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February 8 2023 6.58am

NHS needs a total review

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View Nicholas91's Profile Nicholas91 Flag The Democratic Republic of Kent 16 Dec 22 12.09am Send a Private Message to Nicholas91 Add Nicholas91 as a friend

Originally posted by Wisbech Eagle

In many ways the student loan system is a way of the government funding the qualifications as only the highest earners will ever pay it back. However, it's not well understood, and it puts off people, as who wants a large debt around your neck increasing with high interest rates for your working life?

I am conflicted as my wife is a nurse who works in the way we all hope to be cared for, with devotion, skill and compassion. She deserves more money, but I also know that we cannot afford to give her it at the moment. She works in a clinic, but also does bank shifts on wards. How anyone can handle the pressures on some wards is a wonder. Only today I saw three security officers having to restrain a patient. In my youth you would not see a security officer in a hospital! Imagine the Emergency Department at midnight on Saturday, already overrun with delays, having to deal with abusive, aggressive, drunken men and women who have injured one another. Who wants to willingly care for them, let alone show compassion? Yet they do.

I also hear of situations which are very wasteful. Low quality administration managed by unimpressive people. This isn't so unusual in any big organisation, but it still irks to see it.

I don't see a quick and easy solution to any of the issues. Each one will need its own new long term strategy, with an overall destination as the aim. I do though wonder if the current banding system for pay rates needs to be revisited. There are already higher rates in London and the SE. Maybe we need to pay much higher rates to those who work in the most challenging areas, like the ED and neurological wards? Thus reducing the need to pay agency staff at even higher rates. The qualifications are equal, but the work isn't.

I am sure that some costs can be saved by better management, efficient use of resources and technology, but ultimately we are going to have to pay more. I stopped paying NI 13 years ago, but use the NHS more now than ever. That seems to me to be an obvious change that will have to be made before too long.

It truly does require a far greater mind, and almost definitely a meeting of many superior minds, than mine and unfortunately my despair/panic, highlighting and griping is of very little use.

There are deep problems at many levels yes, however I would not level any ire at individuals, it seems an accumulative and long term snowballing of issues leading to the current position.

I am, I dare to suggest, at least knowledgeable and cognitively capable to enough of an extent to understand how student loans create some sort of provision for 'funding' these careers however I fear it's not enough to provide real incentive and assurances to those wishing to pursue it. I'd like to see more but again would have not the foggiest as to how this can be achieved beyond far more and significant funding.

Whilst we still do have magnificent individuals, such as your wife, with similar sentiment I fear my expression of the highest admiration and gratitude is not enough. I am still amazed by those who not only fail to offer this but actually 'give them grief' as I would colloquially and ineloquently put it.

I certainly agree that this needs both a holistic, long term strategy proposed alongside short-medium term, tactical solutions aligning to reaching the direction/destination of travel. I can only sincerely hope that resolutions are identified, pursued and achieved before catastrophe really does strike. Once again, my utmost gratitude, to your wife and others, will remain for the time being.

 


Now Zaha's got a bit of green grass ahead of him here... and finds Ambrose... not a bad effort!!!!

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View Midlands Eagle's Profile Midlands Eagle Flag 16 Dec 22 6.13am Send a Private Message to Midlands Eagle Add Midlands Eagle as a friend

Originally posted by Wisbech Eagle


I also hear of situations which are very wasteful. Low quality administration managed by unimpressive people.

This can be a big problem and over the years many of my wife's colleagues have left because of the way that they have been treated by their managers who are obviously unsuited for the job.

Wifey was entitled to seven weeks holiday a year and her manager wanted her to take them in one week slots outside of school holidays despite have an autistic son at school. After several years I finally managed to persuade her to leave and join another hospital where they would treat her as a human being and not just as an asset.

Last week she volunteered to be seconded to a local hospital for the winter months and arrived to be given just two shifts totalling 14 hours for the first week. When saying to her ward sister (who looks to be in her twenties) that she couldn't survive on 14 hours and needed more shifts the response was "If you don't want to work here you don't have to"

 

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View Nicholas91's Profile Nicholas91 Flag The Democratic Republic of Kent 16 Dec 22 8.13am Send a Private Message to Nicholas91 Add Nicholas91 as a friend

Originally posted by Midlands Eagle

This can be a big problem and over the years many of my wife's colleagues have left because of the way that they have been treated by their managers who are obviously unsuited for the job.

Wifey was entitled to seven weeks holiday a year and her manager wanted her to take them in one week slots outside of school holidays despite have an autistic son at school. After several years I finally managed to persuade her to leave and join another hospital where they would treat her as a human being and not just as an asset.

