Don’t mention the NHS

TomTom

The NHS is not what the scriptwriters make it out to be. "Cardiac Arrest" was too vivid for the illusion, but hospitals are factories and increasingly run like abatoirs. The NHS has botched dentistry after years of making Britons look like the poor when meeting Americans and Germans with teeth.....and the NHS has strangled innovation in Physio and any ancillary therapies with its monolithic gargantuanism.

If only the NHS was what is portrayed rather than the grim reality of State Provision munificent for the reckless and feckless but Poor Law levels of provision for the middle class paying the bills who could aspire to much better service in France, Germany or even the USA

Paddy

Precott: 'blathering' on about a petition to have NHS Direct reinstated.

It's a pity he didn't get off his backside and topple Brown when he had the chance.

normanc

The problem with Cameron's approach of placing the NHS on a pedestal is that even trimming any area of NHS expenditure will be greeted with howls of protest.

P Savage

It's not just a name change. It's replacing degree qualified nurses with telephone operators who've had a sixty hour training course.

Perry

' Degree qualified nurses '

Don't make me laugh!

If I had to explain you wouldn't really understand.

Marcher Baron

As a matter of interest, has anybody here used the hotline? I know I haven't.

Blofeld's Cat

P Savage - that's just the point - it doesn't take degree qualified nurses to read the contents of a publically accessible website over the phone, or to follow an algorithm that in 52% of cases tells the caller to contact GP or A&E. It is a very expensive duplication of services and has succeeded in diverting many hundreds of well-qualified people away from front-line nursing provision to a call centre.

We're well rid.

AG

As a concerned parent I checked the NHS Swine flu help website when my child was sent home from school with flu like symptoms during the Swine flu outbreak. Before you all tell me I'm a fool I would say that I just wanted to check if antivirals were needed and the government told us to go online rather than ring the GP. Remember most of us don't have access to a 'private' GP. I dutifully answered all the questions about symptoms and aches and pains and cough and fever etc. asking the child as I went along. Finally the computer gave me advice and a diagnosis...the screen turned red and a large flashing sign came up telling me to dial 999 imediately because symptoms of pain in the chest area could indicate a heart attack. My child cheered up no end when I explained why I had nearly died of laughing and I decided that the hard pressed A&E docs were best left to treat the serious cases. I relate this tale only to point out the complete crass nature of an automated health system and I don't think trained telephone operators will be any better.

Tim W

"It's not just a name change. It's replacing degree qualified nurses with telephone operators who've had a sixty hour training course." That's true but what's the problem? They will equally be able to offer advice. It's not as if the nurses currently treat people over the phone. All that training the nurses have is not put to full use over the phone and they probably get some of their information from a computer in front of them.

On a different point: With the NHS being 'ringfenced' why is this saving 'necessary' and will the savings be fully spent within the NHS budget? And how can Andy Burnham complain when he admits he would spend less on Health than the Coalition?

alexsandr

so what. all they do is tell you to ring your GP or go to A+E anyway
And the BUPA website is better for self diagnosis,

AndyinBrum

NHS direct was useless when we used them, both times asking questions about heart attack symptoms. For a broken tooth & back spasm.

Useless

les

NHS Direct already use "trained telephone operators" with nurses on hand to give advice and will speak to a caller if necessary - that is not going to change but to listen to the usual suspects like Prescott and the BBC you would think otherwise - hardly anyone from the government has actually explained properly what the changes are and have as usual let the BBC/Sky dictate the story.

Chuck Unsworth

How much does it cost and how long does it take to train doctors and nurses?

Why are these people being employed in call centres?

Since when have doctors been allowed to examine patients and make diagnoses over the telephone?

Noa Zrk

"I can barely contain my indifference".

Excellent! Nor can I.

firefly

It's even more hypocritical of Labour to make such statements when plans to introduce the 111 service were in the Labour manifesto - it "will make non-emergency services far easier for people to access and book" - in their own words!

This Jan 2010 article mentions the long-term possibility of the new number running services currently provided by NHS Direct:

http://www.pals.nhs.uk/CmsContentView.aspx?ItemId=2045

So this is simply an extension of existing plans...

perdix

The change to the 111 system is an extension of a Liebor policy. Why are they complaining?

Simon Stephenson

"Knee-jerk opposition cheapens the opposition’s impact and the democratic process."

