Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

https://www.theguardian.com/society/...CMP=GTUK_email

Rationed NHS? Not what was envisioned by the originators of the NHS.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

We can expect a lot more of that in future if we priotise tax cuts over investing in our health. You get what you vote for.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Of course this sort of thing never happened before 2010.:rolleyes:

From Apr 2007

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

I have never been called for my 5 yearly Health MOT by our GP. This should include a PSA test for prostate cancer. He thinks it is "unnecessary" despite him being paid to provide the service.

Over the years GPs here have also withdrawn minor surgeries (splinter extraction, cysts drainage, etc.), wart and verruca treatments, lice and headlice treatments, ingrowing toenail treatment, podiatry for the disabled, old or infirm, etc. etc. And now there are no walk-in consultations, just an appointment system with no evening or weekend cover, and neither for 2 afternoons per week.

And now they want to opt-out of out-of-hours cover and most home visits, demanding "another body" be set up to do it all instead.

Ad yet I suspect their pay will not drop a penny....

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Can’t criticise the Tories without acknowledging that the same failures existed in New Labour!

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Nothing to do with failures on either side. Nothing to do with tax cuts. Some of those things are likely to have been already restricted in certain health authorities, even before 2010. Eg The arthroscopic cleaning of arthritic knee mentioned in this list, has been found to not be effective and was restricted in certain(possibly all) regions.
2005

2014
Although.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Blimey, even I get the bowel cancer screening now. Though Mr A gets annoyed by the reminders for his annual check-up, which he refuses as he is already getting these for other reasons.

---------- Post added at 13:50 ---------- Previous post was at 13:49 ----------

Thats the problem. Successive Governments seem absolutely terrified of direct taxation, even for a specific purpose.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Terrified because they know it's not what people want. If the electorate wanted it, they would get their wish.

Good luck with Jo Swinson's proposed tax increase. That should see her installed as our next Prime Minister! :D

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

It’s everything to do with tax cuts. The decisions of what we do (and don’t) fund are a direct result of tax revenues.

You appear to be clouding the matter by bringing in a separate matter on a point people would universally agree: there’s no point funding treatment doesn’t work. That’s of course different from the wider issue.

---------- Post added at 14:15 ---------- Previous post was at 14:09 ----------

“It’s not what people want” is a curious interpretation. You’re assuming people are well informed, and that politicians strive to inform them appropriately.

As I’ve pointed out before - after 40 years of the neo-liberal consensus we are £2 trillion in debt. Politicians were happy to peddle the low tax myth without spelling out to people that it wasn’t sustainable. People were happy to vote for it. Future generations will foot the bill.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

The electorate want the benefits without the cost, which is not possible in the real world.

They need to be educated in TANSTAAFL*

There Ain’t No Such Thing As A Free Lunch

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

You can however borrow against your children’s future ability to find their lunch.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

I’d rather not, thanks all the same... ;)

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Council cuts are down to central government reducing how much they give councils. So they cut repairs to roads, library funding schools & support services, as they are stuck with looking after children in care and the elderly, because they have also been prevented from raising council tax. So people are spending more on car repairs needed due to poor roads, ends up being a false economy. The same applies to NHS funding, if people do not get the treatment they need in a timely manner, they lose their jobs through being unable to work, so more tax income is lost, whilst benefits go up.

People have been sold getting something for nothing. It cannot be sustained.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

If you read the quote in the article it sums it up well.

'These figures show that councils are topping up their reserves where they can, reflecting the absence of a long-term funding settlement for the sector, continued uncertainty around the spending review and Fair Funding Review and an expectation that the long hard winter of austerity is set to continue,’

In other words - councils need to keep money aside because of the uncertainty of how much they will be given in future years.

The amount set aside would barely cover local government spending for three months. As the article also states - some of it is ring fenced so local authorities couldn't even spend it if they wanted to.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

If it was all about tax cuts and revenues, how come it was going on under Labour when they very good revenues and were borrowing massively on top of that?


The example I gave was simply one that I knew of from years back, The others may also have similar studies backing up these decisions.


The problem wasn't tax revenues, it was the various spending splurges, eg tax credit system. Local Housing Allowance(housing benefit).

