What is the alternative?
 

So..now the tories are blaming the GP's for the NHS crisis...

I'm sure everyone would agree that there is a reasonable argument that GP surgeries should be open at weekends and after 5 o'clock...GP's and dentists etc..are the last bastion of 20th Century working hours, where the working man knocked off on Friday and went back in on Monday. Where Accrington shut down during 'wakes' week and between Christmas and New Year.

But...this is NOT the reason why our hospitals are in crisis..and I use the word 'CRISIS' because I've seen this first hand at BRH this week. There really are people on trolleys in corridors, lying in ambulances outside. 4 hours waiting to be seen by an A&E doctor, 3 hours in a corridor waiting to be assessed for a ward and another 2 hours before getting a bed and appropriate medication.

You get on a ward... and guess what...the beds are full of people who want to get out...but they can't..because there is no support for them if they did get out...for the last 10 years the tory government has eroded social care to breaking point. There is no-one to look after you at home so you stay in a bed that could be best used by someone with a more serious issue.

You'd think that something like this would be a godsend to an opposition politician...

And do you know what Jones is bleating about....internal politics, Yemen and bleedin' betting terminals..oh yeah and something from the paper pushing job title 'director of public health for lancashire' about the evils of having a fag...

Just take your free pension Jones and give me an alternative to the tories!

Re: What is the alternative?
 

Guinness, as usual you are right( and i do not mean that in a snotty way).
This problem goes back a long way and it is multi faceted. It certainly predates this tory government.
I have been retired 14 years and we had problems finding beds during winter months when I was in post....many ops were cancelled and our beds given over to the medical teams.
The rot set in when business models were applied to health care, when politicians started to meddle in stuff that they knew nothing about(no change there then)...when they started applying target based care rather than care on a clinical need basis.

The other thing is that we fail to rake in money from the folk who are here and using the NHS when they should really be paying for their care.
It is not beyond the realms of possibility to organise some scheme to get the cash from health tourists..

We have more people livingon this small island and an ageing population so it should not be a surprise to anyone that the system is buckling uner pressure...it stands to reason that if more people use a service , the service is going to be stretched.

The general public have to bear some of the brunt too. Turning up at A&E with a minor aliment should be a criminal offence.
I have been in the situation of taking a history from a patient who presents as an emergency and when you ask how long they had this pain and they tell you two months...and they turn up at 10pm on a Saturday evening. It beggars belief.

I take your point though. Our representative is pretty much useless.

Re: What is the alternative?
 

The misty eyed belief that the NHS of the past is fit for purpose in the 21st century lies at the heart of the UK's health care problems. It needs drastic modernisation & overhauling, but any politico who says as much is pretty much opening themselves up at least for frothing outrage or at worst de-selection by party/public.

At some point the public are going to have to accept that they'll be bound to pay directly for certain aspects of the system as the compulsory contributions from NI payments are insufficient to maintain the standards people expect.

Take a look at the Health systems throughout other European countries & they certainly don't seem to be suffering similar degradations as the NHS despite also having ageing populations, a massive influx of non paying immigrants & a lessened pool of contributors. I can only speak from my experiences here in Germany (and that was very recently pretty intensive) & in comparison with what is shown on the UK news Germany is by far superior in its operation.

Believe me, there are certain things about the German system that could be better but when compared to UK, I believe I'd rather be treated here than there!

Re: What is the alternative?
 

We already pay for dental care and for eye tests(unless you are over 60 or have long term eye problems)...we pay for prescriptions too.
It isn't just about money...and if it were then the last labour government that encouraged private finance initiatives so that new facilities could be built but without saddling the government with debts was a very bad idea.(and during meetings about such things I made the comment that you would have to be mentally deficient to sign up to a mortgage when you didn't know how much you would be paying....or how long you would be paying it for)

Balfour Beattie must have rubbed their hands with glee when they were contracted to build the extension to RBH.
The hospital used to have its own works departments....plumbers, joiners, electricians, engineers builders. Work was done 'in house' at competitive rates.
Not anymore. The simplest jobs have to be done by Balfour Beattie at exorbitant rates(something like £240 to replace a lightbulb).
That, along with the rising costs of treatment and year on year savings which HAVE to be made.

Money wasted on agency staff. Locum doctors and agency nurses eat up great big chunks of budget.

I don't know what the answers are because so many stupid decisions have been made in the past which cannot be reversed...unless the current government decides that all those
PFI agreements are torn up. That would free up a lot of money.
Getting rid of some of the management structure would help too.
Especially those deals where a senior manager gets kicked out with a nice final payment and is re-employed on a lucrative contract the following month.

Re: What is the alternative?
 

Exactly! And that, from an ex-medical professional such as yourself convinces me even more that wiping everything out & starting over is the only way the NHS can be re-affirmed as a world leader in medical health.

Re: What is the alternative?
 

This is an interesting read, a speech by Ken Hargreaves MP about Accrington Victoria Hospital

Re: What is the alternative?
 

Neil, you are right it IS an interesting read.
The problems go back a long long way and they have been worsened dramatically by politicians using the NHS as a political football.
They should take their fingers out of the NHS pie and allow those who know about health care provision to manage the situation...though who would want to take on this poisoned chalice is beyond me.
Beds have been closed, hospitals shut down, A&E services reduced.
So in the face of such stupidity, why are we surprised to find the service on its knees?
When places like the walk in centre at AVH are being closed...there are protests because local people can see their services being eroded and withdrawn, with no real alternative being provided.
Do you really think anyone in authority cares one jot about the protests or the petitions?
Of course they don't. The changes are cut and dried before the public get wind of them.

