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I hadn't (here in the USA) heard anything about "collapse of emergency healthcare in England" -- can anyone provide some links for some context? What is actuall

I hadn't (here in the USA) heard anything about "collapse of emergency healthcare in England" -- can anyone provide some links for some context? What is actually going on, and (to the extent people know/educated guess) why? Have wait times been gradually increasing, or has there been a sudden increase? ("collapse" sounds sudden?) Etc etc.

buro9 4y ago
The Conservative Party have been in power for 12 years. When they gained power they pursued a policy of "austerity" to reduce the size of the govt and local govt, reduce the funding of nationally funded things, and to replace such govt owned things with "public private partnerships". This can be seen everywhere from social care (private care homes), schools (academy schools), transport (where area contracts are bid for by private companies), etc. With health specifically the goal is to have more privately owned profit making companies in the NHS. The NHS as it is constructed doesn't allow for this. But for the Conservatives this opportunity for them and their backers. For the public, there is a national pride in the NHS. So we entered the pandemic with an already under-funded and stretched health care system. Much to the chagrin of those in charge though... this has not led to any calls for privatisation. Nor has it led to a boom in people taking out private health care cover. It turns out that the British stiff upper lip response to something they're nationally proud of is that they'd rather die than embrace health privatisation. So we're in uncharted territory... the playbook that had allowed the privatisation of almost everything else isn't working now, it's just killing people.
- gadders 4y ago
  >> The Conservative Party have been in power for 12 years. When they gained power they pursued a policy of "austerity" to reduce the size of the govt and local govt, reduce the funding of nationally funded things, and to replace such govt owned things with "public private partnerships". You seem to be missing a bit of context here - this was after the Global Financial Crisis when even the outgoing Labour Chancellor of the Exchequor admitted there was no money left https://www.theguardian.com/politics/2010/may/17/liam-byrne-note-successor https://www.theguardian.com/politics/2010/may/17/liam-byrne-... >> So we entered the pandemic with an already under-funded and stretched health care system. It's 12% of GDP currently, which isn't that out of step globally.
  - ben_w 4y ago
    To riff off the Oscar Wilde quote, half a decade of no growth may be regarded as misfortune, one and a half decades looks like carelessness.
  - baobob 4y ago
    Folk talking about austerity as a tory thing are going to be in for a monster shock if energy prices persist through the next elections, and when they realize the size of the Covid bill vs the GFC bill. It may very well be Labour sitting as the final nails are driven into the NHS, just by sheer luck of timing
    - gambiting 4y ago
    - squidbeak 4y ago
      Much of the Covid expense was paid for with newly created money through Quantitative Easing. Even the unlikeliest of Conservatives seem to be waking up to Modern Monetary Theory [1] [1] https://twitter.com/SkyNews/status/1554361779857362945 https://twitter.com/SkyNews/status/1554361779857362945
    - ben_w 4y ago
