7 ms·

NHS waiting lists in England hitting new high of 7.2M people

pharmakom 4y ago
This is roughly 1 in 10 people
- bowsamic 4y ago
  More like 1 in 8 because this is just England, not the entire UK
453qtgreq 4y ago
I think it was such a bad move to tie the driving purpose of Covid Restrictions in the UK to "Saving the NHS". One obvious flaw is that people will retrospectively tie the success of lockdowns with the post-Covid state of healthcare. Given that the NHS was already barely functional pre-Covid, denying healthcare for several years and simultaneously making it harder to give healthcare was a recipe for disaster.
- benjaminwootton 4y ago
  Many of us predicted that the Covid restrictions would kill more people than they would save. Excess deaths have been high all year and this is likely to remain the case for the next decade. We’ve obliterated the health service and also damaged the economic engine to pay to fix the problem. (And I’m still downvoted. Open your eyes people, it’s basically Stockholm syndrome at this point!)
  - jinder 4y ago
    How have you determined that the excess deaths are due to "covid restrictions" and not for example, long term sequelae of covid itself or other factors?
  - lynx23 4y ago
    Thanks for saying that, 100% agree! It was obvious from the start that the restrictions will do more harm then good. Almost everyone in my circles that has kids is reporting psychological problems. Teachers report that they have to care for three suicidal kids during a school trip. People having long term side effects from the vaccination. And still, the restriction-fanatics are trying to ignore the obvious.
    - kevingadd 4y ago
      I wonder what kind of psychological problems result when you watch your loved ones catch covid and end up hospitalized or worse for long periods of time? We'll never know, I guess.
      - benjaminwootton 4y ago
        Fortunately, most of our loved ones under 80 only suffered with a few days in bed, so the psychological scarring wasn't too deep. And the ones over 80 ended up catching it anyway.
      - 453qtgreq 4y ago
        .
      - 543g43g43 4y ago
        There are rather fewer of these people (in fact, I haven't heard from any of them), than people who have had to tell their children they have to stay inside due to the horrible virus stalking outside.
    - ben_w 4y ago
      The trouble with anecdotes is that I have examples of people who were bed-ridden for 6 months with a COVID infection, and I was lucky because other people have examples of corpses from it. My secondary school 22 years ago had enough pupils that, if it’s the same size now, half a dozen to a dozen of those pupils will have faced relatives dying from it, and those stories will have spread around the playgrounds/social media. Then there’s the fact that, even though it’s milder for pupils, they can still get: if you know what it can do to your granny before you get it, it’s going to be terrifying; and if you get it mildly and then granny dies from it, you’re going to feel survivor’s guilt and worry if you killed her. Then there’s the fact that parents were already keeping their kids off school before the official lockdowns, because so many people saw the government wasn’t taking it seriously (which later became the PM almost dying from it, but it was obvious they didn’t care well before then).
  - rich_sasha 4y ago
    I don't really know which way the balance goes, but that the calculus wasn't made is borderline criminal to me. And I don't think it really was done, when UK decided to not implement any lockdowns initially (right or wrong, don't know), most of the response was emotional. How dare you not care about dying people???
    - landoftheice 4y ago
  - ben_w 4y ago
    Yes, many did; and yes, excess mortality is up; so I can sympathise with thinking that’s a smoking gun — but COVID itself also caused excess mortality, some of which was by the pathway “The hospitals are now full of COVID patients so we have to turn away others” followed by “OK, so the COVID has cleared up and we can get back to the others… oh, 10% of those others have since died”. And given this is about the UK, I can also point at Brexit, the final stage of which happened during the pandemic and which I specifically predicted would cause a non-specifically large number of deaths: https://kitsunesoftware.wordpress.com/2019/10/25/oh-no/ https://kitsunesoftware.wordpress.com/2019/10/25/oh-no/ (I’m glad to say that Boris Johnson pattern-matches against what I wrote in the final few paragraphs). I’m sure some deaths will have a causal connection to the lockdown, but I can confidently say that about literally every possible course of action or inaction by any major government on any topic no matter how mundane; to talk about risk to the NHS, one must show that the caused effect is also a substantial part of the total.
