I'm reasonably well informed.
Quote from: GCW on July 01, 2014, 04:57:58 pmBottom line is that patient demand is going upI think this is an interesting point and ties into the A&E (mis-)use.What is driving the increase in patient demand? There has been a slight increase in the population size over the last 50 years, and the standard of medical care in terms of what can be treated is has vastly improved, but this isn't necessarily for the common things, rather its for rare conditions.Life expectancy has increased as a consequence of improved treatments for communicable diseases and as a consequence the population is ageing well, and the incidence of heart disease, cancer, type II diabetes, dementia (catch all term for the broad spectrum) have all increased as a consequence.This, to me at least, seems to be the crux that the continual thrust for "cures" (together we can beat cancer/heart-disease/dementia) which pro-long life expectancy isn't the right direction to be heading. For me as a person touching middle-age (fuck I am feeling old writing that) I've fairly good prospects for another decade or three at least, and this would improved if I gave up smoking as the government would like everyone to do. However, adding another five to ten years to the end of my life doesn't really appeal to me because at that stage my body or mind (or both) will be deteriorating. For me quality is far more important than quantity and I think society would benefit from a shift of focus away from longevity to focusing on quality of life.I've said before that you can't change a society, only individuals who make up that society, but I really think that if there was less focus on living as long as possible and having as good a standard of life as possible with the time available it would be a better way of spending money within the NHS.I don't have any real answers, but will say that recommendations for how money is spent within the NHS on different treatments is for the large part governed by The National Institute for Health and Care Excellence (NICE) which takes an evidence base approach.As an aside the continual Tory v's (Nu-)Labour to-ing and fro-ing bashing is pretty pointless, its clear that current Labour party do not represent the values the party held 70+ years ago when the established the NHS.
Bottom line is that patient demand is going up
This, to me at least, seems to be the crux that the continual thrust for "cures" (together we can beat cancer/heart-disease/dementia) which pro-long life expectancy isn't the right direction to be heading. For me as a person touching middle-age (fuck I am feeling old writing that) I've fairly good prospects for another decade or three at least, and this would improved if I gave up smoking as the government would like everyone to do. However, adding another five to ten years to the end of my life doesn't really appeal to me because at that stage my body or mind (or both) will be deteriorating. For me quality is far more important than quantity and I think society would benefit from a shift of focus away from longevity to focusing on quality of life.I've said before that you can't change a society, only individuals who make up that society, but I really think that if there was less focus on living as long as possible and having as good a standard of life as possible with the time available it would be a better way of spending money within the NHS.
Quote from: slackline on July 01, 2014, 06:14:25 pmThis, to me at least, seems to be the crux that the continual thrust for "cures" (together we can beat cancer/heart-disease/dementia) which pro-long life expectancy isn't the right direction to be heading. For me as a person touching middle-age (fuck I am feeling old writing that) I've fairly good prospects for another decade or three at least, and this would improved if I gave up smoking as the government would like everyone to do. However, adding another five to ten years to the end of my life doesn't really appeal to me because at that stage my body or mind (or both) will be deteriorating. For me quality is far more important than quantity and I think society would benefit from a shift of focus away from longevity to focusing on quality of life.I've said before that you can't change a society, only individuals who make up that society, but I really think that if there was less focus on living as long as possible and having as good a standard of life as possible with the time available it would be a better way of spending money within the NHS.Good post
I was ignoring it because I was avoiding taking the mick out of slackline, who clearly values his own rationality, for being yet another smoker with a ridiculous and self-deceiving justification for his addiction.
But since you've drawn attention to it:Smoking doesn't prevent you living the last years of your life while watching your mortal coil fall apart. It virtually guarantees it. And makes it happen sooner.
http://www.telegraph.co.uk/news/politics/pmqs/10941213/PMQs-sketch-Dave-and-Ed-play-the-numbers-game.htmlAn entertaining little article. It shows how a clear case for privatisation has been laid out along with a clear explanation of the current 'crisis' being drummed up.Or not.
Quote from: psychomansam on July 02, 2014, 04:26:17 pmhttp://www.telegraph.co.uk/news/politics/pmqs/10941213/PMQs-sketch-Dave-and-Ed-play-the-numbers-game.htmlAn entertaining little article. It shows how a clear case for privatisation has been laid out along with a clear explanation of the current 'crisis' being drummed up.Or not.You seem to misunderstand how capitalism works, generally it involves making a profit or going bust. Much i.e. >90% of non primary care in the NHS does is quite simply not suited to profit making (other than the bits that were sold off by Labour) and when you throw in the cost of professional indemnity insurance and over heads unless HMG is royally arse fucked by the suppliers (see Labour's contracts to the PSTC) then even the contracting out isn't going to be profitable.But you carry on believing what you believe, it's not as if facts or reason are going to trouble you.
Ah, so the problem with the NHS is that it's not profitable enough.
Quote from: psychomansam on July 02, 2014, 07:30:49 pmAh, so the problem with the NHS is that it's not profitable enough.Its actually quite useful for the NHS to generate some profit as they can then invest in research via their research arm, the National Institute for Health Research which has any number of funding streams (Health Technology Assessment, Research for Patient Benefit, Efficacy and Mechanism Evaluation etc.) or funding the Research Design Service which exists to assist and improve clinicians and researchers research grant proposals to the various NIHR funding streams so that the quality of the research funded and conducted is higher.More profit would mean more research could be funded, leading to improved care, treatment and services.
Quote from: Sloper on July 02, 2014, 05:18:41 pmQuote from: psychomansam on July 02, 2014, 04:26:17 pmhttp://www.telegraph.co.uk/news/politics/pmqs/10941213/PMQs-sketch-Dave-and-Ed-play-the-numbers-game.htmlAn entertaining little article. It shows how a clear case for privatisation has been laid out along with a clear explanation of the current 'crisis' being drummed up.Or not.You seem to misunderstand how capitalism works, generally it involves making a profit or going bust. Much i.e. >90% of non primary care in the NHS does is quite simply not suited to profit making (other than the bits that were sold off by Labour) and when you throw in the cost of professional indemnity insurance and over heads unless HMG is royally arse fucked by the suppliers (see Labour's contracts to the PSTC) then even the contracting out isn't going to be profitable.But you carry on believing what you believe, it's not as if facts or reason are going to trouble you.Ah, so the problem with the NHS is that it's not profitable enough. Of course. Presumably we should move more toward the US model? They, after all, have a hugely profitable health sector. Or perhaps the problem is one of creating the right interfaces between public and private in a mixed economy - creating the right balance of power between public interest and private capital. Frankly, I don't think any of these are the problem. The health service is already highly cost-efficient. If it's starting to get overwhelmed, then what it really needs a bit more money.I'd start by getting rid of the high-interest debt crippling lots of hospitals.