Collapse of emergency healthcare in England may be costing 500 lives every week • Hacker News Board

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

#401

Post by n4r9 » Wed, Aug 24, 2022, 8:58 AM UTC

refurb wrote: post #346

pjc50 wrote: post #148

Earlier quoted context omitted.

This is silly: all kinds of promises were made for Brexit, and if they weren't delivered then those expecting them are at least disappointed, and if there was no reasonable way they could have been delivered and no real effort to deliver them, then they absolutely were deceived. How did the "£350m for the NHS" bus work out? > actually just another valid opinion Some opinions - sky is green, earth is flat - aren't val…

> Some opinions - sky is green, earth is flat - aren't valid. You just proved my point. You can’t possibly wrap your head around why someone would vote to leave the EU so clearly someone manipulated them. This is the kind of thing people said when women wanted to the right to vote - "Oh those silly women, manipulated to think that's what they want." It's dangerous thinking. I prefer to have faith that people are gene…

Why leave it to faith? There have been studies about how knowledgeable the public is about the EU. For example: https://ora.ox.ac.uk/catalog/uuid:91ddd9dc-f388-43b4-922d-b8...

> [The results] indicate that Britons’ beliefs about some aspects of the EU may be systematically wrong.

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

#402

Post by dustinmoris » Wed, Aug 24, 2022, 9:15 AM UTC

oliwarner wrote: post #116

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…

People can’t be sent home because English people don’t give a shit about their family members. Brits think that the government should provide everything for them, even something simple as looking after an elderly person who is otherwise fine. What happened to family bonds and a bit of responsibility? Every winter around Christmas young family members (40-50 year olds) refuse to take their parents home because “they don’t want them at home over Christmas as it’s inconvenient for them” so they literally demand from the hospital staff to keep them in hospital for 1 or 2 weeks longer. Unfortunately the NHS is not allowed to dump these patients on the street. The problem is brazen entitlement. The NHS needs reform. Zero tolerance for those parasites, charge people for not showing up to appointments, charge people for simple medicines, charge people for choosing to be obese through an obesity tax.

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

#403

Post by TomSwirly » Wed, Aug 24, 2022, 9:34 AM UTC

WalterBright wrote: post #363

trs8080 wrote: post #362

Earlier quoted context omitted.

Yes, the US had its hand in Argentina as well - they supported the violent military junta that saw Peron overthrown and leftist journalists and activists murdered by the thousands during the Dirty War. When I was studying there, the family I stayed with had relatives who had been abducted and "disappeared," which was such a widespread phenomenon under the right wing government that they have a name: "Los Desaparecido…

> Operation Condor ended 40 years ago. The article I cited is today. > but an op-ed from someone at the WSJ isn't going to change my mind Not very open-minded to close your mind to something you haven't read. Do you know what is happening to Argentina today?

https://www.poynter.org/commentary/2021/why-would-the-wall-s...

I'm no liberal. And I used to read the Wall Street Journal every day before Murdoch.

Now it's a pack of lies all the time.

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

#404

Post by TomSwirly » Wed, Aug 24, 2022, 9:35 AM UTC

WalterBright wrote: post #225

asdff wrote: post #219

Earlier quoted context omitted.

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.

I know this is difficult to understand how it works, but the beauty of the free market is everyone benefits while selfishly working for their own self-interest. Socialism, however, requires altruistic behavior, and very few people are consistently altruistic and self-sacrificing for the common good.

> I know this is difficult to understand how it works

Consider not being rude next time. Flagged.

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

#405

Post by origin_path » Wed, Aug 24, 2022, 9:39 AM UTC

oliwarner wrote: post #294

lotsofpulp wrote: post #284

Earlier quoted context omitted.

>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.

It's actually through the local governments, many of which are Labour yet have the same issue.

Root cause: the law says to raise local taxes beyond a certain amount councils must hold a referendum. They systematically refuse to do this because they know they will lose.

Voters by and large think local councils are wasteful and don't really need more money. There's also another issue: some local councils especially in the North have a history of deliberately cutting front line services whilst e.g. expanding the central bureaucracy, because they know they can blame the Tories for not giving them "enough" money and the voters will fall for it. The councils could raise taxes, or rebalance spending, but that wouldn't energize their base.

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

#406

Post by rich_sasha » Wed, Aug 24, 2022, 9:51 AM UTC

missedthecue wrote: post #246

rich_sasha wrote: post #69

Earlier quoted context omitted.

NHS has been underfunded for years. These issues are, in a way, not new. But it just kept getting worse and worse, COVID added burnout and a huge backlog of treatments and missed diagnoses. It probably doesn't help that a lot of the medical staff were from the EU and just before COVID were PTFO. I'm still waiting for those hospitals to be built by all the money saved by Brexit.

How do you know the problem is in fact underfunding? The UK seems to spend as much on healthcare as many other first world countries, but with worse results.

Well, let me rephrase. NHS has for a long time been unable to spend money it considered necessary for a sufficient level of ongoing and preventative care.

At the tail end it certainly seems plausible, stories about lack of funds for hiring doctors, and visible queues at A&E have long been a staple of healthcare. What caused that tail-end lack of funds, I'm not sure.

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

#407

Post by origin_path » Wed, Aug 24, 2022, 10:01 AM UTC

oliwarner wrote: post #157

xtracto wrote: post #124

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…

2004 was the peak of Blair-Brown Labour party investment. They didn't get it all right. They used PFI and outsourcing to fudge the sums on major investments, and I dare say they didn't invest in mental and social health care in the amount required. But nobody ever has. The job of fixing this is so expensive and requires so much political force. We're still worried French immigrants are going to eat our dingos, or som…

The Blair/Brown years left the country bankrupt. They literally left the coalition a note saying "there's no money left"

https://www.google.com/amp/s/amp.theguardian.com/politics/20...

