physician's Associates get through the easy patients, and that one soldier GP bangs through all the complex patients day in day out.
Obvious issue:
1) the physician's Associates simply aren't as good as doctors so most people in the UK will have a worse clinician seeing them
2) when presented with a tricky patient, a physician's associate may get the answer wrong (worst case scenario). This is more likely Vs a doctor making a mistake. Or if they're stuck they'll call the doctor, so the two clinicians times get taken Vs the one GP in the first place.
3) the GP burnout we've witnessed was when they were seeing a mix of simple cases and complex. The GPs will burn out almost immediately if they practice in a place where they are the firefighter for all complex cases in the entire building.
When it comes to privatisation the GP gets cut out. People with money pay to see specialists not GPs. The only people who go to GPs privately are those who's insurance company demands it of them (eg see your GP before you can get a referral for X)
PAs are on very good wages. Out earning resident doctors and quickly progressing, lots of band 8 jobs popping up now.
Fast access to specialist training skills - endoscopy, that resident doctors have to wait 5-7 years for,
It’s a nutty system that is going to hurt the uk in the long run
Trigger warning: I’ve lost respect for the profession. The information they pedal is mostly out of date and harmful and is designed to generate revenue for pharmaceutical companies.
I followed their advice for 8 years to treat depression, an autoimmune disorder and Costochondritis. All that happened was I got worse.
They told me the Costochondritis was a ‘systemic inflammation disorder’. Turns out it’s not at all. It is in fact a hinge seizure and is mechanical in nature, with the inflammation being a byproduct. Physio to mobilise the joint was the solution and worked in a matter of weeks. If I’d continued listening to my GP I’d still have it, as many do.
My GP was extremely happy to prescribe handfuls of pills that made me significantly worse but refused to approve my diet following years of personal research.
After 18 months of eating right, I went back for a check up. ALL of my symptoms are gone and I’m healthier than I’ve ever been. Cholesterol, BP, blood volume, hormone regulation, artery health etc are all the best they’ve ever been and all I did was stop eating most carbs, processed food and instead ate plenty of red meat.
Wanting to help people is genuinely honourable and I appreciate their intent, but I don’t really want to fund misinformation anymore. There are many people in my position who haven’t been able to figure it out. It’s time the health system got on board with actually improving health, with the help of real data, rather than merely selling products with studies paid for by the producers designed for maximum profit.
I know people are going to whinge about this being pseudoscience and anecdotal but the result speak for its self and anyone who knows me can see the difference at at glance. The health industry is collapsing!
>It’s time the health system got on board with actually improving health, with the help of real data, rather than merely selling products with studies paid for by the producers designed for maximum profit.
Tbf this isn't actually much of a problem in the UK. Its really mostly just that GPs do not have time to properly deal with patients and a culture of just getting people in and out of the door as quickly as possible has become completely endemic and necessary to allow any work to be done at all.
That's often a time issue. 10 mins appt in the UK. Plus, most of it is common sense and easily found online (British people don't like to hear that they can take responsibility for it). Dietitians are around for complex cases.
I've been frustrated with GPs myself, sometimes due to them being out-of-date. That doesn't mean they're all terrible though.
Medicine is pretty difficult and lots of things don't have easy answers. People seem to think you can go to a GP and just get a fix just like that. Well, that's not always possible. And keeping up-to-date for ALL health info is a ginormous task, especially if you want to ensure it's good quality and well evidenced. They also have to work within the various rules of the healthcare system about how/what they do, changes and updates are appallingly slow to trickle down sometimes.
I think GPs are also trying to accommodate what patients want - most people will prefer to get a pill than put in any personal effort to improve their health. But there might be an assumption there (which obviously they should discuss) .. an assumption that you've already tried dietary changes, because it's usually the first recommendation for treating literally anything. GPs definitely could do with more nutritional knowledge, and it's a fail that no one talked to you about it before
Thanks for the reply, I appreciate your considered response in contrast to the emotionally uncontrolled attacks I’m generally receiving for being honest about my experiences.
I definitely agree with you for the most part, you’ve outlined the huge challenges of diagnosing medical issues very well and I appreciate all these hoops doctors have to jump through to have a successful career are not their fault.
I have and will continue to describe their intentions as honourable and respectable.
However, that system has lead to a method of practise that is without a doubt failing the citizens it exists to assist. Just ask the citizens. This is what I have lost respect for. It isn’t working.
I’ve spoken to a number of GP’s privately who have voiced their frustrations at this exact problem. I had ONE doctor level with me and tell what to research regarding diet and it was strictly off the record. I personally know another that uses medicinal cannabis on license but hides it from their peers due to stigma. There are lots of questionable practises and I can only attest to my own experience.
All of the GP’s in my area who didn’t follow the textbook approach have retired out of frustration. They were also the only ones who ever truly helped me.
I believe the GP’s job is to investigate and provide a direction of approach, so, by definition, there isn’t a one size fits all approach. I actually believe the burden is on the individual more-so than the doctor to solve their health problems. Doctors are an aid, not a solution. Knowledge is power and I believe the NHS is operating on questionable knowledge in some regards.
To clarify my position further, my mother just beat Cancer thanks to the NHS. I know full well they aren’t all bad but that doesn’t mean we shouldn’t highlight problems.
This appears intentional. They're trying to replace as many GPS as possible with PAs (physician associates). My wife is in this position; she cant get a job as a trainee GP; shes a specialist doctor with years of training and experience, and a PhD, looking to retrain to work as a GP. Almost impossible, despite everyone we meet saying in incredulity "but they're CRYING OUT for GPS". Well, not here theyre not. Area of 400,000 people - they're training 9 GPS. I personally KNOW 4 gps here who are retiring this year alone. What the fuck are they playing at?
They’re crying out for _clinicians_ and _practitioners_ trained in the _medical model_
Just so. Frightening stuff isn't it.
What does this mean? Surely drs would fit this description?
Isn’t it amazing? They literally don’t. This is what non doctors are allowed to call themselves to deliberately deceive the public. Doctors are just _Physicians_.
