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39 minutes ago, coprolite said:

Correct

f**k poor countries. They shouldn't have any medical staff if they can't be bothered having lots of money. 

Every time I try and discuss real things on this site I quickly realise it's a waste of time. I'll head back to the football now.

Those people want to come here, btw. 

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13 minutes ago, GordonS said:

Every time I try and discuss real things on this site I quickly realise it's a waste of time. I'll head back to the football now.

Those people want to come here, btw. 

Of course they do. "Brain Drain" is a major barrier to development in the third world. It's far from being an unconditionally good thing to import highly skilled labour. 

Flounce off all you want and take your pretend moral high ground with you. 

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32 minutes ago, GordonS said:

Every time I try and discuss real things on this site I quickly realise it's a waste of time. I'll head back to the football now.

Those people want to come here, btw. 

 

21 minutes ago, coprolite said:

Of course they do. "Brain Drain" is a major barrier to development in the third world. It's far from being an unconditionally good thing to import highly skilled labour. 

Flounce off all you want and take your pretend moral high ground with you. 

Patrick Cockburn has written about this a few times most recently in June of this year. I believe he said in a previous article that he grew up in the Republic of Ireland where healthcare was hampered by a shortage of medical professionals as a result of them largely leaving for the UK. Combined with our apparent underperforming in producing nurses and doctors it is a point worth considering. 

https://www.independent.co.uk/voices/foreign-aid-covid-vaccines-doctors-nurses-trained-abroad-b1864069.html

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Should maybe go in the petty things that annoy you thread but people working for the NHS conveniently hide their final salary (or average salary) public pensions when banging on about how poor they are paid.

Edited by red23
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1 hour ago, GordonS said:

Every time I try and discuss real things on this site I quickly realise it's a waste of time. I'll head back to the football now.

Those people want to come here, btw. 

When you develop some self-awareness have a wee think about what the common denominator is in the discussions you find a waste of time.

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26 minutes ago, oaksoft said:

And that's fair enough.

The point I'm trying to make is that it cannot be a simple problem to fix and it can't just be a case of throwing money at it because nobody from any party has ever been able to make that work.

The NHS is probably too big to fix in the way you are describing IMO.

What I think is that as a society we need to step back from this and start thinking about our own responsibility not to overwhelm it by not looking after ourselves. We are a nation of fat, unhealthy b*****ds complaining because the NHS can't cope with all the associated illness caused by that.

IMO we need to stop pouring money into a black hole and deal with the root cause - ourselves.

Not having tranches of perfectly healthy staff sitting at home after being pinged would be another thing.

None of this is easy to solve though because of the size of the organisation and what we are asking of it.

You (rightly) get a lot of stick on here from what I've seen but you're spot on with this. 

Instead of CMOs talking about "realistic medicine" we need doctors everywhere to practice it wholesale. Still a long way off I think. 

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23 minutes ago, oaksoft said:

Universities turn down about 7 out of 10 medical school candidates if my memory serves me correctly.

Pretty sure nursing colleges are also turning away most candidates

Happy to be corrected on both points but a lack of willingness is not the problem.

One of the reasons we should be training more.  If anyone can present a good reason why we shouldn’t train more medical staff in the UK I’d love to hear it.

I think I read somewhere that it costs £100k to train a doctor in the UK and that’s one of the reasons why its capped.  Over a 40 year career that’s a small investment for the taxpayer to make for a service we all need at some point.

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17 minutes ago, red23 said:

Should maybe go in the petty things that annoy you thread but people working for the NHS conveniently hide their final salary (or average salary) public pensions when banging on about how poor they are paid.

Our salaries are a matter of public record, we have nothing to hide. 

Worth considering this though. I am far from a CEO, but the CEOs of Lothian and GGC for example take in approx £150k a year before tax. Ask yourself how many private sector CEOs would get out of bed for that at an organisation of comparable size. We are talking multi-billion pound organisations with 25k+ staff. It won't be a popular view because that's clearly still obscene money, but I have a lot of respect for people who will work at that level in the public sector, with the shite and politics and stress that come with it, when they could be making many times as much money in the private sector. 