What effect might the closure of the walk in centre have on A&E at RBH?
Well, for sure it won't make things easier.

Re: What is the alternative?
 

Most people shouldn't be using a walk in centre, they should be using their GP but we have a problem with GP's in this country.

I'm not sure if I think minor injuries should be treated at AVH or if that should be a function of A&E at BRH.
Triage should funnel people in the right direction but doesn't.
I've found the triage system especially poor at BRH with the reception staff allowing someone to sit and wait for 30 mins to be seen by the triage nurse who described classic stroke symptoms to the receptionist. Only when I went to speak with the nursing team did triage happen.

Re: What is the alternative?
 

Another one of the big problems which preceded this debacle is the decision in 2004 to allow GPs to opt out of providing out of hours cover. This was under the auspices of a Labour goverment presided over by the delightful Tony Blair.

The provision of health care has never been a 9-5 situation, and people who go into this profession are aware of this...and that there will be times at weekends, nights, public holidays when they are required to provide services.
GPs are no different and some of them are paid a lot of money to provide a service.
They know this when they take on the job. It is time the got themselves organised and provided services that reflect the pay they are getting.
As Guinness pointed out, the days when people worked Monday to Friday are long gone.
GP services should reflect the needs of their patients and not close on a Wednesday afternoon for 'staff training'. Yes, staff have to be trained, but the service still has to be maintained...with good appropriate management it can be done.

Re: What is the alternative?
 

Neil, you are right. There should be absolutely no need for a walk in centre, but plainly the GPs in this area are failing their patients by not matching their services to the needs of the population they are supposed to serve.

Re: What is the alternative?
 

These are the opening times of my surgery which I regard as one of the best from stories I've heard about others.

I don't understand why they close on Wednesday afternoon and why they close for lunch. Why can't the doctors and reception staff stagger their lunch breaks to provide appointments all day to better suit their customers?

http://www.accringtonweb.com/forum/a...1&d=1484518337

Re: What is the alternative?
 

A few years ago I thought the GP unit was staffed in the evening by several local GP's. Was this how they were providing out of hours service before 2004 you mentioned?

Re: What is the alternative?
 

No, Neil. Surgeries used to provide their own out of hours service in the dim and distant past.
The doctors worked on a rota and went out to see their own patients who needed the services of a doctor. It is a long long time since that happened. Now if you call a doctor out of hours you can get anybody.
It could be someone from a practice in Blackburn, it could be someone who has flown in from Germany for a lucrative weekends locum work...but what you can guarantee is that they will know nothing of your past history, other than what you can tell them(and with some members of the public that is worse than knowing nothing at all)

I would hazard a guess that your practice is the Rhyddings Surgery.
You are right on all counts it IS one of the better ones...The GPs do not seem to be driven by money...but they could manage the hours of opening better by staggering lunches for staff.

Re: What is the alternative?
 

A few years ago mum and I had just arrived at our hotel in Blackpool for an holiday. As I was unloading the luggage I badly gashed my scalp on the underside of my hatchback door. There was a lot of blood which I staunched with a towel. We then checked into the hotel and the receptionist noticed blood trickling on my forehead. She advised me to go the the Walk In Centre on Talbot Road (she said I would be waiting for hours if I went to the A & E). I took her advice and the service was quick and excellent. The nurse stapled the wound and told me to come back at the end of my holiday to have the staples removed.

Re: What is the alternative?
 

Your GP is paid to look after you whether you visit the practice or not. So if you go and get your care delivered by someone else(like a walk in centre) your GP is getting paid for doing nothing.
Michael, your situation is slightly different as you were a 'temporary resident'...and a town like Blackpool will always have loads of those.

The population has increased by more than 10% over the last decade...hospital services have shrunk by a similar amount( beds closed, hospital wards closed, A&E departments closed... Ok some areas got Urgent care centres as an alternative, if you can call them that)
Ask the people of Burnley how they feel about having the journey to Blackburn to an A&E and see how they feel about it.
If you were in Burnley having a heart attack, I am pretty sure you would not relish the wait for am ambulance to ferry you to the A&E at Blackburn ....and it reduces your chances of survival.

Re: What is the alternative?
 

Am I right in understanding that, contrary to most folks' assumption, GPs are not and have never been 'part' of the NHS? Aren't they private businesses who contract to the NHS, in the same way that big companies like Amey now contract to County Council's to do highway works.
GPs have "had their mouths stuffed with gold" at least twice by Labour Governments, to provide services to the public. I'm not old enough to remember Nye Bevan being the first but it's pathetic that sixty-eight years on signs like the one above (closed all day!) is so common.

Re: What is the alternative?
 

They are contracted to the NHS, but can mix the NHS work with private practice.

My understanding is that they are paid for the number of patients they have on their list whether you visit them or not( which is why there was the hooha recently about GP's claiming money for 'ghost patients'...that is patients who are no longer registered with them)
This payment in itself is lucrative, but then GP's will get extra payments for things like flu jabs(though they are rquired to meet certain quotas), family planning services and other health/ education interventions.

http://www.nhshistory.net/gppay.pdf

The above link provides an interesting read, as does the one below.
https://www.theguardian.com/society/...09/nhs.health1

Re: What is the alternative?
 