    - 453qtgreq 4y ago
      The hospitals were never "full" of Covid patients. During the two years from March 2020 onwards, the NHS treated about 70% the number of people that it does during more normal years. These were also mostly not Covid patients. The only reason the NHS stopped treating people during those years is because it was determined that it was too "unsafe", not because the hospitals were full of Covid patients. In fact, now that Covid is more or less over, our health service has become so dysfunctional that only now we are turning people away due to capacity issues (or leaving them in the back of an ambulance for 10+ hours). We didn't save the NHS, we broke it.
      - ben_w 4y ago
        The current breakage is many things, including but not limited to: * Overloaded nurses retiring early or shifting career (one of my in-laws switched from nursing to become a builder). * Pay offer too low to encourage new nurses to join the NHS, as they are valued worldwide and have offers in other countries. * Long-term systematic political footballing. * Brexit (harder access to the UK from the rest of the EU combined with the exchange rate shock making the pay offer look worse). * Many elderly patients have nowhere suitable to go after they’ve been treated, because community care is covered by council taxes not central government and the local councils can’t cope. Fixing this requires shifting the tax burden in ways that the government does not have sufficient support to get through even if they wanted to, and it’s not clear to me if they want to. * Medical costs dominated by the elderly, combined with demographic shifts (important because the non-elderly not only pay the taxes but also do the actual work) which IMO was caused in part by newspapers in the 1980s and 90s deciding that the topic they wanted to treat as a social scandal was all the single mothers and teenage pregnancies, leading to government policy of making all the students of that era as frightened as possible of starting families ever, leading to later families, leading to smaller families, which combined with the social dynamics of basically ending the construction of new council housing (and any boost to the private sector being insufficient) meaning that poor people had a much harder time getting a home, and also the fact that effectively forcing widespread two-income-no-kids relationships without extra home construction leads to house price (and rent) inflation rather than people being able to afford more which again leads to the same demographic shift. Oh, and all that also makes the take-home pay of nurses much worse than it might otherwise be, making it even harder to get nurses from overseas or to keep nurses trained in the UK. * COVID and long COVID
  - andyjohnson0 4y ago
    You're blaming the wrong things. Its a system problem. Waiting lists for elective treatment are high because hospitals are full of mostly elderly people who can't be safely discharged because the social care system is broken - largely due to lack of capacity due to underfunding. And the government recently cancelled the national insurance rate rise that was supposed to fund improvements in social care. Accident and emergency departments, as well as intensive care, can't move patients into regular and high dependency hospital areas because of the problem above. Which is why ambulances have to wait for so long outside hospitals. Which is why ambulance waiting times are seriously dangerously high. The NHS generally has a lot of burnt-out people who are quitting or retiring faster than they can be replaced. Part of the problem is low pay (arguably partly due to under-funding of the service) and perception of that NHS roles are high-stress. The same is true for GPs (who generally aren't NHS employees) although the shortage of people wanting to become GPs is less about pay and more about the stressful nature of the job. The stress of dealing with the pandemic also substantially contributed to burn-out. Ultimately, the UK isn't willing to fund public services properly. Health, education, social care, police, military - they're all grinding to a halt after running hot for too long with not enough people or funding. If you want to take the argument further - we're looking at the economic damage caused by 14 years of austerity topped-off by brexit. The UK economy can no longer fund the expected activities of the state at the level that people expect.
    - 543g43g43 4y ago
      It is - like everything else, our response to Covid has just accelerated anything that was already in decline. The best we can hope for is a well-managed transition to a hybrid healthcare system that all of the other sensible countries use. >the social care system is broken Here, you are talking about social care for old folks. The relevant question here is - why has it got worse over the past 2 years? What we had before wasn't great - old folks basically sold everything they had so minimum-wage staff could care for them in their dying last few years, and needed constant attention from NHS-provided services. Which part of that is now properly broken, and why?