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

And equally they may not. I’d prefer to hear from medical professionals and not armchair Conservatives.

Various spending not supported by tax revenue is exactly what I’m describing. The decision of what to, or not to, fund. Tax credits to support employers paying low wages and housing benefit to support the rental housing market are equally things I disagree with and part of the deception by politicians for 40 years that have left us £2 trillion in debt despite the windfalls of privatisation. New Labour are just as complicit as the Conservatives in this sleight of hand.

A fair living wage and building council houses is a much better approach.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

343 councils in the UK, and if you take out the GLA, their reserves are £1.1 billion, which works out (on average) as £3.2 million per council - not such a huge reserve (which they use to pay for stuff whilst waiting for Central Government money to arrive).

For instance, my local councile (Leeds, population of around 750k)

They have to have some reserves, because, as we have found recently with floods, etc., "stuff happens"...

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

And this is on top of the recent cutbacks of medication available on prescription. I now have to buy two of my medications myself.

---------- Post added at 17:21 ---------- Previous post was at 17:13 ----------

Isn't the NHS now primarily run by GP's? The same GP's who I am led to believe start on £1,000 a week, rising to at least £2,000 a week with many earning much more.

Yes, they do an essential job and have studied/worked hard to get where they are, but it sticks in my throat a bit to have these people on this sort of money telling me (and those much less able to afford it) that due to austerity they now have to purchase some of their own medicine.

I suspect them taking a 1% pay cut (small change to them after paying less tax/NI) would negate the need for these further cuts, but that's not going to happen is it.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Dcotors work very hard Richard and most have huge workloads as don't think its a bed of roses being a GP as it is far from that.

On the possible plans to ration services these are made by quite a few NHS bodies.


https://www.theguardian.com/society/...and-treatments

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

You heard it here first:

GPs to blame for austerity and if only they took a 1% pay cut we could solve it all.

There are around 33,000 GPs in England. A 1% pay cut would be less than £33,000,000. As you rightly point out, we claw back much of that in tax anyway.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

It's pretty arrogant of you to suggest that people don't understand the issues. You are assuming that most of the electorate are a bunch of retards who can't make sensible decisions on what they want.

What is very clear is that most people do want tax cuts. They also want good quality services, and they expect the government to provide these efficiently. It is the latter that is causing the problems - too much bureaucracy and outdated, inefficient systems.

The fact that this seems to come as a surprise to you is telling.

---------- Post added at 18:13 ---------- Previous post was at 18:08 ----------

I think it is perfectly reasonable for our electorate to demand efficiency before pushing ever increased shedloads of money into an expanding black hole.

---------- Post added at 18:15 ---------- Previous post was at 18:13 ----------

We are paying an absolute fortune into the NHS but service levels keep going down. Strange, that.

---------- Post added at 18:16 ---------- Previous post was at 18:15 ----------

Pity the last Labour government didn't note that, jfman.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

I didn’t call anyone retards so there’s no need for such emotive terminology to be deployed.

I think it’s rather arrogant of anyone to claim they do understand all of the various issues in an election and I find it inherently improbable that the vast majority of people look beyond 2 or 3 issues. These could be local issues, constitutional issues, social issues.

People do indeed want tax cuts. People do indeed want public services. Nobody has been honest for the last 40 years that you can’t have both.

Bureaucracy, outdated inefficient systems, is straightforward terminology deployed by those who want to privatise everything in the absence of any evidence that such inefficiency exists. If you compare, for example, administrative costs in the NHS as a proportion of all costs to the privatised US healthcare sector you will find the NHS spends a far lower proportion on administration.

The NHS can also use it’s purchasing power to drive down the price of drugs in a manner that smaller private companies cannot. As can be seen from the “concerns” the USA plan on bringing to the table in any future trade discussions.

Telling of what exactly?

A statement in the absence of any evidence at all.

Probably the profits being creamed out of it from PFI initiatives, etc. People living longer. There’s no magic wand to that.

Neither did their predecessors. 40 years of failure has led to £2 trillion of debt. Every year we have to shell out £40bn a year in interest payments on this debt. That strikes me as a fairly inefficient use of funds for the fifth richest country in the world.