PFI was used because it was a way to get "free money" for the NHS by pushing the real costs into the future.

The core problem for the socialized model is that nobody can assemble a voter coalition that agrees to raise taxes. The poorer Labour voters say no, the rich should pay, or alternatively, the money already exists it's just the evil Tories refusing to fund the system. The more affluent conservative voters say no, because either, the NHS is wasting money and should fix that first e.g. the massive spend on diversity officers, or, the NHS is always overloaded due to uncontrolled immigration, so fix that first. The NHS doesn't have enough admin support as a result. Then the woke middle classes say no, reducing immigration is awful and we will fight it all the way and of course we won't pay higher taxes because if we allowed unlimited immigration the new taxes from all the highly skilled doctor/engineer immigrants would fix the problems.

In the UK there's also the issue that the social care workforce was one of the only professions forced to take vaccines. Lots quit and the rest learned that they have fewer human rights than other people. So having treated the social care workforce like shit, which was already overstretched, the system is now in total collapse for lack of workers.

State run systems always have problems like this. It's one size fits all, so the different groups with their different priorities can never agree and the result is deadlock and collapse. The people who run it are too far removed from the front line and the "too big to fail" problem rears its ugly head. The NHS could never survive as is, it's just a pity that it had to end like this.

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

#408

Post by ahartman00 » Wed, Aug 24, 2022, 10:20 AM UTC

nitwit005 wrote: post #398

rajup wrote: post #316

Earlier quoted context omitted.

Why do you say that, do you have any evidence to back it up? Not saying the US healthcare system is anything to write home about, but it always seemed to me that as long as your pockets are deep enough you should be able to get healthcare when you need it in the US.

It's not too difficult to find comparisons of countries wait times: https://www.oecd.org/health/waiting-times-for-health-service... There are some private practices that will let you pay a premium for quick appointments, but if you need a hospital, you're probably going to experience some wait.

The US isnt listed on either of the Key Data graphs? Clicking read online, and browsing to section 2.2, it seems the US doesnt fare too well in figure 2.1 (The share of people who sometimes, rarely or never get an answer from their regular doctor’s office on the same day varies by more than two-fold across countries), but does much better in figure 2.2(The share of people waiting one month or more for a specialist appointment is two-times greater in some countries than in others). I dont see the US listed in any of the other figures?

https://www.oecd-ilibrary.org/sites/242e3c8c-en/1/3/2/index....

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

#409

Post by makomk » Wed, Aug 24, 2022, 10:27 AM UTC

amrocha wrote: post #386

lambdadmitry wrote: post #355

Earlier quoted context omitted.

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 th…

Even if the water companies were state owned, dealing with the pollution would still cost money and there are a bazillion other demands on the state's finances which are more pressing than keeping rivers clean, such as providing healthcare. This isn't a hypothetical. Scotland has a state-owned water company, and it'd be impossible to write an article like this about theirs not because they're doing better - all indications seem to be that that they're not - but because it relies on information from monitoring equipment that just doesn't exist there. It was pretty recently added in England too, over the last few years, so it's clear that the Environment Agency does actually care about this... not that you'd even know that had happened from the UK news coverage, especially the Guardian's.

Other places in Europe seem to be even worse. For example, I've seen people from Ireland shocked that thsi would happen and preaching the benefits of their state-owned water and their fight against privatisation and water billing. There are places there which literally have no sewage treatment plants still. As in, their sewage goes straight from their houses into the rivers and the sea untreated, not because of a fault or undersized treatment plants or heavy rain ( all of which they have problems with too) but because the sewage system is literally designed to do that 24/7. The government was meant to have fixed this decades ago according to EU rules but has kept dragging its feet on building sewage plants. And they're probably not unique - they were literally the first country I checked, and the second, Spain, had the same issue as well.

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

#410

Post by WickyNilliams » Wed, Aug 24, 2022, 10:28 AM UTC

lambdadmitry wrote: post #334

jmfldn wrote: post #221

Earlier quoted context omitted.

It's a failure of privitisation 30 years in the making since water and waste management was privatised in 1989 here in the UK. Of course you can lay some blame at the door of the regulator but let's not forget the tens of billions that have been siphoned off to shareholders and fatcat CEOs, some of whom are arguably criminally negligent and should be put on trial for the catastrophes that have become apparent in rece…

I really don't like this kind of knee-jerk "privatisation bad, fatcat CEOs bad" reaction sadly prevalent in the UK. Let's talk about the underlying argument, shall we? Firstly, you're talking about a failure of a regulator to regulate an industry and prosecute alleged perpetrators, and the implied solution is to… nationalise the industry, somehow assuming the nationalised entity will be managed better by the very sam…

There's no competition for water here. And even if there were, what are they competing on? They don't produce water, they don't manufacture anything, there's no innovation to be had. The water is the same whatever the case. There's no advantage to a market.

So how do you seek profit as a water company? You can't seek more customers, since that is constrained by population. All that's left is reducing overheads and increasing margins. By reducing quality of service. By not improving infrastructure, or letting it fall into disrepair. Or, as discussed here, dumping sewage and ignoring costly environmental responsibilities. A tragedy of the commons.

As for the regulator. They are duty bound to ensure water companies are making profits. The incentives are all wrong.