NHS Trusts: who is to blame?

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AccountancyAge are reporting:
NHS Trusts: who is to blame?

NHS finance managers are not to blame for government mistakes, argues Stephen O'Brien. A combined effort is required, writes Mark Knight

Link to full article

 

re NHS

Dear All,

the trouble with the NHS can be summarised by one word:

UNIVERSAL

The concept of Universal Health care for free at point of provision is impossible.

If a new drug comes along that will enable 125,000 people with a clinical condition to have this drug as a treatment.

Then you have to add this cost to the current expenditure which we know is in current difficulty.

So how will it be posible to provide health care to the British population within a reasonable and affordable budget.

Those who are very ill look for the most effective t/t regardless of cost .

Those who are not so ill look for relief from symptoms to improve quality of life.

The well want something as they are not ill.

So where do we start.

In our world what is the singular most essential aspect of our role?

Is it possible to fulfill that need within current budget?

Why do we as a profession want to provide non health care related services within NHS budgets?

So as i have asked already where do we start?

regards David

 

This is such a basic fundamental fact, but it astounds me how few people really seem to get it ... just look as to what the cholesterol lowering drugs have done to national health budgets. People may argue the preventative effects, but the incidence of health problems that are related to cholesteral problems will go down as a result of medication use, BUT the prevalance will go up as the population is growing!! .... boy are we in trouble.

Then is comes down to giving the life saving drug to 125 000 people or providing a toe nail cutting service ????

 

Big problem. How do you start with system reform when the bulk of the employees - including management - work against the implementation. The NHS has become the largest employer in Europe with over 1.2 million employees and is a self perpetuating monster. It is rife with political interference and manipulation and characterised by management who fail to understand what healthcare is really all about - and a workforce - at least in podiatry - that is demolarised and pulverised beyond belief.

There was an interesting programme Sunday evening http://news.bbc.co.uk/1/hi/programmes/panorama/4777296.stm that showed the extent to which NHS managers and clinicians are willing to ignore and break the law to ensure their targets are met. Anyone familiar with the Coughlan judgement would be aghast at the extent of the abuse being undertaken by the organisation. http://www.sochealth.co.uk/law/coughlan.htm

What a sad end for a once great institution.

Mark Russell

 

A Grim Reaper Of A Reply

Dear All,

Looking at the web page provided by Mark from the BBc web site there is a common thread amongst the poor individuals involved.

They are basically the living dead, but have not died.

Many very ill frail people (age is not a prerequisite of illness and frailty) are living but are not able to have a reasonable quality of life. Surley if you cannot hydrate or eat yourself, are not able to deal with normal bodily functions have grossly impaired brain function etc etc you are to all intents and purposes DEAD.

Many of these people can afford to pay for their own care, thanks to property values, but do not choose to do so.

So the poor old over burdened tax payer has to cough up.

Now if we were as a society accept that Death is the successful conclusion to life then perhaps we can as a society accept that people do indeed die.

Artifcially prolonging the beating heart after all other aspects of the person have failed does not seem compassionate or desireable.

The veterinary world used to call it a day and euthanise the animals.

but now thanks to modern veterinary practice animals are now enjoying ever longer debilitated life spans.

Surely we as a society value quality of life over length.

Or is just to get maximum return on taxes paid the only reason to prolong life past that which would be considered and acceptable quality.

regard David

 

What non-health care services did you have in mind David?

 

health care

Dear podder,

OT's have a phrase:

Acts Of Daily Living.

This is what a normal healthy adult can do for themselves.

Also many people have medical conditions which they self manage eg taking of drugs, using medical equipment themselves etc etc/.

Obviously you cannot perform surgery on yourself so this is provided.

So when an individual has a health care need which requires medical intervention medication then this should be provided.

This by definition would leave much of what Allied Health Professionals and indeed the nursing profession in their supportive role as not Health Care .

But could be classified as quality of life enhancing.

So in many countries only direct health intervention is provided. Everything else is charged for, including hotel services in hospitals.

So if we were to embrace this then Podiatry in an acute hospital would be provided by the NHS as it is usually acute and long term chronic disease management.

Private Practice could provide everything else outside of hospital.

regards David

 

David,

You said:
"Surely we as a society value quality of life over length."

Any evidence for that?

 

re

Dear David,

It was either an open question or a statement which required no answer.

I did not think evidence was necessary.

But i ask you would you prefer to have a shorter healthy active life or a longer debilitated painful life?

As a practicing clinician of many years standing you will have met many people who are ill frail in pain etc who would prefer not to be here.

regards David

 

David,
I'm aware of no evidence to back your assumption up (doesn't mean it's not there, just that I'm not aware of it).

Cheers,
davidh