Latest Moan From You and Me 2024

Discussion in 'Off-Topic Discussion' started by JWK, Jan 1, 2024.

  1. Fat Controller

    Fat Controller 'Cuddly' Scottish Admin! Staff Member

    Joined:
    May 5, 2012
    Messages:
    27,782
    Gender:
    Male
    Occupation:
    Public Transport
    Location:
    At me 'puter, GCHQ Ashford Office, Middlesex
    Ratings:
    +52,243
    No doubt that a healthier population (and perhaps one that hasn't increased by circa 10-million in the past 30 years) would of course hopefully ease the pressure on the NHS - but the operative word there is hopefully. The blunt truth is that the service was not scaled up to meet increases in population, nor did it do any self-reform and in fact took on even more strands of work to the point where is has broken. As it currently stands, the NHS already has less people needing it's services - because they are going private or buggering off to Turkey to get their teeth fixed.

    You cannot scale a service based upon the hope that you can change behaviours or induce a reduction in need on behalf of the service user; you should scale a service not to run at it's limit at peak times (so it should be close to capacity to be efficient, but it should not be at capacity in peak times) because doing so will mean that failure is certain once variables are introduced.

    As a society, for a very long time, we have relied on the "we will force them to use less" attitude and it now keeps biting us squarely on the arse - whether it is NHS, water, drainage/sewage or engery.... that ethos does not work.
     
  2. Fat Controller

    Fat Controller 'Cuddly' Scottish Admin! Staff Member

    Joined:
    May 5, 2012
    Messages:
    27,782
    Gender:
    Male
    Occupation:
    Public Transport
    Location:
    At me 'puter, GCHQ Ashford Office, Middlesex
    Ratings:
    +52,243
    The thing is, if banks hadn't been so obtuse with the way that they assessed folks ability to pay, people would have been able to buy a house. I've paid rent (and relatively high, South East area rent at that, for at least 25 years - never missed a payment, never been in arrears, yet a bank would never have allowed me to borrow on a property and pay the same amount each month.

    My one shot is going to be my retirement pot - thankfully, I started that age 16, so when I retire it should be sufficient to buy us something like a park home at the least, and maybe something terraced or a flat depending on area, but none of that will be anywhere near where we are now (not that we want to be here anyway); but, that means that I will have no supplementary income and be on only basic state pension.
     
    • Informative Informative x 2
    • Friendly Friendly x 2
    • ViewAhead

      ViewAhead Head Gardener

      Joined:
      Mar 14, 2024
      Messages:
      1,969
      Gender:
      Female
      Location:
      South of the South Downs, north of the sea!
      Ratings:
      +4,295
      I'm not sure you can scale up to ensure demand is met, as demand grows to fill the space. Take the mental health difficulties manifesting themselves in younger people currently. Rather than attempt the impossible (ongoing indefinite support for all), sort out the problem at source, ie the societal issues leading the young to feel hopeless. And, there we come full circle again back to housing and employment. Of course it is depressing if you can't get secure work and stable housing. Of course your mental health suffers if you can't meet your bills or supply yourself with food.

      People have better mental and physical health in societies with smaller gaps between the wealthiest and poorest.
       
    • Fat Controller

      Fat Controller 'Cuddly' Scottish Admin! Staff Member

      Joined:
      May 5, 2012
      Messages:
      27,782
      Gender:
      Male
      Occupation:
      Public Transport
      Location:
      At me 'puter, GCHQ Ashford Office, Middlesex
      Ratings:
      +52,243
      You have to at least attempt to scale up, even if it is not in all areas. In public services there is a habit of holding service levels static or even reducing them in the face of rising demand, until the service breaks and then you have the required data to prove it is broken and thus the argument required to get it scaled up a bit.

      I relate this to buses because that is my world, and service planning is my life, but the principles are the same. We've quite literally just gone through a process of retendering because the contracts we had on services had been done in such a way that things were so tight, the services simply didn't work for the public (nor for us as a business); in some cases, we've injected two or even three buses into a cycle on a route (that is a LOT of money) but that has had to be accepted because the data showed that the provision expected simply did not work.

      I agree with fixing the problem at source to some degree, but how much of young people's mental health issues are borne out of extended lockdowns? How much of it is borne out of everyone continually arguing about Ukraine, Palestine/Gaza or whether a woman can have a penis? How much of it is because we now have children questioning their sexuality from primary school age? How much of it is because they are being asked to use shared sex bathrooms in their teens when their bodies are developing and they don't even want to see their own body, let alone have someone of the opposite sex see it? WE (as a society) have screwed those children up, most likely with the best of intentions, but...

      Our elected leaders are far too busy pontificating about things happening thousands of miles away or things that fall into the 'nice to have' category when they should be concentrating on things that really matter - schools teaching maths, English, cooking, home maintenance skills and none of the fluff; potholes/roads/pavements/street lighting/waste and recycling; policing/law and order and housing.

