Just a bit of NHS trivia

When I was born, almost 50 years ago, in the bitter winter of 1963, the National Health Service was just 15 years old. It must still have been hard for people to believe that – for the first time in the history of these islands – they could fall ill without risking financial ruin, that nobody need die for want of funds.

That\’s also the first year that the NHS actually built a hospital. Before that it was simply using what others had built from private funds.

And as to not dying for lack of funds: what the hell does anyone think NICE does? Decides who will die for lack of funds of course.

It\’s a different method of taking the decision, sure, but it\’s the same decision being taken.

33 thoughts on “Just a bit of NHS trivia”

  1. The left want you to believe that if the NHS did not exist there would not be any health system in the UK. Which of course is bollocks.

  2. Regardless of one’s views on the best way of funding health in an advanced country in the early C21st the mere fact that many regard the NHS, in Monbiot’s words, as “one of the wonders of the world” demonstrates all too clearly the problems with implementing reform.

    It is also ironic that in most every other aspect of economics or public affairs, from energy policy to transport to taxation to financing small businesses, Monbiot will say “take off your blinkered parochial glasses and look to Sweden, Germany, Holland etc etc”.

    But strangely this advice never holds for running and funding a modern health service.

  3. The left want you to believe that if the NHS did not exist there would not be any health system in the UK. Which of course is bollocks.

    And that the only other health system on the planet is the USA’s.

  4. “Want of *personal* funds” is obviously implicit. If a pauper on the street or you or I or Ed Miliband wants a million quid treatment that will keep us alive for an extra ten minutes, we all equally won’t get it.

  5. I am not sure that works. Someone who is rich enough could afford to pay that million quid, so we still end up with the situation whereby some people will die for want of personal funds.

  6. “the first year that the NHS actually built a hospital”

    If that’s the West Cumbria, they’re about to knock it down.

    But even when built, it was only a replacement for an existing hospital, not additional provision. Indeed weren’t there more hospital bed places before the NHS than there are now?

  7. I remind you of my theory that the NHS became the state religion because its introduction happened to coincide with the wonders of antibiotics. For the first time in history physicians were capable of curing large numbers of people.

  8. P.S Before the NHS, people relied on the “panel” and on charitable hospitals. They rather get written out of the history, as does the Labour Partry’s reluctance to support the idea of an NHS, adopted only after the Cons and Libs had more enthusiastically taken up Beveridge’s notion.

  9. Reckon we’ll be getting a Lost_nurse finding us…..any minute…………now.

    Last time he/she answered the emergency call we got to discuss the helicopter enabled medical service we have down here. Luck would have it, Easter Sunday afternoon needed medical help in a hurry so rang them. When could they see me? Now. As I was down in the town, anyway, we opted for me visiting their medical centre a couple of blocks away & the doctor arrived as I did. 40 minutes of consultation & treatment & I got a bill, as a non-subscriber, of a hundred quid.
    The Tuesday I get a phone call. Do I want to become a member? Cost’s £200 a year & that would give me the equivalent of a GP service plus emergency/accident evac. The GP side comes to you, not you to it, 24/365 & they’ve a fleet of ICU ambulances & the chopper. This ain’t exactly the home counties here. We’ve a lot more vertical than horizontal, roundabouts. Sign up & they’ll even knock the hundred quid I paid off the first year’s subscription. No age limits, no med checks, nothing. Family cover would be £400.
    Now our positionally unsure nurse will tell us these people aren’t providing the service the NHS does with it’s hospitals & its labs & scanners & surgeons & all the rest of it. If I wanted that I’d need different cover. But it does give all the services that most of us need on a day to day basis. To our convenience not theirs.