You are spot on there Margaret re the moving of A&E to Blackburn. I live in Burnley and most folk here were appalled when it happened. Everyone said BRH would not be able to cope with the extra patients and so it has proved. As for heart attacks... my mum collapsed in the Arndale in Accrington with one and the journey from there to the old infirmary seemed to take for ever so how much worse for folk from Burnley or Nelson or Colne. Unfortunately in my mums case it would have made no difference but there must be many to whom it would. I remember there being the case of one elderly lady who fell on the path outside Burnley General and she had to wait there on the ground till an ambulance came to take her to Blackburn. Absolutely stupid.

Re: What is the alternative?
 

It doesn't help with Chorley A & E shut.

Re: What is the alternative?
 

Every A&E that is closed increases the pressure on the remaining A&E departments.

If GP services were better then maybe, just maybe some of that pressure might ease.
It would still not solve the pressure on hospital beds though.
It is a sad fact that the closure of wards has made it impossible to accommodate all the patients that need beds.
Also what complicates things is that local councils have to pay for interim residential or half way house care. Every day that they can keep a patient in hospital rather than in a council provided care means money saved.

It isn't just a case of overhauling the NHS, social care needs to be overhauled too and the two services need to run in tandem and complement each other.
It does not matter how much money is thrown at the NHS, if social care is lacking or underfunded then any improvements will never have the desired effects.
You do not need to be a genius to see this.

Re: What is the alternative?
 

A few years ago 'Care in the Community' was supposed to be THE thing. Trouble is that the funding was not forth coming to pay for it. The elderly have been left isolated because Meals on wheels and home helps have been discontinued. The so called help now is a ten minute call if you re lucky. Patients would rather be in their own home but without the back up they cannot manage. If the overseas aid were redirected to the NHS it would be a start. It would certainly do more good than funding a girl band somewhere in Africa.

Re: What is the alternative?
 

I have not HEARD 1 M.P. from any party suggest cutting Foreign Aid and using it for the N.H.S. or Care or anything and seriously doubt i ever will.:rolleyes: yet i know for sure people have suggested this to different M.P.s:rolleyes:

Re: What is the alternative?
 

Can someone tell me, what use is 'Foreign Aid', it has been going on since, well, since before I had to start work and pay taxes!

Every year we get told we are third worlding this or fourth worlding that, we are so generous to the brown world (yes, they deserve looking after) and yet I have a mate in hospital who gets the minimum of assistance even though when he was fit he paid into this corrupt system now he's getting just a polite nod then a shake of the shoulders, 'this is all we can do for you' if only you had worked harder and paid more.:mad:

Re: What is the alternative?
 

The sad thing Less, is that there are many in the similar position to your friend.

Re: What is the alternative?
 

Yes I know, but why should he and the many in similar positions, be left to struggle in this Country whilst our politicians are willing to pay for folk abroad that wouldn't give a toss about him?

:mad::mad::mad::mad:

Re: What is the alternative?
 

They shouldn't..That is the answer, but you and I both know how deaf they are to the concerns of those people the elite consider to be the peasants, the uneducated, the plebs.
We are of little consequence. The politicians don't get any kudos for looking after their own folk, they get kudos from sending money to places where it can be siphoned off by corrupt leaders and despots....countries that have their own space programmes. The Department for International Development should be disbanded and those civil servants should be directed to forming strategies to address the current problems we have in this country. It won't happen because there is no benefit to our international reputation.

We should be giving nothing away while there is a deficiency in elderly care, social deprivation and the current crisis in our NHS....even though I really do believe that the problems in the NHS need an intelligent approach, and radical reform, rather than just money being thrown at them.

Re: What is the alternative?
 

A few years ago such things as lung and heart transplants were the 'in' thing, supposedly giving people an extra 10 years of life, (I imagine at great expense with all the drugs needed for preventing rejection).

If 10 years ago they had just spent a small percentage of that trying to keep him fit instead of ignoring his condition, he would probably have had another 10 years at least to pay towards 'foreign aid'.

Re: What is the alternative?
 

Yes Less...you are right.

Re: What is the alternative?
 

I may be wrong but I have a vague memory that 'Foreign Aid' was created at the time the UN was setup and was/is something all/most 'developed' countries agreed to pay, a bit like the 2% GDP all NATO members are supposed to spend on their forces. Needless to say like most international agreements and commitments most countries are happy to signup and then forget all about what they have agreed to. This country however does tend to do what it signs up for, we probably would have had less hassle with the EU if we followed their directives like some countries do.

Re: What is the alternative?
 

I have read that 10s of thousands of Ex Pats are likely to come back to the UK if their free health care in the country they are living in is stopped when we leave the EU. That would put even more strain on the bed situation in the NHS. I did not realise they got free health care. Perhaps Dave in Germany will know. Another way to save the NHS money would be to stop the practice of not taking back walking aids after folk have had for example knee or hip surgery and no longer need them. The same goes for unused dressings etc that have not been touched. It does seem a terrible waste.

Re: What is the alternative?
 

Not here they don't! Working here legally on the German system, registered & paying my contributions covers me for the same health care as any other person playing by the rules in Germany. I think the folk mentioned in your article are more likely those that have retired after working & paying their stamp in the UK, but then settle somewhere in the sun where their pension has more worth.

Having said that, theoretically they should have health insurance/cover to meet any requirements for health care. Apparently throughout Europe there's a reciprocal agreement for Countries to treat foreign eu nationals as required. Some countries require payment from the patient straight away & their medical insurance details which can then be reclaimed by the patient, others take details & apply to the government of the national involved for repayment.

Something the NHS should be doing but aren't & then they complain they're losing money hand over fist because of "Health Tourism"! More to the point they're losing money because of their own inaction & refusal to apply procedures already in place to enable the recuperation of treatment costs!