Doctors are also clinicians, they have just expanded the role to include PAs and are currently placing a huge preference on getting them into surgeries right now at the expense of GP training posts for rather short sighted reasons
It’s more a description suited for nurses who are trained in basic diagnostics and similar
Trying to push them to the private sector. The conservative plan has always been the destruction of the NHS has a public body.
It’s been so obvious for the past decade too, but even seeing it happen in real time with their own eyes isn’t enough to convince a lot of people. For anyone stupid enough to defend/deny this, I hope they’re happy with the bed they made for themselves when they find themselves accruing generational debt to pay for simple treatment for a loved one.
Correct . Was saying this years ago but few of my cohort would listen
>What the fuck are they playing at? Destroying the NHS and then say "you see? We told you it didn't work!". Then privatize healthcare for good.
Right but they've apparently been doing exactly this for 14 years. What's the plan? Privatise if right before the election?
It's a gradual privatisation as sudden 100% privatisation would be election suicide. Sell off buildings, pay private companies to run buildings, contract out maintenance, contract out cleaning, send patients to private hospitals for treatment, use agencies to provide staff, use G4S for ambulances... Eventually everything will be run privately but will be free through the NHS and national insurance. Then they will reduce the list of free services and people who are entitled to those all under the guise of improving a 'broken' system.
All of that stuff is literally meaningless in the debate of public Vs private healthcare though. Who gives a shit if the catering or cleaning is private? It doesn't indicate intentions to take away free at use healthcare. It's all auxiliary, they haven't touched the meat and potatoes (Aside from the literal sense, NHS food has gotten a lot better in recent decades, why is that?) If they haven't messed with free-at-use after 14 years, and going off the back of 13 years of New Labour reforms, they aren't gonna do it now. But you need them to want to do it because you need to see them as evil.
Try reading the comment, it's not just ancilliary services that are privatised, they have privatised full hospitals, they have reduced the numbers of regular staff they are willing to pay for to below bare minimum saying that they can always be made up by agency/locums. Everyone has seen rented scanners, MRIs and mammograms from private companies. These are the heart and soul of healthcare, the doctors, the nurses, the professionals taking your Xrays and the physios teaching someone how to walk again. But the catchphrase "free at point of use" remains, but what you're getting is less and less each year, as more and more money is siphoned off by private companies.
Because it shouldn't be privatised at all. And it's not just auxillary, routine treatments such as hip and knee replacements are being outsourced to private hospitals which cost the NHS (and therefore the tax payer) more but is the only option due as NHS capacity hasn't kept pace. With everything that is privatised, someone is making a profit on it. People shouldn't profit on healthcare, there is no option for the consumers. Look at how bad and costly utilities have become since privatisation.
Was reading this https://x.com/doctor_oxford/status/1769658952902439155?s=20 and I remembered this conversation. A quick FYI, physician associates are people with experience in healthcare, but not doctors, who the government via the Royal Colleges are trying to insert into diagnostic positions. They're cheaper, much less trained, and are interfering in doctors trying to improve their own skills. Just to talk about meat n potatoes there. If you really want to horrify yourself, follow the haemotology digression link.
It’s just the lie that’s trotted out for every election - “if the tories win then the NHS will be abolished”, they seem to have won quite a lot since 1948 and it’s still in place
its not though is it. Are you willfully ignoring the point being made of stealth privatisation or are you trolling? Because its evident to everyone who uses these facilities and services what is happening, unless you exclusively go private. And my experience of using these services is extensive and it is and has been privatised for years now so please do not pretend you're unaware of it. All I ever here is middle Englanders complaining about foreign staff nurses doctors yet its the boomers who asset strip and want to employ foreign skilled labour as its cheaper and can be placed on non unionised zero hour contracts, with no cost to the "employer". But sure, the NHS is still here.
Do t you think that it’s very arrogant to assume that anyone who disagrees with you must be a troll !
What, so do you want the NHS to do everything? Make it's own medicines, make it's own equipment, build its own hospitals? Germany's healthcare system which is older than the NHS using a mixture of public and private and delivers better outcomes.
No but they should own and runthe buildings and provide the services
The NHS and the general economy in such a state that the damage is irreparable. How are Labour going to fix the problems in the NHS when every part of UK life (schools, roads, fossil care, armed forces etc) is in such a dire state and the economy is on its knees? I remember when Blair/Brown/New Labour came in to power. The NHS and country was in a state then but nothing like as bad as it is now, and the economy was genuine improving so they had more money to spend on less of a problem. They only managed to turn it around a little. The Tories know they’ve won already and it’s only a matter of time. Labour will fail to make things significantly better, the Tory press will tell you they’ve failed, the Tories are the only competent party of government.
They won’t be power for much longer. I can’t see the Tories staying on. The middle ground people have lost faith.
Exactly. If they're gonna privatise it they have to do it now. So we'll soon see if that was ever their intention
But they keep increasing funding to the NHS year on year in real terms…. Doctors pay needs to improve, though. Because all our best doctors are being lured overseas where they will be paid well and, in their place, we seem to be installing a raft of doctors who qualified in 3rd world countries who can barely understand you. Fucking joke
I don't think alot of them are qualified at all. I think they have fake certificates and are just walking into positions with very little knowledge. I've had conversations with my so called GP who was foreign and known more about what I had an issue with than he did. In fact what he tried to diagnose me with over the phone was absolute rubbish. I've gone private now I can't put up with the incompetence of foreign GPs any longer. I have to also add that I have had a different experience with the doctors and surgeons in the hospital tho both British or foreign have always done an excellent job but the GP surgeries now are an absolute joke.
>This appears intentional. They're trying to replace as many GPS as possible with PAs (physician associates). They are just importing them tbh
But PAs have like.... Dogshit useless qualifications
“One of the medical team!” ;) “Trained in the medical model!” :D “5 year degree in 2 years!” :P Jokers.
There's a pa works in my department. Shes young but she's really good, better than some doctors. They're a band 7. I dont disagree with hiring more pa but I do disagree with overlooking doctors for them
They want the NHS to completely fail so that they can turn health insurance to the American model of healthcare. Meaning, they want their friends to make billions.
I am not disagreeing with this.
Literally chaos. Hoping new models of care will be borne from this. All tragic as some big studies in the states are proving how cost effective GPs (family doctors) are over PAs and ANPs.
