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The future of the NHS (if any)

...on serious topics that don't fit anywhere else at present.
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Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1301 Post by Alan H » July 16th, 2015, 2:06 pm

Latest post of the previous page:

Jeremy Hunt's divisive approach to seven-day NHS services benefits no one
Hunt’s commitment must surely match his rhetoric. The previous government’s Nicholson challenge of taking £20bn out of a £100bn budget has brought the health service to its knees. His new cost-efficiency drive is already posing a further challenge on all NHS hospitals. He takes no account of the fact that demands on the health service are growing year on year; general practice is already in crisis, and if we continue at this pace the whole of the NHS will be in special measures because of a misplaced ideology that public services are overfunded, inefficient, and alternative care is the way forward. You do not have to be a pundit to realise that the government can hardly afford its current model, let alone generate a different emergency system and reduce the NHS budget by £30bn by the end of the next parliament.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Dave B
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Re: The future of the NHS (if any)

#1302 Post by Dave B » July 16th, 2015, 9:06 pm

What gets up my nose is the utter hypocrasy of a bunch of barely competents, who make mistake after mistake, who think they can tell others how to run their business!

Wankers one and all!
"Look forward; yesterday was a lesson, if you did not learn from it you wasted it."
Me, 2015

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Alan H
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Re: The future of the NHS (if any)

#1303 Post by Alan H » July 18th, 2015, 10:00 pm

This is what they call in the trade 'evidence'; something that the Tories seem to believe exists simply to be ignored:

What are the Costs and Benefits of Providing Comprehensive Seven-day Services for Emergency Hospital Admissions?
Abstract: The English National Health Service is moving towards providing comprehensive 7-day hospital services in response to higher death rates for emergency weekend admissions. Using Hospital Episode Statistics between 1st April 2010 and 31st March 2011 linked to all-cause mortality within 30 days of admission, we estimate the number of excess deaths and the loss in quality-adjusted life years associated with emergency weekend admissions. The crude 30-day mortality rate was 3.70% for weekday admissions and 4.05% for weekend admissions. The excess weekend death rate equates to 4355 (risk adjusted 5353) additional deaths each year. The health gain of avoiding these deaths would be 29 727-36 539 quality-adjusted life years per year. The estimated cost of implementing 7-day services is £1.07-£1.43 bn, which exceeds by £339-£831 m the maximum spend based on the National Institute for Health and Care Excellence threshold of £595 m-£731 m. There is as yet no clear evidence that 7-day services will reduce weekend deaths or can be achieved without increasing weekday deaths. The planned cost of implementing 7-day services greatly exceeds the maximum amount that the National Health Service should spend on eradicating the weekend effect based on current evidence. Policy makers and service providers should focus on identifying specific service extensions for which cost-effectiveness can be demonstrated.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
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Re: The future of the NHS (if any)

#1304 Post by Alan H » July 18th, 2015, 10:45 pm

Consultant cover and mortality among hospital patients
Dr Foster’s assertions that in-patient mortality is linked to the level of out of hours consultant cover is based on a flawed analysis of the data, argues Margaret McCartney
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1305 Post by Alan H » July 20th, 2015, 3:33 pm

Personal health budgets are a wolf in sheep's clothing
Personal health budgets have been used for personal care for many years. Pilots are now being rolled out to 50,000 patients and will be extended nationwide from April 2015. It’s all about empowerment, right?

Wrong. They represent the logical end-point of the journey with the self-paying consumer in a market for health-care.

The real question is: what happens when your personal health budget runs out?

Easy, people say, you top it up. But it’s not so easy if you don’t have the money.

In other words, they enable insurance for top-ups (co-payments). Hence why insurance companies like WPA and AXA PPP are reportedly enthusiastic.

At the same time, Bupa has been busy preparing its own clinical guidelines and creating networks of doctors gearing up for this brave, new world. Personal health budgets undermine the fundamental NHS principle of equity of care. They are a Trojan horse for privatisation.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

Nick
Posts: 11027
Joined: July 4th, 2007, 10:10 am

Re: The future of the NHS (if any)

#1306 Post by Nick » July 21st, 2015, 8:47 am

Complete bollox, of course. Ever heard of crying wolf?