      - ben_w 4y ago
  - 543g43g43 4y ago
    Not forgetting the obvious problems with turning your entire population into "bubble people". I'm not very excited about the Scarlet Fever outbreak here in the UK, as I have two small kids of my own.
  - orwin 4y ago
    I don't know if it's as general as that. I just checked excess mortality, France VS UK [0] as they have a similar GDP and similar health system (and I know France situation better). This summer, we had three heatwaves, reached new record temperatures in 9/12 of all cities I've lived in, and had the longest heatwave ever recorded, as well as the earliest one. We had way more excess death during the 2020 summer, or even the 2021 summer (tbh, although it was pre-omicron, the excess death can probably also be caused by car crashes). It seems to me that the excess death in my country will reach the baseline (maybe a bit higher since the average age is growing, but not much) as long as this summer is an outlier. UK data almost tell the same story, but I don't think you had the same heatwaves, and I don't know how to explain what is happening right now. Putting that on the lockdowns only would need explaining why this effect isn't seen in France, as ours were both longer and more numerous I think (we had three, and only two in the UK, right?). [0]https://ourworldindata.org/grapher/excess-mortality-p-scores-projected-baseline?country=FRA~GBR https://ourworldindata.org/grapher/excess-mortality-p-scores...
- oliwarner 4y ago
  Covid it's a red herring. As is the attention given to long ambulance queues, overrun A&Es. This isn't a front door admissions problem. What we're seeing is a long and accelerating dissolution of social care in the community, mostly elderly nursing but also mental health. Most hospitals are at least 40% occupied by patients awaiting discharge but who can't be discharged because there isn't a nursing home space, or enough community nursing to support them at home. They stay in hospital. This blocks admissions. Which blocks ambulance transfer. Hospitals give surgical beds over to ease waits but this only makes things worse. Now people aren't getting surgical treatment, and it's more likely they'll end up coming in for the symptoms. Covid made things worse, mainly by treating nursing staff horribly, but this was already a trend. We urgently need to pay nurses more, and desperately train a hundred thousand more. Neither look likely under this government.
CommanderData 4y ago
Did the government ever solve the NHS PFI scandals? I remember these being a massive topic some 10 years ago but haven't heard much if anything of them since. Edit: It looks like some trusts still pay insane interest rates for some of these projects https://www.theguardian.com/politics/2019/sep/12/nhs-hospital-trusts-to-pay-out-further-55bn-under-pfi-scheme https://www.theguardian.com/politics/2019/sep/12/nhs-hospita...
- hermitcrab 4y ago
  I remember at the time hearing that PFI was some sort of magic money tree that was better for everyone. You would have to be massively naive to believe that.
decodebytes 4y ago
It's not just the waiting lists, it's the dire situation at A&E. Folks waiting around 10 hours to be seen and ambulances parked up with patients onboard as there are no beds available for them to offload and see to the next emergency.
- benjaminwootton 4y ago
  And a lot of this comes from upstream. It’s bordering on impossible to see a GP so you need to go to A&E for anything semi urgent. I cannot even speak to our family GP, and if I could I would be offered a telephone appointment in 3-4 weeks. The NHS has effectively collapsed.
  - bowsamic 4y ago
    > The NHS has effectively collapsed. Yep. A lot of people don't realise it because the loudest voices are often Brits that happen to live in locations where it has not collapsed yet, but there is basically no health service in England for a huge proportion of the population. It is only a matter of time before resources get diverted away from those locations where it still happens to be good to try and patch up the failed areas, but that won't solve the problem. Therefore, it is only a matter of time before total collapse in all locations. Currently there is a lot of ignorance about it. People hear that it's bad but because they happen to live in an area where it happens to be good they can't really accept it. Seriously ill or dead people don't have the energy or motivation to spend time complaining about it on social media or to the press. There is also an ideological problem for both sides. Both Labour supporters and socialists do not want to admit that the NHS is failing, because they know that if it goes then it is very unlikely to ever return, and they want to generally support nationalisation. On the other hand, Tories don't want to admit that the NHS is failing, because even for the pro-Capitalist Tories, the NHS is a patriotic symbol of the UK loved even by hardcore conservatives, and a symbol of the "blitz spirit". They also are aware of the fact that its collapse would be a sign of its own failures, since the Tories have been in power for a vast majority of the time that the NHS has been collapsing, so who else is there to blame? I think most likely the Tories are going to try and blame this on Putin, which is quite comical. Obviously there is this idea going around that this is being done on purpose by the Tories to encourage a move to private medicine, but I don't think this is true because the private medicine in the UK is heavily reliant on the NHS to function and the UK government aren't really doing anything at all to encourage more private hospitals to open either. If the Tories really wanted to move people from the NHS to private healthcare they would offer a statutory insurance system like in France or Germany and tell people to use it at private clinics.