      For decades we have been faffing around trying to put wallpaper and curtains up, when there isn't even a roof on the house.
       
      • Agree Agree x 5
      • Like Like x 1
      • ViewAhead

        ViewAhead Head Gardener

        Joined:
        Mar 14, 2024
        Messages:
        1,969
        Gender:
        Female
        Location:
        South of the South Downs, north of the sea!
        Ratings:
        +4,295
        • Like Like x 1
        • DiggersJo

          DiggersJo Head Gardener

          Joined:
          Mar 14, 2024
          Messages:
          1,014
          Location:
          West Yorkshire....
          Ratings:
          +1,581
        • Clueless 1 v2

          Clueless 1 v2 Total Gardener

          Joined:
          Jun 26, 2022
          Messages:
          2,038
          Gender:
          Male
          Ratings:
          +2,769
          Scaling up the NHS is not the answer in my opinion. Years ago we had the GP, or we had A&E and the ambulance service. It seems to work.

          Since those days we've seen walk in centres, 111, and most recently, pharmacists can do some of the work traditionally reserved for the GP. We've also seen the theoretical efficiency gain of all our records being digital. When I was going through my situation last year, I'd had tests and procedures and consultations at various hospitals and the GP surgery. Wherever I went, they were all up to speed with my case as it was all there on their computer screen.

          So it seems to me that in recent years the NHS has already been scaled up a lot. Yet it's still about knackered.

          My theory as to why it's knackered is because it's become procedurally inefficient. Years ago, you had a concern, you had a simple decision. Might you die? Yes, call an ambulance. No, book a GP appointment. If it was the latter, you phone up, you get an appointment, you attend said appointment in person where you talk, the doctor might look in your ears or throat or poke you in the belly, and you might come away with a prescription or you might get sent to the hospital but either way, that's the GP pretty much done with you now, and whoever gets you next will already have the GPs opinion about what's up.

          Now, you have a concern, it goes like this. Are you dying? Yes? Good luck with that, all the best. Or no. Then you try to get a GP appointment. So begins a slow and lengthy exchange of messages where one snippet of info at a time is exchanged. You might be asked to get blood taken. Or you might be asked to try something. More time elapses, and presumably with every update, the GP has to pull up your record, read the most recent notes to remind then of the context, then compose one of their cryptic messages for the receptionist to relay to you.

          Here's an example of the inefficiency. So I was advised to take blood pressure medication. I'm not refusing to take it, but I have some concerns I'd like to discuss first. So I tried to get an apple to spend five minutes to get a few questions answered by someone who actually knows what they're on about. That was the plan. What actually happened, a text message saying please don't take the blood pressure medication for now. They want to understand me better before deciding. So they've scheduled an ECG. In two weeks. Now if there was a suspicion my heart might be doing something weird, I could understand the need for an ECG, but if they thought that, surely it would be an emergency. More likely, something I've said has triggered some red flag talking us down an NHS 'pathway'. If I'd got my actual chat, who knows, maybe the doctor might still want an ECG. Fair enough. But equally likely he'd have just figured out what I'm actually asking, given me a 15 second answer, I'd go away happy, next patient please.
           
          • Agree Agree x 1
          • pete

            pete Growing a bit of this and a bit of that....

            Joined:
            Jan 9, 2005
            Messages:
            51,159
            Gender:
            Male
            Occupation:
            Retired
            Location:
            Mid Kent
            Ratings:
            +94,130
            Any dealings I have with the GP always involve the final warning.
            "If you feel you need more urgent attention ring 111 or go to A&E".
            arse covering exercise in my opinion.:smile:

            The system is broke from the very start, but if you can dodge the first parts, once you get accepted into the system its pretty good, I find.

            Often just getting past the GP receptionist is a major achievement.
             
            • Agree Agree x 6
            • Punkdoc

              Punkdoc Super Gardener

              Joined:
              Apr 19, 2020
              Messages:
              628
              Gender:
              Male
              Ratings:
              +1,994
              The point none of you mention, is the huge increase in the elderly population in Britain. This comes with a massive increased demand [ and cost ] for services and this has not led to a rise in the numbers of drs., nurses and hospital beds. Other measures such as 111 and pharmacist prescribing mitigate the problems to a slight extent, but are nowhere enough to solve the problem.
               
              • Agree Agree x 4
              • Like Like x 1
              • Clueless 1 v2

                Clueless 1 v2 Total Gardener

                Joined:
                Jun 26, 2022
                Messages:
                2,038
                Gender:
                Male
                Ratings:
                +2,769
                I felt very well looked after when I was going through my situation that started at the back end of 2022. I was initially completely and utterly fobbed off by the GP practice. But I complained. Got seen, got referred, then it was a whirlwind of activity while they worked to figure out what they were dealing with, and put me right.

