Election Year or Fear!

[ramAnag]

I think I’ve mentioned before I’ve recently moved practises, both about the same catchment and affluence, the former ‘just alright’ and ‘getting more difficult to see a doctor’, the latter absolutely **** hot, I’ve yet to fail to see a doctor (or other appropriate professional) either on the day or on the appropriate date within a few days where they use a travelling specialist. A lot of peoples’ whinges about general practise is due to process failures within the practises, not all but a good proportion IMO and again as I’ve mentioned before Mrs F and I having come from process improvement and customer relations disciplines can see where the differences arise

Regarding Ashbourne, a genuine question, do you not think that the situation you mention to some degree conditions your opinion?

Absolutely…of course it does and I did concede it was ‘anecdotal’. I’ll also admit that just before Christmas I needed to see a doctor ‘urgently’ and the service I received was first rate.
The other side of that coin however is the experience my wife had both online and, subsequently, via telephone this morning when an initial 15 week wait eventually led to an appointment at the end of March…possibly - can’t be certain - because she is quite articulate and tenacious.
I take your point completely however, imo, the availability of appointments is nowhere near as good as it was many years ago and I suspect, if that is the case in relatively affluent Ashbourne, then it may well be much worse elsewhere.

[Geoff Parkstone]

In relatively affluent Surrey I got tidays (non emergency) dental appointment within 2 days (ok, a cancellation appointment) and when I was in waiting room the receptionist was saying "booked solid for 2 months".

I need a root filling - appointment next Wednesday. No complaints here, but guess I'm lucky

[ramAnag]

In relatively affluent Surrey I got tidays (non emergency) dental appointment within 2 days (ok, a cancellation appointment) and when I was in waiting room the receptionist was saying "booked solid for 2 months".

I need a root filling - appointment next Wednesday. No complaints here, but guess I'm lucky

NHS or private? Had it been a genuine ‘painful’ emergency do you think you’d have been seen quicker?

[Geoff Parkstone]

NHS

When I had a painful issue last autumn I was seen in 24 hours - albeit I had to wait in dentists for an hour before a quick fix could be done, then a proper fix a few days later.

[ramAnag]

NHS

When I had a painful issue last autumn I was seen in 24 hours - albeit I had to wait in dentists for an hour before a quick fix could be done, then a proper fix a few days later.

Good to hear. Not sure how typical it is. The bigger problem seems to be ‘new’ patients gaining access to such availability of treatment.

[Andy_Faber]

NHS or private? Had it been a genuine ‘painful’ emergency do you think you’d have been seen quicker?

A private practise would have seen GP PDQ but of course it’s in their commercial interest to do so

[ramAnag]

A private practise would have seen GP PDQ but of course it’s in their commercial interest to do so

Which is part of the problem imo. For whatever reason, and Swale has touched on them, we have a situation where commercial interest now takes priority over compassion/health interests even where medical/dental matters are concerned.

It’s been happening for a while. About a decade ago I was unfortunate enough to need root canal while on holiday in southern Spain. I was seen within the hour, treated at an excellent German/Spanish practice and charged around €350 for the two necessary visits. About a year earlier I’d needed the same procedure (on a different tooth!) which I had done in Mickleover…the charge was the wrong side of £450. ‘Rip off Britain’ or just a loss of the values of decency and compassion that health providers should be synonymous with and a sign of the times?

[Geoff Parkstone]

"where commercial interest now takes priority over compassion/health interests even where medical/dental matters are concerned."

Not sure I quite get that one rA. The compassion towards and health interests of the patient remain the same whether a private payment is made or if it's a "free" treatment (not that it's free as such).

Dentists need patients one way or the other, so health interests are dealt with. It's just a question as to who is treated, rather than any lack of compassion.

If course anyone who pays privately for healthcare is one less patient for the NHS to deal with: and it's not like you opt out of NI payments when paying privately.

There is a symbiotic relationship between NHS and private healthcare - neither could survive without the other. I chose to pay for private healthcare insurance (exc dentistry) and have to date got little from it. That's my choice. Someone else might chose to spend their disposable income on beer, gambling, holidays etc etc. That's their choice. DobI think beer or holidays should be funded by the state? No...

[Trickytreesreds]

Which is part of the problem imo. For whatever reason, and Swale has touched on them, we have a situation where commercial interest now takes priority over compassion/health interests even where medical/dental matters are concerned.