albertopv 4y ago
Welcome to Italy.
- deleted 4y ago
  [deleted]
langsoul-com 4y ago
Don't worry UK friends, Australia is on its way. In the health care world, you either have private, or wait until your condition worsens. Then get put on a different waiting list for that. There are the haves and have nots. I wonder if going the Singapore route would work? Probs not though, UK is significantly larger than Singapore.
- was_a_dev 4y ago
  Ironically, one issue with the NHS is retention of staff. A sizeable majority of the new cohorts of junior doctors are steadily migrating to Australia due to the better working conditions.
  - StapleHorse 4y ago
    Don't worry spaniards will cover for them and doubling the salary doing so.
- inkyoto 4y ago
  The UK style healthcare system is fundamentally flawed as it does not attempt to address the root cause of a health problem, and is skewed towards providing a tactical solution to the health problem instead. I.e. fixing up the patient just enough to make them come back later again either with the same or with a new but related health problem. Patients are seen as commercial clients (i.e. cash cows) rather than somebody in a real need. It does not matter who pays (the state or the patient out of the pocket or through a health insurance), as somebody generates the revenue stream for the doctor anyway. Which creates a vicious circle for the patient and adds a unnecessary extra burden on the already strained healthcare system. Australia and New Zealand face the same problem, but Australia is rolling downhill at a faster pace.
bowsamic 4y ago
If you're in the UK, please go private if you can afford it. You cannot rely on the NHS.
- hermitcrab 4y ago
  This helps the individual, but doesn't do much to help the NHS. The NHS is one of the best things about the UK and we need to fight for it. Making big corporation and the super wealthy pay taxes would be a good start.
  - robin_reala 4y ago
    It helps the NHS in as much as it reduces load on them. Though what percentage of people would have to do that to have an appreciable benefit is another matter, and it doesn’t do anything about A&E.
    - was_a_dev 4y ago
      The overlap of people who can go private, and use the NHS is very slim. It really would have an miniscule effect. All complications from private healthcare spill into the NHS. There's no such thing, yet, as private A&E for example.
    - hermitcrab 4y ago
      But the more people go private the more excuse it gives the government to privatise the NHS ("it isn't working, look how many people are going private"). Also many of the private doctors are also NHS consultants. Getting more private work might just mean they reduce the hours they do for the NHS. So it isn't clear to me that going private helps the NHS, possibly the opposite. Also, if you pay your taxes, you shouldn't have to go private. It seems to me the main factors here are: a) Healthcare is getting more expensive due to an ageing population and ever more elaborate and expensive treatments. b) The greed of the wealthy (who would rather have a third card than pay taxes to fund the NHS). Who also control much of the UK media. c) The incompetence and venality of the UK government. How many hospitals could have been built by the money paid out in fraudulent COVID loans or trousered by mates of the government for COVID PPE? d) The lack of long-term thinking and investment. We seem to change ministers like most people change theri underwear. It is beyond shameful that the NHS is hovering up doctors and nurses trained in developing countries to make up the shortfall.
ZeroGravitas 4y ago
I believe the new policy document from the Labour party is trying to put healthcare in the constitution, which would help with this.
- hermitcrab 4y ago
  The UK doesn't have a constitution in the sense that countries like the US do. Are they going create a constition as well?
