Shit

Cancer

The NHS:

She had asked the hospital transport to take the both of us to the hospital and when they arrived, they weren’t expecting the two of us. We negotiated with them and I helped her to the ambulance. After waiting around for the usual late running, we were told that we would be collected at half past five. At six, we enquired again only to be told we would have to wait until half past eight… Had we not chased, we would have not been told that. So we got a taxi and paid through the nose to get home.

The misery of the cancer is bad enough, but this indifferent incompetence just adds to the overall agony of the process. We have spent decades working and paying into the system. Now, when we need it, we find ourselves underwhelmed by the service we receive.

40 comments on “Shit

  1. It’s a National Health Service, not a National Transport Service.

    And who doesn’t go to the doctors, hospital, airport etc without a book to read?

  2. Paying nurses higher wages would solve this problem, candidly. At least that’s what the unions were telling us on the BBC this morning.

  3. How can they be expected to manage with a paltry 120 thousand million pounds a year?

    You couldn’t run a corner shop with peanuts like that.

  4. So many of the NHS issues aren’t down to lack of funds, but to sheer mismanagement. I’d like to see ministers firing this back that the unions.

  5. Ah, but the government is responsible for management. That dropped bedpan echoing and all that, thereby ensuring the government is kept busy fighting fires, while allowing the same unions to dictate policy. This was the plan, you know 🙂

  6. I’ve been through an experience similar to Longrider’s. I won’t attempt to describe the pain my wife went through.

    But at no time did we expect the NHS to provide a taxi service for us. It wouldn’t make sense to have spare ambulances on hand to do that. If you think the NHS should pay for taxis, put it in the UKIP manifesto.

    The UK spends about $4,200 per capita on healthcare. France $4,600, Germany $5,600, Norway $6,600, USA $9,900 (OECD data for 2016). So no, the NHS is not generously funded.

  7. Of course what we need is more privatisation of the health service.Privatisation has been such a tremendous success elsewhere in the Uk.Selling I million council houses has redistribured wealth to such an extent that everybody can pay for health care ( by selling their houses) as long as they don’t waste money on fripperies like food.
    Pull yourselves together: everything is possible if you hate this country its history. and traditions. Keep up the attack!!

  8. “Passing by” – the UK is solidly mid-table according to your link. If we accept that the US is a stupid basket case on this front and that Luxembourg is another weird outlier because of its size.
    Also take a look at New Zealand and Italy – 2 of the world’s best regarded healthcare systems both spending significantly less per head than we do.

    If we think Healthcare Policy is important, then cherrypicking our data just won’t do.

  9. DNR, I have lived long enough, and have enough family and friends, that our joint experience with the NHS and private medicine amount to a statistically significant sample.

    The only wholly satisfactory experiences have been private medicine.

    The same is true of Italy.

  10. ‘We have spent decades working and paying into the system.’

    Get over the notion that you are purchasing something when you pay taxes.

  11. Don’t you get tired of peddling Marxian piffle Reedy?

    “Privatisation” as we have seen it in this country is replacing clapped out state socialism with marginally better corporate socialism.

    In neither case does the name of the actual customer appear on the paycheck of any of the various showers involved.

    So please don’t come preaching how the fucking useless state does it better. I was there in 1975 when British Steel were losing £600 million a year. And that was when £600 million was £600 million.

    Piss off back to your refuge up Jezza’a arsehole.

  12. The hospital car I used once with the mother in law had a selection of weaving decorations on the back seat, the driver pointed out the brochure of the ones he had previously made and gave her a business card too.

    She didn’t like the “tat” but had to pretend for 25 mins that she did.

    At least with a taxi driver you can point out the benefits to pedestrians in Norwich city centre to wind him up.

  13. Passing By,

    Ok. It doesn’t matter if you think people should have transport. Or even that they failed.

    Not telling people that you can’t deliver on what you’ve promised is the fucking pits. You could have told me that story without naming them and I’d guess it was the NHS or maybe rail. A tiny private florist or taxi company would manage it.They are contemptuous of the people who pay their wages.

    And the reason they don’t give a toss is that you can’t say “fuck your useless service, I’m going elsewhere”.

  14. If you can’t take folk home in an Ambulance establish a small taxi rank at the Hospital( in larger towns etc) or have a phone line with taxi numbers handy. Or perhaps negotiate a special rate with taxi drivers.

    Don’t just leave people hanging about waiting for somebody to do something they almost never do ( as is the NHS SOP) or put them out in the cold to fuck off home under their own–quite possibly sub-par–steam. Unless they are absolutely cured (ha ha ) and off to enjoy many years of good health.

  15. “And who doesn’t go to the doctors, hospital, airport etc without a book to read?”

    Allow me to recommend Henry James. His writing is so turgid that it takes ages to wade through, so only a thin book is required. Moreover his stuff is eminently forgettable; you can take the same book every time. Just leave it in an inside pocket of your anorak.

  16. Or, or, or: how about a copy of Mr Newman’s epic:

    One thing I am confident of, is that you’ll not be bogged down in leaden prose for hours. Pacing wise, you can rattle through it in no time.