Re: What is the alternative?
 

They are trying to recover costs but for some strange reason the NHS gets abused when it wants to do things like check ID's to make sure you are entitled to treatment. It's a bout time we introduced the an ID card system as was suggested a few years ago to make it more simple to prove who you are and what you're entitled to.

Re: What is the alternative?
 

I do not want to be obliged to carry an ID card.
I have never been in favour of them. I can provide forms of identification...a medical card, my SRN qualification and number, my badge with my picture on it from when I worked within the NHS.
I look a lot different to a pregnant Nigerian woman who has accrued a bill of £350k(for maternity care and intensive care of her babies)
How does someone like that get treatment and care without having to give credit card details?

OK, so you are going to tell me that there are a lot of folk who do not look Nigerian, but will falsely get free health care.
I have a Lancashire accent, I can prove I have lived in the area and paid my dues since 1962...that should be enough.
I will not carry an ID card.

Re: What is the alternative?
 

Solving the problems in the NHS isn't just about money, though of course it is bad business to allow people to escape paying for treatment if they have not paid into the system.

To my knowledge,all hospitals have admin staff whose job it is to determine those patients who come through the doors and should be paying.
Now if they are doing a poor job, that should be sorted.
The problems within the NHS are complex...multi faceted and need an approach which addresses the complexity...and deals with the facets simultaneously.
If this is not done, then whatever efforts are put in will fail, or may only provide a temporary stop gap.
The NHS needs to run in tandem with social care provision for a start.
Social care provision should be a state run concern.
The NHS has been a political football and all parties have meddled and tinkered around the edges. None of this tinkering has been beneficial to the patients.
The companies who provided the PFI contracts should be told that after a certain date the hospitals will pay no more into their fat coffers...and hospitals should be allowed to contract their works to the lowest tender...or set up their own works departments again(far more cost effective and those who actually work for a hospital give a better service because of the pride they have in their work).
GP's need to improve their services too...no more closing for a half day on Wednesday, staggered lunch times. It can be done but needs to be thought out and managed properly.

Re: What is the alternative?
 

Personally an ID card would not bother me if it means sorting the wheat from the chaff so to speak. Years ago I would not have been in favour but in today's world I think it is a necessary evil.

Re: What is the alternative?
 

All for ID cards & the application of checks, as to the NHS recovering costs a lot of the time it's the Doctors, staff & admin people themselves causing the problems by refusing to enforce checks or carry out laid down rulings.

NHS 'Scandal' As UK Pays Millions To EU

NHS hit squads to collect payment from health tourists

Re: What is the alternative?
 

It is just another layer of bureaucracy...and if those admin staff who are supposed to do the checks on how long you have been resident in this country are not doing them, then it becomes another worthless document
The NHS write to me to chase me up for mammograms...that means they know who I am.
I have an NHS number. I have a number which relates to my medical notes...a patient ID number. Why do I need anything else to access a service for which I have paid since 1962?

The systems for checking if you are accessing the NHS appropriately are already in place and have been for more than two decades.
That they are not being used is down to the management of the hospital trusts...or maybe that should be mismanagement.

Re: What is the alternative?
 

For the last ten or twelve years of my working life I was required to wear photo ID.
I did have a photo ID badge, but as to actually wearing it...well it lived in the front pocket of my handbag.
What was it for? Heaven knows, because in all those years I was not asked once to show it, to prove who I was.
Not at any of the meetings, not in any department that I needed to visit. It was a useless plastic card tha was supposed to be attached to my person while I was working to show who I was. That I was there, in uniform with my sleeves rolled up,doing what I was there to do should have been enough. On a health and patient safety issue these cards were attached with metal and plastic fittings which could injure the skin of my patients...and this was my excuse when senior managers challenged me about wearing the blasted thing.

Re: What is the alternative?
 

That is written into all the contracts as they had an end date. Unfortuneately for BRH that is a long time away as it's a 38 year contract. BRH and parts of Burnley General were built in 2006 using PFI so the contracts will end in 2044 ish. It's costing East Lancs NHS Trust about £20 million a year to pay them but that won't include all the increased costs for maintenance/repairs/additions they also pay at inflated prices.

This quote is taken from here

Why didn't they just get a mortgage from a bank?

Re: What is the alternative?
 

Each doctor can only see so many patients in an hour. This means GP's can't see more patients by opening for longer because each doctor isn't going to work more hours in the week. What they can do though is stagger how many doctors on in surgery and extend the opening hours from maybe 8am to 8pm. This would allow people who work to take evening appointments which might take some pressure of walk in centres and A&E

Re: What is the alternative?
 

That's a great example of what is wrong with the NHS. Staff not doing what they are required to do and senior managers not dealing with staff appropriately who do not follow the rules.

If this happens with something as simple as wearing your ID badge so patients know you are who you say you are then what other rules are being ignored by staff?

Re: What is the alternative?
 

I was party to the meetings on PFI, but couldn't remember the costs...after all it is 14 years since I retired.

I don't know why the other oprions for finance were not considered...I have a feeling there was a push from government to do it this way or go without new facilities.

It is a lot of money to find before any services at all are offered...and then of course the hospital have to do the annual savings bit without compromising quality or services.

Re: What is the alternative?
 

Neil, the patients knew exactly who I was. I wore a name and designation badge. I just did not wear the photo ID...as I explained I considered it to be a risk when dealing with personal patient needs.

I had my name badge altered, the pin was removed and it was replaced by a stick pin type arrangement with a guard on the back.

Some rules can be bent without compromising safety.
My immediate manager knew of my infraction of the rules. She accepted my reasons as valid.

