NHS is finished.

The NHS has been run into the ground, while stealthy privatisation has helped put up costs. Now we have not only the impact from Covid (still putting pressure on hospitals) but overseas staff leaving, and support staff leaving for better paid jobs.

I am sorry that your mother was diagnosed at a time when the role of carbohydrates was not taught well to GPs or T2 diabetics. Those of us diagnosed more recently can often avoid the deterioration associated with the old diet advice. However, in addition to whatever she needs to help with her current health issues cutting carbs can probably help avoid things getting worse?

13-14 hours in ambulance outside A&E?
That's awful.

MrsA2 said:

13-14 hours in ambulance outside A&E?
That's awful.

Click to expand...

It is awful and becoming even more common down our way as well. It’s not unusual to se 6 ambulances outside a and E waiting. Two problems, one with people going to a and E inappropriately (I don’t mean those in the ambulances) and secondly nowhere to transfer patients to after assessment in a and E. I don’t know what happened in English trusts but the Welsh hospitals went through an exercise to reduce beds and therefore increase bed occupancy a few years back. Now it means hospitals don’t have the capacity for busy periods and no suitable social care to transfer patients on to so poorly people are left waiting for hours for beds.

MrsA2 said:

13-14 hours in ambulance outside A&E?
That's awful.

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Sadly not unusual atm.

And even once you get into a & e the wait for a ward bed is ridiculous. In sept it took me 14hrs to be moved onto a ward and an older (60’s) relative with pneumonia was sent home alone without support after waiting unsuccessfully more than 48hrs for a bed just last week having previously been told he’d be admitted for a week.

Well ....I can offer up a 21 hours sat in a hospital wheel chair after having to be readmitted after my wounds got infected after my accident .

And that was after spending several hours prior in and out of the A&E assessment area.

Our downstairs neighbour, a few weeks ago felt unwell.
Lass next door explained she had seen him on our front steps, half dressed (a cold morning) been waiting 6 hours for an Ambulance.

When it arrived, he cardiac arrested several times..before heading to the hospital.

Sadly he passed away.
RiP my friend.

Would an earlier ambulance have saved him .?

So yeah, it's not great ...but we are SO blessed that in our hour of need once we get to hospital the care we get is given regardless of our social status or ability to pay.

God alone knows what my treatment cost
5 ops & a month in hospital.

The idea we move to a US system that bankrupts tens of thousands every year must, in my opinion be resisted to the full.

My sister is an A and E consultant reports that things are bad now with an acute problem caused by the inability of the wards to discharge healthy people to appropriate care. The covid policies e.g. restricting access to services and sacking unvaccinated 40,000 carers (note not the disease) itself ) have resulted in higher excess mortality from all causes NOW and disease and shown how frail the NHS is though it does totter on.
I feel that the NHS is dying with a whimper not a bang simply because those that can afford to will opt out along with burnt out staff overwhelmed by unceasing demand. At this stage the bogeyman of the American system is always raised and stops us from discussing the underlying issues for example , what health care can be funded for an ageing and chronically ill population? Can we do anything to reduce that demand (as we are trying to do on this forum!) ? Or zooming out how can we make better lifestyle choices easier - integrating social care with health care to reduce the vulnerability of the poor to worse outcomes. The US has a terribly performing system but other countries that run an insurance based system perform better on similar investment.
I'd vote for a party that put some real options on the table rather than just mouthing platitudes about 'our NHS' etc. then throwing more money without apparently tackling the underlying problems.

NicoleC1971 said:

My sister is an A and E consultant reports that things are bad now with an acute problem caused by the inability of the wards to discharge healthy people to appropriate care. The covid policies e.g. restricting access to services and sacking unvaccinated 40,000 carers (note not the disease) itself ) have resulted in higher excess mortality from all causes NOW and disease and shown how frail the NHS is though it does totter on.
I feel that the NHS is dying with a whimper not a bang simply because those that can afford to will opt out along with burnt out staff overwhelmed by unceasing demand. At this stage the bogeyman of the American system is always raised and stops us from discussing the underlying issues for example , what health care can be funded for an ageing and chronically ill population? Can we do anything to reduce that demand (as we are trying to do on this forum!) ? Or zooming out how can we make better lifestyle choices easier - integrating social care with health care to reduce the vulnerability of the poor to worse outcomes. The US has a terribly performing system but other countries that run an insurance based system perform better on similar investment.
I'd vote for a party that put some real options on the table rather than just mouthing platitudes about 'our NHS' etc. then throwing more money without apparently tackling the underlying problems.