  - ZeroGravitas 4y ago
    Yes, and get rid of the House of Lords etc. It seems quite a smart strategy, they're effectively talking about Brexiting from the Westminster elites and "taking back control". https://www.instituteforgovernment.org.uk/explainers/labour-constitutional-proposals https://www.instituteforgovernment.org.uk/explainers/labour-...
    - hermitcrab 4y ago
      >"taking back control" I never want to hear that phrase again.
    - hermitcrab 4y ago
      Clearly something has to change.
  - was_a_dev 4y ago
    We have a constitution - it just isn't codified [1]. Therefore doing so would just mean having a set of written laws that effectively make public healthcare part of the UK political structure. [1] https://en.wikipedia.org/wiki/Constitution_of_the_United_Kingdom https://en.wikipedia.org/wiki/Constitution_of_the_United_Kin...
- jmyeet 4y ago
  Labour (under Jeremy Corbyn) shares a lot of blame for this situation. Why? In the last election, Labour refused to take a stance on remaining in the UK [1]. To be fair, there was also a massive, coordinated and successful smear campaign against Corbyn. Brexit won by a narrow majority (52-48) and there was no party to vote for to vote against it in the election. The Conservatives went from having a narrow majority (and requiring DUP support for that) to having a massive majority not seen in 40+ years. [1]: https://www.reuters.com/article/uk-britain-election-corbyn-brexit/corbyn-i-would-stay-neutral-in-a-second-brexit-referendum-idUSKBN1XW26K https://www.reuters.com/article/uk-britain-election-corbyn-b...
jmyeet 4y ago
Remember how Brexit was going to save the NHS [1]? It has instead worsened the situation [2]. Remember how the previously short-lived PM Liz Truss wanted to drive up the deficit with massive tax cuts [3] instead of, oh I don't know, spendin gmoney on the NHS backlog and staff shortages? Here's something you may not know: the cost of living situation is a genuine crisis in the UK, Russia's unjustifiable war on Ukraine and the resulting cut in gas supply and rising energy costs have led to the creation of Warm Hubs in the UK [4]. What's a Warm Hub? It's somewhere warm people can go because they literally cannot afford to heat their homes. This is no doubt contributing to demands on the NHS. It's wild to see comments even here suggesting Covid lockdowns were the problem. No, the collapses we're seeing in the NHS were the very thing lockdowns avoided. [1]: https://www.healthjobs.co.uk/health-care-uk/blog/what-happened-to-brexit-s-350m-nhs-pledge/ https://www.healthjobs.co.uk/health-care-uk/blog/what-happen... [2]: https://www.theguardian.com/society/2022/nov/27/brexit-worsened-shortage-nhs-doctors-eu https://www.theguardian.com/society/2022/nov/27/brexit-worse... [3]: https://www.npr.org/2022/10/23/1130782408/how-liz-truss-aggressive-tax-cutting-policy-led-to-her-downfall https://www.npr.org/2022/10/23/1130782408/how-liz-truss-aggr... [4]: https://www.lep.co.uk/news/people/cost-of-living-crisis-warm-hubs-what-are-they-who-set-them-up-where-are-they-who-is-welcome-3897725 https://www.lep.co.uk/news/people/cost-of-living-crisis-warm...
- was_a_dev 4y ago
  > Russia's unjustifiable war on Ukraine and the resulting cut in gas supply and rising energy costs While true, Putin's war is being used as a scapegoat in the UK for poor policy decisions. For a country in Europe with the lowest reliance on Russian gas, we have seen some of the largest increases in energy prices.
  - jmyeet 4y ago
    It doesn't really matter where the UK's gas comes from. That's not how global commodities markets work. If it was domestically produced you could legislatively do something about it but the UK's gas seems to primarily come from Norway. Also, the UK has the second-highest dependence on natural gas in their energy mix (after Italy; ignoring Belarus and Russia) [1]. [1]: https://www.aljazeera.com/news/2022/9/6/infographic-how-much-of-europes-energy-gas https://www.aljazeera.com/news/2022/9/6/infographic-how-much...
robga 4y ago
Much better source than some schlocky tv channel copy https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis https://www.bma.org.uk/advice-and-support/nhs-delivery-and-w...
cosmodisk 4y ago
We left the UK last year. I liked many things there, but the NHS was never one of them. The GPs who are often borderline incompetent. The administrative staff and their endless errors. Wait times were always bad. A few years ago we waited 9 months so for an appointment with a pediatrician. I recently had to make a couple of appointments with specialists, cardiologist was one of them. Less than two weeks wait time+ multiple doctors to choose from. In the UK I would have waited for month for this to happen.