Re: What is the alternative?
 

Neil, you are really stating the obvious there...What you say is true and that is why I said it needs to be managed properly.

Re: What is the alternative?
 

If a 'rule' is true and worthwhile, it doesn't need to be 'bent', I don't like I.D. cards, however I've had to wear them, I hope I never have to do it again.

Re: What is the alternative?
 

If you had a genuine safety concern you should have taken it through your safety rep or union. You could have found that name badge anywhere.

Where do you stop at letting people bend the rules? I've seen all sorts of rule bending going on in hospitals that shouldn't happen. I've probably mentioned a few on here before like putting cups into the waste linen bags after stripping beds off. Not wiping beds down before the next patient uses it. Rules are in place for a reason and management should have pulled you up on it.

Re: What is the alternative?
 

Neil I was management. I did take my concerns to the appropriate bodies and they supplied lanyards( eventually). Just so that you could be garrotted by some disorientated patient coming round from anaesthetic.

Yes, I could have found the badge, but why on earth would I attend to do a physical and mentally challenging job on a busy ward just to use a name badge I had found? You would have to nuts to do that.
My photo was in a large frame with all staff pictures at the doorway of both wards I managed.
I worked at the hospital for 29 years. I was known to staff and patients alike.
People still call out my name when they see me in the street.
There are much bigger issues in the NHS that need radical and immediate attention...many of which have been highlighted in this thread.

Re: What is the alternative?
 

I hope you reported those incidents you observed.
I can't recall throwing used cups into linen skips, or seeing anyone else do that either,as for washing down beds, I have probably washed down more beds than all the hot dinners you will consume in your life.

Re: What is the alternative?
 

This is an old story and maybe incidents like this are the reason hospital staff have to wear photo I'd badges - http://www.heraldscotland.com/news/1...ntal_hospital/


Sent from my iPhone using Tapatalk

Re: What is the alternative?
 

For those who wish to perpetrate such acts there will always be a way.
There are far more cctv cameras now, and in maternity units there is enhanced security.

I always had my photo ID with me, but I just did not wear it and I was never asked to prove who I was...but as I say this is going back 14 years.

Re: What is the alternative?
 

Anyone could be anyone at BRH, I think Neil has been watching diagnose murder too much.:). Things have changed and BRH don't even know most of the staff they have. Especially if he's talking about urgent care or a+e if you want to call it by it's old name. But still it takes about 3 people to get you to the treatment, so the pretenders would be found out.

Re: What is the alternative?
 

Link is almost 27 years old...

Someone as unbalanced as that person in this day and age could...with a little knowledge of Publisher, access to a £30 printer and a £20 laminator, create a facsimile NHS photo ID in less than 10 minutes...they ain't banknotes, nor are they scrutinised by patients under an ultraviolet lamp :)

Re: What is the alternative?
 

Unfortunately in this 'blame' culture led by coffin chasing 'accidents 4 u' money grabbers...a walking frame/crutch that may have a slightly worn grip or a dressing that you cannot prove was not contaminated when you opened the pack could cost the NHS more than the cost of a new frame etc..etc..

Re: What is the alternative?
 

And this is why Doctors close for training days and lessen the amount of appointments and care they can give (which puts more pressure on A&E)...

Blackburn GP practice placed in special measures after lowest possible rating (From Lancashire Telegraph)

Absolutely nothing wrong with patient care..yet they are in special measures..simply because they have not hit the CQC pen pushers targets of having bucket loads of 'risk assessments' for them to tick off their lists and 'staff training in safeguarding'..which pretty much means staff haven't been trained in common sense like 'what to do if you see a fire' or 'what to do if you see a doctor behaving inappropriately'

Unfortunately for Doctors surgeries like this, there is absolutely no comeback, they HAVE to comply... CQC like FIFA has no real governance

Re: What is the alternative?
 

We also had to have training in all manner of things. We still had to run a service and ensure that patients had safe standards of care.
It can be done but it has to be managed.
There is no excuse at all for practices closing for lunch...unless there is only one doctor and one nurse. I do not recall EVER being permitted an hour for lunch.

Re: What is the alternative?
 

It is easy to change the grips on both crutches and walking frames...cleaning them is also a simple matter (soap and water works well, or steam clean them).
As for dressings, I was always taught to inspect the pack to make sure there were no breaks or perforations and also to make sure there was no evidence that the package had been wet.
These are measures that would save maybe only a small amount, but a saving is a saving.

Years ago at a budget meeting I suggested that when patients came into hospital on multiple meds. That we did not send these home, but used the meds that the patient had been prescribed and had brought in with them.
All kinds of reasons were given as to why this could not be done...so what has changed, because it IS what happens now.
Obviously we would not use medications unless they were in the bottles or packages they were supplied in..But way back then this was deemed impossible.

There has to be a will to make the effort to implement savings...and often that is not there...well not in the smallish things anyway, but they spent untold cash in getting bank staff in to cover staff shortages.

Re: What is the alternative?
 

You would not believe the hoops care services like doctors, hospitals and care homes have to jump through nowadays...actual 'care of the person' is of a much lower priority than paperwork that evidences that you provided that care.

Some on this thread have disparaged the need for 'clip boarders/pen pushers'...I'm just pointing out exactly why they are there.

Re: What is the alternative?
 

I did say it was an old story...I also went on to say "maybe incidents like this are the reason hospital staff have to wear photo I'd badges".
Just because someone is determined to do something doesn`t mean it should be made easy for them, nothings going to be 100% but every obstacle should be put in their way. If hospital security are used to seeing staff walking around without ID how are they supposed to detect imposters, just rely on memory as to whether they`ve seen them before?

