Saturday, 8 December 2012

NHS Death Factories

If you're old, if you're sick, if you're inarticulate or incapacitated, if you haven't got a sharp-elbowed champion to protect you from the NHS, then avoid hospital admission like Ebola. An NHS where consultants are the new GPs and the average junior doctor has about as much knowledge of medicine as a PC World salesboy has of motherboards, where nursing staff have never been so highly paid or so poorly vocationally committed, where staff have to be coerced to wash their hands, and where basic human dignity has little place. If you're inconvenient, a nuisance or they simply can't make a diagnosis, you risk being placed on the Liverpool Death Pathway, deprived of food and water and drugged to the point of unconsciousness until you die. It's less offensive than the method used by the T4 clinics to euthanise patients - an exhaust hose from a truck - but none the less effective. 

More and more frequently one hears from friends, relatives and colleagues or reads in papers of all flavours of the deaths of relatives or spouses from lack of care at the hands of the NHS. Even as I write, hundreds of older people, many who served this nation in the last war, are being shepherded towards institutional death. How many would have fared better at home, cared for by relatives, with visits from a wise GP? How many would have recovered, won another decade of quality life? Of course there are few wise GPs left. 

We've lost our way on healthcare. We've spent too long defending the 'Carry On' NHS of competent and caring SRNs, stern Matrons, erudite consultants and clean linen, spent too long defending the NHS of the 1960s, and all the while the real NHS has changed out of all recognition. Nurses with 'tramp stamp' tattoos, binge hangovers and Chlamydia more interested in their mobile phones than their patients, timid and self-doubting Bengali housemen, consultants swamped with trivial referrals from GPs who simply can't be arsed any more, indolent contract cleaners and a stifling bureaucracy isolated from the shit and pus behind walls of Powerpoint presentations and performance indicators. The NHS is sick. More money isn't the answer. 

60 comments:

lilith said...

I was with an elderly friend when her GP asked her what she would like to happen if she became very ill...would she like to go to hospital? My friend said it would depend and that she didn't care much for hospitals. "It's their eugenics policy" I quipped. Blow me down if the GP didn't just give me a sideways grin and a nod.

G. Tingey said...

Presumably that's why we have a higher life expectancy here than in the USA, then?
Erm, err ......
And a lower infant mortality rate, as well ....

Anonymous said...

35 countries with lower child mortality than us. We are below the EU average in fact.

Comparisons to the US are a red herring. How about comparing us to... Japan?

Oldrightie said...

G.T, pure arithmetic.

This post is spot on for the overcrowded, overwhelmed towns and cites. Labour's constant failure, in every area of Government, is much to blame. Not least its policies for mass immigration.

HospitalDrone said...

Coming to hospitals near you soon - uncontrolled drug resistant TB from imported cultural enrichers. You won't need the Liverpool Care Pathway
then. Just park your elderly next to
the patient in the waiting area who is coughing up bloody sputum into a cardboard bowl .

Anonymous said...

I am 'speechless' and even if.. you'll not hear a word of argument from me Raedwald: because your words are incontrovertibly true.

Frank Sutton said...

What a grotesque name, The Liverpool Pathway. SOunds like some squalid piss soaked alleyway with Cilla Black emerging from the miasma saying "You've had a lorra lorra life, chuck, but now it's time to go", and John Lennon, pop's philosopher prince, intoning "Imagine there's no Heaven".
The Scouse Way of Death - couldn't they find somewhere more attractive to name it after?
Personally I plan to go on the Porterhouse Pathway, and will take up smoking and eating drinking to excess when the grim reaper hoves into view.

Anonymous said...

My mother would have been 106 this Christmas Day and, to the end of her life, would never go to hospitals because, as her mother had said before, 'hospitals are places you come out of in a box'.

It seems little, apart from the staggering cost, has changed.

Thank you for a fine piece.

Anonymous said...

Never have an operation at the end of the week - at weekends hospitals are manned by a much reduced number of nurses and recently qualified doctors, and the labs and X ray depts are either closed or have minumum of staff. This is so registrars, consultants, etc can have the weekend with their families. Result - operation a success, patient died of hospital acquired infection and inadequate post-op care. Happened to a friend who went in to Charing Cross hospital to correct a hernia - operation on Friday, dead by Monday. Patient's needs don't come first or even second. Have heard Charing X hospital is to be demolished - Hurrah! Also beware of overprescribing GPs - some will have you taking vast numbers of pills you don't need. People who live to 100 quite often take no medication.

Anonymous said...