    On other fronts, back in May last year got to see my old Mum for the first time for a few years. My father, not someone I like being in the same country as, had been hospitalised & the old girl’s well advance dementia. Flew up to sort home care arrangements. Noticed she was having trouble speaking, her false choppers were flapping about so much. Her face seems to have changed a lot & I don’t suppose she’s had them looked at for a couple of decades. Rang her GP & asked her if she’d noticed the poor woman can’t get a sentence out coherently? She’s been treating her for long enough. No. But maybe she should have. But. But.
    Now Mum’s in her late eighties & confused but the NHS does have a visiting service for folk like her so we get the ball rolling. Of course that’s not as simple as it sounds because the practice doesn’t organise it itself but expects the family to do most of it. Family in this case being 1800km away. Paid the helpful lady I’d organised to do the caring to process it. Contact the service. Get the GP to sign the forms & get them back to the service. Kept an eye on it from a distance. June, July, August, September. Carer, who’s now a fixture, is phoning the surgery, writing letters. Nothing happens though. Mum’s in a queue.
    Start of October we have another crisis. His paternal highness is ambulanced off to hospital with a broken arm & Mum with him because she can’t be left unattended. Rush of organising & get her into a residential home where she’s now permanent. Happy as a lark. Tells everyone her husband’s amongst the departed. Don’t blame her. Don’t think she’s nearly as confused as she seems.
    Father was out of hospital for a while with the carer attending but ended up hospitalised again just before Xmas & is now also in residential care. Different establishment, thank heavens. Whole financial shit’s been dumped in your’s truly’s lap so was up again March to sort lawyers, banks, broker, get the family home sold etc. Go see Mum & her choppers are still floating around her head.
    So we do a bit of investigating. Contact the surgery. What about Mum’s dentures, then? Not our problem sez they. Your mother was transferred to the nursing home’s GP practice. Talk to them. Have done sez I. They tell me she’ll have to go on a waiting list. So what’s happened to the waiting list she’s already on? She’s only 2 miles down the road. She’s not left the planet. Waffle.
    So as I’m UK side I shlep down the surgery. Beard the practice manager in her den. See if we can get some action here. Woman acts like she’s doing me a favour. We toddle down to the dental centre, conveniently in the same building although they don’t seem to have much affection between them. Pull the old girl’s card. There’s a written note on it says the dental service called at the house Oct 2, no one at home. Phone not answered. Well that’s bloody convenient. The old man was carted off accompanied by his beloved Oct 1. Checked with carer & we’ve no receipt of appointment letter, nothing on the answerphone service. Zilch. Load of bollocks.
    Since then, we’ve had a few exchanges of e-mails. I’ve been told about the swinging government cuts. What fucking cuts? This is 2nd quarter 2011 we’re starting from. Government had hardly got its office chairs warm let alone had the effects of its economies work through the system.
    So Lost_nurse. When you show up. Stuff your fucking NHS. Mum worked in an East End factory all through the Blitz to pave the way for you cunts. Slept under the kitchen table because the Anderson used to flood. Lost her brother in a Wellington. That’s how you treat her. I blame myself. Shouldn’t have even considered the possibility you’d come through with the goods. Should have gone private. Have done now.

  10. Worstall, what you right wing bloggers refuse to admit is:

    It was a labour government which invented insurance. Without which your house might burn down or you might have a nasty car accident, know what I mean?

    It was a team of Labour activists which discovered penicillin, the most proletarian of microbes.

    And surely everyone knows by now who was the inspiration behind the Leo do Copra character in “Titanic”? Nye Bevan, of course.

  11. That’s how you treat her

    I didn’t treat her, pal.

    FYI, one of the main criticisms of the current health bill is that it fails to address the ever-more yawning gap between health and social care. In short, hiving off profitable services will do nothing for elderly care.

    Family in this case being 1800km away

    Then perhaps you should adopt a rather more Spanish attitude, and have your parents move in with you. Or else move back here. Either way, don’t lecture me about your parents – when you freely admit to having not seen them for a good few years.


  12. BiS
    Sorry to hear about the ancestors. “producer capture” I think Tim would call it.
    A time traveller from the 21st century would be astonished to learn that the government manages 93% of education, 85% of health spending, etc.

