| 8,200 doctors required in the NHS on 09:09 - Mar 15 with 1564 views | LeoMuff |
System is screwed completely, we have countless agency staff daily here probably making up to 50% of the day to day staff. They are being paid all travel, expenses and board and almost double the wage of the substantive staff, the cost to the trust must be incredible. Meanwhile uk trained nurses and substantive nhs staff fight for 3% wage increases and the dire staffing shortages continue. |  |
|  |
| 8,200 doctors required in the NHS on 09:18 - Mar 15 with 1539 views | C_HealyIsAPleasure |
“While it has already filled 8,209 foundation training places, the 791 who have missed out so far have been put on a reserve list”
“It has sought to reassure graduates without a training place that they will get one somewhere in the UK by August. Places will be freed because historically about 7% of applicants withdraw between applying and starting their F1 training” |  |
| |
| 8,200 doctors required in the NHS on 09:24 - Mar 15 with 1522 views | Churchman |
| 8,200 doctors required in the NHS on 09:09 - Mar 15 by LeoMuff |
System is screwed completely, we have countless agency staff daily here probably making up to 50% of the day to day staff. They are being paid all travel, expenses and board and almost double the wage of the substantive staff, the cost to the trust must be incredible. Meanwhile uk trained nurses and substantive nhs staff fight for 3% wage increases and the dire staffing shortages continue. |
The incompetence of this government and NHS England knows no limits. They were known to be abject five years ago and nothing has changed. The system is directionless, under funded and badly managed. I feel so sorry for the wonderful people that work within it. They deserve far more support than they get.
The question for me is whether or not it’s deliberate by the government. We know they hated the creation of the Welfare Stare and the NHS in the late ‘40s and I don’t think their hate has ever stopped. The holy grail for them is American style privatisation - if you want it, pay for it. If you can’t pay for it you should have worked a bit harder.
The irony of the Tory dream of American provision is that it doesn’t work. Even if you are wealthy you are trapped by the need to fund your insurance. If you are without money, it’s third tier Scutari level of provision. |  | | |
| 8,200 doctors required in the NHS on 09:52 - Mar 15 with 1478 views | BlueBadger |
| 8,200 doctors required in the NHS on 09:24 - Mar 15 by Churchman |
The incompetence of this government and NHS England knows no limits. They were known to be abject five years ago and nothing has changed. The system is directionless, under funded and badly managed. I feel so sorry for the wonderful people that work within it. They deserve far more support than they get.
The question for me is whether or not it’s deliberate by the government. We know they hated the creation of the Welfare Stare and the NHS in the late ‘40s and I don’t think their hate has ever stopped. The holy grail for them is American style privatisation - if you want it, pay for it. If you can’t pay for it you should have worked a bit harder.
The irony of the Tory dream of American provision is that it doesn’t work. Even if you are wealthy you are trapped by the need to fund your insurance. If you are without money, it’s third tier Scutari level of provision. |
Oh, it's deliberate, alright.
The 2012 Health and Social Care bill explicitly legislates to oblige the competitive tender of services(with the concurrent HUGE requirement for a whole tier of unnecessary and expensive management types), the shelving of NICE research with the end game of establishing safe staffing levels, the removal of student nurse training bursaries coupled to spiralling student costs for Allied Helath Professionals and university students, the pointless row picked with junior doctors, the appointment of endless free market wonks and economists to the role of health secretary, the endless demonisation of overseas workers, the generalised contempt for any kind of public sector provision of ANYTHING, the endless adjusting of targets rather than addressing actual problems, concurrent cuts to locals services, the real-terms cuts to mental health services over the past decade, hell Conservative Party policy over the past 4 decades has been explicitly geared towards greater and more obvious involvement of the Efficient Private Sector.
The Deeply Patriotic Conservative and Unionist Party actually hates any British which does genuinely good work because it usually involves very little profit for them or their mates.
I wonder what it is about these incompetent, corrupt sociopaths that Pinewood Blue and Timefliesbyblue like.
I'll give you a pointer lads - none of the people will actually respect or reward you for standing up for them. you're the internet equivalent of Red Wall voters. There for a cross in a box and nothing else. [Post edited 15 Mar 2022 10:04]
|  |
| |
| 8,200 doctors required in the NHS on 11:53 - Mar 15 with 1329 views | SuperKieranMcKenna |
| 8,200 doctors required in the NHS on 09:52 - Mar 15 by BlueBadger |
Oh, it's deliberate, alright.