People die. You need to get over it.
More die in hospitals because that is where ill people go.
More old people die in hospitals because, well, old people die more often than young people (unless there is a war).
End-of-the-week deaths in hospital have been a reality for many years, decades even, hospital consultants are contract workers....not hourly paid, and self-employed. They take weekends off because they are not paid anymore to be there...just like other places of employment find it hard to get people to work overtime if there is no extra pay involved. And the hourly paid in hospitals do get extra, so less are required at weekends because of the cost.
Specialist wards, like orthopaedics, have had few medical staff at weekends for very many years. Not surprisingly some patients tend to end-up dead....because if/when they have complications (like blood clots). They have to obtain doctors from general medical....who are in short supply at weekends. So obtaining someone to diagnose, and treat the clot takes time...of which little is available.
It is little better in other countries, and worse in a lot.
Private. of course, go private my friend....if you ask about you'll note that a large quantity of NHS high-dependency and intensive therapy beds are taken by imported private patients.....and more quite soon because hospitals will not be required to treat NHS patients at all.
Not that it is getting better in general medical practice. The arrival of Clinical Commissioning Groups will herald the departure of free prescriptions soon after, since the health department will no longer be paying the bill (indeed, the health department will no longer be responsible for the NHS !)
Clinics, such as respiratory care and cardiac care, will be cut quite soon because the end of local health authorities means nobody will pay for them centrally and they will fall on the CCG to fund.....of which I have commented previously.
Physiotherapy has gone, at least NHS funded, from my area. To be replaced by a bill for treatment, which the patient pays.
GPs' will soon not be referring minor problems to specialists because the cost will be translated down to their CCG, they may not even refer major problems for that same reason if they think it will be of no use....so back to old = die.
Good luck with the private treatment, at least insurance-funded. Chronic complaints have exclusion problems.

JohnM

mikebravo said...

It's always the biggest wankers who tell you to "..get over it"!
But thanks for the passing on your wisdom anyway JM.

Raedwald said...

Thanks JohnM - a very informed response.

Rush-is-Right said...

When the Telegraph published the Ann Clywd's Husband story (http://www.telegraph.co.uk/health/9724205/Ann-Clwyd-My-husband-died-because-people-didnt-care.html) I was sufficiently outraged to send it to some of my friends and relations. My cousin wrote back with details of his personal experience of the mal-treatment of his immediate family back in the 1990s. This NHS problem is one that has gone on for a long time, has been hushed up until now, and is only starting to emerge after a good many years.

Dan Hodges wrote a blog yesterday (http://blogs.telegraph.co.uk/news/danhodges/100193279/ann-clwyd-had-the-courage-to-criticise-nurses-who-lack-compassion-she-should-not-be-left-to-do-so-alone/) but the comments have, for no obvious reason, been closed.

Anonymous said...

" indolent contract cleaners "

My experience of the NHS, A turd and puddle of urine lying on the floor for at least a day, when I decided to clean it up myself since I found it too disgusting to use the lavatory otherwise.

Of the same experience, Medical and Nursing care were tip top, Food was diabolical, THE one thing that made me want to get out as soon as possible.

Otherwise, they saved my life - but then I am middle aged. So not quite a candidate for the Liverpool pathway.

Oh, and it was a knee cartilage operation that triggered the pulmonary embolism - performed in the Private sector.

Budgie said...

An excellent piece, Raedwald, with which I thoroughly agree.

As for JohnM and his "People die. You need to get over it.", the point was not that people die (amazing insight) but how they die in NHS hospitals.

I have direct knowledge from two close relatives. One frail and undernourished elderly lady was deprived of all food (though kept on a drip) from Sunday evening to the following Friday. She was then only fed because I made a fuss (nearly getting thrown out) and because a bevy of relatives actually did the feeding.

Another is a doctor, who when starting in a hospital after qualifying, was told by management that booking overtime was an indication of incompetence. As she said if she was receiving a patient 10 mins before shift end what was she supposed to do - walk away? Net result was considerable unpaid overtime and long hours just like before the WTD (and contrary to government boasts about reduced hours).

Of the people who deliver the front line service, some a really good, most are adequate, some are appalling (I've met some). But the ever expanding management are actually evil in their own quiet little way.



Edward Spalton said...

Having both a great aunt and an aunt who were nurses under the old dispensation, I can only think that the (partial) collapse in standards simply represents the society from which they are recruited.

My great aunt's training had to be paid for by her family. From St Thomas's she went on to be a naval nurse in th Great War. We knew we were in for a story when she started "When I was in the Navy". With other senior nurses, she was taken to watch the German High Seas Fleet surrender in th Firth of Forth.



It was really only wartime ( the second one) which allowed my aunt to have a nursing career. As youngest daughter, she was expected to stay at home to look after my grandparents. To get accepted for training, she had to have favourable references as an auxiliary. Because her parents were not keen, she had to walk five or six miles to work in a military hospital ( although they could
have found the train fare for her).

She could have become a matron but broke her career to come home and look after her mother, which she did willingly. At this time there was a great reorganisation of the hospitals. She was surrounded by glossy manuals. "I've looked everywhere" she said " and can't find one mention of the patients". That was, I think, in the mid Seventies. She went back to nursing and now, long retired, continues to care for others.

Ian Hills said...

