Blimey

In my own experience, those who laud the NHS have rarely experienced it in its full splendour.

I’m reliant on patient transport nowadays and I can tell you, it’s a nightmare. They turn up at your house when it’s convenient for THEM rather than you. You arrive at the hospital whenever they get you there. If you cancel the transport because your appointment has been cancelled they usually still turn up.

Spud is doing what has become his specialty, honed over years of practice, of talking out of his arse about something of which he has no experience. I sense an award coming on if anyone notices him…

Thank Crunchie It’s Thursday…

As the Guardian has reported in a newsletter this morning:

Wes Streeting has decided it’s time to bring [a] competitive edge to the NHS. Yesterday, the health secretary delivered a “bullish” and contentious speech confirming the government will publish a league table ranking hospitals in England, after a “no-holds-barred, sweeping review” of NHS performance. Those at the top will be rewarded with more funding and autonomy, while those at the bottom can expect “turnaround teams” and sackings.

Streeting’s statements follow an independent review of the NHS that found hospital productivity has sharply declined in the past five years.

In fairness I think this idea is vaguely ludicrous – and the notion of a ‘hospital League table’ might work in a system like the US where you (at least in some regions) have competitive healthcare but with a largely monopoly supplier I don’t think it will make much difference

Let’s ignore the fact that ‘productivity’ in the NHS is an almost meaningless measure that is heavily distorted by the prosperity of the area being served because the wealthy are healthier, are more disciplined with regard to healthcare, and even tend to turn up to appointments more often (because, for example, they have their own means of transport and are not dependent on buses that do not run) than those in lower-income areas. Streeting should know that but clearly does not realise that if there’s a decline in NHS productivity, this is a major cause of it.

It is a meaningless measure. Productivity in the NHS is absolutely shocking – non-existent in many areas. Heavily unionized, deeply regressive, wedded to 70 year old ‘Spanish practices’ as a manner of course – it’s as close to Zero as you can realistically get.

Instead, let’s look at the stupidity of Streeting’s proposal, which produced wholly negative outcomes when Alan Milburn last introduced it as Labour health secretary about twenty years ago and is now being introduced again because Milburn is now back at the Department of Health as a non-executive director and advisor, and has nothing more to contribute now than the crass ideas he rolled out and failed with last time he was near the place.

I am guessing Milburn and other New Labour holdovers are the driver here for sure.

What will this league table measure:

The relative poverty of areas served

That’s actually likely to be the outcome I’d agree

Tory bias over the last 14 years in better-funding Tory voting areas

I think the NHS has been showered with money across the Board. It’s budget is higher than the entire Government of New Zealand.

The difficulty of meeting needs in areas left devastated by Tory austerity

There was no austerity. Taxes are the highest they have been since the 60s. There is no money left to eke out of families destroyed by governmental incompetence, high inflation and murderous levels of tax. Despite ridiculous documents like the ‘Taxing Wealth Report’ put together by malevolent ‘academics’ whose credentials are fraudulent and who are utterly dishonest grifters wedded to absurdities like ‘Modern Monetary Theory’ which posit that money can be created with no limit and no inflationary impact. An idea which conventional economics has thoroughly discredited.

The consequence of that austerity on the lives of millions

Taxpayers and private sector workers face absolute penury as a result of this profligate spending I agree. Austerity is a myth.

So what does Streeting want to do with his ‘league table’? He wants to reward prosperity and punish those seeking to do what Nye Bevan always wanted – which was to deliver healthcare to everyone, whoever they were and whatever their means might be, even though healthcare for those with the least is often the most expensive care to provide.

Well perhaps we should stop providing private healthcare for Asylum seekers – maybe that’s a good place to start?

Rightly, NHS staff are furious.

Noone has a right to be upset at the government. At least that’s what you said about the June Rioters and those farmers who were angry at the inheritance tax reforms?

Rightly, they know this will unfairly punish them.

How will they be being punished precisely?

Rightly, they know that this will increase health inequality – and so other forms of inequality – in the UK.

Is there anything these people don’t know other than how to run a healthcare system?

And rightly, they did not expect this from a Labour health secretary.

What did they expect from a government which is already comfortably the worst in human history and which sinks lower each day?

But then, Wes Streeting is LINO (Labour in name only) and about as much a socialist as David Cameron ever was.

It takes a special kind of lunacy to think a Government which makes North Korea look far right is not ‘Socialist’.

It appears that lacking imagination, not caring, and being utterly indifferent to the harm you might cause by your actions are the qualifications for serving in Starmer’s cabinet. Streeting stupifies those who do.