- zelos 4y ago
  It seems like there's a massive cognitive dissonance in the UK. Everyone 'loves' the NHS, says nurses are underpaid and decries any attempt to privatise provision. But everyone also has endless complaints about it. Useless doctors/nurses, appalling administrators and reception staff, mistakes with test results and communication and so on.
  - cosmodisk 4y ago
    I think for an average Brit the NHS is the same as the queen used to be: you may not like it, but if anyone says something negative about it, you are absolutely ready to die for it. At least this was the impression I used to get whenever I brought up the subject.
usedtoprog 4y ago
Glad to see the leftist lilt on HN downvotes and flags anything contrary to the narrative.

This is roughly 1 in 10 people

bowsamic 4y ago
More like 1 in 8 because this is just England, not the entire UK

I think it was such a bad move to tie the driving purpose of Covid Restrictions in the UK to "Saving the NHS". One obvious flaw is that people will retrospectively tie the success of lockdowns with the post-Covid state of healthcare. Given that the NHS was already barely functional pre-Covid, denying healthcare for several years and simultaneously making it harder to give healthcare was a recipe for disaster.

benjaminwootton 4y ago
Many of us predicted that the Covid restrictions would kill more people than they would save. Excess deaths have been high all year and this is likely to remain the case for the next decade. We’ve obliterated the health service and also damaged the economic engine to pay to fix the problem. (And I’m still downvoted. Open your eyes people, it’s basically Stockholm syndrome at this point!)
- jinder 4y ago
  How have you determined that the excess deaths are due to "covid restrictions" and not for example, long term sequelae of covid itself or other factors?
- lynx23 4y ago
  Thanks for saying that, 100% agree! It was obvious from the start that the restrictions will do more harm then good. Almost everyone in my circles that has kids is reporting psychological problems. Teachers report that they have to care for three suicidal kids during a school trip. People having long term side effects from the vaccination. And still, the restriction-fanatics are trying to ignore the obvious.
  - kevingadd 4y ago
    I wonder what kind of psychological problems result when you watch your loved ones catch covid and end up hospitalized or worse for long periods of time? We'll never know, I guess.
    - benjaminwootton 4y ago
      Fortunately, most of our loved ones under 80 only suffered with a few days in bed, so the psychological scarring wasn't too deep. And the ones over 80 ended up catching it anyway.
    - 453qtgreq 4y ago
      .
    - 543g43g43 4y ago
      There are rather fewer of these people (in fact, I haven't heard from any of them), than people who have had to tell their children they have to stay inside due to the horrible virus stalking outside.
  - ben_w 4y ago
    The trouble with anecdotes is that I have examples of people who were bed-ridden for 6 months with a COVID infection, and I was lucky because other people have examples of corpses from it. My secondary school 22 years ago had enough pupils that, if it’s the same size now, half a dozen to a dozen of those pupils will have faced relatives dying from it, and those stories will have spread around the playgrounds/social media. Then there’s the fact that, even though it’s milder for pupils, they can still get: if you know what it can do to your granny before you get it, it’s going to be terrifying; and if you get it mildly and then granny dies from it, you’re going to feel survivor’s guilt and worry if you killed her. Then there’s the fact that parents were already keeping their kids off school before the official lockdowns, because so many people saw the government wasn’t taking it seriously (which later became the PM almost dying from it, but it was obvious they didn’t care well before then).
- rich_sasha 4y ago
  I don't really know which way the balance goes, but that the calculus wasn't made is borderline criminal to me. And I don't think it really was done, when UK decided to not implement any lockdowns initially (right or wrong, don't know), most of the response was emotional. How dare you not care about dying people???