      The end of the NHS is unlikely to be caused by money or lack thereof, given the NHS was founded while the UK was still suffering the economic consequences of the pyrrhic victory of WW2 — food rationing was still a thing, and was only completely ended six years after the NHS was founded, just in time for the Suez crisis to bring it back for a few more months.
  - deleted 4y ago
    [deleted]
- DanBC 4y ago
  > the NHS as it is constructed doesn't allow for this. This is simply untrue. (What is Livewell South West?) We've had private provision of NHS services for years and the Lansley reforms explicitly embed privatisation (state funded private provision) in the NHS. Commissioners are forbidden by the 2012 law from preferring NHS providers over NHS providers. https://www.legislation.gov.uk/ukpga/2012/7/section/75/enacted https://www.legislation.gov.uk/ukpga/2012/7/section/75/enact... We have a lot of private provision of NHS services (all GP practices are private providers!) and it just doesn't work.
- trappist 4y ago
  NIH budget has increased over 40% since 2015. https://officeofbudget.od.nih.gov/pdfs/FY22/spending-hist/Mechanism%20Detail%20for%20Total%20NIH%20FY%202000%20-%20FY%202021%20(V2).pdf https://officeofbudget.od.nih.gov/pdfs/FY22/spending-hist/Me...
  - pjc50 4y ago
    That set of figures is for the US and therefore completely irrelevant?
    - dekhn 4y ago
      also it's a research institution, not a medical care facility.
  - nobodyandproud 4y ago
    NIH is not NHS.
- nobodyandproud 4y ago
  > It turns out that the British stiff upper lip response to something they're nationally proud of is that they'd rather die than embrace health privatisation. So we're in uncharted territory... the playbook Good for you guys. Basic healthcare should be a public service to maximize most coverage at a reasonable quality level. Not privatized to get the most money for the least amount of service, which is the practice of virtually every long-lived business.
DanBC 4y ago
For years people have been raising the warning about the pressures on healthcare system, and for years the conservative party have asked the NHS to do more with less. What does collapse look like? Well, in the early days, it looks very gentle. The four hour wait for ED treatment goes up a bit. Healthcare people say "Look! This is concerning!" and politicians say "eh, it's just winter pressure, we know things are rough in winter." Or you say "Look at the waiting list for community eating disorder treatment, this is concerning!" and politicians say "we're taking people out of mental health hospitals and giving them treatment in the community, so there's a transition period" (they cut beds for ed treatment, but didn't also fund community ed treatment, so wait lists have gone up a lot). It's like Buckaroo or kerplunk or jenga. You can load the donkey, pull the straws, pull the blocks, and stuff still sort of works (less safe, less effective, more harmful) but then something happens and blam you've tipped over into catastrophe.
- pjc50 4y ago
  As we've learned from COVID, it doesn't matter what casualties the system inflicts if the press aren't willing to see it like that.
  - TillE 4y ago
    This is especially true in the UK, but I think the surprisingly under-appreciated, under-explored fact of western democracies for the past 50+ years is that ultimate power truly lies with the mainstream press and what they're willing to cover, and whose politics they're willing to tolerate. There is no institution more powerful in shaping the minds of the public, and they do very frequently act as a monolith, especially in the UK.

