In the last few days there's been articles in the Mail, one from an A&E doctor, the other a report on the state of the hospital itself. Now, I'm not taking sides as I think all parties are a disgrace. My concern is that when an A&E doctor is working 2-3 hours over their 10 hours shift, yes that's a 10 hour shift, politics goes out the window. This individual stated that they don't need billions on managers and bureaucrats, they need beds, nurses, doctors, theatres and a social care system that works. I can see it, you can all see it do why the fuck will any government do anything about it? |
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Because I genuinely believe no one really knows how to, and that's because the entity which is the NHS is so big and unwieldy, it has reached a point of inertia.
And that's not a criticism of any public body. Private corporate organisations are prone to this as well.
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Which leads one to conclude that there comes a point when the critical mass of any large organisation will be counter-productive to its long term survival and indeed existence.
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Now throw in varying degrees of competence, capability, malevolence, inefficiency, bureaucracy and self-interest and you reach the conclusion that any structure of that calibre is doomed to fail. Or continually be in a state of creaky chaos.
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I can't think of any large enterprise of that calibre which is a well-oiled and efficient machine. Not even Amazon. It still has its "pinch points" and areas of shitness.
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Can it improve ? Yes of course, in fits and starts, but it's still doomed to failure fundamentally. Because of all the reasons (and many more not listed) given previously. Because ultimately...humans.
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Not in my lifetime, or indeed several, but if you could have robodocs applying templated care for the same things that present day in day out, you'd create a standard. All led by AI of course. And advanced AI would examine non-routine and using machine-learning and past precedent resolve such cases. (In the very early days it would defer to a human I suppose, but eventually that will be unnecessary for 99.9E^10% of cases.
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"Because I genuinely believe no one really knows how to, and that's because the entity which is the NHS is so big and unwieldy, it has reached a point of inertia.
And that's not a criticism of any public body. Private corporate organisations are prone to this as well.
.
Which leads one to conclude that there comes a point when the critical mass of any large organisation will be counter-productive to its long term survival and indeed existence.
.
Now throw in varying degrees of competence, capability, malevolence, inefficiency, bureaucracy and self-interest and you reach the conclusion that any structure of that calibre is doomed to fail. Or continually be in a state of creaky chaos.
.
I can't think of any large enterprise of that calibre which is a well-oiled and efficient machine. Not even Amazon. It still has its "pinch points" and areas of shitness.
.
Can it improve ? Yes of course, in fits and starts, but it's still doomed to failure fundamentally. Because of all the reasons (and many more not listed) given previously. Because ultimately...humans.
.
Not in my lifetime, or indeed several, but if you could have robodocs applying templated care for the same things that present day in day out, you'd create a standard. All led by AI of course. And advanced AI would examine non-routine and using machine-learning and past precedent resolve such cases. (In the very early days it would defer to a human I suppose, but eventually that will be unnecessary for 99.9E^10% of cases.
.
"
I don't disagree with some of the points you've raised, however the NHS isn't one organisation, and isn't run like one; it's more of a structure. So when people say "the NHS is broken", what they should really say is "the structure of the NHS and it's funding flows" are broken. |
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Simple really. It's going to get privatised and it needs to be in a really sorry state so
1) they can sell it off cheaper to their 'sponsors'
2) the public will fall for 'it will improve things' bullshit
It's exactly what they did with British Rail and we now have the most expensive and worst trains in Europe.
According to the National Scott last year Streeting has accepted £175K donations from companies linked to private healthcare firms. |
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"
I don't disagree with some of the points you've raised, however the NHS isn't one organisation, and isn't run like one; it's more of a structure. So when people say "the NHS is broken", what they should really say is "the structure of the NHS and it's funding flows" are broken. "
A very salient observation and point, thank you.
I had overlooked the dismantling or decoupling of certain elements / provisioners, typically to private enterprise.
It is too much of a fragmented behemoth for any one government to overhaul in any meaningful time frame. And that's the parts they can affect which have not been outsourced.