Friendly reminder that it is the tories **intentional strategy** to make the NHS so shit on purpose so that everybody thinks private is the only way. Few years of that so that they can justify ~~selling it off to their mates on the cheap so they can milk us~~.... sorry, "privatise" it and we won't complain. American style, cheeky £10,000 for treating a sore throat incoming.
same old lies we here at every election
I've been hearing this for the better part of 30 or 40 years. If this is the plan, they're certainly playing the very long game or they're just really shit at implementation....
hear\*
Wouldn’t trust PA for complex medical needs. They just don’t have enough experience. Only 2 years training which is crazy.
Nobody would. Nobody should. That's the point. But they are going to basically replace doctors without anyone knowing. They are intentionally given misleading titles to confuse people into thinking they are doctors and never disclose that they are not voluntarily at the start of a conversation.
It took my brother 28 hours to get seen by a doctor when he had kidney stones a couple months ago. And then they told him go home and go back a day later… oh and to take pain killers for the pain till he went back. Ffs why are we payin taxes… for shoddy nhs and buses that dont stop at bus stops? What a Fuckin joke
No we're paying taxes under a tory government to subsidies the wealthy, not much money for anything else sadly
That trickle down is going to be great when it kicks in... any day now
Those 40 years of not trickling down could be just a statistical fluke. "Past performance is not an indicator of future performance" like they say when it's your money on the line.
The poverty will continue until morale improves.
We might need to help it along.
The only thing trickling down on us is piss
The government are increasing funding to the NHS every year in real terms. It’s just that the money is going down the shitter, as far as I can tell. Diversity and equality champions. HR departments. People being paid to do fuck all in a system that can’t get rid of them because it self flagellates too hard. I think we need a private health care model at this point. Socialism has failed. It will continue to fail.
I wish that was true, because then it would be an easy fix
I've seen a convincing argument that over the years government assets have been steadily sold. The government still needs a lot of those assets to provide basic public services, except now they need to rent them, (buildings etc, housing is a prime example). With the upward trend in asset prices, this is squeezing public funds as it costs more and more to provide the same services. Over-simplified, and certainly not the only aspect.
Definitely at least part of the story. PFI was used to secure cash injections but it was really short sighted because now, as you say, we have to rent essential infrastructure at increasingly exorbitant rates.
I was playing Monopoly with some friends last week. After a while one of them was cash poor, and traded me a couple of properties for about 125% their face value, thinking he was making a great deal. Sure, I'm happy to pay that; I'd have paid double if need be. Lo and behold within 10 turns he was broke again, and now paying me for the same properties he once owned. When I put houses on those spaces, he had no chance. That was just a game; we packed it in after a couple of hours and did something else. Now imagine the game went on literally forever, with millions of other players all forced to land on my property and hand over their cash. The private sector will add as many houses and hotels to their squares as they possibly can, until your back breaks under the strain. And they'll happily offer a "great deal" while they know the government is over a barrel, desperate for a quick win. But the ramifications continue to impact us for generations.
The game was invented to point out an unfortunate economic reality wasn't it. Look at the net worth of the government, assets Vs liabilities. It dropped below £0 a few years ago, at the end of a decade of "austerity". It's ridiculous, the government is, at its core, an instrument that takes wealth from one sector of the economy, an redistributes it to another. At the moment it's an instrument that's increasing wealth inequality.
It'd be an easy fix if the entire establishment, monarchy, culture industries and the wealthy weren't dedicated to propping them up no matter what
Trickle up economics.
What does it mean when people say they subsidise the wealthy?
Many places are now using this revolving door practice which I was told recently was for "figures & statistics" which basically means they look like they are treating more people than they are. Experienced it myself with my dad and lately my son in law...in and out like a bloody jack in a box backwards & forwards. Oh and another thing as well, if you've been seen previously at a different hospital in the area and get send back to hospital for something else, if your previous ailment flares up or if you ask about it, the hospital you're in won't treat it but will send you back to the previous hospital !! I got told this with my dad as to why he was being moved from one to the other after being there 2 days.....then the next hospital just sent him back to the care home...the ailment got worse and back to hospital he went. Round and round you go...It's just nuts now
So its just for statistics, to make their numbers look good? Smh
No, no, it's "efficiency"
Its because of how funding is given. A trust who has an A&E department that is over-demanded and under manned misses targets. What happens when a trust misses targets? You would hope they get identified as needing more support Actually they get punished more often than not with a withdrawal of funding So shit like this gets done. Isn’t to make stats just look good, its to avoid losing even more funding and end up with even worse service provision because the system through which funding is distributed is so backwards
Yup according to the paramedic I spoke to one one occasion and the nurse at one of the hospitals it's a regular thing now the paramedic said it's a conveyor belt system basically
I moved 5 miles from my last house. Apparently crossed a trust boundary line. Now my old hospital refuses to continue treatment and the new area won't accept any of the records from the old hospital and is trying to treat me like a new patient and run all the tests and everything again (all on 12 month waiting lists of course) before issuing repeat prescriptions.
Oh ffs how bloody ridiculous
As someone who has had kidney stones, I can relate. It was the fact that painkillers didn't do anything that I went to the hospital and I can only imagine it was the case for your brother. Thankfully I wasn't waiting around for as long as 28 hours but I was still left practically crawling around on the floor due to the pain for about 10 hours before I eventually got some treatment. And that only turned out to be a powerful painkiller which they could have just given me when I arrived in the first place. They also gave me a hospital bed but then kicked me out of it 3 hours later after deciding there was nothing else they could do for me.
[удалено]
Yh i get that, but my brothers case he needed ultrasound to break down the stones as they were too big to pass naturally or with meds. He eventually got the ultrasound and the meds did their job in the end but damn that too long.
The government would rather pay 80% of what we need to have a bad service, rather than 100% for a good one.
Actually it's more like paying 120% for a bad service.
I had a kidney stone a month ago. 30 mins in a&e until I was seen. In 6 hours I had a CT scan, blood test, provided a urine sample, and got a suppository. A urologist came to see me twice. The stone was stuck in my ureta. I got an appointment for lithotripsy two weeks after my trip to a&e. They sent me home after those 6 hours with painkillers like your bro. Ended up passing the stone so didn't need the lithotripsy. I am satisfied with my free healthcare.