A good hard-hitting post. For a specialist NHS atrocities blog see -

http://nationaldeathservice.blogspot.co.uk/

Gordon the Fence Post Tortoise said...

One of the prime reasons to my mind that the NHS has plummeted is the epidemic of grotesque lazy, self aggrandizing and self regarding shitweasels that have infected the management structures and it is self evident that incompetence and corruption is rife.

There is no appetite for rewarding true excellence - the entrenched dullards like Rose Gibb and the Staffordshire scum administrators are rewarded with promotions and payoffs by an equally self regarding political elite.

Even when there are no excuses for homicidal mismanagement and negligence - nothing is done. The judiciary is keen to feed on negligence (and fight the corner for the Rose Gibbs)but the NHS simply loots the taxpayers for the compo and carries on, the politicians don't want to invoke accountability as that could unleash a truly apocalyptic epidemic of accountability across the public services which might sweep them down the sewer.

My local NHS trust spends £200K++ a year on promoting plain tobacco packaging Google ads and street poster hoadings (chuck in a few BMWs ...) and the Air Ambulance doesn't get a penny of NHS funds.

Outrage is the only appropriate response.

banned said...

My mum was an SRN, trained during WW2 in London.
She went back to nursing when I went to high school but left when the bean counters took over and started treating like...a bean.

She ignored their repeated blandishments to "Return To Nursing" but they got their revenge by killing her with hospital disease when she went in for a hip replacement.

Mum knew that it would probably come to somesuch when I told her in the late 80's how hospitals were closing down their directly employed maintenance departments.

Her favorite Matrons mantra on the first rule of nursing
"You've got to clean the drains" even if that meant doing it themselves.

Vargs said...

Good health/social care depends primarily upon morale. If morale is high among the frontline there is at least a chance of excellent and committed care. Noone should have any illusions. I've seen shocking care throughout my career since the early '80s.

However, since John Major introduced manager-drones to the NHS every new initiative could almost have been designed to crush engagement, vocation, and commitment.

Whereas nurses used to be actors in the development of care it's now made abundantly clear that they are interchangeable cog-like highly-paid shop assistants.

Public-sector improvement plans invariably come with acres of spreadsheet-filling, hours of poorly thought-through PRINCE2 ritual meetings, and large chunks of time abstracted from senior frontline staff. All this labour to produce "deliverables" which are always bits of paper rather than actual change.

Not that it matters because the dead-eyed middle management drones have invariably moved on to the next initiative/reorganisation but one by the time anything is supposed to have actually happened on the ground.

Net result: burn out and absence from hands-on guidance of junior staff by the senior coalface managers. A whirlwind of activity which is plainly (to the frontline, anyway) futile or counterproductive.

Add to all this the worst possible IT.

Not cynical, then :)

G. Tingey said...

Further to my p[ost a long way up ...
That is not tosay that there isn't considerable room for improvement.

However.
The NHS/Blood transfusion service, back in 1975, saved my life - losing more blood than you had to start with is not a recommended course ...
And my varicose veins surgery last year was a brilliant piece of work ....

Anonymous said...

GP's earn £120k on average what do they do ? No home visits just referals to consultants. The NHS is top heavy with administrators & non clinicians,
You are wrong idiot Raedwald to say nurses are overpaid or don't care.
Nurses are the back bone of the NHS are paid ridiculously low salaries £26k for a degree qualified sister in a speciality role with 30 yrs experience - what a joke. Expected to work 12 h shifts that frequently end up being 14+hrs & unpaid & can't even park at the hospital for free (£30/month for limited spaces).
Infant school teachers, unqualified police etc are paid more - nurses have been made to take on admin roles especially HR that they shouldn't be doing - the NHS is a wasteful heap that is held together by the nurses. There are so many areas where money could be saved you keep coming up with unfounded criticisms research your claptrash before you publish.

right_writes said...

Has anybody noticed that when the market is the be all and end all... For instance when we are witnessing a failing bank... Our friends in government deny/defy every rule in the book of market... Because the banks are too big to fail... (utter bollocks of course).

Then we come to the provision of personal one to one care, one of the few situations in life where the market is totally inappropriate, although that is not to say that healthcare is and should be an area where the markets operate, it is here where the state/government decides that it is going to operate the system as a market, and we have language such as "productivity".

Jeezus christus...

Raedwald said...

Anon 9.31 - I did check my facts. Under Agenda for Change, a Ward Sister with 30 years experience would be on Band 7 - £30,460 rising to £40,157 after 9 years. Overtime over 37.5 hours is paid at time and a half.

And I didn't ever say nurses were overpaid - just that they have never been better paid. Also true.

And, unfortunately, there is increasing evidence that amongst the many devoted, committed and professional nurses are a growing number of those that really just don't care.

I stand by my comments.

Sebastian Weetabix said...

What's the betting Anon 09:31 is a barely literate nurse?