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The bed blocking existed long before covid. In 2014 my father “bed blocked” due to lack of appropriate social care for his ongoing needs. The consultants were extremely clear at the time of their frustrations in the system. It has only got worse for a whole variety of reasons. The pandemic has brought into sharp focus many issues that were swept under the carpet previously

The desperate need for social care (anyone else remember convelesant cottage hospitals?) is the crux of so many health care issues - alongside the chronic need for long term health crisis prevention policies that extend beyond the term of whatever government holds the reins (not just the weeks or months of recent times but proper long term beyond a few years)

MrsA2 said:

13-14 hours in ambulance outside A&E?
That's awful.

Click to expand...

I am afraid as awful as it is, it has been bubbling under the surface long before the current situation. I recall my relative waiting in a corridor, in pain suspected peritonitis, burst stomach ulcer and it was only because at the time I worked for that particular NHS hospital and kicked up one hell of a fuss, threatened to expose the situation that they relented and found a bed on a ward. What I want to know is whats happened to the bed managers, they made sure beds were available even if it meant playing musical beds! Closing the cottage hospitals and not having patients transferred to these hospitals etc has added to the problem, lots of other problems have attributed also and I just cannot see a good ending with the nhs.

NicoleC1971 said:

My sister is an A and E consultant reports that things are bad now with an acute problem caused by the inability of the wards to discharge healthy people to appropriate care. The covid policies e.g. restricting access to services and sacking unvaccinated 40,000 carers (note not the disease) itself ) have resulted in higher excess mortality from all causes NOW and disease and shown how frail the NHS is though it does totter on.
I feel that the NHS is dying with a whimper not a bang simply because those that can afford to will opt out along with burnt out staff overwhelmed by unceasing demand. At this stage the bogeyman of the American system is always raised and stops us from discussing the underlying issues for example , what health care can be funded for an ageing and chronically ill population? Can we do anything to reduce that demand (as we are trying to do on this forum!) ? Or zooming out how can we make better lifestyle choices easier - integrating social care with health care to reduce the vulnerability of the poor to worse outcomes. The US has a terribly performing system but other countries that run an insurance based system perform better on similar investment.
I'd vote for a party that put some real options on the table rather than just mouthing platitudes about 'our NHS' etc. then throwing more money without apparently tackling the underlying problems.

Click to expand...

I'm sure there are other alternative systems that MIGHT be acceptable.

However having watched this governments handling of the covid crisis.

This is NOT one I'd ever trust again to spend our money wisely.

Rock & a hard place, but I'd prefer a better NHS system fully implemented across the board, as noted social care and releasing the well enough not to be in hospital to go home & be cared for properly.

Would that ever happen, next govt maybe or the one after .

Sad truth is once the NHS as we know it is gone, it won't be coming back.

And whatever is left in place is what has to serve us all

Young & old
wealthy & poor
Sick just now or chronically sick.

A very tall ask.

Lainie71 said:

I am afraid as awful as it is, it has been bubbling under the surface long before the current situation. I recall my relative waiting in a corridor, in pain suspected peritonitis, burst stomach ulcer and it was only because at the time I worked for that particular NHS hospital and kicked up one hell of a fuss, threatened to expose the situation that they relented and found a bed on a ward. What I want to know is whats happened to the bed managers, they made sure beds were available even if it meant playing musical beds! Closing the cottage hospitals and not having patients transferred to these hospitals etc has added to the problem, lots of other problems have attributed also and I just cannot see a good ending with the nhs.

Click to expand...

We still have bed managers and a local cottage hospital. Sadly cottage hospital runs at full occupancy and another bottleneck as social care beds are in decline as people improve but are unable to self care. Situation predates Covid.

It's all just beyond

Grant_Vicat said:

I think being aware of the bogeyman is vital if we want people to address this issue meaningfully. I remember when the system was controlled by the Ward Sister, who would oversee the Staff Nurses , who would then delegate to SEN and SRN nurses. Although this meant people were personally accountable, the management was tighter and more efficient. It might not be fashionable, but this would surely be a start to keeping costs down. I also feel that as a diabetic, I was entitled to any medication on prescription and was actively encouraged to do so was absurd and costly. If the majority of taxpayers were assured that their money was going to be spent on keeping a nobly conceived idea running, I'm sure they wouldn't begrudge a small rise in taxes. But as said above, I wouldn't trust any of "our chosen honourable members" to spend the money wisely.