I think you meant to use the term ‘ personify’ not ‘stupefy’??

’…and even tend to turn up to appointments more often (because, for example, they have their own means of transport and are not dependent on buses that do not run)…’

Then find there’s no room in the car park when they get there?

And how many missed appointments are due to this, and not due to people not even setting out at all?

The outpatient department my wife visits does not open on Mondays. This does not stop the people who send out the appointments from booking her in on Mondays. She has twice turned up to find the lights out and the doors locked. Now having learnt the hard way, if she receives a Monday booking she phones up and get it rescheduled for a day when they are open…… the only problem is that they don’t answer the phone and the online system is rarely available.

It would not surprise me if they classify the times people turn up on Mondays as patient “no shows”, which is technically true due thanks to the locked door.

I have noticed that insurance companies are now offering online GP and medical advice for free as a perk of the policy. I have accidental insurance and last year when I received the renewal notice I was informed that I now have free online medical consults as a perk.

I also get this with my employer BUPA healthcare.

These consults are OK. Not fantastic but easier than trying to get a GP appointment since my local GP does not do advanced appointments. You have to phone up on the day and hope you are the first in the phone queue. There are times when I wonder if we are slowly being eased into a insurance based model of healthcare.

Productivity in the NHS.

In my experience, sitting in waiting rooms, watching proceedings and being treated, you can generally judge staff productivity by arse size, speed of walking (or shuffling, i.e. air of urgency) and the presence of that suspicious, resentful, entitled facial expression habitually worn by a certain demographic.

Did spud just take a pop at public transport?

“Then find there’s no room in the car park when they get there?”

My local hospital decided that they would change the payment method for their carparks from a ticket and cash/card one to an APNR system. They forgot that the latter would not allow anyone into the carpark if there wasn’t a spare space, once the carpark is full its one in/one out only, while the old one let anyone in, and out again if they couldn’t find a space, meaning there was more flexibility in the system. The new system now means that at high traffic times there is a queue of cars waiting to get into the carpark, which as there is only one road into the hospital site soon means the entire road network is gridlocked. People who are just heading for the drop off/pick up point are caught in it. It even spreads back out onto the major A road the hospital is located on. They’ve been reduced to sending out people to direct traffic at the worst times. And people are missing appointments because they can’t even reach the hospital. But of course there’s no remorse at all, all the hospital have said is ‘Its OK, ambulances can get in another way’.

“and even tend to turn up to appointments more often (because, for example, they have their own means of transport and are not dependent on buses that do not run”

That is bullshit. The poor tend to live in the middle of towns, and because they use cars less have very frequent buses. From the council estates to the hospital here, there’s a load of services that run and you can almost certainly get a bus every 10 minutes.

You talk to hospital nurses and doctors, they’ll tell you about how it takes 15 minutes to get into a computer system, how slow a lot of them are. Or look at how much the NHS is spending on solar roofs for car parks or hospitals. Many of which will never make the money back.

Or this: curved fucking buildings, solar panels… on Orkney: https://www.bbc.co.uk/news/uk-scotland-58928932

He thinks that his questions about Bitcoin show off what a deep thinker he is. They could all be answered with a few hours of research, but why do that when you can claim to pose deep questions.

What is amazing here, and we should all take a moment of peace to contemplate the miracle – this appears to be a subject that the polymath of Ely claims no expertise in.

Expect his expert analysis of crypto tomorrow

All were “appointments” invented after the fact by the NHS. Who was playing what game is a mystery to me – maybe just simple cover-my-arse? But it’s pretty stupid to write someone an appointment letter, fake the date on the letter so that it precedes the appointment,
I had similar with my late mother’s GP. I went over to England to sort out the mess resulting from my late father’s fall, which put him in hospital. Social Services had adjudged her incapable of looking after herself & installed her in a care home. So I was interested in when the GP who she’d been registered with for over a decade had last seen her. Information I’d been trying to establish my previous trip over since it seemed to have been not. So I went & saw her GP. Who told me that a visit had been arranged, which by some stroke of fortune coincided with the day of my father’s fall. When he was carted off off in an ambulance & she to the care home. The GP showed me the appointment book as evidence. And there it was. Written in a different hand from all the other appointments, out of sequence, with a different coloured biro & a note against it, “No one at home”. But certainly no letters in the house advising of an appointment for that day.

I have been prepared to give Labour a half chance at at least doing something about the NHS, as clearly the Tories couldn’t – against the MSM, the Unions and the Left generally. We’ll just have to see how far the Lefties can get. Let’s not forget that their electorate are as frustrated by all the NHS issues as are other voters (except, of course, when the voters are NHS employees!)