Re: What is the alternative?
 

Totally agree about the walking frames/crutches and dressings, unfortunately smarmy coffin chasers have successfully argued and won substantial damages, hence the NHS current policy.

Re: What is the alternative?
 

Yup..you did say it was an old story..was simply pointing out that it was as easy if you needed an ID for someone as determined, to do exactly what occurred in the article.

My point still stands with your hospital security argument ..if you have a hospital the size of BRH who would challenge the ID I've just created with my laptop/printer/laminator?

Re: What is the alternative?
 

They aren't laminated, so that might be a bit of a giveaway. :D


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Re: What is the alternative?
 

As I said previously, I was never once asked by any other department in the hospital (and this was over a period of at least a decade) to prove who I was.
I visited other departments, attended management and commissioning meetings, I visited other hospitals in the North West. Nowhere was I asked to prove who I was.
So if you implement something that is supposed to be for security and then no-one is there to implement any security measures, what is the point?

I was part of the furniture and fittings of the place. I was seen going about the business of caring for patients at that hospital for 26 years...the previous three years I had spent at BRI.

Re: What is the alternative?
 

They aren't laminated now, but I think they were when they first came out(1990)I still have my first one.

Re: What is the alternative?
 

Another reason the NHS is skint!

NHS spends £100 million on TRANSLATORS in 128 languages | UK | News | Daily Express

Re: What is the alternative?
 

Lanyards should have break aways links in them in case it is pulled of gets caught on something. Mine at work does.


Lots of nuts walking around now, no not me, well not always ;)

Re: What is the alternative?
 

How many languages are needed to say, 'OW'?

Re: What is the alternative?
 

Is it all part of Labours multiculturalism social experiment?

Re: What is the alternative?
 

Or maybe, Enoch's policy of the 60's conservatives? Let the beggars in to steal poor mens jobs? After all WE won't have to put up with them living on our private estates.
That same guy later predicted rivers of blood, I still don't think he was too bothered.

Re: What is the alternative?
 

I think the write everything in many languages policy is a lot newer than the 60's. Probably more like 80 or 90's at a guess. It needs to stop, other countries don't do it, if you need an interpretator take your own.

Re: What is the alternative?
 

Many of the leaflets which have been translated and printed(especially the Asian languages) cannot be read as the people they are intended for either cannot read or they speak village dialects.
So it IS a real waste of resources.
My mother had her money stolen from her handbag in Spain in a gypsy 'bumping episode'.
She had to pay to have an interpreter at the police station.

The world sees this country as a 'soft' touch.
The people who come here with the premeditated intention of gaining access to services at no cost to themselves are fraudsters. They should be labelled as such, not health tourists.

My sister in law came over from Australia some years ago and needed to see a doctor to get a prescription. She tried to pay for this service, but was told not to bother. So her consultation was free as was her prescription medication(she was over 60) but had not lived in this country or paid NI contributions since 1956.

Re: What is the alternative?
 

You may well be right, but the 60's seems to be when the rot set in allowing, our white superiors to take advantage of the white inferiors by introducing cheaper brown alternatives to do the work the white superiors required.

Mill owners all over this county welcomed cheap labour, they didn't care what slums this workforce had to live in.

Now, the new off white workforce own or run taxis, the only mill owners I know of live off nostalgia in ossy.

Oh, yes still reaping it in but unlike their forebears not having to supply decent housing for their workers.

Win, Win for being born into the industrial revolutions elite.

Re: What is the alternative?
 

At long last! Finally a health authority doing what it should do as a matter of routine when dealing with the public & ascertaining the patients eligibility. I really don't see what the problem is, the woman in question was asked for proof & the authority have given her sufficient time to provide said confirmation of eligibility so what does she do? Supply the required info ..... not in the least, she runs bleating & whining to the tabloids!

Pathetic whiny bint, no doubt a simpering lefty apologist! Her & those like her really irk me, it's creatures like her that have degraded & changed my Country for the worse.

Health tourism checks see Briton probed for having Polish husband | UK | News | Express.co.uk

Re: What is the alternative?
 

There has been the mechanism for ensuring those not entitled to free treatment, are charged, for a long time.
I have been retired for fifteen years and the mechanism was in place long before I left the NHS.
Anyone who visits this country needs to ensure that their travel insurance covers them for medical care while they are here.

An impression of a credit card should be obtained from tourists who use NHS facilities...and the money should be chased. If this was done religiously then there would be more money available for care.
I am aware of people who skipped off without paying their dues and what did management do?
Shrugged their shoulders and did nothing to chase the cash.

Re: What is the alternative?
 

oh and how the lefties would love that. the beeb would have it as the main headline showing how some poor foreigner was hounded for payment they OWED to the nhs and their human rights were abused by having to pay it. we then could have the tin rattlers on the streets to try to get us to pay the money for them with corbyn and abbott standing up in parliament saying how bad we treat our foreign visitors.

Re: What is the alternative?
 

Let them! And should their squealing be long & loud just imagine how it would be if you then turned to them & said "Okay then, if you're that concerned put your hand in your own pocket & pay for your pets!".

There shouldn't be an issue if those applying for treatment have the proper documentation/papers. It's absolutely disgraceful that "Foreigners" can come & go as they please, get expensive treatments which are being paid for by British taxpayers without putting a red cent back into the pot!

