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February 8 2023 7.03am

NHS needs a total review

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View Wisbech Eagle's Profile Wisbech Eagle Flag Truro Cornwall 16 Dec 22 10.21am Send a Private Message to Wisbech Eagle Add Wisbech Eagle as a friend

Originally posted by Midlands Eagle

You mentioned this before but I'm not sure that it's true. The role of some nurses has been upscaled into nurse practitioners but not all of them. When I mentioned to my staff nurse wife that you had said that nurses no longer have to feed or toilet patients her response was "I wish"

I am sure that out in the real world she is right and when something needs to be done, it gets done. I think it may well be aspirational rather than always achievable at present.

Nevertheless, that seems to be the direction of travel.

 

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View Wisbech Eagle's Profile Wisbech Eagle Flag Truro Cornwall 16 Dec 22 10.42am Send a Private Message to Wisbech Eagle Add Wisbech Eagle 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.

The student loans are intended to achieve a similar result. The problem I see with your idea is how to collect the debt if, as they would, the doctors and nurses, disappear abroad. The same issue exists with the loans, but the lower earners don't pay them back anyway.

How to reduce the dependency on agency staff and to get a grip on the costs is a priority, but not a easy problem to solve. I am told that many international doctors and nurses cannot wait to complete their initial contract, so they can transfer to an agency, often then doing exactly the same job but at higher pay!

That's nuts! It's also very bad management to allow predatory agencies access to staff, so they can poach them and then feed them back to the NHS. Longer initial contracts seem obvious with visas that depend upon being employed by the NHS directly.

 

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View Midlands Eagle's Profile Midlands Eagle Flag 16 Dec 22 11.34am Send a Private Message to Midlands Eagle Add Midlands Eagle as a friend

Originally posted by Wisbech Eagle

How to reduce the dependency on agency staff and to get a grip on the costs is a priority, but not a easy problem to solve.

The government currently set a maximum amount that hospitals can pay agencies unless it is an emergency. The problem with that is that everything becomes an emergency.

How about a limit set at NHS pay rates with no exceptions which will probably kill off the agencies with their staff returning to the NHS

 

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View Wisbech Eagle's Profile Wisbech Eagle Flag Truro Cornwall 16 Dec 22 11.54am Send a Private Message to Wisbech Eagle Add Wisbech Eagle as a friend

Originally posted by Midlands Eagle

The government currently set a maximum amount that hospitals can pay agencies unless it is an emergency. The problem with that is that everything becomes an emergency.

How about a limit set at NHS pay rates with no exceptions which will probably kill off the agencies with their staff returning to the NHS

I guess that they are worried that they would then see an outflow of international doctors and nurses to other English-speaking countries where the rates are higher. Some of these people are being paid stupid money. I think I heard, last week, of a doctor getting £5,000 for one shift! Maybe that's OTT, but it was certainly an eye watering amount. Some of the senior nurses, employed via agencies but doing regular shifts in challenging positions, are earning £2000 to £3000 per week. Just so the staffing levels are met.

Off subject a bit, but I am aware of eye specialists who work privately as well as in the NHS, who are charging £3000 per eye to remove cataracts. They do this at the weekends, renting space in a NHS surgery with a small theatre for minor ops. They have a nurse and a care assistant to help. So some costs, but they manage 10 to 15 procedures in a day! The silly thing is that most of the patients are NHS referrals to try to reduce the waiting lists.

 

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View Teddy Eagle's Profile Teddy Eagle Flag 16 Dec 22 12.15pm Send a Private Message to Teddy Eagle Add Teddy Eagle as a friend

Originally posted by Wisbech Eagle

I guess that they are worried that they would then see an outflow of international doctors and nurses to other English-speaking countries where the rates are higher. Some of these people are being paid stupid money. I think I heard, last week, of a doctor getting £5,000 for one shift! Maybe that's OTT, but it was certainly an eye watering amount. Some of the senior nurses, employed via agencies but doing regular shifts in challenging positions, are earning £2000 to £3000 per week. Just so the staffing levels are met.

Off subject a bit, but I am aware of eye specialists who work privately as well as in the NHS, who are charging £3000 per eye to remove cataracts. They do this at the weekends, renting space in a NHS surgery with a small theatre for minor ops. They have a nurse and a care assistant to help. So some costs, but they manage 10 to 15 procedures in a day! The silly thing is that most of the patients are NHS referrals to try to reduce the waiting lists.

That is about the going rate for private cataract surgery. Glad I waited a few months to get mine done on the NHS.

 

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View Glazier#1's Profile Glazier#1 Flag 16 Dec 22 12.55pm Send a Private Message to Glazier#1 Add Glazier#1 as a friend

Originally posted by EverybodyDannsNow

Itís hard to know where to start with such lazy s***e but if you think what you earned as an apprentice presumably many decades ago is relevant, I donít know what to tell you. You also didnít do 5 years training to get into the role and Iíll take a guess that you werenít saving lives either.

Quite simply, if it was such a decent gig with so many amazing perks there wouldnít be people leaving in droves and they wouldnít be struggling to recruit new staff

Well said.

The oaf needs brain transplant - privately done, of course, lol.

 

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View Badger11's Profile Badger11 Flag Beckenham 16 Dec 22 2.55pm Send a Private Message to Badger11 Add Badger11 as a friend

Originally posted by Wisbech Eagle

The student loans are intended to achieve a similar result. The problem I see with your idea is how to collect the debt if, as they would, the doctors and nurses, disappear abroad. The same issue exists with the loans, but the lower earners don't pay them back anyway.