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13 minutes ago, Billy Jean King said:
47 minutes ago, red23 said:
Should maybe go in the petty things that annoy you thread but people working for the NHS conveniently hide their final salary (or average salary) public pensions when banging on about how poor they are paid.

Public sector final salary schemes were stopped years ago.

Not all of them.  A mate of mine went to work for a public sector organisation last year.  He’s on a DB scheme accruing at 49ths which is better than the private sector DB pension he was getting in the job he was made redundant from.

ETA I have no idea what schemes NHS staff are on btw.

Edited by Left Back
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Not all of them.  A mate of mine went to work for a public sector organisation last year.  He’s on a DB scheme accruing at 49ths which is better than the private sector DB pension he was getting in the job he was made redundant from.
ETA I have no idea what schemes NHS staff are on btw.
The PS element of my work is still DB but they are now average earnings rather than final salary. I think I have accrued benefits in 4 different PS schemes now over the years but in the current climate 49ths are good going. It was a terminology thing my initial response. A lot of us old timers don't think of the newer schemes as final salary but they technically are. I remember when I worked at one particular LA mid 80s it was standard practice to "promote " someone in their final year just to boost their FS pension. Was also prevalent in the police. I doubt the NHS was too different.
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52 minutes ago, Billy Jean King said:
1 hour ago, red23 said:
Should maybe go in the petty things that annoy you thread but people working for the NHS conveniently hide their final salary (or average salary) public pensions when banging on about how poor they are paid.

Public sector final salary schemes were stopped years ago.

For new entrants, yes. In the govt department I used to work for, anyone who had been there for any real length of time was on a DB scheme. 75% of final salary for the long-timers. Oooft. 

Everyone is now on a career wavwrage scheme but the DB element of it is preserved for those that were in it. 

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On 14/09/2021 at 13:28, The Moonster said:

Seems to be a fair amount of "well my experiences of the NHS have been terrible" stories that all seem to stem from a lack of staff or resources. Almost as if the NHS doesn't get enough funding from a government that doesn't want to keep funding it. Might be something else though.

I think it's fair to blame a good proportion of it on a lack of resources, but I don't think you can really make blanket statements about 'the NHS' that apply to all areas of it equally. 

My own parents both had dealings with Oncology, in which they were treated swiftly, compassionately, and to the satisfaction of both. Government and media in the UK never tire of banging on about cancer, cancer charity seems to be giving the likes of Amazon a run for it's money in terms of size, and any time you see a sponsored this or a sponsored that, it more often than not involves raising money for cancer. Now if it's genuinely such a priority for the public, then of course it should merit appropriate resources, but when you contrast the cancer scenario with that of mental health provision, it makes you wonder why, when both affect broadly similar numbers of people, there is such a colossal discrepancy in provision, resources, and efficacy of treatment.

Most of my own gripes with the NHS, and 99% of what I spend my professional life doing, revolve around thoroughly inadequate mental health services, and more specifically, the behaviours and attitudes of the professionals responsible for providing primary mental health care. While I'm totally accepting that a lot of this can be explained by lack of resources, what that doesn't explain is the number of times I've encountered outright hostility, contempt for the patient, disregard for patient wishes, a refusal to acknowledge any possibility that doesn't marry 100% with the doctor's interpretation of things or their doctrinal approach, people being parked on psychiatric medication that does absolutely nothing to improve their quality of life, yet any request for a review is met with utter indignation that anyone could have the temerity to challenge a doctor's opinion, psychiatrists who believe they can act outwith the law with utter impunity and throw toddler tantrums when challenged on this, leading to the impression that they view laws as an inconvenience and would far rather see a return to the days of bedlam.