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Alan H
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Re: The future of the NHS (if any)

#1307 Post by Alan H » July 21st, 2015, 10:24 am

Nick wrote:Complete bollox, of course. Ever heard of crying wolf?
:rolleyes:

What is, in your opinion, 'complete bollox'?
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Altfish
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Joined: March 26th, 2012, 8:46 am

Re: The future of the NHS (if any)

#1308 Post by Altfish » July 21st, 2015, 10:41 am

Nick wrote:Complete bollox, of course. Ever heard of crying wolf?
How do you envisage it happening Nick? What are the benefits that I, a 60-year old male who for the previous 59-years has hardly bothered the NHS, can look forward to as my health inevitably starts to decline? Will I get credited for my previous years?

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Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1309 Post by Alan H » July 21st, 2015, 4:48 pm

For information and comment: NHS boss demands health information for MILLIONS of Britons - and it could identify YOU
CONFIDENTIAL NHS data revealing millions of patients' private health details and information including their date of birth and postcode have been demanded by an aide to the Prime Minister.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1310 Post by Alan H » July 21st, 2015, 11:48 pm

If doctors made decisions as ill-informed as Jeremy Hunt's, people would die
Hunt did rather hit the jackpot with his speech, managing to be both deeply misguided and highly offensive at once. In suggesting that consultants don’t work weekends, he displayed a profound lack of understanding of how the organisation he is responsible for is run, and the #ImInWorkJeremy campaign provided plenty of immediate feedback to prove that point. The consultants I worked with this weekend were in the hospital day and night, seeing sick patients from the early morning until sometimes well after midnight, as they do every day of the week. To suggest that they are lacking in professionalism is appalling.

More importantly, however, Hunt has not provided any evidence to show that an increased consultant presence will make any difference to patient outcomes. He has seized upon a study showing that patients admitted on a Sunday are 16% more likely to die than those admitted on a Wednesday (and I would urge anyone who hasn’t reviewed this study in depth to do so, because it is of course more complicated than that), but has provided absolutely no evidence that additional consultant presence on weekends will do anything to improve matters.
This nicely highlights the problems: even if that study demonstrated that weekends are more dangerous (it doesn't really say that, but that's been covered elsewhere), it doesn't follow that it's the fault of Consultants or that having more of them in at the weekends would improve outcomes.

That's like saying that there's good evidence that a particular medical condition is caused by a lack of X, therefore consuming more of X can only be good for you and/or will cure/prevent the condition. That's fallacious. It's all too often way more complicated than that.

Frankly, it's the sort of thing I see with quacks: they find one study that has an odd phrase in it that supports their particular fetish and exalt it to death. All sorts of problems lie behind that from inability to understand evidence, how to read a paper, confirmation bias and, of course, a Dunning-Kruger complex. Politicians - with a few notable exceptions - treat evidence in the same dishonest way.

The article also mentions a change.org petition: Resignation or removal of Jeremy Hunt MP as Secretary of State for Health (which has gathered nearly 100,000 signatures since Sunday) but there's also a Government petition To debate a vote of no confidence in Health Secretary the Right Hon Jeremy Hunt started yesterday: it's already achieved 132,000 signatures and Parliament must now consider it for debate. I wonder if the Tories will allow it? Any thoughts?
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1311 Post by Alan H » July 24th, 2015, 7:30 pm

Fantastic! I'm sure Jeremy Hunt will announce the funding for seven-day GPs very, very soon...

Jeremy Hunt's seven-day plan for GP surgeries could cost NHS £3bn a year

But of course, even if he did dig this deep into our pockets, GPs don't grow on trees and it would be a decade before we had sufficient numbers of doctors.

Tory plan for seven-day access to GPs branded 'cloud cuckoo land'
Plans for seven-day GP surgeries have been described as coming from “cloud cuckoo land” by one of the UK’s most senior doctors.