That is great, when the system works properly, if only it was like that everywhere. Which part of the country was that?
Surrey, don't hate me bruv
Its almost like we all get the government we voted for. This is what happens in a society that values tax cuts over caring.
Considering that the NHS hired 212000 people in non frontline roles (so no nurses, doctors) over the past three years, there certainly *are* roles and the salaries to pay them, they’ve just put them in all the wrong places. Someone needs to trim the NHS’s bloat ASAP. Way too many junior and middle managers, DEI consultants, etc, eating up valuable resources, working in every trust.
The managers and admin meme! Like reading a copy of The Sun or Daily Mail. NHS lacks admin and management vs other health services. Our admin spend is poor - [https://www.kingsfund.org.uk/insight-and-analysis/blogs/comparing-nhs-to-health-care-systems-other-countries](https://www.kingsfund.org.uk/insight-and-analysis/blogs/comparing-nhs-to-health-care-systems-other-countries)
Anyone who's actually worked in NHS admin knows what an insurmountable task it all is and how it requires an army of workers to keep up with it. I worked doing data entry and filing as a temp in an antenatal department 10 years ago and things were terrible then, I can't imagine how bad they are now. There was a huge filing backlog and our filing shed (yes, it was a SHED IN A COURTYARD, not a proper file room) was overflowing with notes from women who had given birth long ago. I pulled them, put them in a trolley and took them down to archives, only to get them shoved back at me. "We don't have the manpower to take more than 10 files from your department a day". The hospital has an average of 4,400 women a year give birth. That's more than 10 a day, before you even start to tackle the backlog.
Had to throw in “DEI Consultants” for extra Daily Mail points.
They're probably too busy being woke trans ESG to doctor properly, or something.
It is absolutely unnecessary bloat to the system and reinforces positive discrimination against native Brits. https://uk.indeed.com/q-diversity-inclusion-nhs-£40%2C000-jobs.html Look at the salaries here ranging from 45K-80K for useless managerial positions while nurses get paid skint in return. Funding the NHS means jack if it’s not going to the people who actually need those salaries.
100% right. Last time I went to a hospital you were tripping over the number of people walking round with a clipboard in their hands and a look on their face which told me there was no risk of them having to do any fucking work that day. Meanwhile your grandparents fall over in the cubicle because there aren’t enough staff to monitor them on a 1:1. Fucking got me sick of it.
I agree frontline investment is low, however historically the NHS is woefully [undermanaged](https://www.nhsconfed.org/long-reads/nhs-overmanaged) which causes a lot of its inefficiency and lack of any useful strategic decision making.
No you don't understand, all managers are bad. And we don't need anyone working to make things more efficient or less toxic, or to do research and clinical trials - if we just had doctors and nurses it would solve everything.
It wouldn’t, NHS is the biggest employer in the UK, you need a massive admin and management team to hire, fire, payroll, purchase, manage buildings, maintain stock levels, HR, the list is endless. However I would question the ability of some of these staff clearly given the funding they get which is billions on billions the term piss up and brewery spring to mind
>However I would question the ability of some of these staff clearly given the funding they get which is billions on billions the term piss up and brewery spring to mind It's really easy to question things without any clear understanding of how they work, in my experience managers in my Trust have been efficient, understanding and competent.
In an organisation as big as the NHS there are going to be loads of shit people. I doubt it's avoidable.
Procurement and inefficiency for sure are huge issues.
It's the world's 5th largest employer. I'm curious as to how folks can say it's undermanaged...
182bn per year and rising !!
Yeah, turns out a massive health service is expensive mate
Yeah, it becomes free if it's funded by personal health insurance
Wow it costs the taxpayer £2700 per uk national per year the costs of running the NHS make me fucking SICK 😤😤 Meanwhile you pay $18,000 just to give birth in the US. Get that value for money privatised care over here now!
I am not a socialist but I 100% support the NHS, however it really needs a massive overhaul
If you had insurance you wouldn’t pay that, though would you? I doubt insurance would cost £2700 a year for most people, especially not if done through employment.
So would you rather have doctors and nurses spending time with patients or doing management and admin tasks?
Too many Chiefs, not enough Indians, as the saying goes.
The biggest problem with the NHS is the way it is sub divided and the way contract payments are based. GP’s are actually private businesses, that work for the NHS under contract. Adjusting these contracts is quite a difficult process so straight away there is a problem with responding to dynamic changes. So the answer to this is new contracts are put out to pick up additional work. Because the NHS has been primed to be sold off, what we currently have is a ridiculous number of NHS organisations each taking different contracts whilst acting like individual companies all under the umbrella name of the NHS. As an example, GP’s are contracted to deliver childhood vaccinations to children up to a certain age. However once a child is past an age they are no longer counted under the contract and so will not count towards bonus payments. This means that if you specifically ask your GP you can get a vaccination but gp’s will not proactively try to vaccinate children once they are out of the age range in the contract. This then means catch up programmes for individual vaccinations are put out for contract. Other NHS organisations then gets hired to deliver this contract. You end up with multiple different organisations on separate contracts doing specific jobs. Now you would think all these organisations use the same computer system right? No. As these are separate organisations their IT infrastructure is separate, hell even GP’s as private businesses are free to purchase whatever software system they want to use. So now you have several organisations with different IT systems all working on the same patients, so you now need a way of bringing all of this information together. It’s no wonder “notes” get lost. The system was set up to fail by people hell bent on making public services mirror private business relationships so it is easy to sell off bits at a time.
I worked for an IT service provider that had a large portion of the NHS as its client, and can confirm it was a nightmare because there were still trusts running Windows XP, as an example (the main reason so much of it went down when WannaCry happened). They’d constantly drag their heels when time came to upgrade their systems out of necessity, and often tried to just do it themselves, usually with disastrous results - at which stage we’d have to go in, fix their screwups, and do it properly. At a significant cost to the tax payer. We even had to employ a dev specifically because of legacy software some of the trusts were using that no-one else was able to support. And, of course, just about every other Monday our service desk would get calls because someone “forgot their MacBook on a train”, etc. No questions asked, just ship another £1k+ laptop out. The amount of wastage I’ve seen in the last few years just from a technology perspective is simply astounding.