  13. “In short, hiving off profitable services will do nothing for elderly care.”

    How can the NHS have “profitable” services?

  14. “. . .they could fall ill without risking financial ruin. . .”

    I suppose, unless they need care in exess of what the NHS judges cost effective – then to get it they’ll have to foot the bill for cancer treatment they’ve received in addition to paying out of pocket for the extra. Or if they’re a smoker, then they can just quit smoking or the doctor won’t treat that nasty broken foot.

  15. Lost_nurse.
    So I’m supposed, in your view, to come back & minister to their every need. Sorting out the details of health service bureaucracy it can’t do for itself? So why have they been paying for the NHS? Remember, my old man’s a higher rate tax payer. Top rate at one point. Lot of dosh gone that way. For what? Currently we’re financing £1300 a week nursing home bills. That’s a WEEK not month. And I’ve got to apply for an exhumation order to get my mother a dental fitting.
    Fuck off.

  16. To add to the above & since you’re about perhaps I should explain why I’m so mightily pissed off with you & your cronies. You see as far as I’m concerned you’ve form for this. A neat 2 out of 2.
    Before I finally left your miserable shores I had a run in with your bloody awful service myself.
    At the time I was moving about a bit. Between addresses. Popped into a nearby hospital because I’d got a little lump come up & my GP of record was 60 miles away & the last time we’d had a drink together he was discussing retirement plans. Trinidad might have been a tad out the way. Little lump got a file entry of suspected cancer all of it’s very own. Urgent.
    So like I say, I was between addresses so they got a Bayswater hotel I’d be for the next fortnight. Went for tests. By the end of the week I’d rented an apartment back near the hospital & convenient to Dover & wondering if I’d survive long enough to move to France. Wish I had done & signed on at Lille General.
    You see, you’d think phoning the first hospital & advising change of address. Doing the same with the department of the hospital did the tests. Writing to both. You’d think that’d be enough wouldn’t you? Not for the bloody NHS it isn’t.
    That was end October. November came & went. Seem to remember phoning around in December being referred to dept after dept till I’d done in £25 worth of phone credit & the battery without joy. Xmas’d over in France then jumped the ferry back & drove over to the testing hospital where the specialists lurked. Did some heavy work on the receptionist till we come up with the answer. Admittance notice for surgery was sent to Bayswater hotel. Late November. That was the address they had directly above, below, next to….(who knows) the changed to address. Same file that told her surgery was cancelled due to lack of response from patient.
    So we begin the process for urgent surgery all over again. That was a doozy. I really enjoyed the 80 mile drive I did for the blood tests that when I got there I was told should have been done at the hospital I’d driven past as I left home. The results of which they still didn’t have a week later when I went into surgery.
    D’y know something? When I went back to have the stitches out they wanted me back to see if the op’d been successful. Look I survived. That’s enough.
    It’s not that the theory of the NHS is a bad one. It’s the practice. It’s what my northern neighbour said above. Producer capture. It’s not run for the benefit of the patients but for its own. That hospital dept I went to had four receptionists. I counted them. Four. The crush round the coffee maker was brutal. I also counted 2 nurses & the doctor I saw. The ward only had 8 beds. When you arrive you find your one of a dozen people with a 9 o’clock appointment. By the time you’re seen you’ve run up a £6 parking charge & close to lost the will to live. But they’re deeply concerned you don’t smoke within 5 miles of the hospital or in any way disturb the staff’s social life or in any way ruffle their feelings.
    Like I say, fuck the lot of you & the horse you rode in on.