I've had my own entirely negative and soul-destroying experiences with CMHT, MHAS, and NHS Lothian's various psychiatry departments. Perhaps it's because of my age, lived experience, and professional background that I'm fortunate enough to have enough insight into my own health and the medical model that I can tell when psychiatrists are 'at it'. I wasted 18 months in weekly therapy with a therapist that never once convinced me she had any clue whatsoever what she was doing, or insight into me as a patient, but I persevered with it in the belief that perhaps as time unfolded it would become more apparent to me what the supposed purpose and end goals were. I was completely unsurprised afterwards, that having requested a copy of her final report from my notes, not only hadn't she any basic understanding of my mindset, she then recorded my protestations that she'd been entirely useless and the whole thing an utter waste of my time as an attempt by myself to 'bully' her into offering more therapy! :lol:

 

Probably worth mentioning that this therapy was prescribed after I had been completely misdiagnosed by MHAS, largely in my opinion because they disregarded and poo-pooed the actual symptoms I was describing (another habit of a good number of shrinks), yet were hell-bent on having me admit to symptoms and phenomenon that I had never at any point experienced in my entire adult life. So while I accept that the later therapy was entirely inappropriate, and hence ineffective, that still does not explain the incompetence and intransigence of the initial MHAS shrink, nor the laughable conclusions of the totally useless therapist herself. She should have realised almost immediately that what she was dealing with wasn't what it was initially presented as, but no.

Sorry, but lack of resources doesn't explain away utterly useless doctors with honking attitudes, contempt for their patients, and a 'how dare you challenge me' defensive posture when challenged by an intelligent patient with insight into their own health, and by christ I've met plenty of those in NHS mental health provision.

Edited by Boo Khaki
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2 hours ago, Michael W said:

For new entrants, yes. In the govt department I used to work for, anyone who had been there for any real length of time was on a DB scheme. 75% of final salary for the long-timers. Oooft. 

Everyone is now on a career wavwrage scheme but the DB element of it is preserved for those that were in it. 

I worked in an NHS-related field right at the time finally salary schemes were wound up, and even then the place was full of 20 and 30'somethings who didn't give a shit about their jobs, gave minimal effort and took the absolute piss with things like timesheets and flexi, but were fully open and honest about the fact they intended to meander along until they were eligible for full pension. 

Most of these folk still won't be at the point whereby they have 35 years service, and there's no reason at all for me to doubt that they've been sitting going through the motions for the past 15 years or so since I left. There's also no reason at all to think this department was any different or in any way unusual for public sector.

Edited by Boo Khaki
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My radical idea for funding the NHS (and indeed things like the UC uplift) involves taxing the rich and the government simply spending more money.
I won't be taking any further questions. Thank you.
 


Good idea. Another idea is to do something about the obesity crisis in the country to reduce treatment for all the ailments caused by this
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I know a lot of people who have had terrible experiences with mental health care in the NHS.  There's obviously a difference between that and cancer treatment though, it's almost like a different discipline. 

Other people will know more about this than me but there's obviously a difference in something like treating heart disease and treating mental health problems.  From my experience of having relatives who have had treatment in cardiology departments, that's something the NHS are good at.  From my experience of having friends recieve mental health care, the standard is a lot lower.  I understand why, I understand the challanges of resourcing and the like, but the model seems to be - go to your GP, get referred and wait.  If the service you are referred to isn't for you then repeat.

During one of the periods after the announcements of the increased drug deaths there was a piece in the media about a residential rehab facility in Scotland that had seen NHS patients reduced to almost zero but was now predominantly used by Dutch patients who have thier treatment paid for by state health insurance.  It was interesting - the approach to treating drug addiction, especially opiate addiction, seems to be try to get the person stabilised with a prescription and reduce intake gradually.  There is a reluctance towards abstinence based recovery, which is understandable as it won't be for everyone, but for some people it will surely help.  Does the NHS push one-size fits all approaches?  Obviously that works for some things but not others.  How does that change or improve?  I have absolutely no idea.

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1 minute ago, oaksoft said:

It's not £100k though.

It's £100k plus a career of salary plus their pension.

All of that has to be considered and will be part of the reason why we don't just train more doctors.

Put simply if we, as taxpayers, aren't willing to spend that money then we have no right to complain about a shortage of medical staff.  If we want more medical staff we have to pay for them.  As someone previously pointed out bringing them in from abroad presents a risk and also is morally questionable so having more medical staff therefore should entail training more in the UK.

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It's a few years ago and while Blair was running things, but there was a table of best performing EU countries in terms of waiting lists, and France came top and the UK well down the list. Turned out France had twice the number of doctors but paid them half as much. (very roughly) Maybe we could afford more doctors if we didn't make them work ridiculous hours and have to pay more to attract and keep them.

Edited by welshbairn
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