  17. @ DBC Reed
    No,what we want is sackability of those who do not even try to do the job they are paid to do. Those who recommend privatisation see it as a means tothe end of getting a decent service provided to those with terminal cancer.
    “Right to Buy” has indeed redistributed wealth to those in the middle half (between 1st and third quartiles) of the wealth distribution from those in the top quartile. It has also reduced the waiting lists for council housing since the money available to build new houses was more than enough to replace the houses that would have been vacated by well-off council tenants like Bob Crowe and Frank Dobson moving out of their subsidised accommodation into the private sector.
    No-one has to pay for health care unless they choose to do so because the NHS lets them down – it is *residential care*, including the “hotel costs” part of nursing home fees that are payable. And only if you have some accessible wealth – i.e. not the home that your about-to-be-widow is living in.
    Many contributors to Tim’s site regret that it does not have a “spellchecker” but what you need is a “factchecker”.

  18. After my father retired he volunteered for hospital car service, which paid nothing except mileage. Non-urgent but indifferently ambulatory patients were taken to and from hospital. It all worked quite well, except sometime they were a bit tardy coming through with the petrol money. I don’t know if this system still operates. I can’t imagine the union was terribly keen on it.

  19. Okay, where to start?
    @ Passing by. We were advised to use hospital transport (the clue is in the name – they have NHS on their vehicles and their drivers have NHS passes), so yes, we did expect them to provide the service they were offering and had agreed to provide.

    Up until this point, I had been driving my wife in. However, she needed a chair and I can’t fit one in the boot of the car, we don’t have one and parking next to the oncology unit is pretty much impossible. Guess what, despite asking for transport with a chair, we didn’t get one.

    Then despite being told explicitly that we were going to be collected at five thirty following a three thirty appointment that ran an hour late, suddenly it became eight thirty. I expect them to provide what they have agreed to provide. I would say, that this isn’t asking much, but clearly it is. My comment that they were guilty of indifferent incompetence is being mild, frankly.

    As for Gamecock’s comment, really, I’m saying pretty much the same thing – but we are constantly told that the 50% or so of our income stolen from us over a lifetime’s work is to pay for this “world class service” so I should expect a fucking world class service as I am merely playing them by their own rules here.

    Again, it’s not too much to ask.

    Having had personal experience of both the French and Cypriot health services, I know what a world class service looks like and the NHS isn’t it.

  20. In terms of health outcomes, our “world class” service ranks somewhere in the mid 20’s in the world; rather the same position as this comment in the thread.
    It’s so successful that Cuba have copied it.

  21. Longrider: I sympathize with your situation. I think patients who need it should get timely transport to and from their appointments.

    What I have no sympathy for is people who campaign or vote for underfunding, then complain loudly when it turns out to affect someone they care about. The NHS has been told to find £22bn of “efficiency savings” so that it can meet increasing demand. Since that’s not possible, I wouldn’t be at all surprised if someone has efficiently saved money by not employing anyone to stop the Patient Transport System falling over.

  22. “but we are constantly told that the 50% or so of our income stolen from us over a lifetime’s work is to pay for this “world class service” so I should expect a fucking world class service as I am merely playing them by their own rules here.”

    You are being lied to.

  23. Father in law was discharged last year – we had a phone call in the morning so we knew he was coming home.
    He was expected early afternoon. Late evening he arrived, without any aids to help him in the house.
    We managed to get them later but not that day.

    I’ve been offered lifts into hospital many times, by emergency ambulance.
    Discharge I’m left to my own devices. There’s a phone for taxi company near the entrance to my local hospital, the more distant ones just tell me to wait for my wife – who twice has been unaware of me getting released as no one has informed her despite me asking them to.
    Local hospital I can get a taxi home, more distant its quite a bit more cost so have to be careful about using taxis from there.
    Half the time the cash machine in hospital isn’t working.

  24. Gamecock – well, yes, I know that – hence the sarcasm in my original comment.

    Passing by – there are billions being pissed up the wall. There is no need to under-fund healthcare.

  25. I had a disgusting experience at my local hospital (and I’m leaving parts out here for brevity)

    Asked to arrive at 7am, nil by mouth since 8pm the previous night.

    Turned up, nurse says she’s surprised I was asked to come in so early.

    Sit in an overheated waiting area for 2.5hrs with 20 other people. No staff turn up.

    At 9.30 ‘matron’ turns up. Tells everyone that operations are being delayed due to bed blocking. Apparently someone will update us every hour.

    No updates, of course. At 11am another 20 patients turn up. paramedics dump a very very elderly woman on a seat.

    After 2hrs, a couple of people get taken for operations. The old lady is left sitting there staring into the void – she can’t read, doesn’t have a mobile, no radio or tv. So I say hi. She tells me it’s the second time she’s spent a day sitting and waiting.

    I wander down the corridor to find a nurse and politely ask what’s going on, mention the old lady. In an annoyed tone, I get told to stay in the waiting area and if anything happens we’ll be called.

