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The end of the NHS. (Read 193095 times)

fatdoc

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#125 Re: The end of the NHS.
August 26, 2014, 12:12:10 pm
 :kiss2:

Nothing like aninternet forum to cause chaos.

I  read it you both were saying the same thing!!!!




mrjonathanr

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#126 Re: The end of the NHS.
August 26, 2014, 04:42:10 pm
We were, smartypants  :wave:

GCW

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#127 Re: The end of the NHS.
August 26, 2014, 04:52:33 pm
Maybe so, but I was right  :shrug:

Sloper

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#128 Re: The end of the NHS.
August 26, 2014, 04:58:00 pm
Maybe so, but I was right  :shrug:

But if you don't quote latin it doesn't count, it's abit like no top no tick (mutatis mutandis)

mrjonathanr

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#129 Re: The end of the NHS.
August 26, 2014, 05:46:38 pm
Maybe so, but I was right  :shrug:

As we were saying the same thing, I think I'm right, ipse loquitur.

GCW

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#130 Re: The end of the NHS.
August 26, 2014, 05:57:22 pm
Oh yea.  Coquus est in culina.

tomtom

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#131 Re: The end of the NHS.
August 26, 2014, 05:57:52 pm
EGO innutum per asinus, ignis ad coques, dum fumigantium a clavus in polypus.

petejh

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#132 Re: The end of the NHS.
August 26, 2014, 07:06:34 pm
Lorem ipsum, as they say in guidebook publishing..

How's your audit going GCW - any cases yet which could've been dealt with by a non-professional as effectively as by a professional?

Sloper

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#133 Re: The end of the NHS.
August 26, 2014, 07:32:13 pm
Independent Sector Treatment sectors, initiated by Labour, the introduction of competition between NHS providers via 'choose & book' (and lets not even look at the IT systems) by Labour, the current government's reforms: all of which are which while open to criticism from some due to the 'market' aspects of the policy are all driven by a desire to make the NHS fit for the 21st century.

The NHS was designed for a different age, it cannot continue without an evolutionary event.

Fatdoc & GCW, at least you don't have your regulator imposing a requirement to conduct diversity surveys (or maybe you do) and then changing the reporting mechanism (without telling you of course) and then threatening disciplinary action because you can't complete the task, or imposing reporting criteria and then deciding at the last moment you don't need to report (meaning work over a year (which was always a waste of time) was then wasted) although things may be bad, I would suggest that they're not as bad as the legal profession which has suffered death by a thousand cuts from fucktard consultants.

mrjonathanr

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#134 Re: The end of the NHS.
August 26, 2014, 08:20:21 pm
Fortunately education has been spared this sort of meddling :blink:

Sloper

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#135 Re: The end of the NHS.
August 26, 2014, 08:42:25 pm
Indeed, our system of state education is entirely without critique and clearly in no need of reform .

http://www.bbc.co.uk/news/education-24433320 yep, in real terms we're they only country where the trend is going 'backwards'

4/5ths (i.e. nearly half  ::)) have poor levels of numeracy and that declined in the 8 years from 2003 http://www.nationalnumeracy.org.uk/what-the-research-says/index.html

That Thatcher has a bloody lot to answer for. :spank:


mrjonathanr

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#136 Re: The end of the NHS.
August 26, 2014, 10:10:00 pm
Indeed, our system of state education is entirely without critique and clearly in no need of reform .


Ah I see. Change in education is essential reform but in law it's distressing meddling.

 :lol: :lol:

GCW

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#137 Re: The end of the NHS.
August 26, 2014, 11:16:39 pm
Lorem ipsum, as they say in guidebook publishing..

How's your audit going GCW - any cases yet which could've been dealt with by a non-professional as effectively as by a professional?