Regrettably, having not seen anything like politics for the last 15 years, modern man equates political engagement with the sort of knee-jerk slanging matches with which we are all too familiar. Like just about everything else, the whole process has become about impact, not substance, so there's really no point in anyone giving a considered opinion about anything, since 90% of the population are only geared up to respond to emotionally powerful one-liners.

Moraymint

The plonkers in the Labour Party need to remember that 'twas they that bankrupted the effing country!! If/when services get reduced or stopped, there is only one political party to blame!!

ROJ

Show me someone who thinks that the NHS is the best in the world (envy of the world etc.) - I'll show you someone who has never had medical care in another western country.

Baron

The NHS, as a key part of the Welfare package, resembles neatly the communist model of a society albeit still on a smaller scale. If the paradigm underpinning it doesn’t change, and change soon, it will cripple us. In its current mode it cannot but implode as did the Red Menace equivalent.

TGF UKIP

"Knee-jerk opposition cheapens the opposition's impact and the democratic process" well that may very well be how it might look to a Metropolitan sophisticate but it looks to me like pretty good politics.

Like it or like it not, but NHS has become a hallowed brand and among those contributing most to the brand's development in recent years has been none other than Disaster Dave and his mates. The more they have sucked up to Labour and declined to make any criticism the more inviolable they have made the NHS and any arm thereof.

"Callous" and "uncaring" are going to be Labour dog whistle words we had better get used to.

yank

"Knee-jerk opposition cheapens the opposition’s impact and the democratic process."

.

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...and so does taunting the former ruling party cheapen the coalition's impact and the democratic process, Mr. Blackburn, and we've seen a fair bit of this.

As far as I can see, which isn't much to be sure, Mr. Clegg's recent statements re the budget have been the only adult discussion I've heard from the ruling party these past months. Not that I pay close attention, because I don't, but it's all that strikes me as memorable from the leadership.

I'd also note that Cameron's open letter in the Indian press upon his visit was nearly laughable in its sanctimonious lecturing of both India and Pakistan. Dave's communication seems suspect to me, even tone deaf, and here I thought he was some sorta marketing geek, with his finger on the pulse and all that jazz.

"He did it first" isn't ever the way to go, and is ultimately a political loser. Everybody knows about the past, and no need wasting time reminding them, and it arguably degrades your own validity. Watch as Obama's gang gets slaughtered in a short bit here, all the while bleating about "the last guy".

I'd recommend the coalition tone down their words, and not be so thin-skinned about their opposition's (and as you've posted on this, it would appear your skin wasn't thick enough to contain your indifference)

Verity

If David Cameron had any nous, nerve and any talent for independent thought (stop throwing things! I was joking!) he would:

1. Assess the most suitable between the French and Singapore systems, both of which are outstanding, and choose one of them as a template for Britain.

2. Get a management team from the country whose system Britain chose to adopt, and have them run it on a seven-year contract. That should be enough time to get it embedded.

3. Note with great sadness that anyone who had not paid into the system for five years straight, would not be eligible for free treatment. This would mean no exceptions. At all. No tickee, no raundree. (They could opt to pay the market rate, if they chose, but the entire money would have to be paid in advance, before a thermometer was put in their mouths.)

TrevorsDen

Tom Tom - you are talking a bag of crap.

By definition NHS direct is for non-emergency cases so as promised the front line is being protected - try explaining that to Prescott. The NHS budget is being protected but still faces huge strains on its budget; despite what Tom Tom thinks a lot of dedicated and hard working people are trying to make it work.

The need for cuts of course is down the the incompetence of people like Prescott.

ROJ - there was a story the other day about two Italian surgeons fighting each other over the operating table. Clearly after watching too many episodes of Holby City.

TrevorsDen

Yank - the Democrats inherited an economic mess and I am a Bush fan! In truth going back many years the seeds of the crunch were sown by the Democrats themselves. But the fact is the Republicans left a mess. Obama should be judged on his responses - but I fail to see why its wrong to remind people just why certain measures are necessary.

Here we have labour denying even the need to reduce the deficit, never mind taking responsibility for it in the first place. I think we are entitled to remind the electorate from time to time.

Robert Eve

Nurses don't need degrees.