The 2012 Health and Social Care bill explicitly legislates to oblige the competitive tender of services(with the concurrent HUGE requirement for a whole tier of unnecessary and expensive management types), the shelving of NICE research with the end game of establishing safe staffing levels, the removal of student nurse training bursaries coupled to spiralling student costs for Allied Helath Professionals and university students, the pointless row picked with junior doctors, the appointment of endless free market wonks and economists to the role of health secretary, the endless demonisation of overseas workers, the generalised contempt for any kind of public sector provision of ANYTHING, the endless adjusting of targets rather than addressing actual problems, concurrent cuts to locals services, the real-terms cuts to mental health services over the past decade, hell Conservative Party policy over the past 4 decades has been explicitly geared towards greater and more obvious involvement of the Efficient Private Sector.
The Deeply Patriotic Conservative and Unionist Party actually hates any British which does genuinely good work because it usually involves very little profit for them or their mates.
I wonder what it is about these incompetent, corrupt sociopaths that Pinewood Blue and Timefliesbyblue like.
I'll give you a pointer lads - none of the people will actually respect or reward you for standing up for them. you're the internet equivalent of Red Wall voters. There for a cross in a box and nothing else. [Post edited 15 Mar 2022 10:04]
|
Question - and not intended to be trolling, just something I’ve always wondered.
If the NHS is the biggest employer in Europe, why does it seem so under resourced in terms of (front line) personnel?
Germany has an outstanding health service, and an additional 15m+ population- so surely you’d expect them to have more staff. Is it the old adage of two many non-medical management staff, or is there something else to it? |  | | |
| 8,200 doctors required in the NHS on 12:19 - Mar 15 with 1293 views | BlueBadger |
| 8,200 doctors required in the NHS on 11:53 - Mar 15 by SuperKieranMcKenna |
Question - and not intended to be trolling, just something I’ve always wondered.
If the NHS is the biggest employer in Europe, why does it seem so under resourced in terms of (front line) personnel?
Germany has an outstanding health service, and an additional 15m+ population- so surely you’d expect them to have more staff. Is it the old adage of two many non-medical management staff, or is there something else to it? |
Probably multifactoral, I'd say.
There's certainly an excess of (sometimes wholly unnecessary)managers for sure and there's also been a proliferation of (mostly necessary, in all fairness)specialist nurse roles in the past two decades, partly in response to dropping numbers of junior doctors and partly as a recognition that senior nurses are often better qualified in terms of skills and expertise to manage certain conditions and tasks which means that the frontline can and does suffer.
At the same time, the workforce is ageing and the promotion of those nearing retirement age and cutting hours and often moving away from physically demanding frontline jobs. Plus, there is frequently, sadly, a culture of undervaluing frontline ward work.
When I first qualified, there was a recognised(as in 'actual pay grade for it) 'middle tier' of senior staff nurses on wards which often helped to retain those who might otherwise be tempted away to specialist or senior roles. This disappeared with Agenda For Change and ambitious and/or high competent ward nurses were essentially compelled to move into roles with fewer frontline clinical duties if they wanted to progress and/or earn more. | |
| |
| 8,200 doctors required in the NHS on 12:25 - Mar 15 with 1271 views | LeoMuff |
| 8,200 doctors required in the NHS on 11:53 - Mar 15 by SuperKieranMcKenna |
Question - and not intended to be trolling, just something I’ve always wondered.
If the NHS is the biggest employer in Europe, why does it seem so under resourced in terms of (front line) personnel?
Germany has an outstanding health service, and an additional 15m+ population- so surely you’d expect them to have more staff. Is it the old adage of two many non-medical management staff, or is there something else to it? |
Quick google seems to suggest 1.4m workers nhs and 5.6m in German health system, no idea how accurate that is | |
| |
| 8,200 doctors required in the NHS on 12:43 - Mar 15 with 1240 views | noggin |
| 8,200 doctors required in the NHS on 11:53 - Mar 15 by SuperKieranMcKenna |
Question - and not intended to be trolling, just something I’ve always wondered.
