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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

#411

Post by Dagger2 »

origin_path wrote: post #396
MagnumOpus wrote: post #286

Earlier quoted context omitted.

To put that 1.5% annual real-terms budget increase into context: In the same decade the proportion of people aged 65+ increased from 16% to 22%ish of the population, an increase of a third. Since these are the people who consume the vast majority of NHS resource, the actual age-adjusted funding has been shrinking steadily every year.

But we're not talking about whether budgets increased by as much as random HN commenters feel would be ideal, I said funding had increased massively i.e. in absolute terms, which it has. Any discussion of the NHS budget has to accept this reality - the British state is already deep in deficit for decades and had built up incredible debts just trying to keep the NHS budget rising, which it always has. To say the NHS w…

We were talking about the NHS being underfunded, and you said that funding has increased in absolute terms. Both of these things can be true simultaneously.

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

#412

Post by Dagger2 »

inglor_cz wrote: post #153
solar-ice wrote: post #106

Earlier quoted context omitted.

Supporting the party which consistently underfunds a British institution, and sells off parts of it to their mates, in order to protect Britishness. Sums up Tory politics nicely, really.

Not a Brit, but curious. Looking at the total healthcare expenditure before covid, it consistently hovered around 10 per cent of the total British GDP. https://www.statista.com/statistics/317708/healthcare-expend... If this is underfunded for you, how many per cent would be funded enough ? Accidentally, the EU average is about 10 per cent, with 12 member countries scoring less than 7.5 per cent of GDP. https://ec.eur…

"Funded enough" would mean things like GP appointments in days rather than weeks, and specialized diagnosis/treatment in weeks rather than years.

What percentage of GDP would be needed for that? That question would require a lot of data and analysis to answer, far more than would be reasonable to expect for an HN comment.

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

#413

Post by neilwilson »

robertlagrant wrote: post #186
neilwilson wrote: post #173

Earlier quoted context omitted.

"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.

There is an amorphous system to blame - too much demand and not enough supply.

Some of that demand has money, therefore the private system will take capacity away from the NHS to supply the money. Of course it will.

That is jumping the queue.

Therefore as a society we have to ask whether we want to uphold the NHS's founding aim: "Healthcare free at the point of delivery based upon need not ability to pay".

We can't fix the supply shortage by taxing the rich. But we can stop the queue jumping by constraining who private healthcare is permitted to treat and in what order.

For the record I don't like the Fast Track queues at Alton Towers either. That's not the British way. In Britain we stand in line - whether Lord or Leper.

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

#414

Post by n4r9 »

rob_c wrote: post #379
n4r9 wrote: post #252

Earlier quoted context omitted.

The fact that Blair helped privatise the NHS doesn't show anything about "both sides of the political divide". It just shows how right-wing Blair was.

Please stop viewing everything as a nail for your leftwing political hammer, it's not healthy in the long-term.

I'm not even making a moral judgement here. One of the key traits of right-wing politics is advocating the free market and private ownership. Privatising the NHS is not a left-wing policy.

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

#415

Post by n4r9 »

rob_c wrote: post #376
kergonath wrote: post #204

Earlier quoted context omitted.

It is frustrating to see the country getting polarised this way. A 2-party system is not helpful to a functioning democracy. I am not a fan of fully proportional representation as it leads to government instability and ineffectiveness, but a party getting an absolute majority in Parliament whilst getting 40% of the vote is a travesty. Also, after having lived through Brexit and the successive government, the BBC is n…

Yeah have to agree with pretty much all of that. My worry is that we are defecto the 52nd state these days and we've adopted the 2 party system from across the pond since the coalition was little more than a sitting government against fox hunting, their arguably biggest achievement was placing Cameron in a position where he bailed after throwing national policy under the bus to appease his own party. I won't pretend…

I'd argue that the UK has always had a 2-party system, and if anything the US adopted it from us. The Lab/Con split goes back to ~1910, prior to which we had the Tory/Liberal split going back to ~1850, prior to which we had a Tory/Whig split going back to ~1780, prior to which the political system was very different.

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

#416

Post by DanBC »

missedthecue wrote: post #302
DanBC wrote: post #242

Earlier quoted context omitted.