Dr Maureen Baker, chair of the Royal College of General Practitioners (RCGP), labelled the government’s pledge a “political imperative” and warned that many GP surgeries were already “teetering on the brink”.

Baker said there were other ways to improve GP surgeries besides seven-day availability, questioning whether the government’s plans to extend opening hours across the country should “really be a priority”.

On 18 May, David Cameron reiterated the Conservatives’ plan for a “truly seven-day NHS” in his first major speech after the election, committing to seven-day GP access for 18 million patients by April 2016.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1312 Post by Alan H » July 25th, 2015, 7:42 pm

So is Jeremy Hunt lying, ignorant, mis-informed, or does he not care which of these he is?

7-day NHS services: a factsheet
Why we need 7-day services
1.1 Patients currently get a poorer service at weekends
There is a clear link between poorer outcomes for patients and uneven service provision at the weekend:

Patients are 16% more likely to die if they are admitted on a Sunday compared with a Wednesday.
The risk of death for patients admitted on a Sunday compared with a Wednesday is 37% higher for acute and unspecified renal failure, 8% higher for urinary tract infections and 7% higher for a fractured neck of femur.
Survival rates following a broken hip are much higher if patients are treated quickly, ideally within 2 days. Patients are 24% more likely to have to wait longer than 2 days for a broken hip replacement on weekends.
There is not always access to the right treatments or diagnostic tests at weekends, which can result in delays and worsen the outcomes and experience for patients.
MRI scans, CT scans, ultrasound scans and other important diagnostic tests are not consistently available in all hospitals at the weekends.
Weekend Mortality and the 7-day NHS
“If you are admitted to hospital on a Sunday, you are 15% more likely to die than on a Wednesday”.

This is Jeremy Hunt- quoting a paper without atribution from the Journal of the Royal Society of Medicine, conducted in 2010 by Freemantle et al [1] amongst nearly 15 million admissions.

Here is the actual paper:

Here are the ACTUAL conclusions

1. Patients admitted on a Sunday were more likely to die over the next thirty days than a similar cohort of admissions on Wednesday- the ratio was 1.16 and the result significant, suggesting a true result of increased deaths by 16%

2. 94% of these ‘admissions’ were emergencies

3. 34% of deaths occurred within three days of admission

4. You are actually less likely to die if you are IN hospital on the weekend – the Sunday to Wednesday ratio here is 0.92, or 8% LESS likely. As the authors also conclude, this likely reflects the fact that high-risk, non-urgent procedures are performed during the week.

5. For elective (non-emergency) admissions, the ratio was 1.62 for Sunday to Wednesday, suggesting a 62% increased chance of death. This, as the authors conclude, is likely biased by the fact that high-risk elective patients are brought in early in general for exactly this reason, therefore this is unlikely to be significant.

6. Of 10 conditions specifically looked at, only 7 were found to show the same increased risk: sepsis, acute renal failure, cancer of the bronchus or lung, myocardial infarction, acute stroke, and congestive heart failure.

7. The authors also conclude: “7-day access to ALL ASPECTS of care” could improve such figures, but further ‘economic evaluation’ is required to ensure efficiency with ‘scant resources’ [para]

8. A further third of patients in this study died after discharge

So to summarise, you are 16% more likely to die, over the next thirty days, if you come into hospital on a Sunday- 30% will die within three days (Mon-Tues), and a further 30% will die after discharge. This only applies to emergency admissions, and a list of medical emergency conditions.

One major criticism, published by the authors themselves, is the fact that any conclusion completely ignores the reason for admission and the route of admission- there are no routine GP services on the weekend, and the impetus to admit on a weekend has to be higher than the week when most people would hold out for the GP unless they were very unwell. This immediately selects out a group of sicker patients than might routinely come in on a Wednesday.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
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Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1313 Post by Alan H » July 26th, 2015, 8:26 pm

More debunking of Hunt's nonsense: RESPONSE TO GOVERNMENT PETITION REPLY – VOTE OF NO CONFIDENCE IN JEREMY HUNT

For example, Hunt talked about consultants opting out of weekend working being the cause of so many problems:
A Freedom of Information request responded to by 13 acute NHS trusts so far has revealed just one consultant opting out of a total of 3755 consultants (0.027%). That’s equivalent to just 12 out of the roughly 40,000 consultants working in the whole of England. This destroys the Government argument that the opt-out clause is a “major barrier” to a 7-day service. The opposite is true, it is no barrier at all.
The whole article is well worth reading.