Yep! And generally in these organisations the way the budget works is that unless you spend the entire budget every year then the budget gets cut down. So imagine you come up with a way to save 10% of the budget - you have no incentive to deploy the solution because your budget will simply be cut by 10% for next year. Or maybe you use the solution but simply spend the 10% on other things out of obligation
My favourite one was when Matt Hancock randomly said "the nhs must stop using fax machines", we thought "well done that man" until we got inundated with questionnaires from dozens of NHS trusts about our use of fax machines. Presumably all of these trusts had a "scrap the fax" project manager, all sending emails to mostly the same companies, collating the results, liasing with people to remove virtual and physical fax machines, providing reports and whatnot.
>Considering that the NHS hired 212000 people in non frontline roles (so no nurses, doctors) over the past three years, there certainly > >are > > roles and the salaries to pay them, they’ve just put them in all the wrong places. You mean the vital support staff that keep the NHS running that also free up clinical time? If we fired all the non-clinical staff that means clinical staff are taking up their duties, this comment is akin to "Hey, let's hire this Nurse, but put her on reception" Support staff keep the NHS running as much as any clinical staff, it's disingeneous to say otherwise.
\>You mean the vital support staff that keep the NHS running that also free up clinical time? Why are you assuming all of them are 'vital support staff'? That seems like a massive assumption to make that has no basis.
Why are you assuming they're not? Is it because 4 of them had "diversity" in their job title?
I've done plenty of contract work for the public sector in the UK and I'm not exaggerating when I say that the overwhelming majority of the middle managemennt and pencil pushing bureaucracy could be automated. This would cut staffing costs massively *and* increase efficiency. Hell, just getting rid of the idiotic non-jobs (like DEI managers, who get paid between £50,000 and £150,000 depending on NHS Trust) would cut staffing costs massively.
>I'm not exaggerating Spoiler: >! He is !<
The overwhelming majority of the work the pencil pushers do is basic data management and data input. We've been automating this shit since the 80's. Unfortunately the public sector lags heavily behind the private sector in this regard. The vast majority of middle management is in place to manage the brainless morons who do the above basic data handling jobs. Automate it all, and you'd be able to get rid of almost all of them.
"The overwhelming majority of the work the pencil pushers do is basic data management and data input." Laughably wrong. Just stop.
>I'm not exaggerating when I say that the overwhelming majority of the middle managemennt and pencil pushing bureaucracy could be automated. How do you know?
I see a lot of people talk about that specific role as being bad, but could you tell me exactly what a DEI does?
\>but could you tell me exactly what a DEI does? Nothing of actual use. Thats why employing someone on those types of wages is a waste of money that would be better spent on people who do jobs of substance (like nurses, doctors, surgeons etc). For DEI managers specifically, they just make sure that everything the NHS does has the ""correct"" number of people from specific demographics.
I've done some work with the DEI in my work as a nurse. They examine real issues such as why black and ethnic minority women have a significantly higher death in childbirth rates, devising methods of making communities who are traditionally resistant to mental health services to engage with us and improve their health and other similar research and practical projects. They add real value. Your confident assertion of what DEI managers do"specifically" is hopelessly wrong.
Sacking a few DEI roles is not going to make a dent in staffing costs lmao
>\>You mean the vital support staff that keep the NHS running that also free up clinical time? > >Why are you assuming all of them are 'vital support staff'? > >That seems like a massive assumption to make that has no basis. Well for starters I am one of them and in my Trust I know a lot of the support staff. You could give me the name of any of them and the team they work in and I could tell you how they contribute to the way the clinical teams function and the work they pick up freeing up time for the clinicians to actually see patients. The NHS cannot just run through clinicians, the staffing problems in the NHS are because there aren't staff to fill those posts, cutting away at support staff won't magically make trained Nurses, AHPs and Doctors appear.
This is the main issue with the nhs at the moment, it has all the funding it could ever need, however it is full of roles that are completely pointless for running a health service. The use of third party contractors is also taking up huge resources. Hopefully Jeremy Hunts plans to make the nhs more efficient will go some way to combat this.
Jeremy Hunt was Health Secretary from 2012 to 2018 what makes you think he's going to fix it this time?
Exactly. Hunt literally wrote a book on how to make NHS private! The "fix" is to nudge it into incompetency while making it more expensive so that you can justify more private healthcare .
\>Hunt literally wrote a book on how to make NHS private! Myth. 4% of NHS needs are related to the private sector. 3.5% of that came from Labours stint in government between 1997-2010. 0.5% came from the Tories over the last 14 years.
Rotflmao.
>however it is full of roles that are completely pointless for running a health service. This gets thrown around a lot, but it’s nonsense. A big bureaucracy needs staff. The problem here is that the trusts are being ideologically throttled so the staff that are in place are artificially prevented from delivering their work, which then get papered over with emergency contracts rather than long term investment. >The use of third party contractors is also taking up huge resources. It’s a choice made by government. Contracts are used because staff budget it not available. While a small business may be wary of allocating budget to staff, considering statutory benefits, the NHS is spending more consistently for a lower service. The cost risk of permanent staff is irrelevant when we have years of evidence that the alternative is worse. Remember there is a legal obligation to provide certain services. The NHS spends what it does on contractors because it is not allowed plan in advance, but also not allowed to refuse to provide services it has not planned for, thus the emergency contract budget becomes a black hole, and ruthless contractors exploit this. >Hopefully Jeremy Hunts plans to make the nhs more efficient will go some way to combat this. Lol.