If the example of my late uncle's "care" is anything to go by she'll be eating toast at the nurses station while the patients wallow in their own shit for 10 hours at a stretch. We had to feed him and clean him. The lazy stupid uncaring staff certainly wouldn't deign to.

Fine post, Raedwald. You have put your finger exactly on the problem with our "envy of the world" NHS.

@right_writes: you are wrong about the banks. The problem is the market is not allowed to function. They were heavily and stupidly regulated but then protected from the consequences of their own folly by being bailed out. You can blame corporatism; not the market. In a market the incompetent go to the wall.

Johnm said...

This wanker will "get over it".
Guys: Listen.
And read:
http://www.hesonline.nhs.uk/Ease/ContentServer?siteID=1937&categoryID=1122
Look at the stats. Try talking FACTS, not FARTS.
And yes, EVERY unnecessary death is a tragedy not only to those involved, but ALSO to many medical staff.
Out of the TENS of millions of treatments administered at/by the NHS every year, how many are "bad" ?
Infections ?
MRSA, the much-talked-about "hospital" disease is present on a large proportion of patients pre-admission, AND on VISITORS, One infectious disease specialist said that hospital-acquired disease could be eliminated by stopping visitors. Think about it next time you are either in, or visiting someone in hospital. Locally, two visitors per bed is the "rule". However, patients of asian origin frequently have a half-dozen, and sometimes the pets (just joking, the hospital requires the dog to be left outside).
Work around that problem..lots of people = lots of pathogens.
Post-op care is crucial. Blood clots are part of a living being. They happen in everyone. They happen in every patient treated surgically. If they didn't, you'd bleed to death. Getting the right treatment to a patient suffering from post-op complications as fast as possible is crucial. Yet wards are staffed by part-time health care assistants, who would not know shit from a shovel unless told. Low staff-levels at nights and weekends is a cost cutter.
You think private is better ?
Think again. Private is unreported would be a better description.

Johnm said...

There is, on this date and at this time, not a single NHS Intensive Care bed available for children in the entire country.
The chancellor is recovering a 3 billion-pound NHS underspend into treasury.

Fred said...

Johnm is correct on many points.

Due to a recent chronic condition (sounds like a contradiction in terms!) I've had several spells in Sheffield hospitals (plural) in the past few years. Overall, the care/competence has been excellent.

The main problems were other patients, eg: "A turd and puddle of urine lying on the floor for at least a day...". When I (as a patient) was fit enough to use the ward toilet, I was fit enough - & did - clean up my own 'mess'.


rick hamilton said...

Here in Japan the national health service allows people to go to any doctor or hospital of their choice, and if they aren't satisfied thay can take all their medical records elsewhere and get a second opinion.
Since many hospitals are privately owned they are run as businsses which means - in Japan - excellent service with a 'customer is king' mentality.
This means they do their best to attract patients and to give them as much treatment and in-patient care as they can, thereby collecting more income from the government.
In such a system, with state of the art equipment and dedicated professional staff, patients feel wanted, which they are.
Any careless filthy dirty clinic that passed on infections would be bankrupt in no time as the word got around - nobody would go there.
Oh, and you do pay a small percentage of the cost out of your own pocket.
As the Japanese say "Tada yori takamono wa nai" (There's nothing more expensive than something that's free).

Anonymous said...

@ Gordon The Fence Post Tortoise
One of the prime reasons to my mind that the NHS has plummeted is the epidemic of grotesque lazy, self aggrandizing and self regarding shitweasels that have infected the management structures and it is self evident that incompetence and corruption is rife.


Just what I was about to write. I have had the misfortune to be directly involved with PCT care managers and senior management and again, unfortunately, I didn't find the good in any of them. The staggering arrogance displayed by each left me angry and astonished at the same time. And you can easily see how good hard working staff at the coal-face can become "bent out of shape" with the corrosive political diktats that come from management. Most of these managers wouldn't stand a feckin chance in the private sector.

Coney Island

right_writes said...

@Sebastian Weetabix said... "you are wrong about the banks."

Actually not, you misconstrued what I wrote...

The point is that if ever there was a product line that was suitable for trading in a genuinely free market, it is bank products, but when they cocked up, the government moved in.

Of course, what should have happened is that the bad banks should have failed and the good banks would have picked the wheat out from the chaff... Some people would have lost their shirts and some banks would have disappeared for ever...

But I guarantee that , the banking markets would be back up and running, turning a profit and WE would be prospering...

Instead, the only organisation that could not organise a PUIAB decides it is going to manage the situation... And look where it has got us... The great Cameron talking about the idea of markets in the one place where it is not plausible... that of one to one care.

Anonymous said...

@Mr Raedwald 10:06
Thank you for your response, nurses do not get automatic promotion & very much is made of their feelings of duty & responsibility that goes far above any other profession. The fact that some of them are fed up with it is not surprising considering the long hours NOT always paid, working most weekends, missing time with family, strange times to take holidays etc.
It is not the nurses who have a problem but the stress & workload that is put on them by their management.

