Boris Johnson really historically screwed over his country. Even as bad as some of our leaders have been, it seems like Boris significant eclipses their incompetence.
Collapse of emergency healthcare in England may be costing 500 lives every week
291–300 of 461 posts
Re: Collapse of emergency healthcare in England may be costing 500 lives every week
#292This 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/
Cash doesn't help bedflow if it's not going towards the places required for getting people out of hospital… which I've already said is now a local issue.
Job deterioration, Brexit and the pension cap have all lead to an increase in more expensive locum cover. Few people want to be locked into a job where you have a daily meeting to be shouted at by your site team for not discharging people who have nowhere to go.
Re: Collapse of emergency healthcare in England may be costing 500 lives every week
#293Earlier quoted context omitted.
The Soviet Union accrued massive debt due to internal production inefficiencies caused by corruption and mismanagement. Russia has extraordinary natural resources, by all rights they should be one of the most wealthy countries on earth.
The same goes for South America. Yet they remain mired in poverty thanks to their predilection for socialism.
Exactly. They should know better and vote for governments that are aligned with the US government's interests, so they don't need to go through a CIA-sponsored coup.
Re: Collapse of emergency healthcare in England may be costing 500 lives every week
#294Earlier quoted context omitted.
No, you've learned the wrong lesson. It's almost as if a locally allocated choice between collecting the bins and homing grandma will always go with what inconveniences voters least. Areas with poor, old populations can never pay their way. The excess gets dumped on the centrally funded NHS. It's a bad model that is a massive disservice to us all.
>Areas with poor, old populations can never pay their way. The root of the issue is that this area is now the country. Giving all old people the labor necessary to support them in old age was easier when the ratio of working people to non working people was much higher, in conjunction with old people not living as long. Turn that population pyramid upside down due to drastically reduced birthrates and medical technol…
You say that like it's an imperative but it's not. This is a choice.
Through the government we elected, we choose to starve social care. We choose to starve education and so many other public services.
Yes, our age profile made it more expensive, but so what? We choose to underfund it.
Re: Collapse of emergency healthcare in England may be costing 500 lives every week
#295Earlier quoted context omitted.
The patients are waiting in the ambulance because the waiting room is full, but I see your point. Why not just tip the patient onto the pavement outside the waiting room? I'm sure a full hospital with a full waiting room won't be to busy to sort that out.
> Why not just tip the patient onto the pavement outside the waiting room? I'm sure a full hospital with a full waiting room won't be to busy to sort that out. Literally yes. Keeping them in an ambulance instead of the sidewalk won't get them into the ER any faster. And keeping the ambulance tied up at the hospital won't do any good for the next guy who has an emergency and is sitting on the sidewalk at the site of t…
Then you only rush to another patient who you can't treat either. Paramedics also need to hand off their treatment to hospital staff, if that doesn't happen then hospitals won't know what treatments were administered.
Re: Collapse of emergency healthcare in England may be costing 500 lives every week
#296This 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/
Still not in line with what is required. An aging population which is also living longer couple with poor staff retention and management has left it in a much worse state that 12 years ago.
Re: Collapse of emergency healthcare in England may be costing 500 lives every week
#297Earlier 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…
>with the objective of pushing private for-profit healthcare (which just doesn't make sense) Maybe it doesn't make sense for you, but it makes their buddies in the private sector a lot of money. And that's the game in capitalism, making a lot of money. The government competing with affordable options for everyone against the private sector is "bad for business".
You're correct that the game is to make a lot of money but the key to making that work is ensuring transactions are beneficial to all parties.