  17. b i s

    Your experience is the kind that happens all too often in the NHS but it isn’t all about producer capture by any means, at least not from the medical staff, it’s the lousy and sometimes corrupt bureaucracy that is the main culprit. My sister works in that very unfashionable area mental health, her recent experiences have been horrendous, her department which was functioning properly and meeting its budget has been completely fucked by the incompetence and probable misappropriation of funds of the local trust, which was already failing when for some inexplicable reason it was allowed to take over the neighbouring trust which contained her department. I could say more but I don’t want to risk identifying the place concerned, suffice it to say that it’s in one of England’s poorest areas and is now faced with probable closure and the total loss of the service as it isn’t a statutory requirement. It is things like this that doom Lansley’s reforms to failure, attempting to fiddle about with the structure of a dysfunctional organisation can’t work, it can only risk bringing the whole thing down, how we reform and improve the NHS I have no idea but I don’t believe anyone else has either and talking about producer capture – the ‘right wing’ approach or the ‘left wing’ one of preserving it in aspic and elevating it to secular miracle are equally useless.

  18. BIS,

    I’ve just finished a 12.5 hour shift, and I’m not going to sit here and argue about either your mum’s dentures, or receptionists you’ve done battle with. I work in emergency surgery, where we look after patients who are often in a very bad way. If you or your kin are in our care, and we fcuk up, feel free to broadcast it from the rooftops. Until that point, quit casting aspersions about how I’ve failed your parents.

    And spare me the Blitz stuff – I agree entirely that Britain owes a debt to the WWII generation (half my lot never even made it back alive), but I don’t see much evidence that we as a society are prepared to put the necessary graft in. The shortfall in elderly care provision (and the increase in onset dementia) is probably the biggest single challenge for the NHS. Has Lansley used his grand re-org as an opportunity to address this? He has not.

    the total loss of the service as it isn’t a statutory requirement

    There is going to be a lot more of this.

    Tim adds: Given that this is my blog I’m allowed to add my opinions here. Emergency surgery, “stat, theatre now” is one of the things that the NHS does really well. I have a feeling, but cannot prove, that it’s one of the things that the NHS does as well as, if not better than, any other health care system on the planet.

    For it’s one of the very few that looks at the right here, right now, requirements of treatment. Not at payment methods, insurance coverage etc.

    Now, having said that: the NHS is, as far as my experience goes, entirely crap at treating anything that is not “right now, death immediate”.

    Which is something of a problem as, yes, we’d all like a really good A&E, but the vast majority of health care isn’t A&E, is it?

    And I’ve no problem with the NHS method of A&E: I just want all the rest of it sorted out.

  19. Tim
    The part of the NHS that my sister works in isn’t emergency care but without going into details is important and it’s loss or malfunction has a wider impact than just the immediate detriment to the patients who are in no position to help themselves, it isn’t an area that the private sector is ever likely to be interested in either. As I said her department was functioning well and within budget, now it’s shafted. This isn’t a direct result of the ‘reforms’ but it has come about through the cost cutting and bureaucratic turf wars that the politicians and their mates excel at, asking the same people to come up with market led reforms and in areas where proper markets can’t even function is just wishful thinking. I have a lot of sympathy with lost_nurse in this.

  20. is one of the things that the NHS does really well

    A number of the team where I work are not long back from Camp Bastion – perhaps the place for skilled emergency care. When I keel over, I want to be staring up at their ugly faces.

    I just want all the rest of it sorted out.

    Well, you & me both – with the caveat that Franco/German style systems will require added investment, and that the challenge of elderly care is going to require a major shift in attitude by everybody. As it is, I suspect the incumbent political class would piss themselves with fear if they had to work a shift in a nursing home.

    Anyway, I’m outta here. Peace be upon BIS – I’m getting too old & tired for arguing on the internet.

  21. I have a lot of sympathy with lost_nurse in this.

    Thanks. Acute & community mental health services in my area are becoming increasingly ragged (with knock-on effects elsewhere) – your sister certainly has my sympathy.

  22. I agree with Tim – The NHS is brilliant at patching you up if you have bits hanging off, blood pouring out of holes, and are at deaths door. Anything else that doesn’t fall into the ‘Fix this NOW or the patient dies’ category just gets lost in a bureaucratic maze. Very few get out quickly, some get out in reasonable time, most take longer, some a lot longer, a few don’t make it at all.