The hashtag #WeNeedToTalkAboutJeremy is starting to trend on Twitter.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1314 Post by Alan H » July 27th, 2015, 7:37 pm

The best way to refute Jeremy Hunt's latest spiffing wheeze is, as always, is by, erm... looking at the evidence: Displaying the cost of prescribed drugs: what’s the evidence?
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Altfish
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Joined: March 26th, 2012, 8:46 am

Re: The future of the NHS (if any)

#1315 Post by Altfish » July 27th, 2015, 7:43 pm

Alan H wrote:The best way to refute Jeremy Hunt's latest spiffing wheeze is, as always, is by, erm... looking at the evidence: Displaying the cost of prescribed drugs: what’s the evidence?
Or by using a sousaphone....

https://www.youtube.com/watch?v=lExnBadkFZg

:laughter:

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Alan H
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Re: The future of the NHS (if any)

#1316 Post by Alan H » August 4th, 2015, 11:07 am

How to sell off the NHS – in nine easy steps
So you want to sell off the NHS? The 67-year old behemoth has radically improved people’s quality of life for nearly a century, so it won’t be easy. Here’s a handy step-by-step guide to privatising the health service.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

User avatar
Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1317 Post by Alan H » August 9th, 2015, 1:08 pm

Jeremy Hunt warned over plans to cut pay for trainee GPs
Proposals to cut salary supplements for trainee GPs would have a "catastrophic impact" on recruitment and lead to more pressure on doctors, Jeremy Hunt has been warned.

The chairwoman of the Royal College of General Practitioners (RCGP), Dr Maureen Baker, said in a letter to the Health Secretary that the Government must reject the plans if it hopes to meet its target of increasing the number of GPs to 5,000 by 2020.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

User avatar
Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1318 Post by Alan H » August 9th, 2015, 11:32 pm

I'm sure no one could possibly have any objections whatsoever to this: Boots, Tesco and Superdrug to get access to NHS medical records
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

User avatar
Alan H
Posts: 24067
Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#1319 Post by Alan H » August 10th, 2015, 7:01 pm

Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

Nick
Posts: 11027
Joined: July 4th, 2007, 10:10 am

Re: The future of the NHS (if any)

#1320 Post by Nick » August 11th, 2015, 1:01 am

Altfish wrote:
Nick wrote:Complete bollox, of course. Ever heard of crying wolf?
How do you envisage it happening Nick? What are the benefits that I, a 60-year old male who for the previous 59-years has hardly bothered the NHS, can look forward to as my health inevitably starts to decline? Will I get credited for my previous years?
You can look forward to the NHS providing exactly the sort of service that a 60 year old male would require. For UK citizens such as yourself, NHS provision has nothing to do with previous contributions, and it is pure political lies to say otherwise. As I said: complete bollox.

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Alan H
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Re: The future of the NHS (if any)

#1321 Post by Alan H » August 11th, 2015, 1:09 am

Nick wrote:
Altfish wrote:
Nick wrote:Complete bollox, of course. Ever heard of crying wolf?
How do you envisage it happening Nick? What are the benefits that I, a 60-year old male who for the previous 59-years has hardly bothered the NHS, can look forward to as my health inevitably starts to decline? Will I get credited for my previous years?
You can look forward to the NHS providing exactly the sort of service that a 60 year old male would require. For UK citizens such as yourself, NHS provision has nothing to do with previous contributions, and it is pure political lies to say otherwise. As I said: complete bollox.
Just don't ever be in need of a hip replacement, a knee replacement, need cataracts removed or have varicose veins...
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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