It doesn't matter how you structure things you end up with some way to climb the hierarchy. The problem with pure communist systems is they try to prevent all hierarchies. Human nature attempts to circumvent this, the only way to do so is via corruption and political power. Corruption and political power exist in abundance in free markets as well, but there is another outlet for personal ambition. People can get rich. The hope is that you can build a system that incentivizes people to get rich by providing value for everyone. You can have private for-profit healthcare but you have to make sure that people get a good deal out of that. Normally we rely on competition to ensure customers always get a good deal. I don't think that works in this setting. Healthcare is tricky, I don't think we've found a good way to setup incentives for heath systems to have the best outcomes. We will need strong government regulation no matter what we do. Competition will not provide sufficiently good outcomes.
In the US you have great hospitals but at astronomical costs, the entire system is distorted by insurance companies and massive bureaucracies. Here in NZ the hospitals are terrible underfunded socialist messes. We can't hold on to staff because we don't pay enough. Emergency waits are hours. My friends wife just spent 3 days before getting emergency surgery to reattach nerves and tendons in her hand. She had to travel 3 hours to another city to get that care. The last two times I required emergency care the wait was over 8 hours. I can't pay for better service and there is no private emergency option.
Re: Collapse of emergency healthcare in England may be costing 500 lives every week
#298As a UK tax payer, and as a UK tax payer that winces every time they see how much they lose to taxation in their P60 each year (six figures in tax), what are people's solutions to this? It seems like the NHS budget keeps on going up and up and up [1], as does the number of doctors and nurses (while "managers" has either declined or stayed relatively static) [2]. So NHS is getting more funding, and there are more doct…
The best thing about NHS (from my perspective as a US person, although I lived in the UK for a while) is the use of QALYS to allocate budget, rather than spending huge sums on a small number of interventions at extreme cost and limited benefit. Has that focus shifted? (My personal belief is there should be a level of universal medical care funded by some public entity, probably the nation state currently, but it shou…
Agreed...the biggest failure of "Obamacare" was not separating out a basic level of care as a minimum that all citizens get and requiring those kinds of plans be made available in every state.
Where I live I can only buy plans that include things like Chiropractic and Acupuncture and all kinds of other non-basic or catastrophic services. If I want a low-cost basic care + emergencies plan, I'm SOL.
Re: Collapse of emergency healthcare in England may be costing 500 lives every week
#299Earlier quoted context omitted.
Yes, The ambulances are waiting outside the hospitals with the last patient so they can't go to get the next one. Source: Family members have recently waited some hours outside A&E in an ambulance.
This is hard to believe. Just wheel the patient through the front door and let the hospital do the babysitting. There is no sense in using an ambulance as a waiting room.
Babysitting? These are patients deemed medically unfit enough to bring in. Who's looking after them after they're turfed out the ambulance? Every bed in every bay in A&E is occupied, each with an allocated nursing provision.
Oh we just double the number of nurses? Yeah, but no. They don't grow on trees. The current ones don't stretch (we asked). You can't just absorb 20-40 patients into your acute departments without space and staff. The paramedics are acting as those staff, their ambulances the space. Yes it's far from optimal.
Re: Collapse of emergency healthcare in England may be costing 500 lives every week
#300Earlier quoted context omitted.
An ambulance is a portable "mini" ER room...
Using a parked ambulance as an ER room is gross mismanagement because the 'waiting room' for an ambulance 'ER room' is casualties spread across the entire city, such that the worst cannot be prioritized. Even if the hospital's ER room has saturated capacity, moving all the casualties to the hospital waiting room as rapidly as possible still has utility because that allows the hospital to prioritize the worst, which t…
I can promise you that the many smart people working in hospitals have considered this issue.
If someone is walking-wounded, they WILL be unloaded to sit and wait for 6 hours in a corridor.
The people who the ambulances are holding for long periods are those who are too sick to be left without attention. The paramedic staff continue to monitor them in order to escalate further if their condition deteriorates, and depending on the situation, medical staff from the hospital will be involved in this.
The ambulance staff obviously have a moral and legal duty of care, and can't just leave a seriously unwell patient on the floor outside the hospital entrance to get to the next call, which would likely be a patient no more ill than the one they just abandoned.