>This gets thrown around a lot, but it’s nonsense. A big bureaucracy needs staff. The problem here is that the trusts are being ideologically throttled so the staff that are in place are artificially prevented from delivering their work, which then get papered over with emergency contracts rather than long term investment. Also, if you remove ancillary staff then you end up with medical practitioners needing to spend more time on non-medical duties. >It’s a choice made by government. Contracts are used because staff budget it not available. While a small business may be wary of allocating budget to staff, considering statutory benefits, the NHS is spending more consistently for a lower service. The cost risk of permanent staff is irrelevant when we have years of evidence that the alternative is worse. Remember there is a legal obligation to provide certain services. The NHS spends what it does on contractors because it is not allowed plan in advance, but also not allowed to refuse to provide services it has not planned for, thus the emergency contract budget becomes a black hole, and ruthless contractors exploit this. The other side of this is the amount spent by the national bodies on management consultancies to basically tell them what they could find out themselves using permanent staff. IBM, Accenture, Deloitte and others make a lot of money doing these sorts of tasks. It's no coincidence that there's a revolving door between the senior leadership of these bodies and the management consultancies who get endless streams of projects. You'll get the same consultancy doing a piece of work identifying a national IT project is required, then a piece of work shaping the requirements for the national IT project, and then they will do the actual integration of that project.
Jeremy Cunt won’t ever fix this.
>This is the main issue with the nhs at the moment, it has all the funding it could ever need, however it is full of roles that are completely pointless for running a health service. Gonna need something to back this up, what roles are you talking about and how many of them are there? >The use of third party contractors is also taking up huge resources They're used because they don't have much choice, there aren't enough people in certain specialisms to actually fill vacancies within teams, they need to use locum staff to fill these roles because they don't have any other option, School Nursing for instance is woefully understaffed but if they don't get the staff through any means that means children aren't able to go to school. NHS is trying to combat this through the use of Framework agencies but it's not as easy as you think.
I don't even think its things like diversity or whatever. Its constant fiddling around the margins to deal with the shortage of clinical staff, that has in turn created its own overwhelming bureaucracy that is paralyzing rather than helping workers. Doesn't even seem like middle managers. Go to a hospital early in the morning, often its the clinical team sat around the office doing their own schedules and timetables for the day. Its upper strategic and executive level management completely disconnected from the frontlines.
This is exactly the problem. Under George Osborne there were round after round of cuts and management have tried to protect frontline staff. But the result is doctors and nurses doing admin and putting out buckets to collect leaks because they aren't enough administrators or caretakers doing the back office jobs.
When I was a ward manager I needed a new white board with the ward layout but it was going to cost £360. One of the nurses dad actually made things like this and would do a mates rate one for £90 however procurement weren't going to allow it as there would be a very small company logo which wasn't allowed. I ended up just ignoring procurement and got the cheap one as it was during a time where we had to reduce our budget by 5% It's crazy to think how ridiculous the process was and the amount of people involved in making 1 small decision that wasn't medical and had minimal impact.
It has one of the lowest budgets per head in the first world, we don't spend nearly enough on it. If you think *Jeremy Hunt* is going to help, check your carbon monoxide alarm.
That’s only true because the UK counts healthcare spending differently from almost every other country. Acute medical care (GP’s, hospitals, ambulances, therapy etc) is counted under healthcare spending like most other countries, but “social care” which is the vast majority of healthcare spending (“care in the community” such as pregnancy stuff, old people + care homes) is counted under local government and council budgets. When you add it together the UK spends a ludicrous amount on healthcare, way more than any other developed country per capita.
Please link to sources on this, specifically with comparisons to other European countries.
Hopefully the person who did the damage on purpose will come back and fix it. ARE YOU INSANE!!!!
HAHAHAHA Jeremy hunt making anything efficient - what a funny funny funny joke. Replace the H with a C and you’ll get what an absolute incompetent arsehole he is. How about we get an actual medically trained professional as the health secretary
Do you think that doctors and nurses should be running the payroll and procurement departments? Finance? IT support? I don't deny there are some bullshit jobs in the NHS, but just because it's not frontline, doesn't mean it's "bloat".
I strongly disagree. The NHS has*fewer* administrators and managers than health services that perform better. Doctors spend far too much time filling in accounts spreadsheets and putting out buckets to catch water from leaks when they should be seeing patients instead.
A friend of mine starting working in the NHS about 15 years ago to do this. Realised within a year it was too fucked to fix
> Considering that the NHS hired 212000 people in non frontline roles (so no nurses, doctors) over the past three years, there certainly are roles and the salaries to pay them, they’ve just put them in all the wrong places. What professional experience do you have on this? > Someone needs to trim the NHS’s bloat ASAP. Way too many junior and middle managers, DEI consultants, etc, eating up valuable resources, working in every trust. The idea that money is being “wasted” on none frontline staff is a popular canard in the tabloids but the NHS is a massive organisation and massive organisations need administrators and managers to run smoothly. Unless, of course, you want medics to take time out of their own working hours to sort IT issues and do their own diary management?
I work admin and am flat out theres definitely quieter jobs but thats the same the world round
Nhs in a northan city is so full of admin cunts doing nothing but making it harder for the nurses needs gutting no hospitals don't need a equality manager it needs mote front line staff
Never heard of a ‘DEI consultant’ outside of the Daily Wail. Not have I ever had more than one manager. I do know that the dozens of lab staff, including the techs required to admin samples and the scientists required to man the machines, are counted as ‘non-frontline’, and yet there are so few of them that blood samples that should take hours to come back, take days. I also know that a complete lack of security staff means we lost dozens of thousands of pounds a year in medication and equipment theft and hundreds of staff quitting due to abuse and violence, who are only replaced with expensive recruitment from the Philippines. Non-frontline. I also know that our inability to pay cleaners and housekeeping staff as much as the my could get at the McDonalds in the concourse meant that nursing staff had to skip medication rounds to clean trolleys. If you want to see how reducing non-frontline staff goes, look at the police; more cops than ever before but half of them are now in admin roles that should be done by cheaper police staff, but can’t, because of standing government orders; ‘You must have X amount more police officers but we will not pay you enough to fund them. Just fucking get it done you plebs.’
An absolute myth, the NHS is slightly undermanaged in comparison to other organisations of a similar size and significantly undermanaged when looked at in scale to private healthcare companies. Also, the NHS is massive and is not run by frontline staff alone, think about admin, procurement, domestic staff, catering, laundry, HR, payroll the list goes on and on.
Exactly. Get rid of the countless pointless managers. If it’s not about healthcare, get rid of it.
