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Collapse of emergency healthcare in England may be costing 500 lives every week

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Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#101

Post by dkarl »

ben_w wrote: post #82
dkarl wrote: post #61

Earlier quoted context omitted.

> Democracy turned out to be easily manipulatable with large sums of money and media control. Is it, though? Establishment interests spend huge sums of money and often lose. The Republican party was an elite country club party, but when evangelicals emerged as a political force, the party had to jump on that wave, no matter how distasteful the old party elites found it. Then Trump came along, giving blatantly shallow…

Wrong country. Despite the joke, the UK isn't an American state.

Do you think it doesn't apply to the UK? I drew on a US example because it was something I could explain in enough detail. Maybe UK economic elites have mastered control of their voters in a way that US elites have not. Although, you'll have to explain which economic elites in the UK decided that Brexit would be to their advantage and how they stole a march on the UK finance industry.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#102

Post by dominotw »

hadrien01 wrote: post #96
dominotw wrote: post #81

Earlier quoted context omitted.

Its always the same answer. People stuffing their faces with garbage food and chilling on the couch all day. Apparently there was an explosion of obesity in UK during covid. These people clog up all the available supply leaving very little for the rest. Its the same story everywhere. Ppl whine about funding, shortages ect but no one cares about if we can do something about the demand. Govt pushed covid vaccine on you…

They did: https://www.nhs.uk/live-well/exercise/running-and-aerobic-ex...

lol. i don't see how this being marketed as duty to society like covid vaccine. No denunciation or shaming of voluntarily obese as a strain on society. No "COVID is a disease of unvaccinated" by the presidents.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#103

Post by nosianu »

iam-TJ wrote: post #64
bananapear wrote: post #45

But what has caused the collapse of emergency healthcare in the UK? A lack of supply or an increase in demand?

Increase in demand - much of which is attributed (by the NHS itself) for people having poor life-styles (meaning tending to obesity [0] and not maintaining physical and mental fitness), and the tendency for people to be kept alive longer existing with chronic conditions that a few decades ago would have naturally expired (dead!). There's been an endemic problem for the last 30+ years where-by a large proportion of th…

> Nearly two-thirds of adults in England are overweight or obese.

That means the issue is systemic and one needs to look at things outside of individual control. Yes, often systemic issue can be overcome by individuals - by the top quartile kind of individuals with more luck, better genes, better education (including what they picked up at home while growing up), more money, more suitable lives than the majority, or with outliers in levels of personal discipline. But systems should work for the people that actually live, if you need to blame two thirds of the population(!) it's most likely your system that is wrong.

Yes you can look at most of the individuals that are part of those two thirds and find what seems to be personal choices - but you miss the environment and the pressures from it that lead people into making those choices.

For example, that a lot fewer people know how to cook today than several decades ago (example link: https://www.bonappetit.com/entertaining-style/trends-news/ar...), do yo want to blame each individual? To me this very much looks like a bigger societal issue. It's not like people make such choices after careful consideration, it "just happens" and they "slip" into those behaviors without much deliberation, based on their living situations.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#104

Post by M2Ys4U »

simonswords82 wrote: post #95
M2Ys4U wrote: post #47

Earlier quoted context omitted.

"This Twitter chap" is a journalist at the Financial Times and is a senior fellow at the London School of Economics. He's not just some rando bashing government...

So you're saying as a result of these two positions that he holds he cannot possibly be wrong and I should blindly trust anything he says so long as he shows some workings?

No, I am not saying that.

I'm saying that you shouldn't dismiss what he's saying because he posted it on Twitter and/or because (you feel that) people are bashing the government.

He's a journalist at a well-respected newspaper, who has practical and academic experience using and interpreting data for his journalism, communicating his story in accessible way (both accessible in a pedagogical way and because the FT has a paywall). Engage with what he's posted and evaluate it on its merits, not just dismissing it because it's a Twitter thread containing a viewpoint that you don't want to be true.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#105

Post by badcppdev »

JustSomeNobody wrote: post #34

Sooo... are they trying to destroy HC so they can rebuild it as the monstrosity we have here in the USA?

Yes there are significant and multiple areas where private healthcare companies are being paid to 'provide' services to the NHS in a classic outsourcing process similar to what you would see in IT.

Private company charge a lot more, pay their staff a bit more to attract workers from the NHS, extend their contracts to provide more services where there are NHS staff shortages. Taxpayer money turns into company profits. I wouldn't object if it provided more efficient care but it doesn't seem to.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#106

Post by X0Refraction »

simonswords82 wrote: post #27
Cthulhu_ wrote: post #20

Earlier quoted context omitted.

Private enterprises are already running a significant chunk of UK health care at the moment; the Tory government is dismantling the socialized health care in favor of short-term profit. It's not about whether people are willing, it's whether they can afford it or if they have no choice but to go into debt. Anyway, the NHS has also paid private clinics already because their own facilities are at capacity.