I live & work in Germany, about a year ago I fell off the back of my works wagon while delivering to customers I ripped my collarbone from its anchor point at the shoulder & it was stuck up in the air under my skin like a tent pole! I finished that delivery, rang my boss told him I couldnt finish the tour as I was off to the Hozzy, wife came & picked me up & off to the Hozzy we went.

On arrival I was greeted with "Oh that looks bad, we'll get you down to X-ray & the bone menders ASAP, but first could you fill out these forms & we need your medical insurance card!", so you see, even here in modern day civilised Germany, no proof no treatment! So why shouldn't the UK be any different?

Re: What is the alternative?
 

Let the loony lefties and the BBC bleat...it is what they are famed for and really the only thing they are truly good at(well, they have had plenty of practice, to be fair).
These people are the first to complain about how the NHS is being left short of funds(it isn't shortage of funds which cripples the NHS, it is the layers of bureaucracy and people who do little to improve patient care but are paid eye watering salaries)
Try going to America or Australia and getting treatment for injuries/illness....you have to pay. they will have someone rendering aid, but on the other side of the trolley there will be an administrative assistant taking your insurance/credit card details.
Even if you go on the continent...the treatment is not free...so why should it be free to all comers here?
It is called the National Health Service not the international health service.
It is for the people who have paid into the sytem...anyone else better have travel insurance which covers ill health.

The NHS is not rigorous enough in the collection of moeny owed to them for trearment

Re: What is the alternative?
 

It is called the National Health Service not the international health service.
It is for the people who have paid into the sytem...anyone else better have travel insurance which covers ill health.

that sounds too much like common sense to me margaret. its a dying trait of people nowadays and they try to call it a symplistic solutions. the thing is those at the top do not have any solutions trying to keep everyone happy at the same time.

Re: What is the alternative?
 

Today in one of the online articles I have read, it says that very few trusts have a dedicated overseas visitors manager to identify those not entitled to free care.

EVERY trust in the country should have an Overseas Visitors Manager...they would be repsonsible for identifying, billing and chasing these people for payment.
we have NO responsibility to treat these patients without charging them....and many f them come here with the prime aim of getting treatment at no cost, because they know they can.

Re: What is the alternative?
 

It is a common sense approach. Not really simplistic. Why would you make things more difficult to work out? You would only do that if you were working to some hidden agenda(and that might be the case here....make NHS care so difficult to access that people will beg for privatisation. I am not saying that this is what is happening here, but just conjecturing)

Many of the problems which are deemed 'insurmountable' are of little interest to those in high places, because they are untouched by these issues...so there is nothing in it for them.
They are not inconvenienced by having to wait for their cataracts to be treated...or have a new hip or knee...or just see a GP.
I feel pretty damn sure if these issues DID impact on their lives, then there would be a lot more invested in finding solutions.

Call me cynical if you like,but that is how I see it.

Re: What is the alternative?
 

When I lived in the US you had to produce either a Medical Insurance Card (which they then checked to see what was covered), or a Credit Card which was swiped and as soon as an estimated cost of treatment was known that amount was blocked on to your CC. Of course Identity Cards would allow any hospital to determine whether you needed to provide Health Insurance or a Credit Card.

Re: What is the alternative?
 

Identity cards are not necessary to do that.
I have an NHS number and a national insurance number.That should be enough.

If no one is checking people's details then it sends out the message that anyone can come and get treatment...many large hospitals in areas where the population is fluid, have no one checking who is entitled to treatment and who isn't.

Re: What is the alternative?
 

Aye, the NHS number is issued for a patient after the presentation of an NI number on first turn to for treatment, all fine so far, but as the Country is chucking out NI numbers left, right & centre (so the news is informing us) to every Abdul, Amir, Zlatan & Poppov ......

Re: What is the alternative?
 

If someone has a NI number then they are entitled to treatment as they are not a health tourist visiting purely to get treatment.

Re: What is the alternative?
 

I beg to differ on that comment Ma, it has been stated often enough by politicoes & immigration officials that there is a vast divergence between NI numbers issued & immigration numbers. this to my mind highlights the fact that some come here with the aim of getting an NI number (to get free NHS treatment) and to access the available benefits without the intention to work.

Much as I dislike & mistrust Al Beeb, here's one of their articles, it doesn't quite cover the point I'm trying to make but at short notice (and it being 07.30 in the morning here & I'll be heading to work in 10 minutes) it's the best I can offer at present.

NI numbers prompt row over 1.2m EU 'immigration gap' - BBC News

Re: What is the alternative?
 

I take your point, but that is not the issue that I was posting about.
If someone has a NI number then they can work legally here.(and access services for which they have paid nothing...an which those of us who have contributed over the years, are paying for).
Whether they DO work, pay taxes and NI contributions is a whole other story...and maybe the substance for another thread.
If they do not have an NI number then they cannot work legally...they will pay nothing in income tax or contribute to the NHS.

This is really not the issue that I was posting about. The issue that I was posting about was the fact that someone will come here from another country and avail themselves of NHS care and treatment.
I have seen it first hand when I was working.
Elderly(and some not so elderly) come to stay with family for a holiday, and while here get surgery or treatment for conditions that, in their home country, they would have to pay for.

A couple of years ago a woman who was expecting a multiple birth flew here, had her babies(which were premature and were in neonatal intensive care for quite a while) racked up care that cost us nearly half a million quid(well, no I exaggerate, it was £400,000) and no efforts were made to get that money.

That is a large part of the issue. There is no one, in many of the NHS hospitals, charged with the responsibility of seeking out those who should be paying...and even less effort is expended in making sure that they do.