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I am one of those who would happily pay more tax towards NHS, and I have been of that opinion for decades. But there need to be better management.
I trained as a nurse in those times that you are referring to, so I know what you are talking about and I agree totally. I had to give up nursing due to health issues but when, several years later, I had a long session as an in-patient I noticed deterioration in patient care. Even later, during the last ten years when my husband needed to stay in for several months I observed a lot more sub-standard care, much of which would have been easy to fix with just better nursing behaviour. In a particular ward in our local hospital, to which patients were transferred when their condition was no longer acute, I noticed that there were seven 'Sisters' and a great number of Care Assistants but no Staff Nurses. These nursing 'Sisters' were nothing like the old-fashioned Ward Sisters who were good managers as well as well trained nurses. It seems that these were all 'Sisters' so that they were able to move up in the pay-scale, and occasionally a 'Senior Sister' would pop into the ward. The patient care could have been better if the staff had cared but only 30% seem to care. For instance, my husband had difficulty swallowing drinks and needed a lot of encouraged to drink and, therefore, I asked that some needed to spend five minutes with him until he had drank the glass of water or cup of tea. I was told they would put him on a fluid-chart. However, what actually happened is that filling the fluid chart was left to the care assistants who would bring a drink and then walk away. Whenever I walked in there was a cold cup of tea next to husband, but the fluid chart looked good.
I don't know when the SENs stopped being trained and they were probably converted to SRNs at some stage. I have noticed that there are some 'Associate Nurses' in training because sometimes they do work experience in our general hospital, but even they seem to do they studies at the local university but I assume with lesser entry requirement than student nurses. I do not mind what the nurses are called but their training ought to include empathy and sense of pride in actually caring for patients.

@ElenaP ...have to agree on the more subtle side of 'caring'.

Whike my care was overall very good ..5 stars

The food / drink thing strikes a chord

Major operation on my leg, meant I couldn't move myself about after the ops, so adjusting myself was almost impossible...( bed the motorised in many places type.)
Nurses sat me up, but I invariably I slipped down over a short time.
But I guessed I must have looked safe & ready to eat something.

Cue breakfast/ lunch / dinner the first days being left tantalisingly in front of me, (starving hungry after so long in theatre )
But broken shoulder, meant I couldn't use right arm....
And left hand broken meant I couldn't use left hand....lol

Sling on one and plastered up on the other, with large hook holding thumb in place,... it wasn't like people couldn't spot the issue...haha

It was like wearing boxing gloves trying to pick up the knife or fork those first few times.

I did ask for help...which was usually the 'just let me serve everyone else, and I'll be right back '

Eventually another patient came over and cut my food & fed me...bless him .

Might have been nice if one nurse was in charge...who might have spotted my issues re eating & assigned someone to facilitate it.

Saw mum & dad at various times in hospital suffering similar..but I or other family was about to help them out.

I was on far side of London, so visits a tad more infrequent.

Do agree, the model is wrong.

Perhaps too many chiefs means no one is really in charge ?

In general, I am a HUGE fan of the NHS. We are incredibly lucky to have a system where we can end up at a hospital, in need of significant care and know we will not be asked for our insurance card, or credit card before we are seen, but there can be no denying the system has ginagerous flaws.

I am in general agreement with sentiments that management should be focused locally, via old style matrons, sisters and through a nursing system where not all nurses need to be graduates. Care, compassion and patient care is not necessarily highly intellectual. On the other hand, the NHS Procurement system is a criminal shambles, with Trusts negotiating their own deals. This means in areas drugs and some services cost very different amounts to other.

However, I do believe that we, the great unwashed, are also part of the most recent problems. During lockdown there were thousands of people on their doorsteps, weekly, clapping people, basically for doing their job. I totally accept that those were scary and very unpleasant times, however, when signing up to be a medic, nurse, or whatever, these are the potentials, just as those signing up for the armed forces have a prospect of being deployed to conflict - even the pen-pushers and musicians (not insulting those roles, just they aren't the ones we might readily think of staring down an enemy).

I can recall an incident during the earlier phases of lockdown, waiting to enter Tesco (remember the days? Only so many in the store at once?) The door marshall spotted a lady wearing an NHS lanyard queueing like everyone else. He strode up and wanted to usher her into the store because she worked for the NHS, and was keen to reminder her to flash her ID for her however much discount NHS staff were being universally given at the tills.

Fair play to the lady, her response was that she worked for the NHS, but in those times that meant she worked from her back bedroom, and communicated by Zoom, like lots of others. She declined to move forward in the queue and stated she would not be seeking any discount, suggesting such help might be better afforded to those whose businesses were mandatorily closed, but were receiving little or no support.

There needs to be a root and branch reform of our health services, but which politician has the guts to tell these heroes they might not be so heroic after all.

(Just to add that I do have family and friends who work in the NHS - one in anaesthetics, so you can imagine what she was doing in those dark days.)