Last week she volunteered to be seconded to a local hospital for the winter months and arrived to be given just two shifts totalling 14 hours for the first week. When saying to her ward sister (who looks to be in her twenties) that she couldn't survive on 14 hours and needed more shifts the response was "If you don't want to work here you don't have to"

Awful and ridiculous.

 


Now Zaha's got a bit of green grass ahead of him here... and finds Ambrose... not a bad effort!!!!

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View The Dolphin's Profile The Dolphin Flag 16 Dec 22 8.19am Send a Private Message to The Dolphin Add The Dolphin as a friend

Originally posted by Nicholas91

Given the nursing profession is so pivotal, and to a certain extent vocational, I would like to see any qualification funded, even if partly, by the Government.

I don't have any idea nor inclination to sufficiently investigate how that may work at any level, or if it currently does, however I think the societal reward would be great enough to justify something at least resembling this. The profession can be highly demanding and as previously mentioned, is an absolute necessity, so therefore the renumeration should reflect this.

A basic understanding of supply+demand should validate this stance however my very, very limited knowledge or insight leads me to believe that the supply is currently both less than the demand and under further threat. I have previously made clear my stance on the NHS and I do fear for it long term if conditions, including management and pay for staff, are not addressed.

Edited by Nicholas91 (15 Dec 2022 3.46pm)

Train all Doctors, nursing, clinical staff etc.for free.
They sign a Contract before training that they are obligated to work in the NHS for "x" years after they are fully qualified.
Say 5 years for nurses, 10 years for Doctors and so on.
Anyone who leaves - unless through illness - in those periods should have to repay the cost of training which will reduce pro-rata as the cut off date approaches.
This would get more people in the system, better working conditions working with fellow employees rather than agency staff and in the long term save the NHS a fortune because agency staff are charged out at huge rates per day.
This is an idea that could work in my opinion.

 

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View Badger11's Profile Badger11 Flag Beckenham 16 Dec 22 8.21am Send a Private Message to Badger11 Add Badger11 as a friend

Originally posted by The Dolphin

Train all Doctors, nursing, clinical staff etc.for free.
They sign a Contract before training that they are obligated to work in the NHS for "x" years after they are fully qualified.
Say 5 years for nurses, 10 years for Doctors and so on.
Anyone who leaves - unless through illness - in those periods should have to repay the cost of training which will reduce pro-rata as the cut off date approaches.
This would get more people in the system, better working conditions working with fellow employees rather than agency staff and in the long term save the NHS a fortune because agency staff are charged out at huge rates per day.
This is an idea that could work in my opinion.

Agreed I've been saying this for years and I would extend it to teachers as well. I cannot believe one of the major parties hasn't thought of it.

As long as they stay in the public sector their student loans etc. should be reduced on an annual basis until eventually cleared at which point if they wish to join the private sector so be it.

 


One more point

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View Nicholas91's Profile Nicholas91 Flag The Democratic Republic of Kent 16 Dec 22 8.42am Send a Private Message to Nicholas91 Add Nicholas91 as a friend

Originally posted by The Dolphin

Train all Doctors, nursing, clinical staff etc.for free.
They sign a Contract before training that they are obligated to work in the NHS for "x" years after they are fully qualified.
Say 5 years for nurses, 10 years for Doctors and so on.
Anyone who leaves - unless through illness - in those periods should have to repay the cost of training which will reduce pro-rata as the cut off date approaches.
This would get more people in the system, better working conditions working with fellow employees rather than agency staff and in the long term save the NHS a fortune because agency staff are charged out at huge rates per day.
This is an idea that could work in my opinion.

Something like that Dolphin certainly.

 


Now Zaha's got a bit of green grass ahead of him here... and finds Ambrose... not a bad effort!!!!

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View The Dolphin's Profile The Dolphin Flag 16 Dec 22 8.47am Send a Private Message to The Dolphin Add The Dolphin as a friend

The reason they won't do it is the initial cost and the fact that politicians only seem to think in terms of 3-5 years.
If this Government started this now it would be a vote winner and people could look forward to a better NHS in 5-10 years time.
Degrees for nurses should be a no no and there should also be a commitment to reduce management staff by say 50% over ten years while at the same time increasing clinical staff by the same amount.
Commit to building "x" hospitals over a ten year period as well.
All enshrined in statute so that if another party pulls the plug they will as such be wrecking the NHS in the eyes of the public.
It is all so easy if they had the guts to implement it

Edited by The Dolphin (16 Dec 2022 8.48am)

 

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View Nicholas91's Profile Nicholas91 Flag The Democratic Republic of Kent 16 Dec 22 9.00am Send a Private Message to Nicholas91 Add Nicholas91 as a friend