    That was my experience with my Father’s heart problems. You collapse with heart attack, the NHS swings into action and keeps you alive. Once they’ve stopped you dying, and you can be shoved out home again, they lose interest in sorting out the whys and finding any solutions. A constant stream of consultations, waiting for tests, waiting for results, waiting to see specialists, who want more tests, and the whole thing goes round and round in circles, until you have another episode, and the NHS does its ‘envy of the rest of the world’ schtick again.

    Fortunately for my Father he had the money to pay for a heart bypass when he needed it, not when the NHS was prepared to give it to him. Similarly with his recent pacemaker fitting.

    I just feel sorry for the vast majority of people who don’t have that luxury. They deserve better than the NHS.

  23. And from the positionally challenged nurse we get the standard response to any criticism of the NHS. Let’s get the violins out for the backing track, shall we?
    This is what you get anytime anyone suggests doing anything to sort it. The dedicated professionals selflessly striving long & unsocial hours….yada yada yada …defence. Close conversation, critics depart to boos & hisses.
    D’y know something? You’ve just come out with the line I’ve heard in every department in every company I’ve ever worked for. Heard from every part of every company I’ve ever had to deal with. We’re working our fingers to the bone here. Not our fault. it’s a variation on the riff the practice manager of Mum’s GP was playing. You get the same reply, pretty well word for word, I gave her.
    You’re part of a service that’s paid for by your customers. Your my point of contact with it & they’re paying you. I don’t give a monkey’s fuck about your problems. I’m only interested in my (or in this case Mum’s) problems. You sort it. If you don’t regard it as your personal responsibility, good. It certainly isn’t mine so I suggest you find who in your organisation is responsible & kick their arse like I’m kicking yours because, believe me, if I have to come back again I’ll be kicking yours a lot harder.
    Now on the merits of Lansley’s proposals I personally haven’t the vaguest. Not my country now. Not my problem. But there’s been umpteen attempts to do something about the NHS and every single one of them has been greeted by the same violins & rattling of the begging bowl. Last bunch of idiots to run the country tipped so much gold into it s’wonder it didn’t fold space in around itself & collapse into a black hole. Or maybe that’s what it’s been all along.
    Let’s return to Mum’s erratic choppers for a moment. Time I’ve spent chasing the issue, time I’ve paid the carer to, if I was billing that at my usual rates I’d be invoicing north of £500. On the other, the GP’s, side; fielding the phone calls, letters, e-mails (last one came back, printed out, would have filled four pages) At the exorbitant rates anything to do with health care seems to bill at, the cost might be even more. YET TO DATE, AFTER TEN MONTHS, NOTHING WHATSOEVER HAS OCCURRED WITHIN MY MOTHER’S MOUTH!!!
    Or at least as far as the health service is concerned.
    Do you not think that is telling us something?

  24. Do you not think that is telling us something?

    Do some light reading: NHS Dentistry has (largely) gone the way of the Dodo – why the fcuk are you blaming a surgical nurse for that? As for exorbitant rates – just wait until GP consortia are permitted to behave (i.e. charge) like dentists.

    You’re part of a service that’s paid for by your customers

    Quite so, and I do my job properly. In surgical admissions, that is – not in your mum’s GP Practice. Or at her Dentist. Observe the distinction.

    As for playing the violin: bollox. I’m merely suggesting that after a long day at work, I’m in no mood for listening to you moan about your parents’ welfare – here’s a thing: in the future, visit them more often.

    Enough already. Adios.

  25. Tesco employ nearly 300,000 staff in the UK not as many as the NHS to be fair (1.43 million) but not a workforce to be sniffed at either. A lot of people working very hard to ensure that their shelves are stocked with vital supplies of food for the nation. If Tesco’s shelves went empty, there would be riots in the streets, so its quite important work.