The nhs also has a shedload of funding. Let’s not overlook the aging population in the UK please. There are many more factors than simply “the Tories are to blame”

This is the actual issue, spending isn't keeping up with the demand. I'd agree that "the Tories are to blame" doesn't capture it, but I don't think they're equipped to deal with the problem. Real terms spending per age adjusted capita appears to have been on a downwards trend [0] since they took power. I think this has gone up since the pandemic, but I think it's likely too little too late and will probably be a short term increase.

I'm also skeptical the IFS have managed to accurately estimate the required increase in funding. They don't go into their workings from what I can see, but I doubt they've accurately included the effect of the lifetime allowance on pensions causing doctors to avoid overtime or the £100k tax bracket where you lose your personal allowance not moving since 2009 which more and more doctors will fall into. I'd imagine they've underestimated it, but would be happy to hear evidence to the contrary.

That's not to say that I think any other party has a solution or is properly holding the Tories to account on this.

I'll admit I haven't thought too hard about the problem, but I think the fairest solution would be to make pensioners pay national insurance on their income. It wouldn't affect the poorest pensioners and since national insurance is no longer ring fenced for pensions/healthcare I'm not sure what the justification for a tax break based on age even is anymore.

As someone who intends to subsist on more in retirement that change would negatively affect me, but I still think it's fair. I know that this would be deeply unpopular though, so I don't hold out much hope of it happening anytime soon.

Maybe that isn't the best solution, but I really wish we'd start to have real discourse on how we need to restructure our society as the demographic of the country continues to skew older.

[0] https://ifs.org.uk/publications/9186 (figure 5)

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#107

Post by M2Ys4U »

pjc50 wrote: post #54
spywaregorilla wrote: post #43

I don't have time to go in depth on this but I'm a bit skeptical of the claims here After adjusting for age, the english excess death rate is 5% above. It is the highest. But it also just came from being the lowest several months ago. How much natural variance is in this data. Is this moment noteworthy? Is it possible we're not seeing more people die sooner but rather a large chunk of people putting off death a few m…

> This does suggest the general problem is really that we don't know where to put all these incapable poor health old people. This has been the case for years: there are plenty of people who should not be discharged home to fend entirely on their own, but there's no social care in place to look after them, so they aren't discharged. This is also technically the responsibility of the local council rather than central…

>This has been the case for years: there are plenty of people who should not be discharged home to fend entirely on their own, but there's no social care in place to look after them, so they aren't discharged. This is also technically the responsibility of the local council rather than central government.

Not to mention that local government had has its funding cut to the bone (and beyond, in many cases) over the last 12 years of Conservative government.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#109

Post by cmrdporcupine »

betaby wrote: post #97
cmrdporcupine wrote: post #65

Earlier quoted context omitted.

There's a public sector salary cap in many parts of Canada, despite roaring inflation. And a general vibe from the public and the government that generally despises public sector unions and would almost certainly backlash against nurses and teachers should they sensibly decide to go on strike. For two years they busted their asses for the public in tough straits and now COVID numbers in the hospital system are still…

At the same time there are plenty of medical specialists in the sunshine list making 400K+ CAD. Keeps me wondering why radiologists are paid that well, compared say with oncologists. Also do not forget 1) province caps on medial school admission and 2) administrative bloat. Nurses shortage is only one of the many issues with the healthcare in Canada.

Yes, I agree in general.

However when I was taking a $300k+ CAD comp package at Google for a (relatively low ladder) SWE position, it was really hard for me to sympathize with people griping about anybody being overpaid in the public service.

Pricing irrationality is one of the usual critiques that libertarian types have against state-run anything. Thing is that the US health care market also exhibits similar distortions. I think it's a constant struggle.

I think the Canadian system (and probably UK NHS) is due for major reform. I just do not trust the people in power to make the right kind of reforms. Again, foxes and henhouses.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#110

Post by gadders »

buro9 wrote: post #99
jrochkind1 wrote: post #68

I hadn't (here in the USA) heard anything about "collapse of emergency healthcare in England" -- can anyone provide some links for some context? What is actually going on, and (to the extent people know/educated guess) why? Have wait times been gradually increasing, or has there been a sudden increase? ("collapse" sounds sudden?) Etc etc.

The Conservative Party have been in power for 12 years. When they gained power they pursued a policy of "austerity" to reduce the size of the govt and local govt, reduce the funding of nationally funded things, and to replace such govt owned things with "public private partnerships". This can be seen everywhere from social care (private care homes), schools (academy schools), transport (where area contracts are bid f…

>> The Conservative Party have been in power for 12 years. When they gained power they pursued a policy of "austerity" to reduce the size of the govt and local govt, reduce the funding of nationally funded things, and to replace such govt owned things with "public private partnerships".

You seem to be missing a bit of context here - this was after the Global Financial Crisis when even the outgoing Labour Chancellor of the Exchequor admitted there was no money left https://www.theguardian.com/politics/2010/may/17/liam-byrne-...

>> So we entered the pandemic with an already under-funded and stretched health care system.

It's 12% of GDP currently, which isn't that out of step globally.

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