Gordon the Fence Post Tortoise said...

@Coney Island

yep...

the administrators are by and large appalling - one PCT near me gave the obnoxious, unrepentant nearly totally absentee alcoholic head of IT a paid year off "to sort himself out" another was quietly shut down as not fit for purpose (and essentially bankrupt) - but managed to splurge several hundred thousand on their chums at Smoke Free Southwest before being shuttered. Said goons just hop over into the next gaffe...

NHS administrators taking poor decisions on clinical competency almost cost my sister in law her life last year when they employed an inexperienced anesthetist who administered paralysing drugs incorrectly prior to an appendectomy.

People make mistakes - sure - but the bureaucratic culture present in the NHS at the moment is toxic and the waste is epic.

Raedwald's last paragraph nails it.

The idiot politicians cozy up to pompously titled "directors" for PR scmooze - I suspect my local NHS main hospital has more PR people than full time employed cleaners FFS. The administrators locally are so incompetent that they spend vast amounts on business and management consultants ... to umm... tell them how to run hospitals.

yokel said...

The Health services were nationalised in 1948, along with road transport, railways, electricity, gas, coal mining, steel manufacture and all the other "commanding heights" of the economy, as dictated by clause 4 of the Labour Party constitution. After nationalisation, all those industries were run for the benefit of the top brass of both management and unions. The ordinary worker might have got an occasional look in, but the customer - never!

The wonder is that it has taken so long for the NHS to die. Who can remember British Road Services having a monopoly on all road haulage over 50 miles? Or what became of British Steel, or the National Coal Board?

The British Railways Executive, the unions, and the interfering civil servants at the Department of (Road) Transport had almost killed the railways to the point where Major thought that if he left it to the ravages of the private market it would surely die without blaming him! Where it has actually been freed from the dead hand of the Department, it has thrived. Who'd have thought it?

This is now the same point to which the National Sickness Service has progressed. It is time to give the hospitals back to the charities from whom they were stolen in 1948 (or some modern equivalent) and get healthcare back to being local people caring for local people. While it remains a branch of multinational government, it is doomed.

Gordon the Fence Post Tortoise said...

@yokel

fair comparison - it's a Fabian Holy Cow.

Accountability has been almost totally expunged. Achievement and commitment is largely unrewarded beyond nauseating self congratulatory PR.

Then we are repeatedly hosed with the catechism that it's precious and the best in the world by politicians wanting to hitch a ride on the best bits... - and there are some - but the wholesale failure to deal with the obvious problems.

I hope it's canker and not cancer....

G. Tingey said...

Budgie:
But the ever expanding management are actually evil in their own quiet little way.
But that is or can be true of any organisation.
This week, a company I used to work for, an internationally-known name, ahs filed for Chapt-11, due entirely to its' own (private) management gross incompetence. [Think yellow boxes]

Gordon Fence-post etc.
Yes, but bad management is not necessarily a guvmint thing, is it?

yokel & Raedwald.
You note that several other services do better than here - where, actually?
And I'm prepared to guarantee that they are all "state" (i.e. paid-for-out-of-taxes) NHS-type services.
I would guess France & Sweden & Norway & Germany, for starters ... but have you seen their costs?
Now, make your choice - do you want to pay for it, or not?
In the meantime, we are heading towards the worst of both worlds.


Dembones said...

The rot starts with no compassion. How can a compassionate organisation put frail and sick people out in the cold in order to have a smoke? My mother was a nurse in the '50s, did not smoke herself yet lit and held cigarettes for those too frail to do so. Is that not more compassionate than the LCP, where people desperately suck on the sponges to wet their lips but are denied fluids.
Management having meeting about meetings. Clinicians holding meetings to discuss paper clips. Surgeons attending mandatory training on lifting and carrying. That is just in hospitals, the waste is all the way throughout the NHS. GPs cannot think for themselves and have to follow (not)NICE guidelines.
Britain's NHS is the laughing stock of world medicine never mind the envy of the world.

Budgie said...

GTingey said: "This week, a company I used to work for .... has filed for Chapt-11"

So when will the NHS file for our equivalent of Chapter 11?

You see the difference? If a private co has management so bad that it goes under - it goes under full stop. But not the NHS because it is a state run monopoly with a guaranteed income (just like the BBC, in fact).

Johnm said...