£40bn of course that could go into the NHS, for example.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

To have that sort of income, they must have an overload of patients on their books per GP, which also means longer hours to get through the workload. GP income covers all the outgoings of a practice as well.

Only 10% of the population of England actually have to pay for prescriptions, maybe this needs looking at, particularly where cheap OTC medicines are concerned.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

If that is an excuse you have made up to excuse Labour for its gross overspending and failure to establish safe reserves of money or gold which led us into a situation where the UK had no money to offset the ravages of the global financial crisis, you are fooling no-one.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

You can count on one hand the number of times any Government has ran a budget surplus since 1979, and as a result the total debt has largely risen year on year in that time, outstripping inflation over that time.

It’s an outright, albeit convenient for you, lie to claim that this countries problems started with the 2008 financial crisis. The gold reserves, or lack of, are a complete red herring - the country was already heavily in debt and running a deficit. As it has been since 1979.

I note you didn’t address any of the other points I made in my fairly lengthy post instead focusing on a single sentence for a sound bite.

A poor response even by your own standards, Old Boy.

For information: the gold Brown sold was for $3.5bn, in 2007 it’d have been worth double. An absolute drop in the ocean compared to the £500bn rescue package the banks got for their failed ventures in capitalism.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Just heard today on Radio Kent that the Medway area has the highest patient to Doctor ratio in the country (2900) to my Northern, Welsh, Scottish and N. Ireland friends this is supposed to be the affluent South that I come and live in....:shocked:

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

So affluent even a Doctor can't afford to live there, and they're loaded!;)

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Thing is, BoJo and millionaire inherited wealth chums can just buy their healthcare. The NHS is for the plebs as far as they are concerned. As Dominic Cummings admitted Tory MPs don't give a toss for the NHS or the poor.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

And no long waiting list for them either...

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Instead the Tories will cut council funding, forcing councils to raise council tax.

People want to pay less for things they have to buy. This is where tax cuts are needed. Income tax is money people don't see in the first place, so raising it by just 1p will make very little difference to the pay packet. Council tax going up to pay for the Police and Social services is a far more visible rise.

Raising VAT also means people buy less.

The NHS is being underfunded, particularly as it is used as a dumping ground for elderly patients the Council care system cannot afford. If people want to keep the NHS they WILL have to pay more for it.

False accounting on claiming 50,000 New nurses is one proven lie. 40 new hospitals is another. Where is the money coming from for these claims? If they are not genuinely achievable in the first place, the cost is correspondingly negligible.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Clearly, you are not one of the 'many' who are struggling to pay their bills.

You cannot just ignore the fact that the NHS is woefully inefficient. Pouring shedloads of money into it for a worsenening service is not the answer.

Most people would agree that the NHS needs sufficient resources to enable it to run properly and provide a good service to its patients, but increased resources need to be conditional on increased efficiency.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

I don't think anyone is disagreeing with the latter..It's a given in any part of any publicly funded and publicly run organisation.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

You may find this of interest.

https://www.kingsfund.org.uk/publica...ue-nhs/summary

However, bear in mind the old Business Improvement mantra - "it’s hard to drain the swamp whilst you’re fighting off the alligators"; people expect the same people to undertake improvement work at the same time they are snowed under with their day job...

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

All too true, we are expecting the hard working front line and technical staff to be more efficient and employ efficiency experts (consultants) usually at high wages to tell them how and make them fill out forms to prove how efficient they are and expect them to get more done in the reduced time they have left.

It's not helped though by the public (some of them) who abuse the system. Don't turn up for appointments, don't follow instructions and so on, let alone those trying to get support they aren't entitled to. If people used the system properly maybe the rules could be more simple and not need loads of investigations into abuse.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

We live on my income and Mr A's small pension. We could claim benefits, but don't. We really are at the lower end of the tax paying spectrum, but live frugally and limit our outgoings. We don't even claim the married persons tax allowance as Mr A despairs of getting sense out of the government as they ask for P60 income and he has none.