If the NHS is the biggest employer in Europe, why does it seem so under resourced in terms of (front line) personnel?
Germany has an outstanding health service, and an additional 15m+ population- so surely you’d expect them to have more staff. Is it the old adage of two many non-medical management staff, or is there something else to it? |
|  |
| |
Login to get fewer ads
| 8,200 doctors required in the NHS on 13:07 - Mar 15 with 1178 views | SuperKieranMcKenna |
| 8,200 doctors required in the NHS on 12:25 - Mar 15 by LeoMuff |
Quick google seems to suggest 1.4m workers nhs and 5.6m in German health system, no idea how accurate that is |
Statista suggests under 1m employees of the German Health sector, so perhaps the larger figure is the wider Healthcare industry? | | | |
| 8,200 doctors required in the NHS on 13:12 - Mar 15 with 1169 views | SuperKieranMcKenna |
| 8,200 doctors required in the NHS on 12:19 - Mar 15 by BlueBadger |
Probably multifactoral, I'd say.
There's certainly an excess of (sometimes wholly unnecessary)managers for sure and there's also been a proliferation of (mostly necessary, in all fairness)specialist nurse roles in the past two decades, partly in response to dropping numbers of junior doctors and partly as a recognition that senior nurses are often better qualified in terms of skills and expertise to manage certain conditions and tasks which means that the frontline can and does suffer.
At the same time, the workforce is ageing and the promotion of those nearing retirement age and cutting hours and often moving away from physically demanding frontline jobs. Plus, there is frequently, sadly, a culture of undervaluing frontline ward work.
When I first qualified, there was a recognised(as in 'actual pay grade for it) 'middle tier' of senior staff nurses on wards which often helped to retain those who might otherwise be tempted away to specialist or senior roles. This disappeared with Agenda For Change and ambitious and/or high competent ward nurses were essentially compelled to move into roles with fewer frontline clinical duties if they wanted to progress and/or earn more. |
Thanks that’s insightful.
Osborn scrapping the bursaries it says reduced applications by 40pc (shock). Another political short-termist approach that will so obviously lead to staffing issues. I wouldn’t be surprised if it costs more to recruit experienced overseas staff in the long term than the bursery. Not to mention depriving other countries of valuable medical staff they payed to train! | | | |
| 8,200 doctors required in the NHS on 13:26 - Mar 15 with 1146 views | GlasgowBlue |
| 8,200 doctors required in the NHS on 12:43 - Mar 15 by noggin |
|
Health system in Germany
"Health insurance is mandatory in Germany. Approximately 86 percent of the population is en-rolled in statutory health insurance, which provides inpatient, outpatient, mental health, and prescription drug coverage. Administration is handled by nongovernmental insurers known as sickness funds".
Too many people think it's either the NHS or the US health system. It's not. Plenty of European countries provide excellent insurance based healthcare. [Post edited 15 Mar 2022 13:30]
|  |
| |
| 8,200 doctors required in the NHS on 13:38 - Mar 15 with 1123 views | BlueBadger |
| 8,200 doctors required in the NHS on 13:12 - Mar 15 by SuperKieranMcKenna |
Thanks that’s insightful.
Osborn scrapping the bursaries it says reduced applications by 40pc (shock). Another political short-termist approach that will so obviously lead to staffing issues. I wouldn’t be surprised if it costs more to recruit experienced overseas staff in the long term than the bursery. Not to mention depriving other countries of valuable medical staff they payed to train! |
The other wrinkle with overseas staff is of course, Brexit. Post 2016 recruitment from the EU is essentially nil.
As an EU member, we had a set 'basic' standard of qualifications and competencies for nursing, medical and AHP staff Which meant that those coming in from the EU were basically subject to a basic literacy test(or as we call it 'an application form and job interview') and, with broadly similar working cultures across healthcare in Europe there was a lot shorter adaptation period for overseas nurses in particular(as an aside, they often arrived with skills and knowledge far above that of their UK equivalents).
That freedom has obviously gone now and, with the collapse of the pound against the Euro coupled to the open xenophobia and incompetence of the UK government that recruitment pool has essentially gone. Spanish, Italian and Portuguese nurses, for example, now tend to go to Germany rather than the UK.
This means that we have to recruit further afield - the man places being:
The discussion of working practices are based on my own anecdotal experience and are VERY broad.