"get healthcare back to being local people caring for local people"

That's where it is going now....or maybe you do not read detail ?
The local health trusts are history, to be replaced by Clinical Care Commissioning Groups, theoretically run by a GP "collective"
In this real world they will, and are already, be run by private health companies.
Core services will remain free at point of treatment" (the NHS motto)
Others will not.
After-care clinics, physiotherapy, other care clinics (heart, respiratory, auditory, opthalmic)will have a price attached.
Free prescription may well not be so for long, although news will not get out until after 2015. Labour is keeping shtum about this, by-and-large, because they are also going to do the same (indeed, they started a lot of it anyway)
Care will NOT improve, because, quite simply, you cannot have low staffing costs and high staffing levels. Care costs. Simple really.
You think the country is going back to small cottage hospitals ?
You really need to get out more, and get into hospitals on the service side.
Those nice little machines that check your heart is going, and do your blood pressure...you know, the ones scattered about the ward ?
They cost several hundred pounds. The pulse oximeter that clips to your finger costs nearly fifty. They all have to be cleaned after each use.
Things have come a long way since we cleaned peoples wounds with carbolic acid, at the start of medical hygiene. But then, most do not know that way back then IF people survived the surgery, they almost certainly died from infection. And that wasn't so far back either....until sulphonamides, then antibiotics, death after surgery, and for even minor wounds, was extremely common.
The REASON for hospital infections being on the increase is because extremely common pathogens are now resistant to the drugs that used to be used to treat them. Excepting virus of course. But then with the population growing at the rate it is, what else do you expect ?
1 in 6 of the population are aged 65 or more.
Work it out. Old people are more likely to die post surgery. They are more likely to die from infections. Never mind antibiotics...even if the drugs are administered they may not work. Old peoples bodies have a much lower auto immune response than younger peoples....the majority of antibiotics do not kill bacteria, they stop it growing. The immune system then kills the bacteria.
You seriously need to stop reading the 'papers and read history.

Anon2 said...

Physiotherapy has gone, at least NHS funded, from my area. To be replaced by a bill for treatment, which the patient pays. Interesting, John M. Back when I was a physio, one of our uses/aims was prevention of blood clots in post-op and inactive patients.

Thanks for Lilith's comment, too: Genocide is the name of their game.

Thanks for opening up this topic, Raedwald. One thing you didn't mention was the use of foreign medical staff these days. I was very badly treated once by a (white) doctor from somewhere in the eussr --I couldn't pronounce his name, or he mine.

Then there's the sad case of the nurse who didn't know enough about our culture to be in charge of one of our major cultural figures....


yokel said...

@johnm

I fear it is you missing the point. Things are getting local in name only under the latest wheeze intended to show that the NHS is in good shape. BUT, who pays? The national government. Who sets the standards? Who could initiate another reorganisation if the present post holders don't do as they are told? National government.

That is NOT local. Being local is local charity ownership of the property, local charity and local benefactors finding ALL the money, and being accountable to the local people for its proper use.

As for all the advances in healthcare over the last 60 odd years being down to the NHS, how did other countries manage to have even more advances without having the NHS? They might have happened on the NHS's watch, but they weren't cause and effect!

Go back to reading your Socialist history books; set up a fan club for the work(s) of Gordon the Ruiner, but I'll not trouble myself with your comments any more.

G. Tingey said...

Budgie
You STILL don't get it, do you ...?
So, the NHS can't file for Chap 11 ... but even the NHS is more efficient than the US non-healthcare system.
Um.
And the better systems (at greater cost, I may add) of France, Sweden, Germany, etc. are all state-funded.
Erm, err .....

Let's face it PRIVATE hospital care, for 99% of us, would mean NO hospital care.
It would be back to the worst possible combination of pre-1939 medicine here + the grasping excesses of the present US syatem.

I agree that the NHS needs real reform, but I don't think you have got the picture.

Those countries that really do have the best medical care have "socialised" medical systems.

Get over it.

And, if it is so important, and it is, then please devise a better one than we now have, without destroying care for the 95% who cannot afford private treatment.

Johnm said...

Oh please.
I CERTAINLY know that things are "going local" in name only. With all the CC groups run by a few companies.
I'VE known it for years.
Things are NOT going to go back to community projects because healthcare won't run that way in a country of over 60 million people.
And where did I say, or infer, that the improvement, if any, in healthcare is down to the NHS ?
The major improvements in healthcare are OVER.
Control of pathogens by drug treatment and antisepsis. Done. To death.
From now on it is minor improvements, if that. Loads of "great white hopes" to attract investment.
Inoculation against disease continues, with resistance to treatment from people, for various reasons: And maybe with some justification.
There is no treatment for death.
Everyone dies.
The old die more easily than the young, because their bodies systems are operating at lower efficiencies.
That is a medical FACT.
Nothing medicine will do can alter that.
As for "another ten years"; maybe.
But people have to face the fact that if they want the elderly to live longer, and at home, then they are going to have to look after their elderly relatives a lot more than they do, a LOT more. We could always chose the African/Asian option and take them for a long walk at night, then come back alone ?
Otherwise, we get used to the monster we created: Healthcare.
Costly, and by the nature of the beast that is us, doomed eventually to fail.
I sit here typing, at 60+ years of age, with COPD and a respiratory infection, and realising that all the treatments available, including physio (now at added cost) are only going to slow-down the inevitable decline. Nothing any form of healthcare can do, including cottage hositals or caring doctors, is going to halt it because everyones lungs decline in efficiency due to age and attack by disease and dust etc.
Discussion movement towards what you think, without being aware of the cost and complexity of modern health treatments, because you too obviously are not, would be interesting.
Local hospitals staffed by volunteers ?
Well, the need for enhanced crb checks for each (38 quid a shot) would slow that down...
And volunteers would also need to be trained in disease control (tens of millions each year in the NHS)
60 million and growing, and densely packed, says anything tried is going to fail.
The department [no longer] for health knows this.
Doctors know this.
People don't want to know that.
People don't want their children to have measles, mumps or rubella. They also don't want them to have the mmr jab.
Medical waypoints.
Antiseptics (still working because they kill bacteria)
Antibiotics (less effective now, but with the drug being matched to the pathogen they work better)
Vaccination, the true success story. After all, smallpox is eliminated (well, Porton Down has some)
Anything else ?

