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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

#381

Post by ben_w »

baobob wrote: post #172
gadders wrote: post #110

Earlier quoted context omitted.

>> 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 o…

Folk talking about austerity as a tory thing are going to be in for a monster shock if energy prices persist through the next elections, and when they realize the size of the Covid bill vs the GFC bill. It may very well be Labour sitting as the final nails are driven into the NHS, just by sheer luck of timing

The end of the NHS is unlikely to be caused by money or lack thereof, given the NHS was founded while the UK was still suffering the economic consequences of the pyrrhic victory of WW2 — food rationing was still a thing, and was only completely ended six years after the NHS was founded, just in time for the Suez crisis to bring it back for a few more months.

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

#382

Post by oliwarner »

mensetmanusman wrote: post #358
oliwarner wrote: post #294

Earlier quoted context omitted.

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.

If everyone is taking care of the elderly there is no one left to generate the wealth that props up society.

Community care is far cheaper for society than having families take on extra dependants, especially at the most taxable end of their lives. Its interactions with the economy are very much like childcare.

But neither are happening. Old people are abandoned to healthcare providers. This, in turn impacts on the life expectancy of much younger people requiring emergency care who won't get it because the hospital and ambulances are full. It's not sustainable for patients or providers.

There are two ways out. Choose to do this properly, or choose a much uglier withdrawal of care for the old and infirm.

Before you choose, remember that these are people who worked for 45 years being told that their National Insurance payments were paying it forward for this kind of care. If you're going to change the rules —and especially if you're going to start incinerating grandmas when they get "too costly"— you have to expect the next generation probably isn't going to stick around. Many of that exodus will be doctors.

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

#383

Post by oliwarner »

makomk wrote: post #343
oliwarner wrote: post #299

Earlier quoted context omitted.

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…

I don't really see how patients so severely ill that they need a bed in A&E with dedicated nursing provision could be discharged into community social care, though maybe I'm missing something...

About a third of beds are blocked at our local DGH by medically fit people who still require community care provision. These are people waiting to go home (or to a home) from an inpatient stay.

Until they go, A&E can't admit people through to the beds they're currently in.

Even if you lie to the population and claim you'll add 7000 beds this winter, those beds aren't staffed. We can't surge 5000 nurses and 2000 support staff out of nowhere. They're all busy.

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

#384

Post by amrocha »

gruez wrote: post #354
amrocha wrote: post #345

Earlier quoted context omitted.

How can you look at horrible evil companies literally destroying the environment around us just because it makes them more money and say there's no alternative??? If you need a regulator to make sure companies don't literally dump sewage all over the country then it's pretty clear that this is a failed system with bad incentives. What pressures would a nationalized system have? How about the fact that normal people d…

>What pressures would a nationalized system have? How about the fact that normal people don't want to ruin the environment around them? You don't need additional pressure to make sure that doesn't happen. Elsewhere in this thread people are literally talking about nationalized healthcare systems where people are waiting hours for ambulances, or dying in hospital waiting rooms. I think the statement of "normal people…

Entirely different situations. One is happening by design, the other is happening due to external circumstances.

Private companies pollute because dealing with externalities costs money. It's not a problem they're trying to solve, it's a feature they implemented to increase margins.

The NHS doesn't have appropriate funding. If you increase funding you fix the problem. From what I've seen, the NHS used to be great until the 90s when the cuts began.

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

#385

Post by amrocha »

missedthecue wrote: post #360
amrocha wrote: post #345

Earlier quoted context omitted.

How can you look at horrible evil companies literally destroying the environment around us just because it makes them more money and say there's no alternative??? If you need a regulator to make sure companies don't literally dump sewage all over the country then it's pretty clear that this is a failed system with bad incentives. What pressures would a nationalized system have? How about the fact that normal people d…

"How can you look at horrible evil companies literally destroying the environment around us just because it makes them more money and say there's no alternative?" I guess for me I just don't understand how nationalising a given company makes it stop emitting carbon.