    Now lets examine the response to a bit of criticism of such an organisation. If accused of some fairly minor failing, of the sort that will undoubtedly happen in even the best regulated environments – a mum finds half a dead mouse in her loaf of bread say. What do we hear? Do we hear the union of shopworkers representative going on local TV and decrying the complainant as denigrating the hard work of all his members in providing mouse free bread to 99.9999% of customers? That she should be count herself lucky to have any bread at all, even with a bit of free mouse thrown in? Does the local MP make a speech on the House about the wonderful work that all the Tesco employees in his or her constituency do? Does our mouse finding mum get fobbed off with a special Tesco investigative committee, who never admit anything, ever, under any circumstances? Or ever apologise unless forced to by the courts?

    I think not. Management are desperate to placate said unhappy customer, offer free goods, a fulsome apology, and when all the dust has died down, to kick some serious ass in the bakery dept (or kick the suppliers ass from here to next Tuesday) to ensure such a bad piece of PR doesn’t happen again.

    Would that the NHS had similar reactions to criticism of its failures. I wonder why it doesn’t?

  26. Incidentally, if anyone thinks Mum’s dental problems are trivial……they are.
    I’ve just read Tim’s post above & I wholeheartedly agree with it. I’ve been through A&E. Died in it briefly, I was told.
    Doesn’t alter my view that it’s one of the bits the NHS hides behind whenever the rest of it comes under scrutiny.

  27. Jim.
    So why if the Lost_nurse is so proud of his/her contribution is (s)he so ready to defend the rest of it?

  28. And if he/she returns.
    “Do some light reading: NHS Dentistry has (largely) gone the way of the Dodo – why the fcuk are you blaming a surgical nurse for that?”
    I’ll tell you why.
    Because I don’t give a fuck about your services internal structure, problems, who works doing what where or the rest of it. Nothing to do with me. A far as I’m concerned your my point of contact with the system. Like the lass on the customer service desk at Tesco. If I’ve a mouse in my loaf it’s her problem. I don’t want a lecture on baking practice.
    You don’t like having your arse kicked? Then go kick someone else’s. But don’t diss the people who pay your wages.

  29. A far as I’m concerned your my point of contact with the system. Like the lass on the customer service desk at Tesco. If I’ve a mouse in my loaf it’s her problem. I don’t want a lecture on baking practice.

    Which makes you an arse. When I deal with the poor sods in customer service for dysfunctional organisations, I always try extremely hard to remember that it’s not their fault and that my problem is with the high-paid arseholes who specified the stupid system that’s shafting me, not the girl on minimum wage plus a couple of quid who’s set up to take the blame…

  30. Sorry John but no. The point of contact is where the employee is representing their employer. If the customer’s dissatisfied it’s not the customers fault it’s the employer’s.
    “not the girl on minimum wage plus a couple of quid who’s set up to take the blame”
    Then don’t do the job.

    Something I used to tell my guys. A customer complains, listen to the complaint, ask what they wish to be done to rectify the situation & apologise that the customer has reason to complain. Never, ever, get into a discussion about who did what, who’s fault it was etc. You’re a representative of the firm. We are all jointly responsible to the customer & the customer is where we make our living. If there’s been a failure we’ve all failed. Who’s to blame, what went wrong are internal matters to the company. Not the customer’s problem.

    Apologies to Tim & anyone else. Had about enough with all things NHS these last few days but doesn’t excuse.

    Just to clarify what I’ve been trying to say.
    The NHS seems to play a clever ploy when criticised. When an individual fails it almost impossible to get them to take responsibility. It’s always the system’s fault. Yet if you criticise the system it dodges behind the few bits of it that work pointing at them & saying “But if you change anything you’ll lose this.”
    My beef with lone_nurse is he/she is facilitating this because A&E is one of those bits. Now I’ve a lot of respect for what he/she does. But it’s a skillset. There’s a lot of people post here with skillsets. It’s because there are, we’re not living in mudhuts scratching at the ground.
    If you’re going to separate the wheat from the chaff. Support those who do great work Kick the asses of those who don’t. Get rid f those that are more trouble than their worth. Then the wheat has to be willing to be separated from the chaff. Not support it.

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