How to reduce the dependency on agency staff and to get a grip on the costs is a priority, but not a easy problem to solve. I am told that many international doctors and nurses cannot wait to complete their initial contract, so they can transfer to an agency, often then doing exactly the same job but at higher pay!

That's nuts! It's also very bad management to allow predatory agencies access to staff, so they can poach them and then feed them back to the NHS. Longer initial contracts seem obvious with visas that depend upon being employed by the NHS directly.

You don't collect. However I think the majority who quit the NHS in those circumstances are more likely to go private in the UK. Even if they go abroad after completing training how is that any different from now?

Waiving student loans is a logical solution to encourage people especially on low income to join the NHS most will stay for their working lifetime but if they choose to go private in the UK they will still have to pay off their student loan.

Agency staff I agree is a big issue the private sector is leaching NHS staff and then loaning them back on higher wages. Not sure what the solution is but something needs to be done. This and stopping staff working for NHS and private companies needs to be tackled.


Edited by Badger11 (16 Dec 2022 2.56pm)

 


One more point

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View dreamwaverider's Profile dreamwaverider Flag London 16 Dec 22 3.14pm Send a Private Message to dreamwaverider Add dreamwaverider as a friend

50% of NHS UK employees are administrative and management who receive 60% of the pay costs.
The NHS management is like a mafia. Completely self policed and self controlled. They determine their own wages etc etc.
If you want to review or break up and reform the NHS you would never be able to infiltrate their very tight ship.
NHS UK are one of the largest employers in the world employing just short of 1.8 million people.
It is all staggering stuff. No politician dares challenge them. All the clapping nonsense all self generated to kid their clinical staff.
We are being badly conned.
When Tony Blair came to power, annual NHS costs were £40 billion. He virtually doubled their costs trying to improve the service. 70% of those increased wage costs went to the admin and management. Now the NHS annual cost is £180 billion in England alone.
In 1980 we had 300,000 NHS beds. Now we have 130,000. Beds have more than halved.

Edited by dreamwaverider (16 Dec 2022 3.21pm)

Edited by dreamwaverider (16 Dec 2022 3.43pm)

Edited by dreamwaverider (16 Dec 2022 3.57pm)

 

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View Spiderman's Profile Spiderman Flag Horsham 16 Dec 22 3.53pm Send a Private Message to Spiderman Add Spiderman as a friend

Originally posted by dreamwaverider

50% of NHS UK employees are administrative and management who receive 60% of the pay costs.
The NHS management is like a mafia. Completely self policed and self controlled. They determine their own wages etc etc.
If you want to review or break up and reform the NHS you would never be able to infiltrate their very tight ship.
NHS UK are one of the largest employers in the world employing just short of 1.8 million people.
It is all staggering stuff. No politician dares challenge them. All the clapping nonsense all self generated to kid their clinical staff.
We are being badly conned.
When Tony Blair came to power, annual NHS costs were £40 billion. He virtually doubled their costs trying to improve the service. 70% of those increased wage costs went to the admin and management. Now the NHS annual cost is £160 billion.
In 1980 we had 300,000 NHS beds. Now we have 130,000. Beds have more than halved.

Edited by dreamwaverider (16 Dec 2022 3.21pm)

Edited by dreamwaverider (16 Dec 2022 3.43pm)

Here we are!,

[Link]

 

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View cryrst's Profile cryrst Flag The garden of England 16 Dec 22 4.35pm Send a Private Message to cryrst Add cryrst as a friend

Originally posted by Glazier#1

Well said.

The oaf needs brain transplant - privately done, of course, lol.

Tbh you donít think well do you; or your pal EDN.
After 7 people dying in a gas explosion in jersey just last week and if you Google gas explosions in the uk you could say Iíve saved more lives than you, EDN and many nurses ever will. Attending a gas leak, isolating the supply, testing and finding and repairing a gas leak clearly did and has saved lives. But never mind I called a dog a slag so Iím an oaf !

 

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View HKOwen's Profile HKOwen Flag Hong Kong 17 Dec 22 12.40am Send a Private Message to HKOwen Add HKOwen as a friend

Originally posted by cryrst

Employment law wouldnít 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.

There would need to be a specific piece of legislation relating to medical work, the possible reasons for not completing NHS service would be many adn would likely turn into an employment tribunal nightmare except for the lawyers involved.

 


Responsibility Deficit Disorder is a medical condition. Symptoms include inability to be corrected when wrong, false sense of superiority, desire to share personal info no else cares about, general hubris. It's a medical issue rather than pure arrogance.

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View cryrst's Profile cryrst Flag The garden of England 17 Dec 22 5.09am Send a Private Message to cryrst Add cryrst as a friend

Originally posted by HKOwen

There would need to be a specific piece of legislation relating to medical work, the possible reasons for not completing NHS service would be many adn would likely turn into an employment tribunal nightmare except for the lawyers involved.

Thinking about it maybe a system where the loan payback salary start point increases by a certain amount for each say, two year period you work for the nhs. That way if the start point is increased you get to keep more of your wages as an incentive to stay.
Here is a link but a brief skim through it and itís not as brutal as portrayed in reality.

[Link]

 

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