Budgie said...

I wonder if JohnM and GTingey would be quite so complacent if the old people were being deliberately murdered for administrative convenience in private hospitals rather than in the NHS? But then ideologists are always keener on their ideology than on the facts.

Johnm said...

What makes you think they are not ?
Private hospitals tend to transfer very seriously ill persons to NHS high-dependency/IC units. After all, maintaining a staffed IC unit is extremely costly, many times the expense of a general medical ward, per patient.
Ideally all wards should be so staffed. But times are hard, and staff today want to be paid. A nurse can get a few times more working agency, especially if specialist trained...and that would also be working NHS !!

Consultants also work private..that would be the same consultants you see at the NHS hospital (and probably also the same nurses).

Lifes full of shit.

You really need to attend an "End of Life Planning" tutorial. The NHS do that at most clinics. Funnily enough, they are well-attended, even though completely voluntary.

1. All drug treatments eventually become ineffective.
2. At some time your body is just not going to recover from illness/injury, no matter what treatment is given, or by who.
3. Most patients, told that, tend to leave hospital to depart this mortal veil at home with friends and family.
4. Some have neither, or their friends/family don't want to know.
5. Make a will.

Of course, all this is irrelevant to the accusation/s of neglect, or murder.
Many thousands of people die in hospitals every month. Most elderly. Few are neglected. Those few are a tragedy for all concerned.
Staffing levels, trained staff, need to be higher in all geriatric and post-op wards. Unfortunately the money is not available. It never will be, since the more you put in, the more you need.
So NHS staff have a life outside
work. So do undertakers, their jokes are little better.
Death is part of the life of both.
Don't insult the messenger because the message is distressing.

Edward Spalton said...

Johnm
Your exhortation reminds me of the excellent advice in the Order for the Visitation of the Sick in the Book of Common Prayer (1662). The mortal condition does not change!


" Then shall the minister examine whether he repent him truly of his sins, and be in charity with all the world; exhorting him to forgive from the bottom of his heart, all persons that have offended him; and, if he hath offended any other, to ask them forgiveness; and where he hath done injury or wrong to any man that he make amends to the uttermost of his power. And if he hath not before disposed of his goods, let him be admonished to make his will, and to declare his debts, what he oweth and what is owing unto him, for the better discharging of his conscience, and the quietness of his Executors. But men should often be put in remembrance to take order for the settling of their temporal estates whilst they are in health"

Of course, death was much more with our ancestors, so they had to know and cope with it throughout their lives. Now we think it is rather a let down that the state hasn't abolished it - poor planning that!

G. Tingey said...

Budgie
PRODUCE SOME EVIDENCE for your allegations of "deliberate murder" ...
& then go to the press & police.
OR SHUT THE FUCK UP.

OK?

Johnm said...

As soon as I can, I'll dig-out some stats....not that it'll make a jot of difference to those whose only interest is moaning destructively.

Have a read:
http://www.official-documents.gov.uk/document/hc1011/hc08/0822/0822.pdf

And that's just CT, MRI and LinAccs
Not to mention the trained staff, and MRI machines run 24/7..
All this makes diagnosis easier, and faster. I've just had to have an MRI spinal scan...in the scan image you can see individual nerves clearly. It all costs.
304 MRI installations, at some £900,000.00 each. Oh, and that is labours legacy, since the vast majority have been installed in the last 10 years. Make of that what your personal politics will.
So, please don't ask what the NHS can do for you....next time two dozen of you visit your friends/relatives...and deposit several hundred million pathogens in the wards...think.

Johnm said...

And if you think it will get better privately run.....the cleaners are all private contract.
Pathology is usually contract.
Lots of ambulances....are contract.
Many of the buildings are privately run, on the infamous PFI scheme/scam (the NHS equivalent of the payday loan)
I have always been surprised that many more do not suffer, and die. The logistics of the NHS is a nightmare. Trying to tie everything together, when many of the private contractors are running on a shoestring, and get everything to dovetail....nightmare.
Small is not good, modern medicine-wise.

Budgie said...

JohnM, all your waffle about usual end of life conditions is irrelevant to the issue that patients in the NHS are being starved and/or dehydrated to death deliberately.