AG

TrevorsDen, if NHS direct is for non-emergency cases (ie.to try and deflect the worried well), then how can it use non-medical staff to work out which of the non-emergency cases need urgent medical treatment because some of them will and some people spend five years plus training to do this and they are called doctors and it could be that in your rush to defend the coalition you have overlooked what is blindingly obvious to us here that the politicians are thinking that they know better than medics who's sick and who isn't and I would respectfully suggest that most commenters on this site are offering their sensible advice as friends who tell it straight instead of sycophantically defending government drivel.
The politicians have interferred too much in the role of doctors instead of getting out of the way. We have ever increasing health care demands in a country that's broke so either new money has to come in from private sources or there has to be rationing of provision. Neither are electorally pleasant but at least that's being honest and our politicians are treating us as fools if they think we will fall for childish stories about a service that we all have everyday experience of.

Baron

re-naming the NHS Direct, tweaking the way it operates ain’t even nibbling at the edges of the problem, it’s just sniffing at it. The whole of the NHS, a job for the apparatchiks ranking it in size third after the Chinese Army and the Indian Railways needs to be disposed off. It’s now costing each man, woman and child over £2,000 pa, most of which goes never near a patient. It’s an insatiable hole, and Cameron keeps digging deeper into it.

Verity’s suggestion @ 9.29 (or anything like it) should be blindingly obvious to anyone who possesses but a smidgen of capacity to think rationally, which in today’s Britain amongst those who govern comes close to a miracle.

shufflebox

'Fraid you're jumping the gun saying 111 is more cost-effective; just because something costs less doesn't mean it's more cost-effective (unless you're myopic). - it's still on trial run and could actually turn out (like so many policies we're seeing now and that we've seen for 30 years) to be false economy.

Dr Sri

Its true NHS killed innovations and now will have to pay the price. If at all there is something I admired in the past twenty five years ago was some great Doctors who contributed to advances is medicine. Products and drugs R&D made ICI and Boots very rich and brought in money. Since 1980s, I've not seen one which I can say simply made life better for others living in this planet like penicillin ,beta blockers and surfactant. Even medical text books are basically reprints or re-edited versions.

Media hype innovations but none which create jobs and brings in money have been pioneered in UK. Research conducted by NHS were all just confirming others work or sponsored by pharmaceuticals. I developed innovations that could create jobs and save millions for NHS but did they care?

Archie

A friend, a dentist in Canada, has only to look in the mouth of any new patients to determine whether they are from the UK or any other Third World country.

Fergus Pickering

I have used it twice. Both times it was effing useless. You've got somebody (possibly for all I know, a 'degree qualified' nurse - as opposed to what other kind of nurse?) sitting at the end of a telephone line dispensing words of wisdom to someone she can't see, doesn't know etc etc. What use would you EXPECT the wretchedf woman to be? What did people do BEFORE the Labour Government in its wisdom gave us NHS Direct. Die in our countless thousands for want of advice to take an aspirin?

ajs

Verity:
I am so happy to see a piece from you with which I entirely agree (get a French or Singapore team to review, propose and when approved by Govt, to instal the New NHS - New Labour should love that - is my preferred route). The Opposition can then conduct a reasoned response to the proposals - in Parliament repeat in Parliament, which will be broadcast - rather than through the usual spin and twist methods.

anne allan

AG - you posted earlier that NHS Direct was useless - with, presumably degree (don't get me onto that subject!) standard nurses.
Now you're complaining that a service run by non-medical staff will be useless.
So, in your opinion, they are both equally useless.
At least, by releasing the nurses from call centres, we should get a few more back on the wards.

AG

Anne, doctors used to be trained in using clinical examination to make a diagnosis, that's why you had to go and see them. This is still the best way to find out if you've got a medical problem that needs treatment. Nurses training was in the practical care of patients. The two professions are not interchangable and the politicians have tried to get nurses to take on medical roles because they're cheaper. The patient needs both professions to be working at the best of their ability for a sucessful outcome.
The use of telephone helplines and internet diagnosis sites are a political gimmick designed out of desperation to reduce demand and lower costs. They have nothing to do with good health care.

TrevorsDen

AG - there will be medical staff on duty. But if any staff cannot give an answer do you not think that the likely advice would be - 'go see your doctor'?

If someone actually THINKS they need urgent attention do you not think they would have the 'nouse' to go see a doctor themselves?

Just what it the point of this overblown apparatus anyway?

On another tack - diagnosis from a list of symptoms is arguably an ideal use for a medical computer programme. The level of medical competence needed for a telephone consultation is arguably very limited.

NHS Direct is just an expensive gimmick.