  - landoftheice 4y ago
- ben_w 4y ago
  Yes, many did; and yes, excess mortality is up; so I can sympathise with thinking that’s a smoking gun — but COVID itself also caused excess mortality, some of which was by the pathway “The hospitals are now full of COVID patients so we have to turn away others” followed by “OK, so the COVID has cleared up and we can get back to the others… oh, 10% of those others have since died”. And given this is about the UK, I can also point at Brexit, the final stage of which happened during the pandemic and which I specifically predicted would cause a non-specifically large number of deaths: https://kitsunesoftware.wordpress.com/2019/10/25/oh-no/ https://kitsunesoftware.wordpress.com/2019/10/25/oh-no/ (I’m glad to say that Boris Johnson pattern-matches against what I wrote in the final few paragraphs). I’m sure some deaths will have a causal connection to the lockdown, but I can confidently say that about literally every possible course of action or inaction by any major government on any topic no matter how mundane; to talk about risk to the NHS, one must show that the caused effect is also a substantial part of the total.
  - 453qtgreq 4y ago
    The hospitals were never "full" of Covid patients. During the two years from March 2020 onwards, the NHS treated about 70% the number of people that it does during more normal years. These were also mostly not Covid patients. The only reason the NHS stopped treating people during those years is because it was determined that it was too "unsafe", not because the hospitals were full of Covid patients. In fact, now that Covid is more or less over, our health service has become so dysfunctional that only now we are turning people away due to capacity issues (or leaving them in the back of an ambulance for 10+ hours). We didn't save the NHS, we broke it.
    - ben_w 4y ago
      The current breakage is many things, including but not limited to: * Overloaded nurses retiring early or shifting career (one of my in-laws switched from nursing to become a builder). * Pay offer too low to encourage new nurses to join the NHS, as they are valued worldwide and have offers in other countries. * Long-term systematic political footballing. * Brexit (harder access to the UK from the rest of the EU combined with the exchange rate shock making the pay offer look worse). * Many elderly patients have nowhere suitable to go after they’ve been treated, because community care is covered by council taxes not central government and the local councils can’t cope. Fixing this requires shifting the tax burden in ways that the government does not have sufficient support to get through even if they wanted to, and it’s not clear to me if they want to. * Medical costs dominated by the elderly, combined with demographic shifts (important because the non-elderly not only pay the taxes but also do the actual work) which IMO was caused in part by newspapers in the 1980s and 90s deciding that the topic they wanted to treat as a social scandal was all the single mothers and teenage pregnancies, leading to government policy of making all the students of that era as frightened as possible of starting families ever, leading to later families, leading to smaller families, which combined with the social dynamics of basically ending the construction of new council housing (and any boost to the private sector being insufficient) meaning that poor people had a much harder time getting a home, and also the fact that effectively forcing widespread two-income-no-kids relationships without extra home construction leads to house price (and rent) inflation rather than people being able to afford more which again leads to the same demographic shift. Oh, and all that also makes the take-home pay of nurses much worse than it might otherwise be, making it even harder to get nurses from overseas or to keep nurses trained in the UK. * COVID and long COVID
- andyjohnson0 4y ago
  You're blaming the wrong things. Its a system problem. Waiting lists for elective treatment are high because hospitals are full of mostly elderly people who can't be safely discharged because the social care system is broken - largely due to lack of capacity due to underfunding. And the government recently cancelled the national insurance rate rise that was supposed to fund improvements in social care. Accident and emergency departments, as well as intensive care, can't move patients into regular and high dependency hospital areas because of the problem above. Which is why ambulances have to wait for so long outside hospitals. Which is why ambulance waiting times are seriously dangerously high. The NHS generally has a lot of burnt-out people who are quitting or retiring faster than they can be replaced. Part of the problem is low pay (arguably partly due to under-funding of the service) and perception of that NHS roles are high-stress. The same is true for GPs (who generally aren't NHS employees) although the shortage of people wanting to become GPs is less about pay and more about the stressful nature of the job. The stress of dealing with the pandemic also substantially contributed to burn-out. Ultimately, the UK isn't willing to fund public services properly. Health, education, social care, police, military - they're all grinding to a halt after running hot for too long with not enough people or funding. If you want to take the argument further - we're looking at the economic damage caused by 14 years of austerity topped-off by brexit. The UK economy can no longer fund the expected activities of the state at the level that people expect.