The Phillipines, which is less ethically challenging than other places as historically, the Philippines has tended to produce an excess of nurses, India and African nations(locally, we seem to be recruiting a lot from Nigeria currently) which is certainly a lot more ethically challenging.
Additionally to 'local quirks' in practices which are generally based in working and/or cultural practices of their training country, there's nearly always an 'adaptation' period in which qualifications are brought into line with legal requirements as set by the NMC here - this can take up to 18 months. Add in the fact that recruitment from these places is by it's nature, more long winded and expensive.
Still, we've Got Are Country Back. | |
| |
| 8,200 doctors required in the NHS on 13:40 - Mar 15 with 1121 views | BlueBadger |
| 8,200 doctors required in the NHS on 13:26 - Mar 15 by GlasgowBlue |
Health system in Germany
"Health insurance is mandatory in Germany. Approximately 86 percent of the population is en-rolled in statutory health insurance, which provides inpatient, outpatient, mental health, and prescription drug coverage. Administration is handled by nongovernmental insurers known as sickness funds".
Too many people think it's either the NHS or the US health system. It's not. Plenty of European countries provide excellent insurance based healthcare. [Post edited 15 Mar 2022 13:30]
|
Which also brings with it, a massive layer of red tape on its own.
Getting father in law funded treatment for a pressure sore secondary to care provided for a traumatic brain injury a few years back was an undertaking in itself, requiring multiple consults and letters. Here, it would have been a simple phone call/bleep and online referral as part of an inpatient stay for the aforesaid.
It's certainly a step up on the US free for all, but I don't if I'd trade it for what we've got. [Post edited 15 Mar 2022 14:23]
| |
| |
| 8,200 doctors required in the NHS on 14:17 - Mar 15 with 1064 views | OldFart71 |
My Granddaughter manager to get a place at Uni. Only 100 were selected out of over 1000. When my Dad was alive he went into hospital after a heart attack. All one of the nurses was interested in was getting him shifted out of his bed a.s.a.p. we resisted as I said he wasn't leaving the hospital until an alarm system was installed in case he had a relapse. We had already sorted one out and were waiting for it to be fitted. Further to this, when my dear old mum was alive (She died aged 50) there were convalescent homes, usually at the seaside, Felixstowe had one, where people who were recovering could go. Guess what ? They were all done away with. Now they blame the elderly for bed blocking. | | | |
| 8,200 doctors required in the NHS on 14:30 - Mar 15 with 1038 views | DanTheMan |
| 8,200 doctors required in the NHS on 13:26 - Mar 15 by GlasgowBlue |
Health system in Germany
"Health insurance is mandatory in Germany. Approximately 86 percent of the population is en-rolled in statutory health insurance, which provides inpatient, outpatient, mental health, and prescription drug coverage. Administration is handled by nongovernmental insurers known as sickness funds".
Too many people think it's either the NHS or the US health system. It's not. Plenty of European countries provide excellent insurance based healthcare. [Post edited 15 Mar 2022 13:30]
|
You make this point fairly often, but how does changing the way funding happens (either through direct taxation or through insurance) actually help fund the system? If we moved from a taxation method to health insurance, but the amount people pay is still the same (or less) I don't see how it improves anything.
Per capita I believe that Germany pays far more than us. [Post edited 15 Mar 2022 14:31]
|  |
| |
| 8,200 doctors required in the NHS on 14:33 - Mar 15 with 1031 views | BlueBadger |
| 8,200 doctors required in the NHS on 14:30 - Mar 15 by DanTheMan |
You make this point fairly often, but how does changing the way funding happens (either through direct taxation or through insurance) actually help fund the system? If we moved from a taxation method to health insurance, but the amount people pay is still the same (or less) I don't see how it improves anything.
Per capita I believe that Germany pays far more than us. [Post edited 15 Mar 2022 14:31]
|
And adding in an insurance requirement *WOULD* result in additional tiers of management and accompanying paperwork. | |
| |
| 8,200 doctors required in the NHS on 14:36 - Mar 15 with 1022 views | jontysnut |
| 8,200 doctors required in the NHS on 12:19 - Mar 15 by BlueBadger |
Probably multifactoral, I'd say.