                A friend of mine summed it up nicely. The NHS is actually really good, if you can get passed the wall that is the GP.
                 
                • Agree Agree x 4
                • Like Like x 1
                • Clueless 1 v2

                  Clueless 1 v2 Total Gardener

                  Joined:
                  Jun 26, 2022
                  Messages:
                  2,038
                  Gender:
                  Male
                  Ratings:
                  +2,769
                  I don't think people are criticising the people in the NHS. The NHS is just a good litmus test of how effectively state services have been run, because it's the one service that when people need it, they need it now, and it's the one service that pretty much everyone, regardless of age or gender or anything else, needs at some point.

                  I would maintain that the NHS being on its knees is the result of many things being neglected. At an immediate level we hear of hospital beds being occupied by people that no longer need to be in hospital, but have nowhere else to go, because of failings in social care. I would say the NHS would be less busy if the education system reflected the importance of good nutrition, keeping fit, stress management etc. Having been a customer of A&E a few times, I think A&E and the walk in centres would be a lot less busy if more people knew first aid. National transport infrastructure is not conducive to good health either is it. Nobody walks anymore, and since racism and sexism and ageism and disability discrimination rightly became illegal, cyclists are the new fair game for discrimination so you can't really do that unless you have a death wish.

                  It's hilarious that my teenage son at secondary school has a class on his schedule called 'life skills'. As far as I can tell it's basically a class about how not to be a total knob. When I was his age the community taught that class, in that if you were a total knob you got punched in the face, and it would keep happening until you stopped being a total knob. To my mind, 'life skills' that are not taught in the community should be keeping fit, nutrition, stress management, spotting BS, and things like that. Better education would lead to less pressure on the NHS. But it is rarely discussed because it's effects are not immediate. Introducing actual life skills now would have no visible impact for many years, so it's of no interest to politicians who will be long out the door before any benefit becomes visible.
                   
                  • Agree Agree x 1
                  • RowlandsCastle

                    RowlandsCastle Total Gardener

                    Joined:
                    Mar 21, 2024
                    Messages:
                    1,028
                    Gender:
                    Male
                    Location:
                    North Kent
                    Ratings:
                    +3,964
                    I had the same GP for almost 45 years. We understood one another. I always got to see him, because he worked long hours, five days a week. His reception staff were mainly efficient - and I made sure I was jovial with them.
                    I only ever went to A&E if it was indeed an emergency, or an ambulance took me there. The one time my wife called 111 on my behalf, they told her to take me to A&E. I opted not to go, because we were on holiday.
                    My GP has just retired. He deserves it. His replacement works just four days a week, and even then, not full days.
                    We've moved away, and the system at the new practice is, well, confusing. But I've been in once, and was told the GP was unwell. However, they called another one in, who was having a day off. The advantage of a multiple doctor practice.
                    If I have an issue with my epilepsy, I contact my hospital. That allows my GP to concentrate on general matters. But I do feel that having certain services at a pharmacy is a backward step - especially as you now have to pay to have ears syringed, for example. Those on low incomes may decide to do without.
                    GOVERNMENT, CAN YOU HEAR ME?!!
                     
                    • Like Like x 3
                    • Funny Funny x 1
                    • pete

                      pete Growing a bit of this and a bit of that....

                      Joined:
                      Jan 9, 2005
                      Messages:
                      51,159
                      Gender:
                      Male
                      Occupation:
                      Retired
                      Location:
                      Mid Kent
                      Ratings:
                      +94,130
                      OK, I own up, I'm one of them.:biggrin:

                      But isn't the NHS about getting people to live longer?

                      The massive increase in demand has come slowly, but since Covid its gone off the scale.
                       
                      • Like Like x 1
                      • Punkdoc

                        Punkdoc Super Gardener

                        Joined:
                        Apr 19, 2020
                        Messages:
                        628
                        Gender:
                        Male
                        Ratings:
                        +1,994
                        Currently over 30,000 people are off work with long COVID. This is causing the NHS major problems.
                         
                        • Informative Informative x 2
                        • Fat Controller

                          Fat Controller 'Cuddly' Scottish Admin! Staff Member

                          Joined:
                          May 5, 2012
                          Messages:
                          27,782
                          Gender:
                          Male
                          Occupation:
                          Public Transport
                          Location:
                          At me 'puter, GCHQ Ashford Office, Middlesex
                          Ratings:
                          +52,243
                          @Clueless 1 v2 surely when population has risen by almost 20% in 30 years, there is an argument that some scaling up should be needed?

                          I agree that it can be hampered by it's own procedures and as I stated previously I also feel that there is double work because there are errors made, plus it is taking on or being lumbered with a lot of work it should not be doing.

                          @Punkdoc is that figure of 30k NHS staff?
                           
                        Loading...

                        Share This Page

                        1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
                          By continuing to use this site, you are consenting to our use of cookies.
                          Dismiss Notice