East Dulwich (Mobile) Forum

The NHS fiddle the waiting times in A&E

It has been in the news a lot lately, about the "Crisis in the NHS" and reports of waiting times, but the figures we are given are NOT ACCURATE, as bad as they appear - they are a lot worse.

My elderly relative had a fall, had broken wrist. He was treated at St Thomas's the fracture people put a temporary splint on the kind that does up with velcro and sent us home, this took all night, we left at 7pm and got back at 4am. They said his blood pressure was low and to STOP taking 3 meds. Being as they have Alzheimers the splint kept getting taken off. Two weeks later, another fall and large gash to forehead. The paramedics glued the wound, but visiting GP said he should go to hospital for a scan incase of a brain bleed as they were feeling ill and wobbly. The GP called non-urgent ambulance at 6pm, but it didn't arrive. After nearly 3 hours I got a cab to St Thomas's. We waited in A&E for 3 and half hours, I filled his forms and sat with him, but after this six hours of waiting around they were very tired and restless it was about 12.30am. There was no tea available for them. A triage nurse checked his blood pressure. When it was getting near four hours, all of us gathered in the A+E were sent to Majors dept. There are a large amount of chairs which we all filled up. There were a few visibly wounded people, one other with a gashed head, vommitting in a bowl. We were all told they are very busy (this a week-day) and to expect to wait another FIVE OR SIX hours wait to be seen. My relative was very confused, tired and anxious and creating a fuss, wanting to go home to bed. After eight hours, I myself was very tired and couldn't handle the situation anymore. I asked if there had been a major incident to cause such delay, but there wasn't. One medical person approached me to tell me that if we get seen in several hours, they probably would just send us home without treatment. I DECIDED TO LEAVE. Manhandled very tired frail old person out of building, which was difficult as most entrances locked now. GOT CAB BACK. 2.15 am. EIGHT HOURS FOR NOTHING.
I phoned the GP myself as worried, to find relative still on the 3 BP meds that were to be stopped a fortnight ago, no-one can explain where the letters go?

So when the report says so many per cent get seen in four hours, its a big fat lie, as you are NOT SEEN AT ALL, just sent off to sit somewhere else, while they tick the box that you are not in A&E anymore!
what do people expect- the city is swamped. A friend was stuck in Salisbury and got taken ill....20 minute wait....
Is that a typo uncleglen? Do you mean the NHS in the city is under-resourced? Or is this something to do with a need for better drains? In a word-association game one is straight at Trump Towers with that word now.

My experience with NHS England is much the same as stringvest's and also the impressive Birmingham NHS management chief who was on Newsnight last night. A and E (and by no means just in London) is at breaking-point because care in the community has been cut. So people are using A and E as primary contact for what should be provided elsewhere. She was at pains to point out that government know this perfectly well.
I think a reasonable person who is not grinding any axe would have to acknowledge that more people (even those paying taxes), especially the ones who are not au fait with how one registers with a GP and what A and E is really for, have to be a factor in services being stretched, as well as accepting that a reduction in funding of some parallel services also has a negative effect. Adhering to a certain narrative on any side doesn't get you anywhere.
Ah, a political post that grinds no axe. Well, in your dreams Nigello.

Is your point 'not au fait' so 'a factor in being stretched' simply saying THERE ARE A LOT OF PEOPLE IN LONDON?

I think it is: if there are a lot of people then the NHS needs to be resourced appropriately, no?

THAT is my axe.

The 'reasonable person' would then reject absolutely the idea that because some of the people waiting at A and E are from Eastern Europe that they are somehow the cause of the crisis. They are not 'a factor' at all.
We are living in the right now. So, even if there were to be a rise in tax (which I would welcome right now - my cheque book is ready for a one off payment if needs be) the resulting funding would not make itself known for some time. So, it is fair to say that right now, in the current circumstances (which one may or may not endorse), there are many factors that are behind poor performance at A and E and in other departments, including the fact that there are more people than had been expected.
You will note that my post was restrained and balanced, seeing at least two sides to a complicated situation. Yours, with its block capitals and sneery tone, demonstrates the way in which discourse about the NHS often ends up going nowhere.
Stay healthy!
You are of course morally admirable, cheque-book in hand, with no axe to grind, taking the objective and balanced position. The world is just too complicated for simpletons like me.

But you are prepared to say that the east Europeans are a cause of the current NHS crisis?

They are in the queue, so they are obviously a cause. If they were not there then the queue would be shorter. If they did not live here we (i.e. not them) could get treated more quickly.

You have not thought beyond this??
The NHS is in such a mess and with multiple factors affecting it, that it is not possible to identify one, singly.

I would love to review their budgets and what they spend money on.

It would take a complete objective review - but unfortunately, it would seem too many beneficiaries to allow that to happen...
I was always a fan of the concept of an extra 1p on tax to fix the NHS. Then I read the other day that 1p on income tax would raise about £4.6 bn. That, whilst useful, would not go anywhere near solving any of the current problems.

I am starting to think the NHS cannot survive in its current form. But I have no idea what a different NHS would look like.