TrevorsDen

PS
Some reality needs to be injected into the claims about France's wonderful healthcare system - and the criticisms of our own
Note this from the WSJ dated 2009
'When Laure Cuccarolo went into early labor on a recent Sunday night in a village in southern France, her only choice was to ask the local fire brigade to whisk her to a hospital 30 miles away. A closer one had been shuttered by cost cuts in France's universal health system.'
'Ms. Cuccarolo's little girl was born in a firetruck.'

http://online.wsj.com/article/NA_WSJ_PUB:SB124958049241511735.html

'Doctors, trade unions and others have called national protests against French health-care cutbacks this year. One petition signed by prominent physicians said they feared the intent of the reform was to turn health care into a 'lucrative business' rather than a public service.'

'The French system's fragile solvency shows how tough it is to provide universal coverage while controlling costs,'

'French taxpayers fund a state health insurer, Assurance Maladie ... patients get treatment even if they can't pay for it. ... The problem is that Assurance Maladie has been in the red since 1989. ... the annual shortfall is expected to reach ... 15 billion in 2010, or roughly 10% of its budget.'

Oh and if you want to attract the best quality into the profession then think again and look at what happens in France ... "If you are in medical care for the money, you'd better change jobs," says Marc Lanfranchi, a general practitioner from Nancy, '

Medical care everywhere is under pressure and rattling off ignorant comments might make you feel clever but it is no answer.

HJ

P.Savage:

"It's replacing degree qualified nurses with telephone operators who've had a sixty hour training course"

You do know that only a quarter of nurses have a degree, don't you? Even now, there are far more nurses on diploma courses than there are on degree courses.

In any case, the academic level of nursing 'degree' courses is pretty modest. Most of these course are at pretty much the same level as diploma courses. Just because we call nearly every course a 'degree' course nowadays doesn't mean that somehow everybody is really much better educated.

Boudicca

P Savage
August 29th, 2010 5:53pm

We don't need degree educated nurses to tell callers that they need to go to their local A & E.

Most callers are phoning about relatively minor complaints and someone with 60 hours training is perfectly capable of telling someone to "drink plenty of water, take some paracetemol and go to bed. If the symptoms persist over 48 hours, go see your GP."

The new 111 call-centre will have a number of fully qualified medical personnel on hand to assist with the more urgent/critical calls.

Anne Wotana Kaye 1

This was a complete waste of time and money. Now I visualise a call-centre, probably situated in India or some other country where wages are cheap and there are plenty of people who speak the language (even if they can't understand it so well). The operators will be issued with printed cards, which have a series of set answers, rather like school exam tests, where one writes (a), (b), (c) or (d). Won't do any good, but probably less harm than trotting off to the local A&E where one will either catch a superbug, or be vomited over by one of the drunks or stabbed by a druggie.

AG

TrevorsDen, it is not possible to see 'your' doctor when you want to because they all work in a limited resource state monolith which is run in a top down central command way which means that the politicians have had to invent a sop for the people in the form of NHS Direct to try and camouflage the poor(in terms of user friendly) service. It gave me no pleasure to see a prominent former labour minister on prime time TV and all over the internet telling everyone how NHS Direct saved his life by diagnosing his kidney stones. People do have the wit to go to A&E in desperation because it's all they can do and I would imagine that a graph of admissions would show exponential growth in this reflecting the increase in demand because they delivery is so bad. So why the demand?Go and look there. The problem for politicians is one of responsibility because as soon as someone asks for a medical opinion then it is beholden on the service to take responsibility for the 'patient' and I think that's why Labour invented the helpline to try and deflect demand. I think that the money would be better spent giving everyone a good medical dictionary and getting nurses and doctors back on wards and in surgeries. The question for the Conservatives is how can they get to a better system without taking an electoral hit from Labour. I suggest you take a leap into the unknown and try a little competition and variety and localism and yes let medics, hospitals and nurses and all the rest form their own cooperatives. Free hospitals sounds good.

Verity

HJ - Plus degrees for nursing are just plain silly. Nursing is about care, not academic qualifications. In fact, I would worry about a nurse who had a joke "degree" because I would think she had ideas beyond her nurse's station and would be focussed on elevating herself.

TrevorsDen

AG - all health services operate with limited resources - as I have explained with the French system.

Its a fallacy to say you cannot see your doctor.