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It's like trying to fix a plane that must keep flying but the multiple parts of the plane are all owned by different people, some private, some public, and everyone has their own rules on who can do what and when and how and with what funds.
 |
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"
I don't disagree with some of the points you've raised, however the NHS isn't one organisation, and isn't run like one; it's more of a structure. So when people say "the NHS is broken", what they should really say is "the structure of the NHS and it's funding flows" are broken.
A very salient observation and point, thank you.
I had overlooked the dismantling or decoupling of certain elements / provisioners, typically to private enterprise.
It is too much of a fragmented behemoth for any one government to overhaul in any meaningful time frame. And that's the parts they can affect which have not been outsourced.
.
It's like trying to fix a plane that must keep flying but the multiple parts of the plane are all owned by different people, some private, some public, and everyone has their own rules on who can do what and when and how and with what funds.
"
Add in to that that each area is a trust. And in sussex you have Brightion university hospital and within it mental health is done by susse partnership so effectively to trusts that don't agree under one roof.
This will always fail. |
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“”Because I genuinely believe no one really knows how to, and that's because the entity which is the NHS is so big and unwieldy, it has reached a point of inertia””
This
And an unhealthy nation
What are they going to do about food supply. Sugar chemical laden cancer inducing foods. Fast foods. Cheap factory farm meats, climate and economic damage to farming etc
37% adults overweight
26% obese
Third children overweight
£6.5bn nhs cost on obesity rising to £9.7bn as we get fatter
6 million smokers
3 million on drug rehab/treatment
£2.8 bn nhs cost treating alcohol and
£27.4 billion cost of alcohol harm in England (alone) every year
Malnutrition cost to nhs £22.6bn a year
Off work sickness due to these causes cost economy £138bn a year
Tens of millions of people and tens of billions pounds (30% odd of nhs budget) spent dealing with this much of which avoidable
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Isn’t one of the main problems the lack of social care so that people who don’t need or want to be in hospital can’t be discharged?
Also the lack of GP provision, and unrealistic expectations of GPs (such as extended opening hours) mean people are going to A&E unnecessarily. Part of this is also that people seem to be less resilient and need help for minor stuff we used to just treat at home.
Then you have all the points from another poster regarding ill health in the population caused by poor lifestyle. And the huge increase in population, mainly in lower income classes caused by immigration.
It is impossible to keep the original concept of the NHS under these pressures. |
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By *otMe66Man 12 hours ago
Terra Firma |
I'm not a fan of the NHS in its current form, but I will say this; Take a step back from the end point failure and look at what is causing it to fail, in a unbiased way.
Is it right to keep blaming funding, management, lack of nurses, privatisation etc.
The simple fact of the matter is the system is overwhelmed by the numbers of people using it, from the GP surgery, to A&E, surgical operations, right the way through to after care.
We need a new model that removes the strain of unnecessary visits, we need to charge non UK citizens for using the service, the same as we would be charged if we were in any other country, we need to promote private healthcare and offer tax relief for those that pay for treatment themselves.
The hierarchy within the medical profession needs dismantling, along with the BMA who think nothing of holding the country to ransom as it plays politics. The NHS needs a radical change but not in isolation of the people that use it, even if that is removing some services unless paid for and removing free access to all.
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"I'm not a fan of the NHS in its current form, but I will say this; Take a step back from the end point failure and look at what is causing it to fail, in a unbiased way.
Is it right to keep blaming funding, management, lack of nurses, privatisation etc.
The simple fact of the matter is the system is overwhelmed by the numbers of people using it, from the GP surgery, to A&E, surgical operations, right the way through to after care.
We need a new model that removes the strain of unnecessary visits, we need to charge non UK citizens for using the service, the same as we would be charged if we were in any other country, we need to promote private healthcare and offer tax relief for those that pay for treatment themselves.
The hierarchy within the medical profession needs dismantling, along with the BMA who think nothing of holding the country to ransom as it plays politics. The NHS needs a radical change but not in isolation of the people that use it, even if that is removing some services unless paid for and removing free access to all.
"
👏👏 |
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