The NHS is severely understaffed, this has a HUGE effect on costs. Nothing to do with efficiencies, you cannot get more out of a system that does not have the human resources to do the job in the first place. All you can do is hope the winter crisis is small and short lived, as there is no capacity for worse.

Leaving the EU has already lost us badly needed staff, who are going elsewhere in the EU for better pay and conditions. Removing the nursing bursary has cut the numbers going into the profession. Longer hours often with no pay, just because they care, is causing staff to leave or retire early. None of these have anything to do with "efficiencies".

Teaching the next generation of Doctors costs money and time. Time senior Doctors no longer have due to staff shortages and so the problem multiplies. All for what? Some mythical ideal, where stress no longer exists, with all the corresponding health problems vanishing. Get real.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

I think I should clarify that I don't think the efficiency problem is down to the medical staff. It's the bureaucracy and the clapped out systems that they have to live with that is the problem.

We should be looking at those issues, implement the changes required and with the savings, improve working hours for the medics to attract more to the profession. The hours they have to work are ridiculous - no wonder we can't get the staff.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

And when they tried to modernise their computer IT systems it was a clear and unmitigated disaster which the taxpayer had to foot the bill for.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

The NHS is ruthlessly efficient in actual fact. A far smaller proportion of money spent goes on administration by comparison to US private sector healthcare.

What Old Boy means is we can't cream off profits into tax havens. Which is good for me, the UK taxpayer and the recipients of healthcare.

Could the "many" struggling to go without afford private health insurance? Probably not if they can't pay their bills as it is.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

And every time the myth of "too many managers in the NHS” comes up, I post this, but people still keep repeating the myth.

https://www.kingsfund.org.uk/project...s/nhs-managers

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

The average health insurance premium in the USA is $321 a month for individual coverage.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

And that doesn’t include co-pay and deductibles...

https://www.verywellhealth.com/deduc...erence-1738550

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

A fair chunk out of ones salary.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Especially if you are one of those struggling to make ends meet that Old Boy cares so much about.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Tax havens, health insurance schemes....where are you picking this up from? That's not what I am advocating. You've been hallucinating again, it seems.

There are plenty of inefficiences in the NHS, and anyone who has visited a hospital on a few occasions can see that. Huge paper files being carted about, hospitals in one area unable to communicate or access your papers from your surgery if it's in a different area, trolleys with nothing on them being pushed in one direction, then another, with no obvious purpose - the list is endless.

We can do better than this.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Private sector healthcare is a worldwide enterprise.

---------- Post added at 19:14 ---------- Previous post was at 19:10 ----------

Because something has no visible obvious purpose doesn’t mean it has none, as a lay casual observer with no medical expertise, no knowledge of the job roles, no knowledge of the internal workings of a hospital would surely agree?

We can do better I’m sure, which brings us back to the 2 trillion of debt accumulated from 40 years of neo-liberal capitalist failure. We lose £40bn a year in interest payments alone. Roughly one third of NHS expenditure in England.

Politicians have to be honest. Pay a few extra pence in tax, pay $321 a month in private heath insurance. Those are the options.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

We tried, and failed - too much internal politics (between areas and trusts), disagreement on standards (as local systems had grown/been developed organically to meet local needs), incessant change outwith agreed contractual change, lack of suitably skilled staff (legal, compliance, IT business analysis and development), lack of additional staff to undertake the workload of those seconded to the Change Programme, political interference at local and national level leading to more unplanned change.

For comparison, I have worked on migrating the data from current systems and implementing an SAP ERP system in a University, which covered Finance, HR, and Education (about half the systems in use in the University at that time, but the rest had to integrate with the S4/HANA) - that took 3 years and about £30 million.

The NHS, with multiple times the complexity and organisational change required (you don’t just implement IT systems, you have to analyse the business processes required to support and drive the business forward, amend the systems to reflect the business processes, then redesign and train colleagues to be able to use the systems whilst doing their day jobs), would take decades and 10s of billions of pounds - we don’t plan or invest that long term in this country.