All I do know is that it MUST stay free at the point of delivery.
Many people who go to A & E are not registered with a GP, they get admitted if their condition warrants this and when they are about to be discharged, the ward try and find a GP that will take them on. This adds to the delay in discharging.

There is a Rapid Response Team in Southwark which a GP can refer someone to prevent an admission into hospital The team is staffed by nurses, OTs. Physios, carers and I believe a doctor.
Loz Wrote:

-------------------------------------------------------

>
> I am starting to think the NHS cannot survive in
> its current form. But I have no idea what a
> different NHS would look like.
>

I realised this ages ago - if it's the "Envy of the world" how come no-one else in the world uses its model? PLUS there are alternatives to the US model. It's not fixable by taxation.....it's going to grind to a halt (demogs/technology etc)...but it's still untouchable
The NHS has been raised to a secular deity, a level hard to achieve let alone maintain and one which prevents it from being discussed and adapted rationally.
More taxation would be good but so would better use of resources, improved management and a more respectful use of its services by all of us.
Angelina wrote she would like to see the nhs budget and what they spend money on.my wife has been in st Thomas's.and also guys hospital in the last 2 months.each time being admitted to a ward.and each time she has received a welcome pack. Consisting of a eye mask tooth brush tooth paste hand held paper fan nonslip bedsocks plus a bar of soap.if all hospitals.i don't know if all nhs hospitals are doing this if they are .then that will come to a bit of a wad.also in side rooms and wards.they have them dyson bladeless fans.costing £200_£300 apop another good wedge.i the welcome packs are given wether you want one or not.ordernairy fans would do the same job I'm sure .surely some of this money could help pay for extra nurses or doctors which all hospitals need.just my opion .
teddyboy23 Wrote:

-------------------------------------------------------
> Angelina wrote she would like to see the nhs
> budget and what they spend money on.my wife has
> been in st Thomas's.and also guys hospital in the
> last 2 months.each time being admitted to a
> ward.and each time she has received a welcome
> pack. Consisting of a eye mask tooth brush tooth
> paste hand held paper fan nonslip bedsocks plus a
> bar of soap.if all hospitals.i don't know if all
> nhs hospitals are doing this if they are .then
> that will come to a bit of a wad.also in side
> rooms and wards.they have them dyson bladeless
> fans.costing £200_£300 apop another good wedge.i
> the welcome packs are given wether you want one or
> not.ordernairy fans would do the same job I'm sure
> .surely some of this money could help pay for
> extra nurses or doctors which all hospitals
> need.just my opion .

BUPA possibly - I haven't joined my companies BUPA scheme
but most of my colleagues have and the side rooms in NHS
hospitals are possibly for private patients.
Sorry John meant to say my wife was in a side room.we are not private .my wife was told .they are there for every one.
teddyboy23 Wrote:

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> Sorry John meant to say my wife was in a side
> room.we are not private .my wife was told .they
> are there for every one.

I was on the general ward a few years ago for an
emergency op - there's a lot of patients looking
after other patients (and if you have no visitors
it would be even more difficult).
Yes teddyboy I was a bit surprised by that welcome pack at ST Thomas's - 3 years ago now ,so I guess they're still giving them out . I didn't need one ,my admission was planned .
Never knew that.we left ours in the room.agree with you if your booked in then you take your own stuff in.i understand if someone comes in due to an unexpected illness or accident.then the packs could help in the short term.but to give them out Willy nilly is a waste of resources.im sure that money would be better off in a nurses paypacket they deserve it
If the NHS got any extra money of significance, some pen pusher would probably spend it on a new machine that goes 'ping'
I am not sure who your message is directed to, or even if you are plainly criticising NHS staff, or trying to do them a favour. Things are sometimes lost in writing I suppose. However, I did feel I ought to respond. As you might imagine, the NHS staff feel slightly tetchy at the constant criticisms to a service we give both our private, and professional lives to. Often, in their entirety.

It does cost the hospitals around 1000 quid if you breech 4 hours, then about 6 grand for 6 hours, then something insane like 32 grand for 12 hours (as it goes on I am not sure of the numbers so don't quote me on them). I can tell you, as an NHS doctor (who has worked in Tommie's A&E - the kid's part admittedly) that it doesn't help ME to fiddle these figures. Going to work is already like going into a war zone everyday (although I am currently at another hospital in my rotations). It does us no favours to cover up the figures. In fact I ENCOURAGE you to go to your PALS at the hospital (Patient liaison service) and complain away. That way, they have to look into it and look at what happened. I can tell you that your NHS staff are going under, so drawing attention to how much the NHS isn't coping with the demand will only aid us.

For your information, what would normally happen when a patient goes home, is the nurse in charge would ask someone when they left and what happened, and then document the information. I suppose what I find hard about reading your comments are the insinuation that the nurse in charge is in on a cover up. It doesn't represent the nurses that I work with. As I say though, I work in the kids bit, not the adults bit.