Now I have quoted just one incident. How many nurses would that one patients care have paid for?

The issue of uncontrolled immigration on ALL public services and the infrastructure of society was not considered when Tony Blair supported multiculturalism...the long term consequences of immigration was not were thought out...and now we pay.

It has little effect on the elite...other than the fact that they can employ cheap cleaners, and other domestic staff.
They will not be inconvenienced by crowded NHS facilities, a wait for surgery, a wait to see a GP....no, that is you and me Son and the many who are taken for mugs by politicians.

Re: What is the alternative?
 

As for EU Nationals...I thought that they were allowed to access NHS care while they were here...And that the cost of their treatment is retrieved from their home country by the NHS.
If I am wrong about this then I feel pretty sure someone will enlighten me.

Re: What is the alternative?
 

They are supposed to hold a European Health Card (EHC), and then the NHS can claim back, from the country that issued the card, all the costs incurred. There are reports that the NHS doesn't chase up these payments. The reverse applies for British Nationals that go to any EU country. We have to apply through NHS Newcastle (or did), which is what we did when we went to live in France. Cashy probably had to do the same when he was in Spain.

Re: What is the alternative?
 

I know that the NHS is very lax at chasing the money...because no one is tasked to do it.
Looking at reports, there are not that many hospitals with dedicated staff to do the job.

I know that before I retired, a member from the records department would come to the ward to take details from any person the nurses identified as being subject to costs.
Private conversations with members of the records team who did this job, make me absolutely sure that very little(if any) of the money(at that time) was actually collected.

Yet, when I was involved in a road accident I was sent a bill for £73 pounds for my visit to A&E....this despite the fact that I pay my NI contributions.
I paid and was later reimbursed by my insurance company.

Re: What is the alternative?
 

if that is the case then its absolutely disgusting. no point banging on about lack of money for the NHS when thousands of pounds is being thrown away like that. would hate to go down the privatisation line but i,m sure that a private company would chase any money that is owed to them.

Re: What is the alternative?
 

You are looking at it the wrong way round. Everyone who attends hospital/GP should have to prove they are entitled to treatment or produce a payment means first. Like Dave said happens in Germany.

Re: What is the alternative?
 

Neil, if my GP sends me to hospital or to a clinic, it is because I am entitled to treatment.
I have been registered with the practice since the early eighties.
If I go to some other location...the Isle of Wight for instance, I can prove who I am with my NI number...I can prove I have paid into the system which I wish to access.
I think we have trodden this ground before.

The point is that hospitals are very poor at collecting their dues when it is blatantly obvious that the person being treated needs to be billed.

Maybe things have changed at out local hospital, but somehow, I very much doubt it.

Re: What is the alternative?
 

Spot on Marge, my wife and I spent three weeks in the afore mentioned Isle of Wight in September, as I was not feeling too chipper after the first couple of days I called into the local medical centre, explained my symptoms and received an appointment with a GP within twenty four hour's.
Without going into detail I was diagnosed with a double infection and was prescribed a seven day supply of a strong antibiotics, once these kicked in we were able to enjoy the rest of our holiday.
Many folk in our great country decry the N.H.S. but to my mind it is still the best in the world, (if you have a genuine complaint).

Your's Taddy.

Re: What is the alternative?
 

Glad it served you well Taddy...but my point was wherever I go in these islands that make up the Uk...I have the ability to prove that I am entitled to treatment without having an identity card.

The other point I was making was, it is all well and good to say that those who are NOT entitled, will be charged if there is no one in the trusts who is responsible for doing the chasing of the money then it makes a mockery of the whole thing.
It is 15 years since I worked in the NHS...maybe it has changed, but I seriously doubt it.

It makes absolutely no sense at all to be asking me(who has a hospital record on microfiche going back to the early seventies) if I am liable to pay.
It does make sense to ask those who speak no English, or very little English...those who ask for an interpreter if they are entitled to treatment without charge...and even take financial details before treatment commences(except in dire circumstances).

The questioning has to be profiled...and it should be administrative staff who do this rather than medical personnel.

Re: What is the alternative?
 

I agree with you entirely.

Re: What is the alternative?
 

Had to drag this thread back out again due to an article I read today. Is it any wonder the NHS is constantly bleating it's skint? Paying for interpretors (it doesn't happen anywhere else in Europe to my knowledge) & common purpose Judges awarding for the stupid!

Personally I find something not quite right about this incident, the redolent whiff of "compo" taints the air.

Refugee Family Set to Win Millions from NHS for Not Using Foreign Language to Explain Importance of Feeding Newborn | Breitbart

Re: What is the alternative?
 

Says everything about what is going on in this country...The mother's so called common sense should have come into play here, she should have known how and when to feed her baby, no interpreters needed. Yes Dave you are right it does and probably will have been compensation motivated.

Re: What is the alternative?
 

When I worked in the NHS, we spent shed loads of money having patient information leaflets printed in foreign languages.
These were useless as many of the women in our care could not read them as they spoke different dialects.
We employed link workers but theu only worked office hours.
Anyone using any health services should have to find(and if necessary pay for) their own interpreters.
The alternative is to get these women to learn English.
Some of the women I looked after had been here in excess of two decades and still could not speak the language.

Re: What is the alternative?
 

Thing is with interpreters, we had to pay for em,when we lived in Spain, never bothered us one bit, and not just for the health service,Mind Spain are obviously not as stupid as the pillocks that decide things here.:rolleyes:

Re: What is the alternative?
 

Re: What is the alternative?
 

What's the betting that this mother still does not speak English?