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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

#211

Earlier quoted context omitted.

It is too bad that corrupt government officials keep systemically defunding Social Health programs with the objective of pushing private for-profit healthcare (which just doesn't make sense). Then they point to the deficient healthcare and blame the "socialized" aspect of it for the issues. Here in Mexico we've seen it all play out: We had an amazing social healthcare system (in the form of the IMSS) in the 70s and 8…

> Back in 2004 when I lived in the UK, the NHS was really good. And I remember hearing at that time that it was nothing compared to the NHS in the 80s and 90s. In a lot of respects, this isn't very accurate. It got pretty bad in the early '90s, anything that needed to go beyond the GP had really bad wait times, people stuck on trolleys in A&E, etc. By 2004 it was much better, so that anything which required a hospita…

I have to wonder how much of the current "crises" we are seeing right now are simply because of a massive aging population. Of course the medical system is going to have issues, no matter if it is public or private, if you suddenly increase the demand, as the older you get the more health care you need, while at the same time all your most capable and experienced doctors are retiring.

Another is housing, right now we have one generation coming up right as the most populous generation is towards the end of their life, resulting in an increased demand and price, in 20 years as more and more the later generations start passing on they'll be leaving behind houses and properties, it's not like those disappear when the people do.

I've noticed that the media seems very engaged in making everything the crises of the moment and the focus on looking at things over the course of years or decades is often ignored in favor of sensationalism.

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

#212

This isn't a collapse of emergency healthcare, it's a very predicted collapse of community social care: hospitals can't discharge if they need a care home place that doesn't exist. Without inpatient bed availability, ERs and AMUs can't admit to specialties and everything gums up at the front door. Let's be clear: we do need many more doctors and nurses, but the existing ones can't do their jobs because their wards ha…

It appears NHS funding has increased year over year: https://fullfact.org/health/spending-english-nhs/

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

#213

Earlier quoted context omitted.

Compared to the cesspool that is the US system? The NHS was amazing. We don’t talk about it, but people still die for non-COVID emergencies because hospitals in the Us are routinely full in 2022. Privatization of hospital systems in the US have lead to very warped incentives, where C sections are the norm because it’s faster and more money for the hospital and Drs.

> Privatization of hospital systems in the US have lead to very warped incentives, where C sections are the norm because it’s faster and more money for the hospital and Drs. The US rate of c-sections was 32% in 2017 (and roughly the same for 2020), the same as Switzerland. It's 27.7% in Canada, 33.7% in Australia and 27.4% in the UK. 28% across the OECD, 30% in Germany, 45% in South Korea, 34% in Italy. So much for t…

Your own source disagrees.

Per your own link: “ Variations in caesarean section rates across countries have been attributed to a number of factors, including financial incentives, malpractice liability concerns, differences in the availability and training of midwives and nurses, and the proportion of women who access private maternity care. For example, there is evidence that private hospitals tend to perform more caesarean sections than public hospitals. In Switzerland, caesarean sections were found to be substantially higher in private clinics (41%) than in public hospitals (30.5%) (OFSP, 2013[1]).”

Privatization correlates to more C-Sections.

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

#214
post #133

Earlier quoted context omitted.

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.…

It's a bit complicated. Private providers can have different staff mixes, so you might have more healthcare assistants and fewer nurses. You might have more unregistered nurses and fewer registered nurses. You might find more staff are on zero-hour contracts, or things like "hotel services" (food, cleaning) are contracted out to companies that are low pay poor condition companies.

Don't most countries in the EU have a mix of public and private health care providers? How do they manage it?

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

#215

This isn't a collapse of emergency healthcare, it's a very predicted collapse of community social care: hospitals can't discharge if they need a care home place that doesn't exist. Without inpatient bed availability, ERs and AMUs can't admit to specialties and everything gums up at the front door. Let's be clear: we do need many more doctors and nurses, but the existing ones can't do their jobs because their wards ha…

>Social care is now on the council to fund and many councils have squashed social care, along with libraries and early years provisions. The trap of outsourcing caught many councils out.

It could be phrased as - social care was a way to paper over cultural and societal cracks, by paying peanuts to people with limited job choices.

As in most things, our response to Covid has just exposed the endgame much quicker than expected.

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

#216

Earlier quoted context omitted.

That's not what I said.

The game in socialism is also making a lot of money.

The Soviet Union seems to have failed that game by collapsing through external debt.

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

#217

Earlier quoted context omitted.

The game in socialism is also making a lot of money.

Problem: Politicians are corrupt! Solution: Give more power to politicians! Lack of power corrupts, need to give them more until they stop being corrupt! Not sure why anyone thinks that would work.

Just do Sortition, give more power to a representative sample of the population.

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

#218
post #197

Earlier quoted context omitted.

I wouldn't trust a stat like that without digging into the underlying causation. The whole twitter presentation is a nice narrative but I see many places where it could just be outright wrong, or saying misleading things (I work in medical biology and have plenty of familiarity with how hospitals run their ERs).

I agree that this sort of thing needs a study. Fortunately the previous tweet linked to the original source, a published study of 5 million ER visits which appears to have a full set of controls and specifically measures time to inpatient transfer in excess of 5 hours as a mortality risk factor https://emj.bmj.com/content/emermed/39/3/168.full.pdf

A retrospective, observational (IE, after the fact data analysis from a population without controls) study found a risk factor (association). That's not enough to make any real conclusions as to whether this is causal.

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

#219

Earlier quoted context omitted.

The game in socialism is also making a lot of money.

Problem: Politicians are corrupt! Solution: Give more power to politicians! Lack of power corrupts, need to give them more until they stop being corrupt! Not sure why anyone thinks that would work.

I really don't understand how people can simultaneously believe that governments are corrupt and the private sector would support the public's interests. Guess who is corrupting government: the private sector who only support their own interests.

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

#220

My 80 year old grandfather was due for a knee operation and it was delayed twice. On the day after the second time it was delayed, his knee collapsed and he smacked his head on the concrete floor. His speech was slurred, his vision was affected, and he was in extreme pain. Bearing in mind in his younger years he's had eyes slashed open and fingers cut off, so he has a high pain threshold. The ambulance took six hours…

As someone in the U.S., don't expect the timeliness to improve any with private healthcare.
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