1. Kid with a sore mouth eating QuaversTM.
2. Woman with sore labia after shaving.
3. Bloke with sore arm after breaking it, and having fracture clinic follow up.
4. Man with poor memory
5. Woman with a cough for 3 days.
6. Guy that ran the C2C in 4 days, with an infected leg. Had a nice chat about the 3 rings of Shap. He kicked my ass. Dick.
7. Guy needing a sick note.
8. Man the hospital advised to see me for some medication.
9. Man with prepatellar bursitis that has settled but was told to see GP for follow up.
10. Man for BP check. It was ok.
11. Woman with strong urine for a day - no evidence of infection.
12. Boy with a wart.
13. Man that had some questions after his consultant appointment.
14. Woman with a red eye for a day, conjunctivitis that a pharmacy could treat.
15. Woman that wanted more tramadol than we were unhappy to give.
16. Guy on 1/4 of a mirtazepine per day for years came to ok it for the next year.
17. Man with a deaf ear, needed referring for a hearing test. Pardon?
18. Nursing home resident that hasn't eaten since admission, needs dietician input?!?!
19.Woman with indigestion for a few days.
20. Man with a headache for 5 days on and off.
21. Woman I saw 2 days ago feeling a bit viral, that seems to have a virus.
22. Man with a solar keratosis on his face that hasn't gone with dermatology treatment, so he comes to see me again.
23. Woman with bad OA knee that I'll aspirate and inject.
24. Elderly chap whose careers think has lost 500g despite their attempts to feed him.
25. Man that broke his shoulder, and is due to be seen in fracture clinic. It's sore.
26. Woman with a headache on and off for 3 weeks. Only when she's stressed.
27. Man with prostate issues that urology changed his meds. He needs a script.
28. Man with arm injury that needs a date changing on his sick note.
29. Elderly lady comes to check the dose of her medication.

That's 3 I would think needed to be seen, out of 29. And you wonder why I'm sick of it???? A monkey could do this. And possibly a Sloper, although I'm not convinced.....

 

Sloper

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#138 Re: The end of the NHS.
August 27, 2014, 07:38:00 am
Indeed, our system of state education is entirely without critique and clearly in no need of reform .


Ah I see. Change in education is essential reform but in law it's distressing meddling.

 :lol: :lol:

There's been very little change in the law, or indeed in the practice of law, the regulation (and public funding of access to law) has changed massively but the law remains the same, outcomes remain broadly stable and in some areas including criminal law have improved massively (judged on the number of appeals and successful appeals falling).

But then you'd rather avoid the harsh reality that the standards of education are falling and therefore teachers (as a collective group)  are failing, (or do we blame the parents or society?) and instead play a bit of whabouttery.  How depressingly true to form.

Sloper

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#139 Re: The end of the NHS.
August 27, 2014, 07:42:17 am
Lorem ipsum, as they say in guidebook publishing..

How's your audit going GCW - any cases yet which could've been dealt with by a non-professional as effectively as by a professional?

1. Kid with a sore mouth eating QuaversTM.
2. Woman with sore labia after shaving.
3. Bloke with sore arm after breaking it, and having fracture clinic follow up.
4. Man with poor memory
5. Woman with a cough for 3 days.
6. Guy that ran the C2C in 4 days, with an infected leg. Had a nice chat about the 3 rings of Shap. He kicked my ass. Dick.
7. Guy needing a sick note.
8. Man the hospital advised to see me for some medication.
9. Man with prepatellar bursitis that has settled but was told to see GP for follow up.
10. Man for BP check. It was ok.
11. Woman with strong urine for a day - no evidence of infection.
12. Boy with a wart.
13. Man that had some questions after his consultant appointment.
14. Woman with a red eye for a day, conjunctivitis that a pharmacy could treat.
15. Woman that wanted more tramadol than we were unhappy to give.
16. Guy on 1/4 of a mirtazepine per day for years came to ok it for the next year.
17. Man with a deaf ear, needed referring for a hearing test. Pardon?
18. Nursing home resident that hasn't eaten since admission, needs dietician input?!?!
19.Woman with indigestion for a few days.
20. Man with a headache for 5 days on and off.
21. Woman I saw 2 days ago feeling a bit viral, that seems to have a virus.
22. Man with a solar keratosis on his face that hasn't gone with dermatology treatment, so he comes to see me again.
23. Woman with bad OA knee that I'll aspirate and inject.
24. Elderly chap whose careers think has lost 500g despite their attempts to feed him.
25. Man that broke his shoulder, and is due to be seen in fracture clinic. It's sore.
26. Woman with a headache on and off for 3 weeks. Only when she's stressed.
27. Man with prostate issues that urology changed his meds. He needs a script.
28. Man with arm injury that needs a date changing on his sick note.
29. Elderly lady comes to check the dose of her medication.

That's 3 I would think needed to be seen, out of 29. And you wonder why I'm sick of it???? A monkey could do this. And possibly a Sloper, although I'm not convinced.....

The joke in insurance litigation is that you can train a monkey to do it in 8 weeks, two weeks of which is training in law and the other six is to get them to stop defecating on the floor and throwing it at colleagues. Obviously that's a joke, you can't train a monkey to stop defecating on the floor.