Originally posted by The Dolphin

The reason they won't do it is the initial cost and the fact that politicians only seem to think in terms of 3-5 years.
If this Government started this now it would be a vote winner and people could look forward to a better NHS in 5-10 years time.
Degrees for nurses should be a no no and there should also be a commitment to reduce management staff by say 50% over ten years while at the same time increasing clinical staff by the same amount.
Commit to building "x" hospitals over a ten year period as well.
All enshrined in statute so that if another party pulls the plug they will as such be wrecking the NHS in the eyes of the public.
It is all so easy if they had the guts to implement it

Edited by The Dolphin (16 Dec 2022 8.48am)

My feeling is perhaps not 'easy' but certainly do/achievable.

I agree absolutely in the short-termism, as I have mentioned previously, leading to the culmination and aggregation of issues over a longer time span.

The NHS should be almost be segregated entirely from all other matters which are open to political influence and therefore investment. It's all games until you yourself end up in any need of sincere medical help. I wonder how many (politicians etc) have reached something circling an end of life or critical situation stage for themselves or a loved one and perhaps thought the NHS is something to be cherished more so than they had done?

 


Now Zaha's got a bit of green grass ahead of him here... and finds Ambrose... not a bad effort!!!!

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View Badger11's Profile Badger11 Flag Beckenham 16 Dec 22 9.15am Send a Private Message to Badger11 Add Badger11 as a friend

Originally posted by The Dolphin

The reason they won't do it is the initial cost and the fact that politicians only seem to think in terms of 3-5 years.
If this Government started this now it would be a vote winner and people could look forward to a better NHS in 5-10 years time.
Degrees for nurses should be a no no and there should also be a commitment to reduce management staff by say 50% over ten years while at the same time increasing clinical staff by the same amount.
Commit to building "x" hospitals over a ten year period as well.
All enshrined in statute so that if another party pulls the plug they will as such be wrecking the NHS in the eyes of the public.
It is all so easy if they had the guts to implement it

Edited by The Dolphin (16 Dec 2022 8.48am)

The problem with the big hospitals is that they try to be all things to all people, I don't think it is practical.

The big hospitals should focus on serious emergency care (road accidents) and major illnesses e.g. cancer.

What we need to do is go back to local cottage hospitals or minor care centres. These would deal with broken bones etc and cover for GPs out of hours.

We also need short term care homes for the elderly so they can be discharged into a safe environment freeing up the bed.

 


One more point

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View cryrst's Profile cryrst Flag The garden of England 16 Dec 22 9.39am Send a Private Message to cryrst Add cryrst as a friend

Originally posted by The Dolphin

Train all Doctors, nursing, clinical staff etc.for free.
They sign a Contract before training that they are obligated to work in the NHS for "x" years after they are fully qualified.
Say 5 years for nurses, 10 years for Doctors and so on.
Anyone who leaves - unless through illness - in those periods should have to repay the cost of training which will reduce pro-rata as the cut off date approaches.
This would get more people in the system, better working conditions working with fellow employees rather than agency staff and in the long term save the NHS a fortune because agency staff are charged out at huge rates per day.
This is an idea that could work in my opinion.

Employment law wouldn’t allow this and changing the law will mean any firm in any profession training an employee can obligate in the same way. It would be a legal minefield.

 

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View Badger11's Profile Badger11 Flag Beckenham 16 Dec 22 9.53am Send a Private Message to Badger11 Add Badger11 as a friend

Originally posted by cryrst

Employment law wouldn’t allow this and changing the law will mean any firm in any profession training an employee can obligate in the same way. It would be a legal minefield.



They already do. I believe Ryanair and Easyjet train pilots which I believe costs circa 50k but in return they have to do x number of years for the company or pony up for the training.

I can't believe it would be that hard to change the law for public service employees and I would expect all parties would support it.

 


One more point

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View Dubai Eagle's Profile Dubai Eagle Flag 16 Dec 22 9.54am Send a Private Message to Dubai Eagle Add Dubai Eagle as a friend

I would have thought most fair minded & reasonable people would be on board with a planned structure similar to the one outlined - maybe the legal people or those that set out to gain or derail the proposal would spoil it for others -

I know in the late 90s I took a course paid for by my employer
(maybe £4000 worth) & I willingly signed to carry on working for them for 4 years or repay the cost on a reducing balance because my passing the course was of a significant benefit to both parties -

Originally posted by cryrst

Employment law wouldn’t allow this and changing the law will mean any firm in any profession training an employee can obligate in the same way. It would be a legal minefield.

 

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