As I think I have previously implied - NHS Direct was indeed a face saving sticking plaster. The current govt are going to run a similar system more efficiently. Good news I think.

TomTom

"Plus degrees for nursing are just plain silly."

Too true ! But it was Kenneth Clarke as Health Secretary who cut this deal with the RCN to give them "status" and "respect" and define them against Unison nurses.

They can learn Cultural Marxism and Feminism in a classroom as preparation for emptying bedpans....or becoming an Administrator supervising Filippinas to do the real nursing

Noa Zrk

The annual cost of the NHS is @£90billion.

Yes, £NINETY BILLION!

Half that sum in 2011, and half it again in 2012.

There will still be stupendous waste, but it will produce real value and clear as many or more cases.

Victor Southern

I only tried to use NHS Direct once and it was one of the most exasperating experiences I have ever suffered.

It ended with my son driving me to hospital A&E at 4am with violent coughing fits that rendered me unconscious with pain reaction. The black comedy carried on when I told the Asian triage nurse that I was suffering from coughing fits. She asked me how long I had been having fits and what medication I took for them. The staff were much more concerned about a minor wound to the shoulder I had suffered in a swoon than the cause of the fall.

When I got home at 11am an ambulance arrived to take me to hospital in response to my NHS Direct call.

JohnAnt

Surely the answer is obvious: the whole system costs so much that any saving is welcome: bin the 111 calls.
Emergencies = A & E.
Non-emergencies or doubts = glass of whisky and a good night's sleep.

TrevorsDen

Noa the French 'NHS' costs 150 billion Euros (just to give you a comparator) and its 15 billion in debt. Spending on the NHS is something over £100 billion actually.

So how little you know - but how brave you are to support cutting NHS spendng to a quarter of its current size; you clearly expect never to have to use it, nor your parents nor your wife and nor your children. Nor do you ever expect to grow old. You must give us your secret.

Baron

TrevorsDen @ 11.19:

sorry my friend, it’s you who should do the sums better.

the current spending on the NHS runs at £120bn or E145bn (see below); the population of France is some 10% higher than ours.

http://www.ukpublicspending.co.uk/

Rob on the job

Mugs or Martyrs?

As a long term chronic illness patient of 35 years who has survived numerous careless blunders by the NHS staff, I feel it is my duty to report on the real wonders of the NHS and the ridiculous nature of our generosity.

NHS hospitals have been treating foreign patients (gratis) for many years and we also provide work for foreign doctors, nurses, surgeons, cleaners, porters, receptionists, drivers,clerical workers, administrators,have I left anyone else out?

The NHS should be awarded the George Cross for its consistant aid in providing employment to members of other countries while providing free treatment to their country's citizens. And all this at taxpayers'expence and resulting in the shortage of beds and treatment for UK citizens.

The people of this country deserve immediate sainthood from that pope chappie as We are either mugs or martyrs, the whole lot of us.

RichardH

Did it actually work? Measurably?
In such a target-driven culture as the NHS presumably some measure of effectiveness was made.
And yet I doubt it. If you can't measure a change I rather suspect it was never needed.

As for what to do with loads of degree-educated doctors and nurses, well, judging by the number of non-English speaking foreign staff at my hosital I suspect there are plenty of frontline jobs ready and waiting for them. Freeing up some properties too, reducing prices, reducing need to subsidise housing for the self-same frontline workers. Marvellous.

Rob on the job

OK, maybe I may have been a bit harsh, tarring one and all with the same brush. However, the fact still remains that in some hospitals we receive very poor services and many of the non-English speaking staff couldn't give a monkey's. The good nurses leave, can't say I blame them.

After receiving treatment in 6 different hospitals around the country, it has to be pointed out that not all departments are guilty of mismanagement within the same hospital; i.e. the Cardiac Dept, in a hospital I visit, is excellent yet it's renal dialysis unit is rotten to the core and is closing down soon,

The mistakes there are rampant, some nurses work endless hours and send the bulk of their pay-packet to their families in the Philippines or wherever before turning into zombies. And, oh... never a single English person in sight.

alexsandr

May I take this opportunity to commend BUPA's health factsheets on their website
http://www.bupa.co.uk/health_information/asp/your_health/factsheets/
Far far better than NHS offering IMHO

Rob on the job

Bupa site is full of excellent info yet they are in a different league when it comes to medical care and longterm treatment is not an option in their hospitals unless you own Harrods.