We've had privatisation experiments in English healthcare for years. Dentistry is a fucking mess. Eye care is a fucking mess. Care and Nursing homes are a fucking mess. Large private provision of GP care? They can't do it and they hand the contracts back. Specialist commissioning in mental health? It's a fucking mess. > It's run by Whitehall and politicians, with little input from those actually doing the real work.…

"Dentistry is a fucking mess. Eye care is a fucking mess. Care and Nursing homes are a fucking mess" A mess in what way? Do you have to wait 2 years for a private dentistry appointment? Because that's the current wait time for an NHS psychiatrist.

Your dentist example is a bit weird - you're comparing private provision with NHS provision, and that doesn't work. If you want a private dentist, or a private psychiatrist, you pay and get rapid access.

If you can't afford private treatment you go on the NHS. At the moment NHS dentistry is simply not available for very many people. Those people cannot get treatment at all. But for psychiatry, the vast majority of people who need a psychiatrist will get same day or next day access. This is one of the problems - that's a statutory function, they must provide it, and so community care has been cut in order to meet the statutory function.

> Because that's the current wait time for an NHS psychiatrist.

This is untrue in the way that you've presented it. I'm not able to find this statistic any where - what's your source for it please?

There are long waits for some community mental health services, but these are mostly caused by decades of underfunding of MH treatment. Also, your argument says that this problem would be fixed with competition. We've competition and right to choose for first episode of mental health care since 2014[1] and that competition has done nothing to improve things and in many situations has made things worse.

For Early Intervention in Psychosis services (these are services for people with their first episode of psychosis) the current numbers[2] are that 83% of people were seen within 2 weeks after referral.

The number of people in contact with specialist mental health services has increased[3] since 2019 from 1.3m to 1.6m people. This is combined with a decrease in bed numbers and a complex change from CCGs to ICSs. New referrals data is complicated (one person can have multiple new referrals; someone already in contact with services can have a new new referral) but the trend is increasing[3]. The number of young people accessing MH services has increased a lot over the past 12 months, from 575,000 in Mar 2021 to 690,000 in May 2022.

[1] https://www.england.nhs.uk/wp-content/uploads/2018/02/choice...

[2] https://www.england.nhs.uk/south/our-work/mental-health/earl...

[3] MHDS Mental Health Time Series data dashboard

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

#417

Post by Dagger2 »

cameronh90 wrote: post #328
detaro wrote: post #16

Earlier quoted context omitted.

> Are there still major pandemic restrictions in Britain? No. My impression is that in the UK (just as in other countries to a degree) the healthcare system hasn't really gotten out of the overload-state ever since the COVID waves. So while delays due to lockdowns certainly happened, it's also an ongoing crisis independent from that. (and if I'm being cynical, advocating for fixing those issues doesn't fit various pu…

The medical industry still hasn't got out of the covid mindset. Doctors are still working from home. Hospitals are still refusing visitors and requiring a week of self isolation before a patient comes in. Staff are still isolating for two weeks if they test positive. They still haven't put back full seating in waiting rooms and refuse to let you in the hospital if you're 10 minutes early for your appointment. Frankly…

Dropped considerably? I'd say our risk tolerance has gone up, not down.

On top of that, the underlying risk has gone up. This is not a good combination for our healthcare systems. They can't get out of the COVID-19 mindset, because they're still dealing with COVID-19.

> I know people will say covid is still around, which is true, but we are ~all vaccinated. This is as good as it's going to get.

We can do much better than this. Something like 80% of the population has been vaccinated, which is far lower than it could be, and we aren't giving regular booster doses like we do with the flu. Almost nobody is wearing masks in public spaces. We should be improving ventilation in all public buildings, but we aren't.

Things could be a lot better -- but our tolerance for risk has gone up, so we're not doing any of this.

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

#418

Post by regularfry »

regularfry wrote: post #261

Oh, for heaven's sake. It's not that patients delayed treatment. It's not the sodding vaccine. It's emergency medicine collapsing because A&E departments can't discharge. They can't discharge because there aren't enough social care workers. There aren't enough social care workers because a) Brexit, b) vaccine hesitancy, c) shit pay, and d) chronic underfunding of public services in general. Given that this is an arti…

As if by magic... https://mobile.twitter.com/jburnmurdoch/status/1562004612172...