Sloper

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#140 Re: The end of the NHS.
September 03, 2014, 08:36:18 pm
Here's the perfect exemplar of why the NHS needs radical surgery.

http://www.theguardian.com/society/2014/sep/03/four-heart-experts-jailed-fraud-nhs-trust-basildon-thurrock

They were only doing 55% of their hours and no one noticed for four years? FFS If you tried that in the private sector you wouldn't last 4 weeks (indeed 4 days would probably be pushing it)

drdeath

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#141 Re: The end of the NHS.
September 04, 2014, 10:45:27 am
Here's the perfect exemplar of why the NHS needs radical surgery.

http://www.theguardian.com/society/2014/sep/03/four-heart-experts-jailed-fraud-nhs-trust-basildon-thurrock

They were only doing 55% of their hours and no one noticed for four years? FFS If you tried that in the private sector you wouldn't last 4 weeks (indeed 4 days would probably be pushing it)

Absolutely...I mean the idea that this could or would happen in the private sector is simply laughable...

Oh, wait a minute, that's utter bollocks...

http://www.economist.com/news/leaders/21603026-how-hand-over-272-billion-year-criminals-thats-where-money

And if that's too much like standard America bashing for you, let's try Germany, land of ruthless efficiency...

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1143614/



« Last Edit: September 04, 2014, 11:12:55 am by drdeath »

Jaspersharpe

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#142 Re: The end of the NHS.
September 04, 2014, 01:06:02 pm

Sloper

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#143 Re: The end of the NHS.
September 05, 2014, 11:05:56 am
Absent the fact that I haven't got a clue what 'pwned' means (I imagine it's not complimentary) but Dr Death is talking through his arse, I would have thought a doctor would understand the flaw in comparing the equivalent of a broken leg and a viral infection. The two examples he cites are akin to supply chain fraud (although the economist link is paywalled).

There's also a fair amount of straight financial fraud in the NHS too, let's see the successful prosecutions this year shall we?

http://www.nhsbsa.nhs.uk/4635.aspx
http://www.nhsbsa.nhs.uk/4634.aspx
http://www.nhsbsa.nhs.uk/4472.aspx
http://www.nhsbsa.nhs.uk/4456.aspx


The point is, the culture in the NHS is/was so inefficient that for four years, that's almost 200 working weeks these four critical staff were not at work for >50% of the time and that that was not addressed.

Quite simply this is simply inconceivable in the private sector.

GCW

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#144 Re: The end of the NHS.
September 30, 2014, 03:00:13 pm
Cameron tells GPs they must work weekends.

Er, how is this even vaguely possible within five years?????

Sloper

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#145 Re: The end of the NHS.
September 30, 2014, 03:11:19 pm
I've absolutely no idea how it can be made to work*, but as a policy objective it's a good one.

* Although I would say restructuring practices, recruitment of more allied health professionals and reducing attendanes of a routine nature would free up a significant amount of capacity.

GCW

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#146 Re: The end of the NHS.
September 30, 2014, 03:38:30 pm
The KPMG survey just done suggests around 40% of GPs in this area plan to leave within 5 years. The current intake of trainers won't even cover the current needs, never mind to staff an extra 2 days each week. GP has been made such an unpopular specialty due to all these changes, the training posts aren't filled anyway. No amount of restructuring will provide the numbers needed. Unless it's all privatised.....

Oldmanmatt

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#147 Re: The end of the NHS.
September 30, 2014, 03:46:27 pm

Cameron tells GPs they must work weekends.

Er, how is this even vaguely possible within five years?????

Increasing the role of the Practice Nurse to include basic diagnosis?

As in "yes dear, you've got a cold dear" and " No dear, antibiotics won't help" or possibly even "No, dear, little Jaden won't have rabies because your Bull Terrier torn his face off"...

Oldmanmatt

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#148 Re: The end of the NHS.
September 30, 2014, 03:56:57 pm
Seriously though...

Is there no scope for a mid tier with a GP practice?

As I recall, the first point of call in my military days was the MA or MedTech. They filtered out the "take two aspirin and call me in the morning" brigade and reduced the Duty Medical Officers work load dramatically.

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#149 Re: The end of the NHS.
September 30, 2014, 04:11:56 pm
Yes, as I've said before a lot of stuff doesn't need to see a doctor. It needs a huge reeducation if patients and their expectation. And it needs more funding than £60 per patient got unlimited access.

 

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