It’s been happening for a while. About a decade ago I was unfortunate enough to need root canal while on holiday in southern Spain. I was seen within the hour, treated at an excellent German/Spanish practice and charged around €350 for the two necessary visits. About a year earlier I’d needed the same procedure (on a different tooth!) which I had done in Mickleover…the charge was the wrong side of £450. ‘Rip off Britain’ or just a loss of the values of decency and compassion that health providers should be synonymous with and a sign of the times?

Really?
So ask yourself this. If Germany has sucj a wonderful health service and ours is falling to bits. WHY?

How much of Germany's GDP is spent on healthcare?
Germany: health expenditure as a share of GDP 1980-2022 ...
In 2022, Germany spent 12.7 percent of its GDP on healthcare. The total expenditure on health as a percentage of GDP has increased since 1980.


Health funding data analysis

British Medical Association
https://www.bma.org.uk › nhs-delivery-and-workforce
10 Aug 2023 — OECD data shows that the UK spent around 12% of its GDP on health in 2020 and 2021, compared to only 10% in 2019.

Germans even pay less in prescription charges. So that balances out the slight GDP difference.

So why do we have monstrous waiting times?

I'll let you all list the reasons.
I'll start with piss poor staff structure of too many chiefs and not enough indians, with many stupid jobs/roles taking up resources.

[Trickytreesreds]

Excellent, the NHS is another sympton of a bigger disease.

https://www.telegraph.co.uk/news/202...r-for-britain/

IN CASE YOU CANNOT SEE IT.

Whenever it’s suggested that Britain could manage without importing 1.2 million people every year, out come the usual voices with the usual lines.

The NHS would collapse overnight, care homes would go unstaffed, our best universities would implode into a financial black hole, the ravens would leave the Tower of London and the last trumpet would sound as Britain sank slowly, gracelessly into the frigid waters of the North Sea.

This is scaremongering. Britain would be fine with massively reduced immigration; the only thing standing in the way is the Government.

Let’s start with the NHS. 2022, it hired some 12,148 foreign doctors. Over the 2022-23 financial year, they were joined by an additional 24,000 nurses. You could cut the numbers arriving by over a million before touching this tiny group. The health service is not a barrier to reform.

Even if it was, we could work around it. Every year, hundreds of qualified students are turned away from medical school due to the Government capping places. This has left Britain significantly more reliant on overseas staff than its peers, and hasn’t necessarily increased quality, either.

Doctors trained overseas are significantly more likely to face serious complaints than their domestic counterparts, and it is notable that the countries providing the most – Nigeria, Pakistan, and India – have two universities in the top 500 worldwide between them, compared to 54 in Britain. We might find it worth looking at what’s obstructing supply at home.

The university sector, on the other hand, does rely on funding from overseas students. It’s not hard to work out why; frozen domestic tuition fees have seen their real value fall £3,000 per student. Fees for foreign students, meanwhile, are uncapped.

The result has been an explosion in student visas, driven by huge numbers from poor countries attending the least selective, cheapest universities. These institutions are not selling education; they’re selling the right to work on the post-study visa.

Nobody is suggesting that the likes of Oxford, Cambridge or Imperial should be forced to turn away talented students. But at the lower end of the scale, we should either raise fee caps, or let failed institutions fail. Allowing what amounts to a backdoor work visa fee is absurd.

The social care sector, too, could probably function without massive immigration. It’s true that large numbers are recruited from overseas - 101,000 last year. But this isn’t because British workers aren’t capable of doing the job. It’s because it doesn’t pay enough. The median care home worker earned just £10.11 an hour in March. Aldi and Lidl pay £11.40, and Amazon warehouses around £13. It’s no wonder people are leaving.

The primary issue, again, is the government. Local authorities are responsible for publicly funded care; their real terms budgets have fallen 29 per cent between 2010 and 2022. The Treasury could dig into its pockets, and let wages rise. It wouldn’t cost that much; the full time equivalent social care workforce is about 1.2 million people, so giving every single worker a £2/hour pay rise would cost about £5 billion. The net cost would be even less if we could shift some of the 5 million on out of work benefits into employment.

Rather than do this, the Government is bringing in people willing to work for less. This looks great in the short run; the Chancellor can stand at the despatch box and promise tax cuts, with the OBR dutifully plugging in fancifully low spending assumptions for the larger population.

The problem is that it’s a ponzi scheme. People on care visas are eventually eligible for permanent residency, and free to work elsewhere, requiring more migrants to replace them. Meanwhile, studies have shown time and time again that these low skilled, non-EU workers almost inevitably turn out to be a long run fiscal drain.

But by the time those costs show up, the politicians have moved on and the mess is someone else’s to fix. It’s a pattern repeated from sector to sector. Britain deserves better than this reliance on immigration to cover the government’s incompetence.