    4pm, I get called for a pre-op consultation. In a broom cupboard. No joke. Apparently matching the number of active doctors with consultation rooms is not done.

    4.30, it’s all cancelled. Told to go home and I’ll get a letter when they want to reschedule it.

    I’m hot, dehydrated and annoyed.

    Next day, I went private.

  26. @ Passing By
    The NHS has already saved many £millions by getting volunteers to transport non-emergency patients to and from hospital in many areas. My mother-in-law was, until she became too ill to drive, a member of a group ferrying people to the various local hospitals and my parish church sends a round robin email whenanyone needs a list to hospital. These work without the need to pay for a taxi.
    The problem with “efficiency savings” is that the NHS has forgotten the meaning of the word “efficiency”.

  27. Passing By–120 thousand million is not underfunding in anyone’s book.

    The fact that it is poured down the drain into a shite soviet style system is the issue.

    As for 22 billion savings –not ordering a 12 billion IT system that never works would be a flying start.

    The 22 billion will not be an actual cut in their money. Just them being told no more cash despite ever rising demand.

    Start by bringing migration down to ..oh…say…zero. That’ll help. Then train our own staff not import the fucking UN. And train ours properly not two expensive years before nurses find out if they can cope with pain, blood and shit. And stop training female doctors who piss off to drop a litter after three years and either don’t come back or do so for half the hours.

  28. “The NHS has been told to find £22bn of “efficiency savings” so that it can meet increasing demand. Since that’s not possible, ”

    You don’t explain why it is not possible.

    My wife has worked for the NHS on and off for 20 years. She’s german and has that particular ethos. There are some good people there but there is a godly amount of wankers who the NHS is terrified of firing (you know, claims of discrimination, racism, etc, take your pick). So they cost the same as good people, except good people have to waste time covering the job those wankers do badly. Great for morale.

    Or take the consultants who charge the NHS for hours they do not do which apparently is quite rife. I think it is called fraud.

    Another simple example: in her field, you use radioactive markers. Those are useful on the day of the appointment for the particular patient, and if the latter doesn’t turn up, the markers go the bin. If they’d spend £30k on a secretary whose sole job would be to remind people to turn up and fill the empty slots, they would save millions.

    Just a few examples from someone who works there and who regularly blows off when confronted with such waste and inefficiency.

    I could go on with the examples I personally experienced, and since I’m not a big user, I assume they are widespread.

    So £22bn is certainly there. Were it that we got a government with some cojones.

    Instead, we get a minister for the lonely.

  29. My dad, God rest his soul, spent a number of years managing hospital purchasing and supplies. When he got there he discovered a culture where pilfering was considered a right and there was no accountability. Putting a stop to it involved receiving threats of violence. I suspect few of his fellow managers even tried.

  30. Passing By: ” The NHS has been told to find £22bn of “efficiency savings” so that it can meet increasing demand. Since that’s not possible…”

    Ha ha ha ha ha! Good one!

    Oh,

    Wait. Were you serious?

  31. monoi,

    “Another simple example: in her field, you use radioactive markers. Those are useful on the day of the appointment for the particular patient, and if the latter doesn’t turn up, the markers go the bin. If they’d spend £30k on a secretary whose sole job would be to remind people to turn up and fill the empty slots, they would save millions.”

    Employ someone? SMS messages sent the day before. Something my hairdresser and dentist both manage just fine. Huge success rate (reduces missed appointments by around 90% for a few pennies). And they don’t have anything like the scale of the NHS. You could run that for everyone in the NHS for a couple of million/annum.

  32. Passing By,
    “The NHS has been told to find £22bn of “efficiency savings” so that it can meet increasing demand. Since that’s not possible, I wouldn’t be at all surprised if someone has efficiently saved money by not employing anyone to stop the Patient Transport System falling over.”

    At a discussion on the NHS at last year’s Festival of Economics in Bristol, Prof Carol Propper a heath economist at Imperial College:

    Carol’s research interests focus on the impact of incentives on the quality of health care delivery and health system productivity and, more widely, on the design and consequences of incentives within the public sector and the boundary between the state and private markets

    made the point that the least efficient NHS hospitals are 50% less efficient as the most efficient, and that doesn’t say how efficient the most efficient hospitals are. She also made the point that if the efficiency of the poorest was raised to the efficiency of the best it wouldn’t solve the NHS’s long term funding problems.

    So yes, there is scope for efficiency savings, whether its £22bn I don’t know, but there is scope.

    If you think these are all neo-liberals you can listen to the full discussion here and you will find that they are all fans of the NHS, as was the very large audience.

  33. It’s possible to find efficiency savings in almost any organisation. Among other things, there’s always new technology available.

    However, you have to spend money to achieve these savings, which is difficult to do when under severe financial pressure.

    And there is no expert who says that £22bn is possible.

    Thanks for the link BiND. I note that “if you look at other countries in the developed world, not one system which is different to the general tax-funded system of the NHS is better in terms of efficiency…”

    (I recognized Propper’s name as a purveyor of low-quality social-science statistics.)

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