buro9 4y ago

The Conservative Party have been in power for 12 years. When they gained power they pursued a policy of "austerity" to reduce the size of the govt and local govt, reduce the funding of nationally funded things, and to replace such govt owned things with "public private partnerships". This can be seen everywhere from social care (private care homes), schools (academy schools), transport (where area contracts are bid for by private companies), etc. With health specifically the goal is to have more privately owned profit making companies in the NHS. The NHS as it is constructed doesn't allow for this. But for the Conservatives this opportunity for them and their backers. For the public, there is a national pride in the NHS. So we entered the pandemic with an already under-funded and stretched health care system. Much to the chagrin of those in charge though... this has not led to any calls for privatisation. Nor has it led to a boom in people taking out private health care cover. It turns out that the British stiff upper lip response to something they're nationally proud of is that they'd rather die than embrace health privatisation. So we're in uncharted territory... the playbook that had allowed the privatisation of almost everything else isn't working now, it's just killing people.

gadders 4y ago
>> The Conservative Party have been in power for 12 years. When they gained power they pursued a policy of "austerity" to reduce the size of the govt and local govt, reduce the funding of nationally funded things, and to replace such govt owned things with "public private partnerships". You seem to be missing a bit of context here - this was after the Global Financial Crisis when even the outgoing Labour Chancellor of the Exchequor admitted there was no money left https://www.theguardian.com/politics/2010/may/17/liam-byrne-note-successor https://www.theguardian.com/politics/2010/may/17/liam-byrne-... >> So we entered the pandemic with an already under-funded and stretched health care system. It's 12% of GDP currently, which isn't that out of step globally.
- ben_w 4y ago
  To riff off the Oscar Wilde quote, half a decade of no growth may be regarded as misfortune, one and a half decades looks like carelessness.
- baobob 4y ago
  Folk talking about austerity as a tory thing are going to be in for a monster shock if energy prices persist through the next elections, and when they realize the size of the Covid bill vs the GFC bill. It may very well be Labour sitting as the final nails are driven into the NHS, just by sheer luck of timing
  - gambiting 4y ago
  - squidbeak 4y ago
    Much of the Covid expense was paid for with newly created money through Quantitative Easing. Even the unlikeliest of Conservatives seem to be waking up to Modern Monetary Theory [1] [1] https://twitter.com/SkyNews/status/1554361779857362945 https://twitter.com/SkyNews/status/1554361779857362945
  - ben_w 4y ago
    The end of the NHS is unlikely to be caused by money or lack thereof, given the NHS was founded while the UK was still suffering the economic consequences of the pyrrhic victory of WW2 — food rationing was still a thing, and was only completely ended six years after the NHS was founded, just in time for the Suez crisis to bring it back for a few more months.
- deleted 4y ago
  [deleted]
DanBC 4y ago
> the NHS as it is constructed doesn't allow for this. This is simply untrue. (What is Livewell South West?) We've had private provision of NHS services for years and the Lansley reforms explicitly embed privatisation (state funded private provision) in the NHS. Commissioners are forbidden by the 2012 law from preferring NHS providers over NHS providers. https://www.legislation.gov.uk/ukpga/2012/7/section/75/enacted https://www.legislation.gov.uk/ukpga/2012/7/section/75/enact... We have a lot of private provision of NHS services (all GP practices are private providers!) and it just doesn't work.
trappist 4y ago
NIH budget has increased over 40% since 2015. https://officeofbudget.od.nih.gov/pdfs/FY22/spending-hist/Mechanism%20Detail%20for%20Total%20NIH%20FY%202000%20-%20FY%202021%20(V2).pdf https://officeofbudget.od.nih.gov/pdfs/FY22/spending-hist/Me...
- pjc50 4y ago
  That set of figures is for the US and therefore completely irrelevant?
  - dekhn 4y ago
    also it's a research institution, not a medical care facility.
- nobodyandproud 4y ago
  NIH is not NHS.
nobodyandproud 4y ago
> It turns out that the British stiff upper lip response to something they're nationally proud of is that they'd rather die than embrace health privatisation. So we're in uncharted territory... the playbook Good for you guys. Basic healthcare should be a public service to maximize most coverage at a reasonable quality level. Not privatized to get the most money for the least amount of service, which is the practice of virtually every long-lived business.

DanBC 4y ago

For years people have been raising the warning about the pressures on healthcare system, and for years the conservative party have asked the NHS to do more with less. What does collapse look like? Well, in the early days, it looks very gentle. The four hour wait for ED treatment goes up a bit. Healthcare people say "Look! This is concerning!" and politicians say "eh, it's just winter pressure, we know things are rough in winter." Or you say "Look at the waiting list for community eating disorder treatment, this is concerning!" and politicians say "we're taking people out of mental health hospitals and giving them treatment in the community, so there's a transition period" (they cut beds for ed treatment, but didn't also fund community ed treatment, so wait lists have gone up a lot). It's like Buckaroo or kerplunk or jenga. You can load the donkey, pull the straws, pull the blocks, and stuff still sort of works (less safe, less effective, more harmful) but then something happens and blam you've tipped over into catastrophe.

pjc50 4y ago
As we've learned from COVID, it doesn't matter what casualties the system inflicts if the press aren't willing to see it like that.
- TillE 4y ago
  This is especially true in the UK, but I think the surprisingly under-appreciated, under-explored fact of western democracies for the past 50+ years is that ultimate power truly lies with the mainstream press and what they're willing to cover, and whose politics they're willing to tolerate. There is no institution more powerful in shaping the minds of the public, and they do very frequently act as a monolith, especially in the UK.