UK NHS: Government proposed changes from July 2024

https://www.theguardian.com/society...veil-radical-nhs-changes-to-cut-waiting-times

This might be politics but it is directly relevant to ME/CFS care as well as all other care. My reading of this confirms that the current UK government has no understanding of what the health care problem is. The problem is about £80B per annum. Without that on the counter all that any new ideas will do is to waste more money on trying to save money.

It is ludicrous. Why does the general public not see this? Why do journalists not see this and write headlines saying 'The Insanity Must Stop' rather than pussyfooting around all the opinions of the vested interests.

Who can bend someone's ear?

 

It’s not in any powerful institution’s interests to actually resolve the problem. That’s why people just make these attempts so it looks like they are doing something. See also - benefits, education etc. Hope that helps!

 

But I think it may be in Starmer's interest to resolve it. At the current rate the government is going to get absolutely nowhere righting the accumulated problems because it seems to think the route to success is stimulating a business-drive economy that is the cause of the problem and cannot any longer be stimulated. So next election everyone will say 'well that Labour was a non-event wasn't it' and there will be a free for all with a hung parliament with four parties ending up with a coalition with Nigel Farage the power broker, like in Holland.

The alternative might seem painful but at least it wouldn't be suicidal for Labour.

People are talking of things going backwards for ME/CFS but my perception is that that is almost entirely driven by this greater political agenda of dumbing medicine down to contracting out recipe following with no mention of research.

 

@Jonathan Edwards - I don't understand enough about how the NHS works or should work to be a useful member of the public here! I suspect I'm not alone. What would a rational system or solution look like, and is anyone running a campaign to promote it that people could ask their MPs to support?

 

He won’t reform the NHS into an efficient and effective institution in 5 years with this global economy.
Also isn’t he Sir Starmer?

 

Surely the global economy is no barrier to good health care. The world economy needs to shrink massively to save the planet from destruction. But that does not stop you paying people to provide a good health service. In fact paying people to do that is probably the best way to boost the 'economy'. Health workers all pay their tax because it comes off at source.

 

Easy. You remove this absurd division between providers and purchasers. Make it all one 'community' system but based in hospitals because they can provide high quality expertise. Hospitals are in the community just as much as health centres. The distinction is an illusion based on the stupid internal market invented by Thatcher.

In urban areas all health care should be hospital based. Hospital care is not expensive. That is a myth generated by pretending that everyone in a hospital bed is contributing to the cost of ITU, surgery and high tech cancer care. They aren't. You could double the number of beds in hospitals and provide very cost efficient care. We have fewer beds than almost any country in the world. Which is why nothing works.

The New Idea is entirely in the wrong direction. You save money by having expert doctors making sensible decisions on use of resources, not be allowing GPs to order expensive Tess they do not need. It will never have any impact anyway because the GPs don't have the budget to do it.

 

It does if you have to balance the books

 

Is anyone pushing for this?

 

Balancing the books is a myth…

 

Are there expert doctors who can make sensible decisions on use of resources though? Seems like everything is a paint-by-numbers “pathway” these days.

 

Only me as far as I know.

 

Exactly. The idea that you finance public services with growth is entirely a con trick put about bt industry, which has a stranglehold on 'academic' economics. It is all a huge lie, as anyone with any sense can see. The vast amount of human effort put into moving other people's money around could easily be devoted to curing the sick. If people were not greedy.

 

The point is that a doctor who has seen two hundred cases of rheumatoid arthritis is more likely to know how to recognise the two hundred and first than a GP who has seen six. GPs use a huge amount of useless physio whereas rheumatologists these days by and large don't use physio at all. So patients either waste their time going to see a physio or suffer in agony because what they really need is surgery.

Unfortunately there are relatively few doctors who can go beyond 'pathways' in unintelligent way. But that is because a generation of doctors children, together with their schoolmates were put off going in to medicine because they saw how fed up their parents were from trying to do a job with no resources - my daughter being one. It wasn't the pay we complained about, it was the fact that there were no resources to treat patients properly and safely. Why go in to a job you aren't allowed to do?

 

Exactly, that’s why we don’t have enough useful experienced doctors.

 

Alberta's provincial government has restructured the health care system several times in the past decade, each promising to cut costs and improve care. I've yet to see any analysis saying that any of those changes actually improved patient care. I agree that changing management systems doesn't solve anything. I don't know what would work, but changing paper-pushing doesn't.

 

Money lots and lots more money would work

 

Not necessarily. With bad management and ineffective monitoring of spending, actual patient care might not improve.

 

So is the solution to bypass people with experience of specific diseases altogether, without addressing the black hole of funding deficit that has pissed off all the people who might have been decent doctors, as Starmer is suggesting?

 

Adequate funding. At the moment people are quite happy to spend thousands of pounds on replacing a half decent car but the government does not allow them to spend that money on a communal insurance system that will provide a life-saving operation when needed (my personal situation). Adequate funding is perfectly affordable. Other countries spend easily enough. Unfortunately, for some of them like the USA the money is mostly siphoned off by rip-off pathology, imaging and pharmaceutical interests.