As for GTingey, you appear to think that your apoplexy is an adequate substitute for for sense - it isn't. The Liverpool Pathway is well known and well reported; and the lack of compassion, and the neglect is also regularly reported even by Labour ex Ministers.

The pair of you are so blinded by your dogma that you, and people like you, are accessories to murder.

Anonymous said...

No. It's you who are bigoted, and stupid.
There are tens of millions of people successfully treated every single year in NHS hospitals.
In all the country there are very few neglected, or starved to death, or lying in their own body wastes.
And if it was murder, then I would expect the due process of law to intervene.
Or maybe the police are involved too.
I would like to see the medical treatment files on the case. In particular I would be interested in whether DNR was noted.
As I have stated previously, although you seem to have failed to comprehend that statement, with almost everyone near end of life, treatments will fail to have any effect. Patients near end of life are very frequently unable to feed themselves, or to even assist in being fed. Perhaps someone as foolish as you would insist on feeding via insertion (a distressing routine that frequently leads to throat discomfort and injury)....Maybe you could define exactly how far the hospital should go to extend life...
An interesting discussion maybe...

Budgie said...

Anon 14:32 said: "Maybe you could define exactly how far the hospital should go to extend life..."

Extend??

Do you read anything before you rant? The issue is the deliberate regime of withdrawal from a patient of food and drink, with the intention of procuring death as a direct result. And also the deliberate or incompetent neglect that contributes to a premature death indirectly.

It is indefensible, full stop. You need to take a good look at yourself - you are defending deliberate killing in the NHS for mere ideology. Your god is the NHS and it can do no wrong.

Johnm said...

I'm not defending anyone/thing.
I have no Gods.
Go nurse a terminally ill person then come-back and talk to me.

Budgie said...

JohnM, my point is not about "nursing a terminally ill person", it is about a deliberate, institutional policy in parts of the NHS of starving or dehydrating a person to death.

To make it clearer (I hope even to you), where the death is purposefully caused by starvation or dehydration, not the (natural) terminal illness. Until you address that, as far as I am concerned, you are waffling in the wind at best, or aiding and abetting the NHS cover-up of murder.

Johnm said...

No, if you have any evidence you are legally bound to inform the authorities of same.
If you have any, and are nor acting upon it, you too are complicit in the event.
Every death in hospital is subject to autopsy. The next of kin of every patient who dies are told of that, and can avail themselves of that "service". The results of that autopsy are reported to the coroners office. No cremation can take place, after an autopsy, without it being "cleared". Even if the death is not autopsied, the remains are examined prior to burial/cremation by two doctors. The patients own doctor, and another not concerned with the patient or hospital.
So physical evidence will remain, even if only in those buried.
So report it.
If I noted any patient, or any person, being murdered by any means, the police would be immediately informed.
I am aware there are issues with the NHS, but since it is near the top in the world for efficiency, and half the cost of the US health service....and it is the best we have....look at the stats for private care, both cost and deaths in treatment (never forgetting that a proportion of their deaths take place in NHS care units.....it's called "socialising your deaths" ....)
This discourse if getting nowhere. You are set in your ways, and wrong.
EOS.

Budgie said...

No, JohnM, you are wrong. As well as morally bankrupt. The Liverpool Pathway has been deliberately used to cause death of patients by dehydration and/or starvation. "Professor Patrick Pullicino said doctors had turned the use of a controversial 'death pathway' into the equivalent of euthanasia of the elderly" (Mail 14-12-2012: http://www.dailymail.co.uk/debate/article-2217748/Care-No-pathway-killing-people-doctors-deem-worthless.html#ixzz2EyVFo89I).

The BBC and the Telegraph have both run articles on this controversial issue. The government have got involved by strengthening relatives rights under the Health Act 2009. But relatives are easily overwhelmed and coerced (I have seen it happen). And the fact that relatives have consented is hardly a relief to the dehydrated and/or starved to death patient.

Ordinary people can do little in the face of the monopoly NHS, the official obfuscations and because of people like you besotted by their imitation god, the NHS. It is an outrage, and indefensible.

Anonymous said...

I believe the mail not a lot...or the telegraph.
So right wing and anti-nhs anyway...
But then you know that anyway...

Edward said...

Tingey and others ignore th daily articles in the press that document murder at the hands of NHS "carers". The problem with the ideologues is they will happily murder us all to insure they don't have to experience the pain of recognition. To those who site the millions who got good care, first that's what they get paid to do, and second I am sure the majority of Germans were very happy with the Nazi's while they were filling their ovens with all those they thought to be worthless. NHS is the UK's dirty little secret and soon it will be seen as our Holocaust, and for good reason.

Edward said...

To JohnM and all those who love to bash private care, which depends on people CHOOSING them as providers so tend to try very hard to do a good job, remember the Royals routinely drive past 5 NHS hospitals to check into their private preference. No turds on the floor there........

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