There are in England:

207 clinical commissioning groups
135 acute non-specialist trusts (including 84 foundation trusts)
17 acute specialist trusts (including 16 foundation trusts)
54 mental health trusts (including 42 foundation trusts)
35 community providers (11 NHS trusts, 6 foundation trusts, 17 social enterprises and 1 limited company)
10 ambulance trusts (including 5 foundation trusts)
7,454 GP practices
853 for-profit and not-for-profit independent sector organisations, providing care to NHS patients from 7,331 locations

How do you gain agreement with all these groups on a standard way of doing things?

tl:dr - it’s not that simple or easy

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

The fun thing is they'll probably have to something at some point, even if it's transitioning in a new system for new generations of patients whilst the rest of us use older systems.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

What’s wrong with that?

I would have always thought that surgery be the last resort anyway?

Evidence is evidence.

I’m just going off the article but it seems from those examples to be completely rational.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

30% of that goes towards administration costs. That is how inefficient the American system is.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Oh it's very profitable for some, to whom we're an open goal if we're daft enough to elect Mr Blobby.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

You are re-writing history if you are trying to deny now the mess that Labour left behind when they lost power, and you are ascibing views to me and others that we do not have.

As far as the NHS is concerned, I would remind you that the Conservatives stripped a huge layer of management out of the NHS after they came to power in 2010 and nobody seems to have noticed! We have a way to go yet. Problems are not resolved just by throwing money at them and the measure of a well-run service is not how heavily they are sponsored by the State.

---------- Post added at 09:41 ---------- Previous post was at 09:34 ----------

Who said we need to be like the US?

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Most systems are setup to protect the system whether that is private or public. Those running in ensure that they are looked after first.

So whatever and however it's funded the admin layers are protected and the front end both patient and practitioner are looked after only as it helps the admin layer.

I used to work in NHS IT at a specialist hospital. Was always annoyed that we updated our platforms to meet new requirement and others with big, paid for systems couldn't. Then we hear about how it's so hard to build a NHS network and me thinks that some of the issues need a firm hand rather than technical waffle. The NHS should specify the interface and suppliers/unit comply with that interface e.g. a query looks like this and you provide the answer like this - how you do that is then irrelevant.

The problems in other areas are similar, too much interference in the minutia. The NHS supplies standards/targets, units work to those however they want to. Being ridiculous, a national target to deal with farm incidents isn't needed for an inner city hospital but (if not careful) would still be a target needing budget set aside.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

I worked in NHS IT many many moons ago when The Spine , Choose and Book and ETP were trying to be implemented.

I used to see the clinical systems trainers coming back from training primary care (GP's) on C&B they would be distraught as many GP's surgeries would just completely ignore what they were being told to do or actively refuse to do it. and that was only IF they could get past the practice manager (who generally were incredibly obnoxious individuals who took every opportunity to block progress)

There was and to a degree still is a considerable disconnect between primary and secondary care services within the NHS.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

That statement is factually incorrect - the numbers started going down in 2007.

https://www.wbs.ac.uk/news/how-many-...uk-s-nhs-need/

The clue's in the title - managers manage workloads and budgets, allowing the clinicians to focus on patients.

---------- Post added at 15:15 ---------- Previous post was at 15:02 ----------

CF'ers may find this informative (it's from 8 years ago, and the reporting and funding have got even more complex since then).

https://www.kingsfund.org.uk/publica...rs-and-the-nhs

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

Anyone who cares to look back at the amount of debt, in real terms, will see it has risen for 40 years. It’s an absolute fallacy to blame the Labour Party for 40 years of flawed neo-liberal capitalism. Ten years on from New Labour there is still a defecit, and more debt than ever.

---------- Post added at 17:47 ---------- Previous post was at 17:46 ----------

Old Boy doesn’t care for facts. Merely obfuscation of reality to blame Labour for everything.

---------- Post added at 17:48 ---------- Previous post was at 17:47 ----------

Profits creamed off, less spent on patient care. Glorious for shareholders I’m sure.

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

The profit for the Insurance companies, Hospitals and Doctors comes out of the 70%

Re: Millions to be affected by NHS plan to ration 34 everyday tests and treatments
 

You know very well that Gordon Brown wasted all our reserves. That was the reason we had a bigger problem than we would have had with the financial crisis. The debt has risen substantially since then due to the deficit, which had to be addressed at the same time.