Personally, I have experienced both the good and the bad in the NHS. The good is those people whose professionalism is evident – at all levels. The bad is a function of management and the sheer ‘don’t give a shit’ behaviours of members of the huge bureaucracy.

Sadly, some members of the public really don’t help. I once waited at the GP’s reception while the receptionist explained over and over again to an old biddy why she couldn’t get a prescription for Paracetamol. I’m sure that you would get one for huge quantities, but for the odd packet, no. I’m in the ‘free prescriptions due to age’ bracket, but I wouldn’t mind paying something – the problem being that I’m not volunteering to pay nearly ten quid for stuff that doesn’t cost anywhere near that on the Internet (and trust me, I’ve looked).

Recently, I was writing my autobiography. I remembered the only 2 times I went to a doctor’s surgery when I was a child. Mostly, the GP came to my home. The past truly is a foreign country.

We moved house, and a hospital where the late Mrs Nerd was having scans was suddenly 30 miles away rather than 12.

The NHS paid £150 a time for her to have a taxi.

Because none of the NHS Patient Transport drivers work after 5pm.

Like many I have had widely differing experience of the NHS

GP services are completely useless and misdiagnosed my cancer

The only time in the last decade when they were acceptable in my area was when a private clinic was contracted to pro ide primary care. The local NHS closed it down so 12000 residents now have to share two GP surgeries along with all our temporary visitors during holiday periods

Cancer care has been excellent. Two surgical procedures , follow ups, CT scans and immunotherapy. All appointments on time , no faffing about and what they said they would is exactly what they have done, updating me as they go and consistent use of the NHS App

My dad’s cancer care was also excellent

It all seems to be a lottery

Best thing Labour could do is use the functioning bits of the NHS to sort out the poor bits

Not looking to defend him – he expresses himself clumsily.

But if a GP works X hours, is his/her output (eg number of patients seen in that time) dependent on the level of ‘no shows’? Won’t a GP with a high level of no shows will be shown in the numbers as being less productive than another with a low level of no shows – through no fault of the GP?

Since he can’t apparently get his head round the concept of a token of value, V_P, I wouldn’t hold out much hope he’d understand the answers to his questions.

Is he really saying that public transport – run and funded by the government – is unreliable enough to skew NHS stats . . . therefore we should have the government run more things?

BIND, the same kind of excellent service is what we get in Hornsea in East Yorkshire. Still not quite up to the standard that Max and Millie enjoy from the vet though. If the rest of the NHS was up to this standard there would be no complaints.

Murphy failed to mention that better off people tend to take more care of their diet, go to the gym, moderate their alcohol intake and are less likely to smoke. Basically doing voluntarily the things that Spud would like to force everyone to do by law.

“I wonder how much of this is the age profile, Dorset being well know for its older population and survivor bias? Maybe our expectations are more realistic or maybe we are politer and so get better responses from staff?”

I’d be interested to see whether there is any correlation between the efficiency of an NHS Trust and the level of ‘diversity’ in the population it pulls its employees from.

“I tend to think that any system will be colonised by politics. Just because those who would control will go where the levers of control are.”

Well in that case better not give the levers to people that we the public can’t vote out of office. The pols may be sh*t at running things, but at least they are boot-out-able. Fat Arse Bailey isn’t.

Starfish,

“It all seems to be a lottery”

The public sector is full of a variety of people in my experience. Some are fantastically lazy, or spend their day trying to chase pussy, or do fun things. Others are really good, dedicated people who just believe in helping people and work hard at it.

In the private sector, you get two things. The fantastically lazy people get fired, the dedicated people get promoted. Someone who has figured out how to say, run a hospital unit efficiently gets brought in to tell another hospital unit how it’s done.

There’s no version of the McDonalds binders in the NHS – this is how you do this. The downside of huge organisations is all the bureaucracy but what you’re supposed to get as an upside is that very good processes get replicated. The NHS is the worst of both. It has all the bureaucracy, but no-one goes and asks the guy that runs the Oxford Eye Hospital to come and explain how to set up an efficient hospital unit.

Those letters that arrive after your appointment also tell you how many hundreds of pounds missed appointments cost the NHS.
Yet when you actually get to see a doctor it’s an hour later than scheduled because he’s booked too many appointments.
However, the NHS is seeing fewer patients today than in 2019, at an extra cost of 40 billion or so, so in accounting terms maybe missed appointments are really costly.