In terms of the welcome packs - yes this might be a waste of money - but for every person that says, 'thanks I have my own' there are some that demand anything. I recall one man demanding a doctor to speak to him cos he had had to buy his wife a potato from the canteen as she hasn't liked the lunch, and he wanted his money back. She had just given birth to his child, and he clearly didn't think this meant she deserved the cost of a potato for him. Some people will wait hours for a paracetamol prescription (not poverty stricken, but know their entitlements). We are talking 26pence or something to purchase some privately. And many don't expect to come to hospital. We could make cuts there, I agree, but how to judge it. I think the final comment was about dyson fans - no idea who bought these or where they are from, but I can tell you that there are lots of initiatives. Infact - we just gave a load of dyson fans to another part of another hospital - by money raised in spare time by the NHS staff and given to the NHS.

Many thanks all - I am not trying to be provocative but I just wanted to give a different side to what was offered. I agree - the NHS is in an absolute mess, but the staff have shouted long enough. We are heading to an insurance based system, and it is in the interest of the destructors to make it look like it doesn't work. It does work, it did work, and it can work. It is chronically underfunded and the staff are broken. If you work with us, we can pull it back.

Many thanks,
thankyou
Rogla,

Thank you for your candour. It matches uncomfortably closely with what the few NHS staff I know are saying. They all feel it's being actively sabotaged to make way for US healthcare companies to come in and make a fortune.

As one of them put it, "anyone who believes their taxes will go down when they have to buy a medical insurance plan is a fool".
From the King's Fund:

"Whatever the flaws of international comparisons, it’s clear the UK is currently a relatively low spender on health care – as the Barker Commission pointed out – with a prospect of sinking further down the international league tables. The question is increasingly not so much whether it is sustainable to spend more – after all, many countries already manage that and have done for decades. Rather, it is whether it is sustainable for our spending to remain so comparatively low, given the improvements in the quality of care and outcomes we want and expect from our health services."

source: [www.kingsfund.org.uk]
Loz Wrote:

-------------------------------------------------------
> I was always a fan of the concept of an extra 1p
> on tax to fix the NHS. Then I read the other day
> that 1p on income tax would raise about £4.6 bn.
> That, whilst useful, would not go anywhere near
> solving any of the current problems.
>
> I am starting to think the NHS cannot survive in
> its current form. But I have no idea what a
> different NHS would look like.
>
> All I do know is that it MUST stay free at the
> point of delivery.

The NHS is incredibly efficient. That doesn't mean it's the best service, but that it delivers great value relative to what we put in. Really what we need to decide is whether we want
(1) a less efficient service, paid partly via taxation, delivering different levels of service, with higher quality care to those willing to pay more.
(2) the current system, efficient, cheap, delivering the same service to everyone, but not as high quality as it could be with better funding.
(3) similar to the current system, efficient, delivering the same service to everyone, but with higher funding in order to provide higher quality care, paid via taxation.
(4) a private system, more expensive, less efficient, delivering only to those willing to pay.



Edited 1 time(s). Last edit was february 20, 09:46am by rahrahrah.

... personally, I'd go for option 3.
I agree - the NHS is in
> an absolute mess, but the staff have shouted long
> enough. We are heading to an insurance based
> system, and it is in the interest of the
> destructors to make it look like it doesn't work.
> It does work, it did work, and it can work. It is
> chronically underfunded and the staff are broken.
> If you work with us, we can pull it back.

Brilliant post from someone who's able to draw from his / her broad experience of the NHS rather than extrapolating from one or two isolated incidents. And echoing others here, if you look at any breakdown of cost pressures on the NHS it's aging population, costs of new technologies and new types of treatments which hugely outweigh any cost pressures from immigrant patients. Immigrants coming to the UK tend to be young....
I think everyone would go for option 3, provided they are not the person paying extra tax.
I think many would pay more tax if it were hypothecated.
As I said above, 1p extra on income tax raises £4.6 billion. We're talking 4-6p extra just to keep the NHS's nose above water, if you believe current reports, so I don't think hypothecation would really be an issue.

Usually the conversation goes like this:

We need more spent on the NHS
If you want more spent on the NHS, taxes will have to go up.
Why should I have to pay more tax? Why aren't we taxing [insert name of any famous multinational here]?

Some people, like you and me, would be happy to pay more, but most want someone else to pay.
To fix it with tax we are talking -realistically - a several percentage point increase in the basic rate of tax.

The problem with more tax is in reality a smaller and smaller amount of people pay a larger and larger share of tax in reality (especially when transfers are put in) - they are probably less keen and we are getting to a point where the social contract would start to break on this, I feel. Frame it as say - more tax into the NHS but your tax credits will be cut I'm not sure you'd get such support. High rate tax much past 40Ish% starts to be counterproductive (ask Hollande).

People's income are squeezed as is - some more tax at a general level, especially in the 'squeezed middle' will reduce this further

The multiplier effect of public spending is generally below private expenditure - our economy is doing just about OK spurred largely by Consumer Spending...take several % points out of people's income and this grinds to a halt.

I don't (genuinely) think tax is the answer here as it won't 'fix it (NHS)' in the long term. We have to cut spending elsewhere; operate within existing budgets; do health better........or fund via some self-funding of sorts direct or contrinbutory/insurance (as is the case in much of Europe) . But, you know, national religon

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