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

#419

Post by heurisko »

kergonath wrote: post #314
okeuro49 wrote: post #268

Earlier quoted context omitted.

> This old chestnut. Go read the Rome treaty or the Schuman declaration. The “it’s only economic” is a lie you’ve been sold by your own governments. The aim has always been political Union, from the beginning. That's not true. The Schuman declaration refers to the European Coal and Steel Community, which was about making war between countries materially impossible ie. through economic, not political, integration. It…

> The Schuman declaration refers to the European Coal and Steel Community, which was about making war between countries materially impossible ie. through economic, not political, integration. Right, I’ll quote it here for you: “The contribution which an organized and living Europe can bring to civilization is indispensable to the maintenance of peaceful relations. In taking upon herself for more than 20 years the rol…

> “The contribution which an organized and living Europe can bring to civilization is indispensable to the maintenance of peaceful relations. In taking upon herself for more than 20 years the role of champion of a united Europe, France has always had as her essential aim the service of peace. A united Europe was not achieved and we had war.

> Europe will not be made all at once, or according to a single plan. It will be built through concrete achievements which first create a de facto solidarity. The coming together of the nations of Europe requires the elimination of the age-old opposition of France and Germany. Any action taken must in the first place concern these two countries.

And as your quote shows, it's a long stretch to take the aspiration of a "united Europe" to mean inexorably leading to the problematic; often anti-democratic, institutions we have today. The aspirations were from the beginning economic, and there is no reason at all to think that this can instead take an intergovernmental, rather than supranational form. There was, contrary to what you suggest, no "single plan" that was always in place that governments have subsequently had to, in your words, "lie" about.

> And the common agriculture policy. And the fisheries policy. And the customs union. And the human rights. And Ireland. The British government had a lot of incompatible red lines from the beginning. This was obvious to anyone who has been paying attention.

No, it's freedom of movement, that's the main thing. There wouldn't have been Brexit without the European migrant crisis that shortly preceded it. Brexiters like Farage want a return to economic, not political, union, even if there is grumbling around certain policies.

https://www.youtube.com/watch?v=bQrUFrnW1R4

> That is not going to happen, at least in the foreseeable future

And the weaker member states who have adopted the Euro will continue to pay for it.

> More undemocratic than the Parliament in Westminster? You must be joking. And how accountable is the Bank of England? But yeah, rule Britannia.

Please read hackernews comment guidelines https://news.ycombinator.com/newsguidelines.html

> Be kind. Don't be snarky. Have curious conversation; don't cross-examine. Please don't fulminate. Please don't sneer, including at the rest of the community. Comments should get more thoughtful and substantive, not less, as a topic gets more divisive.

Also please read Yanis Veroufakis's "Adults in the Room" on how the democratic deficit resulted in undemocratic austerity being forced upon Greece, resulting in a humanitarian crisis. There is no comparison between the ECB and Greece and the Bank of England and Parliament.

A return to a European Economic Community, with additional, optional, further integration around freedom of movement, for those who want it, would benefit the citizens of Europe. I don't expect that to happen, however.

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

#420

Post by inglor_cz »

Dagger2 wrote: post #412
inglor_cz wrote: post #153

Earlier quoted context omitted.

Not a Brit, but curious. Looking at the total healthcare expenditure before covid, it consistently hovered around 10 per cent of the total British GDP. https://www.statista.com/statistics/317708/healthcare-expend... If this is underfunded for you, how many per cent would be funded enough ? Accidentally, the EU average is about 10 per cent, with 12 member countries scoring less than 7.5 per cent of GDP. https://ec.eur…

"Funded enough" would mean things like GP appointments in days rather than weeks, and specialized diagnosis/treatment in weeks rather than years. What percentage of GDP would be needed for that? That question would require a lot of data and analysis to answer, far more than would be reasonable to expect for an HN comment.

Is it possible that the problem isn't caused by lack of money, but by organizational issues?
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