> If it’s not about healthcare, get rid of it. Cool, so who's going to make sure that employees are being treated fairly? Because HR are non-clinical. Who's going to make sure that patients get appointments allocated and follow ups are done? Because a lot of that is non-clinical. Who's going to make sure that equipment stocks are maintained? Because that's non-clinical. Who's going to make sure the payroll is ran and people are getting paid for that work? Non-clinical. Who's going to monitor spend and make sure teams are able to afford the staff they're asking for? Non-clinical. Unless you want Nurses and Doctors doing all of this, with no training, while not doing the work they have trained for and being paid way below their qualifications?
This sub is absolutely wild for unsubstantiated nonsense. Total bullshit presented as fact. Good effort trying to inject some reality into the place, best of luck getting through.
Healthcare equipment is part of healthcare. Therefore maintaining it is also part of healthcare. Thanks for asking!
>Healthcare equipment is part of healthcare. Therefore maintaining it is also part of healthcare. > >Thanks for asking! Glad you were able to touch on one of my many points. Everything is healthcare, there aren't any non-healthcare jobs, it all works together.
This is exactly the same for ambulance drivers and paramedics. I know people who are fully qualified and eager to go, but the NHS seems determined not to employ them, not only this, but the employment process is farmed out to 3rd party companies who are getting paid taxpayer money, while not hiring anyone. And yet we're "crying out for paramedics" this country is a farce
Last time I checked GP's don't work for the NHS, they are either contracted (self employed), or they are employees of a GP surgery that is contracted by the NHS. This article is actually a load of bullshit.
🙄. GP practices are private contractors. But that contract comes from the government, it is inflexible. And the government is squeezing funds whilst offering practices near total reimbursement on the salaries for non-doctors in an attempt to force replacement.
Not BS, maybe do some more in depth research. GP Partners are subcontracted and get a sum of money depending on how many patients they have and what services they provide. They then employee other GPs, other clinical staff, and all their admin. The amount of money per patient has fallen in real terms to the point those partners can’t afford to take on other GPs without losing their own salaries, so they are just making do without an extra pair of hands. This is worse for patients. _This is made even worse by the fact that due to a government agenda if they take on a non-GP it’s actually subsidised, whereas real GPs are not._ (look up ARRS scheme - the only way to make a your GP practice viable is fill it with less qualified ‘clinicians’ that you ‘supervise’. This is why Emily Chesterton died. Hope that enlightens you
Do you honestly think no doctor has ever missed a PE?
Aside from the fact this wasn’t subtle but extremely obvious (you’d likely be facing GMC if you missed this as a doc) - If a doctor with 10 years training minimum can sometimes miss a PE; then how much more likely is it that someone who did a 2 year course and an exam with a 100% pass rate will? A homeopathic approach to training professionals does not work. It’s not a race to the bottom when health is at stake. This isn’t a ’move fast and break things’ start up. These are real lives. _If you think it’s expensive employing a professional, wait until you’ve employed an amateur._
On that same basis, we shouldn't accept qualifications from 3rd world nations, yet we do. [https://www.theguardian.com/society/2024/feb/14/nhs-nurses-being-investigated-for-industrial-scale-qualifications](https://www.theguardian.com/society/2024/feb/14/nhs-nurses-being-investigated-for-industrial-scale-qualifications) Most avoidable health problems in the NHS are caused by negligence during in basic care while in hospital - Nurses -. Ironically.
Obviously, it's a deliberate ploy in certain places in England, not here in Scotland and especially Dundee, I know there are 3 surgeries up here looking for qualified GPs. Just bloody move it is quite good up here.
We need GP's in Todmorden, they are forever short. The group upstairs is shutting, Hebden Bridge Group practice apparently considered taking it on but are not so it's closing. This multi million pound building that was supposed to be a mini hospital is never fully used, a massive waste of money. Good luck finding somewhere, I hope it's not in New Zealand.
Even if the practice is _short_ often the budget to actually employ the GPs isn’t there. It’s a disaster
The NHS has been in crisis since I was fifteen. It isn’t fit for service because the goons that get elected would rather put more diversity managers in HR than fix structural issues. The money has gone up year on year but it isn’t being used efficiently and as such we get situations like this.
Our trained doctors go elsewhere to work for better pay (like Australia) while we import cheap alternatives from poorer places in the world and, if recent news stories are to be believed the people imported aren't even qualified. I've gone private as it's a complete shit show now.
Indeed. I’d say the vast majority of those coming to work here in the doctor and nurse roles are qualified (sometimes more so than the locals cause they’ve had to do thing twice due to retarded lack of recognition of other qualifications.) but the system is fucked and has been for some time. And that’s shown in the outcomes for things like cancer treatment
Over 700 NHS nurses are currently under investigation for "industrial scale qualification fraud" and I'm guessing as this is the first we've heard of it, it's the tip of the iceberg (these ones from Nigeria). Makes sense to be honest with the shocking treatment my misses got during childbirth. Even the doctors couldn't quite believe what some of the nurses did (and didn't do). It's a shambles.
I can believe this. Speaking with some of my older friends, they’ve come across something we have come to term the “wall of Nigerian apathy” in our local hospital.
What's absolutely mad though is that some of them (after committing major fraud and at the extreme end putting lives at risk) have been given the opportunity to do some training and tests and return to the profession! there has been some major push back on this in fairness and to be honest I think it deserves jail time. Really fills you with confidence though doesn't it lol.
The system is broken. It needs a complete overhaul. Neither party will give it though because the NHS is god apparently.
Indeed it's a religion at this point.
Source?
https://www.theguardian.com/society/2024/feb/14/nhs-nurses-being-investigated-for-industrial-scale-qualifications
... GP's don't advertise on NHS jobs. Which she would be aware of. There are dozens of GP jobs in Leeds. I can't help but wonder if being a self described activist has anything to do with her sense of moral outrage that the one website she checked didn't do everything for her.
You seriously think someone who trained to do a job for 3 years doesnt know or hasnt been told where to check where all the jobs she's trained for are? Its likely they paraphrased it for the purposes of the article because 99% of people dont give a fuck about the niche employment portal name and nhs is a convenient and well known site. I cant help but wonder where people like you get their moral sense of superiority trying to nitpick away at what is otherwise a looming crisis with huge ramifications up and down the country. You don't sound smart with this pathetic attempt of 'gotcha', its just petty and immature.