There's certainly an excess of (sometimes wholly unnecessary)managers for sure and there's also been a proliferation of (mostly necessary, in all fairness)specialist nurse roles in the past two decades, partly in response to dropping numbers of junior doctors and partly as a recognition that senior nurses are often better qualified in terms of skills and expertise to manage certain conditions and tasks which means that the frontline can and does suffer.
At the same time, the workforce is ageing and the promotion of those nearing retirement age and cutting hours and often moving away from physically demanding frontline jobs. Plus, there is frequently, sadly, a culture of undervaluing frontline ward work.
When I first qualified, there was a recognised(as in 'actual pay grade for it) 'middle tier' of senior staff nurses on wards which often helped to retain those who might otherwise be tempted away to specialist or senior roles. This disappeared with Agenda For Change and ambitious and/or high competent ward nurses were essentially compelled to move into roles with fewer frontline clinical duties if they wanted to progress and/or earn more. |
It's complicated but there's a lack of approved training places which is the result of a decade's worth of underinvestment. Junior doctors who want to go into specialty training and eventually become a consultant have to be in an approved programme with appropriate education and service components and senior supervision. Some will choose to take non-training posts or locum work, but this is a workforce issue that's been building for years. Staffing costs take up around 2 thirds of the budget and we're no nearer having a properly costed workforce plan to ensure the right number of staff doing the right things in the right places. Lots of medical students want to be surgeons at teaching hospitals in big cities, fewer want to be psychiatrists in Grimsby. Given the money involved and the impact on patient care its nothing short of a national scandal. |  | | |
| 8,200 doctors required in the NHS on 14:44 - Mar 15 with 1005 views | GlasgowBlue |
| 8,200 doctors required in the NHS on 14:30 - Mar 15 by DanTheMan |
You make this point fairly often, but how does changing the way funding happens (either through direct taxation or through insurance) actually help fund the system? If we moved from a taxation method to health insurance, but the amount people pay is still the same (or less) I don't see how it improves anything.
Per capita I believe that Germany pays far more than us. [Post edited 15 Mar 2022 14:31]
|
Because we seem wedded to the idea that it’s the NHS or the USA. There is never a grown up conversation where alternatives are discussed.
There isn’t a single country that models it’s health care system on the NHS. But we treat it as a national religion.
We need a complete re think about how we find our health care and how the people working in it can be better paid and the system by petter funded. That may mean continuing in with the same NHS system with massive tax increases, but no one will have the conversations on a national level. | |
| |
| 8,200 doctors required in the NHS on 15:01 - Mar 15 with 974 views | DanTheMan |
| 8,200 doctors required in the NHS on 14:44 - Mar 15 by GlasgowBlue |
Because we seem wedded to the idea that it’s the NHS or the USA. There is never a grown up conversation where alternatives are discussed.
There isn’t a single country that models it’s health care system on the NHS. But we treat it as a national religion.
We need a complete re think about how we find our health care and how the people working in it can be better paid and the system by petter funded. That may mean continuing in with the same NHS system with massive tax increases, but no one will have the conversations on a national level. |
That's not really answered my question though.
Why does a system where health insurance is mandatory make any difference compared to taxation if the funding levels remain the same? The biggest difference to me with the German system appears to be they pay more per person.
I'm fairly sure last time we had this conversation you could cite both examples with more public funding and less public funding which have better general ratings than the NHS which would suggest that how we fund it is not the significant issue. | |
| |
| 8,200 doctors required in the NHS on 15:04 - Mar 15 with 967 views | jontysnut |
| 8,200 doctors required in the NHS on 14:44 - Mar 15 by GlasgowBlue |
Because we seem wedded to the idea that it’s the NHS or the USA. There is never a grown up conversation where alternatives are discussed.
There isn’t a single country that models it’s health care system on the NHS. But we treat it as a national religion.
We need a complete re think about how we find our health care and how the people working in it can be better paid and the system by petter funded. That may mean continuing in with the same NHS system with massive tax increases, but no one will have the conversations on a national level. |
Problem is that the NHS is more of a health treatment service than a prevention and improvement service. There are many determinants of poor health, including poverty, housing, employment which in turn affect levels of smoking, diet and other long term conditions. etc. You can't look at the NHS in isolation - social care is another factor and just look at the noise about increasing NI to help with that. The debate isn't just about what kind of NHS we want but what kind of society.