Nobody's talking about carbon here mate

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

#386

Post by amrocha »

lambdadmitry wrote: post #355
amrocha wrote: post #345

Earlier quoted context omitted.

How can you look at horrible evil companies literally destroying the environment around us just because it makes them more money and say there's no alternative??? If you need a regulator to make sure companies don't literally dump sewage all over the country then it's pretty clear that this is a failed system with bad incentives. What pressures would a nationalized system have? How about the fact that normal people d…

Because I'm well aware of horrible evil governments doing exactly the same. Norilsk became what it is now under Soviets, which were not keen on private enterprises. Pollution is more or less orthogonal to the form of ownership. No, the problem does not go away. You start optimising for short term political goals (see also: ongoing property debt crisis in China), and minimising short-term drama (see also: regulatory c…

Stop fighting with the man in your head and actually engage with the argument. Private for profit companies inherently optimize for profits. Dealing the pollution costs money, so they don't do it. This is by design. This is a bad system, and it will never work no matter how much duct tape you throw at it.

Neither government agencies or crown corps are perfect, but at least they're not inherently flawed either. Yes they're subject to different circumstances than market companies, but that can be dealt with. Capitalism's inherent drive to cut corners and destroy the environment can't.

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

#387

Post by dogcomplex »

tenpies wrote: post #350
c7DJTLrn wrote: post #199

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…

Not that it helps, but this is happening in most Western countries. In Canada, healthcare has similarly collapsed. Decades of mismanagement and absurd government policy finally broke the system during the COVID lockdowns and now the system is worst than many third world countries. Like in your example, it will take hours to get ambulance and I don't mean in some rural town in Canada, I mean in downtown Toronto. Most…

> The worst part is there is no private system allowed here

This is not the worst part. The worst part is years of strategic systemic defunding and dismantling of the supports of the public system while spreading propaganda far and wide has led to a desperate public with Stockholm-syndrome wishing for private healthcare.

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

#388

Post by DanBC »

pkaye wrote: post #214
DanBC wrote: post #133

Earlier quoted context omitted.

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?

In England we can talk about NHS funding and private funding, and we have both.

We can also talk about NHS providers and private providers of NHS services, and again we have both.

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

#389

Post by dogcomplex »

cmrdporcupine wrote: post #171
dmix wrote: post #167

Earlier quoted context omitted.

No comment on unions but I never understood the salary caps, especially that new one for nurses. That's the opposite of what we should be doing.

It's the opposite of what you'd be doing if you wanted the system to function correctly... But what if you didn't? Because you wanted to replace it, but it was dangerous to say that out loud? The Conservatives (and to some extent some Liberals as well) have been playing a long game -- since the 70s when it was introduced -- to get rid of medicare. It's incredibly popular with Canadians as a whole, but if you take con…

Same playbook in every Western country, with a long game from very deep pocket interests. Inevitable declining force barring a resurgence of power in democracy against capital - i.e. a change in our voting system, which will forever be locked to a 2/3 party system which is easily captured.

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

#390

Post by dogcomplex »

raydev wrote: post #224
cmrdporcupine wrote: post #171

Earlier quoted context omitted.

It's the opposite of what you'd be doing if you wanted the system to function correctly... But what if you didn't? Because you wanted to replace it, but it was dangerous to say that out loud? The Conservatives (and to some extent some Liberals as well) have been playing a long game -- since the 70s when it was introduced -- to get rid of medicare. It's incredibly popular with Canadians as a whole, but if you take con…

I'm still an outsider (recent immigrant to Canada) but my impression of right vs left politicians here reminds me very much of Dems vs Reps in the US. When the right obtains power, they incrementally and consistently put the pieces in place to ensure that the quality of gov-provided services decreases over time. Then when the left obtains power, they simply maintain status quo, never improving or fixing the problems…

https://en.wikipedia.org/wiki/Ratchet_effect
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