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Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

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Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#181

Post by rightbyte »

r_hoods_ghost wrote: post #98
ogogmad wrote: post #38

Earlier quoted context omitted.

One person I'm speaking to claims that the NHS hires too many bureaucrats who are impossible to fire, and who he believes provide the doctors with too much paperwork. He suggests that instead of paying those bureaucrats, the money should go to doctors, nurses and equipment. He claims that the NHS gets about the same amount of money - GDP-wise - as other European countries, while underperforming them. They already hir…

As someone who was embedded in the NHS for a number of years it has many problems, but counterintuitively one of them is actually a lack of paper pushers or at least low level admin and other auxiliary staff. Because governments have constantly demanded the NHS spend less money, but have also been under pressure to preserve numbers of "front line" staff you've ended up with serious shortages of low level admins, medi…

Lack of administrative staff in operations is a mayor problem, pushing paper work to medical staff. Where I live we have the same problem in schools, pushing administration to teachers.

Admin bloat seems to be at a higher level if it exists. Because ordinary secretaries are long gone.

Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#182

Post by rleigh »

matthewmacleod wrote: post #176
rleigh wrote: post #165

Earlier quoted context omitted.

> that's not what anyone wants The NHS has been turned into what is effectively a state religion in some quarters. It's untouchable. It can't be criticised. It's immune to meaningful improvement and reform at this point. Yet everyone I know who works for the NHS has a litany of stories about the inefficiency and waste. And it consumes an increasing proportion of the GDP. Eventually, something will have to give. Its b…

I find this is a common and totally unjustified take. The NHS is fairly frequently subject to alteration and reform in various ways, and there is no real truth to the “piles of bureaucracy and waste” stories - it remains broadly pretty efficient as a healthcare system when compared with other developed countries. You’ve also misrepresented the nature of private healthcare in the UK - this is almost universally not a…

> You’ve also misrepresented the nature of private healthcare in the UK

I mentioned that we don't have the right to opt out of paying for the NHS. It's not possible go entirely private. If you could opt out, you could pay that money to a private provider instead and entirely forego the use of the NHS. That isn't an option today. But it should be.

Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#183

Post by ethbr0 »

r_hoods_ghost wrote: post #126
klabb3 wrote: post #120

Earlier quoted context omitted.

The shift in the western world into paper pushing in healthcare, education, construction, etc doesn't always come in the form of more bureaucrats. Sometimes it's teachers spending time with ever more frequent and granular grading and survey systems, and doctors filling forms for hours a day. It feels like the McKinsey-style design of large orgs has permeated the public sector just as much if not more than the private…

Yes the demand to have a documented policy, procedure and metrics for everything even if no one ever reads them, follows them or analyses them is insane. At the same time there's been this huge increase in the amount of useless correspondence and a cultural shift away from hiring people to help manage and filter this stuff so people can do actual work (aka old school secretaries and admin assistants). Harrumph

IMHO, every required documentation policy should have its opportunity cost measured against the decrease in actual work being done.

E.g. "Do we think this form being filled out is worth someone not being able to see a doctor?"

Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#184

Post by gus_massa »

zbdngkhab wrote: post #70
julianlam wrote: post #42

Earlier quoted context omitted.

Why jump to it when simpler explanations exist? Delays in diagnosis or no diagnosis at all is likely a more fitting explanation.

Mass inoculation with a new type of vaccine that behaved very differently than the science hypothesized is also a very simple explanation. I don't really think anyone here has the ability or expertise to judge which is more fitting. For what it's worth, the fact circulatory issues is mentioned in the article should ring alarm bells for COVID vaccines being a potential cause. We just found out recently the prevalence…

> that behaved very differently than the science hypothesized

Can you give more details about that part? IIRC it worked as intended.

Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#185

Post by zimpenfish »

Biologist123 wrote: post #19
jajahusjsna wrote: post #8

Covid is one aspect of this. Another is the massive. underfunding of the NHS over the last decade. This has become much more evident post-covid thanks to the backlogs. - Getting a GP to see you in person is now quite difficult (they want to do everything via phone). - Seeing your GP (depending on your area) can involve a 2-3 week wait and waiting in an hours long phone queue. - When you are referred to hospital for t…

Price inelastic healthcare is a private equity dream. The project to leave NHS funding unreformed in order to buy acquiescence to its sell off, all the whilst leaving people to rot, is to my eyes scandalous. But somehow unremarked in the twilight zone that the UK has become.

> is to my eyes scandalous. But somehow unremarked

There's a lot of remarking going on - Private Eye, for example, have been banging the "NHS privatisation" drum for a couple of decades at least. The Guardian, too, mention it not infrequently.

Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#186

Post by robertlagrant »

neilwilson wrote: post #173
rleigh wrote: post #165

Earlier quoted context omitted.

> that's not what anyone wants The NHS has been turned into what is effectively a state religion in some quarters. It's untouchable. It can't be criticised. It's immune to meaningful improvement and reform at this point. Yet everyone I know who works for the NHS has a litany of stories about the inefficiency and waste. And it consumes an increasing proportion of the GDP. Eventually, something will have to give. Its b…

"I pay privately through my employer's plan, and then again for the NHS." And yet it is the private system in the UK that is taking away scarce supply from the NHS making it more vulnerable. There is a supply side limit on doctors and nurses, which means private healthcare works like the Fast Track queue at Alton Towers. All it does is allow people with money to jump the queue at the expense of everybody else. And re…

> And yet it is the private system in the UK that is taking away scarce supply from the NHS making it more vulnerable.

It's not a system doing it. Healthcare professionals are choosing to work for private companies instead of the NHS. If you would like to ban that, then say so, but don't pretend there's an amorphous system to blame.

Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#187

Post by Folcon »

ChrisLomont wrote: post #161
Folcon wrote: post #122

Earlier quoted context omitted.

I don't wish to be snarky, but you are aware that the NHS as an institution has existed since the late 1940's and has been working reasonably well for a long time? An institution does not become beloved by the public for failing to provide a good standard of care for a long enough time that people become used to it doing so. So when you say: > It never had a great track record to begin with. Are you talking about gov…

Isn't it possible that demographics have changed enough that funding requirements have changed enough that the 1940s-2000 or so system is no longer viable? I know the demographics in the US has vastly changed some cost models over that time, making some earlier social program hit major funding problems through no evil from govt actors.

The demographics have changed, but they take that into account in terms of how they handle and manage care.

There's a lot of thinking and work that goes on to cover working out the changing needs of your population that has to be handled by any well managed healthcare service.

In the NHS specifically I am aware that they also have change management procedures that exist to try and understand how to provide continuous improvement as needs and situation change.

That's not to say things are perfect, by any stretch of the imagination. For example the NHS still has a big blindspot when it comes to tech. Most people aren't willing to take the effective pay-cut of being a techie and working in the NHS, a lot of people inside the service don't really respect people with tech skills and there's still a bit of a holdover of not paying much for anyone that isn't a doctor.

That's not to say the situation remains static, some doctors for example are slowly accumulating tech skills as a result, so what will probably happen is that success for a tech person in the NHS is going to require a prerequisite medical degree, at least in the near term.

Which though I don't think it's the best strategy, I can't also argue it's a terrible one to expect people who provide tech services into the NHS have a reasonably high level of domain knowledge.

This is a large institution with a substantial mandate, we should expect to pay a reasonable amount proportional to what it provides us. The fact that it's substantially cheaper than other healthcare services while still providing a very high quality of care leads me to believe that it's doing a pretty good job meeting that mandate.

So I don't think blindly questioning it without taking such things into account is helpful, nor do I think that pointing to costs as being "too high" are helpful without considering what is happening and why they are being paid for in the first place. Chesterton's fence and all that, it's not enough to just cut costs, you have to ask what doing so gains you. There are too many social programs which we cut because "spending less is good" without asking if the spending actually gives us a positive return as a society.

Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#188

Post by rob_c »

acallaghan wrote: post #44
rob_c wrote: post #35

Earlier quoted context omitted.

But let's ignore the blairite solution to sell the land and get further into debt and refuse to take more money from the populace or detach NHS funding from state pensions...

I mean blaming the PM that was last in power over 15 years ago seems a stretch?

Yes citing counter example of how the problem is not on one side of the political divide is clearly wrong...

Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#189

Post by zeryx »

We have the same issues in Canada with our public health system. No one wants to talk about this, but my unpopular opinion is the real problem is our retirement program and lack of fertility - we're way too generous, and without a tax base there's only so much we can do.

Unless a politician actually makes the unpopular move to cut retirement benefits or massively increase fertility this is only going to get worse.

Re: Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

#190

Post by rob_c »

kergonath wrote: post #61
rob_c wrote: post #35

Earlier quoted context omitted.

But let's ignore the blairite solution to sell the land and get further into debt and refuse to take more money from the populace or detach NHS funding from state pensions...

Two wrongs do not make a right. I’d wager the people upset about the Tories are not by and large enamoured with Tony Blair’s New Labour either.

You would think that but a lot of people can't see beyond its the Tories in power. We'd be better off with proportional representation but the beeb did an excellent job at mis-selling that to the masses
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