Anyway, who remembers Spangles.. | | | |
| 8,200 doctors required in the NHS on 15:24 - Mar 15 with 919 views | noggin |
| 8,200 doctors required in the NHS on 15:04 - Mar 15 by jontysnut |
Problem is that the NHS is more of a health treatment service than a prevention and improvement service. There are many determinants of poor health, including poverty, housing, employment which in turn affect levels of smoking, diet and other long term conditions. etc. You can't look at the NHS in isolation - social care is another factor and just look at the noise about increasing NI to help with that. The debate isn't just about what kind of NHS we want but what kind of society.
Anyway, who remembers Spangles.. |
Ooooh, Old English. | |
| |
| 8,200 doctors required in the NHS on 15:25 - Mar 15 with 915 views | HARRY10 |
| 8,200 doctors required in the NHS on 09:09 - Mar 15 by LeoMuff |
System is screwed completely, we have countless agency staff daily here probably making up to 50% of the day to day staff. They are being paid all travel, expenses and board and almost double the wage of the substantive staff, the cost to the trust must be incredible. Meanwhile uk trained nurses and substantive nhs staff fight for 3% wage increases and the dire staffing shortages continue. |
Part of that higher pat is to cover pensions, sickness and holidays,
I doubt any of those staff are using that money to pay into any pension scheme. We are building up problems for the future believing that the next generation can take out even higher mortgages to pay for the 'fck the future' policy of our present government.
Before privatisation, workers were entitled to a pension via the Electric/Gas/Water board etc. Those have long gone, along with pretty much all final salary pensions. What will they have in 30/40 years time ? Sell their house ?
Sadly the dimwitted forelock tuggers believe that allowing their betters more of what is produced will mean more crumbs fall to the floor, for them.
The biggest threat to them is naughty brown faced folk taking their jobs (something the cap doffers don't seem too keen on now they are available). And the gutbuckets claim that brexit is increasing wages has shown to be yet another lie.
"Average wages in Britain have fallen at the fastest rate since 2014 "
https://www.theguardian.com/business/2022/mar/15/uk-unemployment-covid-inflation
it would be hilarious to laugh at the rightie thickos, had not their stupidity affected us all. | | | |
| 8,200 doctors required in the NHS on 15:36 - Mar 15 with 894 views | BloomBlue |
| 8,200 doctors required in the NHS on 14:30 - Mar 15 by DanTheMan |
You make this point fairly often, but how does changing the way funding happens (either through direct taxation or through insurance) actually help fund the system? If we moved from a taxation method to health insurance, but the amount people pay is still the same (or less) I don't see how it improves anything.
Per capita I believe that Germany pays far more than us. [Post edited 15 Mar 2022 14:31]
|
Germany does pay more but the German model encourages private health care which can replace or top up state cover. The Germans work on the basis if you can afford private health it should be encouraged as it reduces the strain on the state health.
In this country in previous General Elections parties have talked about increasing the tax on private health insurance including those who receive private health as a benefit from their company, in Germany they encourage companies to offer private health to their staff. Also note those same individuals with private health care don't receive any reduction in their taxes so the same amount is still used towards the state health care
We will never have a grown-up conversation in this country about health |  | | |
| 8,200 doctors required in the NHS on 15:51 - Mar 15 with 861 views | jontysnut |
| 8,200 doctors required in the NHS on 15:36 - Mar 15 by BloomBlue |
Germany does pay more but the German model encourages private health care which can replace or top up state cover. The Germans work on the basis if you can afford private health it should be encouraged as it reduces the strain on the state health.
In this country in previous General Elections parties have talked about increasing the tax on private health insurance including those who receive private health as a benefit from their company, in Germany they encourage companies to offer private health to their staff. Also note those same individuals with private health care don't receive any reduction in their taxes so the same amount is still used towards the state health care
We will never have a grown-up conversation in this country about health |
This is at the crux of the social care problem. There is a significant mumber of people who have enough resource to fund themselves without relying on limited state care. If you take them out of the equation than any other pooled solution to cover the not rich but not poor becomes unviable. | | | |
| |
By continuing to use the site, you agree to our use of cookies and to abide by our Terms and Conditions.