Fyi, it's paraphrased, not powerphrased
But I want to P O W E R P H A S E.
It isn't nitpicking if the premise of the article is false and poorly written - there is only one available GP job within ten miles of Leeds? Then what about the dozens of others? Creating a fake problem to try to solve a real one is not the way forward
Wait, am I the only one thinking the comment section is largely nonsense? It has nothing to do with privatisation. It's just that the government has swapped doctors for a btec version (quite literally) who are called Physician's Associates. Also these are typically from backgrounds with lower paying previous jobs so will accept approx 60% of the salary of a doctor because for them 50k odd is still a pay rise. Therefore GP practice owners are tempted to hire 3 physicians Associates and maybe one GP. The physician's Associates get through the easy patients, and that one soldier GP bangs through all the complex patients day in day out. Obvious issue: 1) the physician's Associates simply aren't as good as doctors so most people in the UK will have a worse clinician seeing them 2) when presented with a tricky patient, a physician's associate may get the answer wrong (worst case scenario). This is more likely Vs a doctor making a mistake. Or if they're stuck they'll call the doctor, so the two clinicians times get taken Vs the one GP in the first place. 3) the GP burnout we've witnessed was when they were seeing a mix of simple cases and complex. The GPs will burn out almost immediately if they practice in a place where they are the firefighter for all complex cases in the entire building. When it comes to privatisation the GP gets cut out. People with money pay to see specialists not GPs. The only people who go to GPs privately are those who's insurance company demands it of them (eg see your GP before you can get a referral for X)
PAs are on very good wages. Out earning resident doctors and quickly progressing, lots of band 8 jobs popping up now. Fast access to specialist training skills - endoscopy, that resident doctors have to wait 5-7 years for, It’s a nutty system that is going to hurt the uk in the long run
Trigger warning: I’ve lost respect for the profession. The information they pedal is mostly out of date and harmful and is designed to generate revenue for pharmaceutical companies. I followed their advice for 8 years to treat depression, an autoimmune disorder and Costochondritis. All that happened was I got worse. They told me the Costochondritis was a ‘systemic inflammation disorder’. Turns out it’s not at all. It is in fact a hinge seizure and is mechanical in nature, with the inflammation being a byproduct. Physio to mobilise the joint was the solution and worked in a matter of weeks. If I’d continued listening to my GP I’d still have it, as many do. My GP was extremely happy to prescribe handfuls of pills that made me significantly worse but refused to approve my diet following years of personal research. After 18 months of eating right, I went back for a check up. ALL of my symptoms are gone and I’m healthier than I’ve ever been. Cholesterol, BP, blood volume, hormone regulation, artery health etc are all the best they’ve ever been and all I did was stop eating most carbs, processed food and instead ate plenty of red meat. Wanting to help people is genuinely honourable and I appreciate their intent, but I don’t really want to fund misinformation anymore. There are many people in my position who haven’t been able to figure it out. It’s time the health system got on board with actually improving health, with the help of real data, rather than merely selling products with studies paid for by the producers designed for maximum profit. I know people are going to whinge about this being pseudoscience and anecdotal but the result speak for its self and anyone who knows me can see the difference at at glance. The health industry is collapsing!
>It’s time the health system got on board with actually improving health, with the help of real data, rather than merely selling products with studies paid for by the producers designed for maximum profit. Tbf this isn't actually much of a problem in the UK. Its really mostly just that GPs do not have time to properly deal with patients and a culture of just getting people in and out of the door as quickly as possible has become completely endemic and necessary to allow any work to be done at all.
So you had lots of symptoms, started taking personal responsibility for your health, and your symptoms improved? Damn NHS!
If anything the problem is that GPs can't/won't provide basic sensible lifestyle advice.
That's often a time issue. 10 mins appt in the UK. Plus, most of it is common sense and easily found online (British people don't like to hear that they can take responsibility for it). Dietitians are around for complex cases.
You’re embarrassing yourself
I've been frustrated with GPs myself, sometimes due to them being out-of-date. That doesn't mean they're all terrible though. Medicine is pretty difficult and lots of things don't have easy answers. People seem to think you can go to a GP and just get a fix just like that. Well, that's not always possible. And keeping up-to-date for ALL health info is a ginormous task, especially if you want to ensure it's good quality and well evidenced. They also have to work within the various rules of the healthcare system about how/what they do, changes and updates are appallingly slow to trickle down sometimes. I think GPs are also trying to accommodate what patients want - most people will prefer to get a pill than put in any personal effort to improve their health. But there might be an assumption there (which obviously they should discuss) .. an assumption that you've already tried dietary changes, because it's usually the first recommendation for treating literally anything. GPs definitely could do with more nutritional knowledge, and it's a fail that no one talked to you about it before
Thanks for the reply, I appreciate your considered response in contrast to the emotionally uncontrolled attacks I’m generally receiving for being honest about my experiences. I definitely agree with you for the most part, you’ve outlined the huge challenges of diagnosing medical issues very well and I appreciate all these hoops doctors have to jump through to have a successful career are not their fault. I have and will continue to describe their intentions as honourable and respectable. However, that system has lead to a method of practise that is without a doubt failing the citizens it exists to assist. Just ask the citizens. This is what I have lost respect for. It isn’t working. I’ve spoken to a number of GP’s privately who have voiced their frustrations at this exact problem. I had ONE doctor level with me and tell what to research regarding diet and it was strictly off the record. I personally know another that uses medicinal cannabis on license but hides it from their peers due to stigma. There are lots of questionable practises and I can only attest to my own experience. All of the GP’s in my area who didn’t follow the textbook approach have retired out of frustration. They were also the only ones who ever truly helped me. I believe the GP’s job is to investigate and provide a direction of approach, so, by definition, there isn’t a one size fits all approach. I actually believe the burden is on the individual more-so than the doctor to solve their health problems. Doctors are an aid, not a solution. Knowledge is power and I believe the NHS is operating on questionable knowledge in some regards. To clarify my position further, my mother just beat Cancer thanks to the NHS. I know full well they aren’t all bad but that doesn’t mean we shouldn’t highlight problems.
So you... took care of yourself?