  - 543g43g43 4y ago
    It is - like everything else, our response to Covid has just accelerated anything that was already in decline. The best we can hope for is a well-managed transition to a hybrid healthcare system that all of the other sensible countries use. >the social care system is broken Here, you are talking about social care for old folks. The relevant question here is - why has it got worse over the past 2 years? What we had before wasn't great - old folks basically sold everything they had so minimum-wage staff could care for them in their dying last few years, and needed constant attention from NHS-provided services. Which part of that is now properly broken, and why?
    - ben_w 4y ago
- 543g43g43 4y ago
  Not forgetting the obvious problems with turning your entire population into "bubble people". I'm not very excited about the Scarlet Fever outbreak here in the UK, as I have two small kids of my own.
- orwin 4y ago
  I don't know if it's as general as that. I just checked excess mortality, France VS UK [0] as they have a similar GDP and similar health system (and I know France situation better). This summer, we had three heatwaves, reached new record temperatures in 9/12 of all cities I've lived in, and had the longest heatwave ever recorded, as well as the earliest one. We had way more excess death during the 2020 summer, or even the 2021 summer (tbh, although it was pre-omicron, the excess death can probably also be caused by car crashes). It seems to me that the excess death in my country will reach the baseline (maybe a bit higher since the average age is growing, but not much) as long as this summer is an outlier. UK data almost tell the same story, but I don't think you had the same heatwaves, and I don't know how to explain what is happening right now. Putting that on the lockdowns only would need explaining why this effect isn't seen in France, as ours were both longer and more numerous I think (we had three, and only two in the UK, right?). [0]https://ourworldindata.org/grapher/excess-mortality-p-scores-projected-baseline?country=FRA~GBR https://ourworldindata.org/grapher/excess-mortality-p-scores...
oliwarner 4y ago
Covid it's a red herring. As is the attention given to long ambulance queues, overrun A&Es. This isn't a front door admissions problem. What we're seeing is a long and accelerating dissolution of social care in the community, mostly elderly nursing but also mental health. Most hospitals are at least 40% occupied by patients awaiting discharge but who can't be discharged because there isn't a nursing home space, or enough community nursing to support them at home. They stay in hospital. This blocks admissions. Which blocks ambulance transfer. Hospitals give surgical beds over to ease waits but this only makes things worse. Now people aren't getting surgical treatment, and it's more likely they'll end up coming in for the symptoms. Covid made things worse, mainly by treating nursing staff horribly, but this was already a trend. We urgently need to pay nurses more, and desperately train a hundred thousand more. Neither look likely under this government.

CommanderData 4y ago

Did the government ever solve the NHS PFI scandals? I remember these being a massive topic some 10 years ago but haven't heard much if anything of them since. Edit: It looks like some trusts still pay insane interest rates for some of these projects https://www.theguardian.com/politics/2019/sep/12/nhs-hospital-trusts-to-pay-out-further-55bn-under-pfi-scheme https://www.theguardian.com/politics/2019/sep/12/nhs-hospita...

hermitcrab 4y ago
I remember at the time hearing that PFI was some sort of magic money tree that was better for everyone. You would have to be massively naive to believe that.

decodebytes 4y ago

It's not just the waiting lists, it's the dire situation at A&E. Folks waiting around 10 hours to be seen and ambulances parked up with patients onboard as there are no beds available for them to offload and see to the next emergency.

benjaminwootton 4y ago
And a lot of this comes from upstream. It’s bordering on impossible to see a GP so you need to go to A&E for anything semi urgent. I cannot even speak to our family GP, and if I could I would be offered a telephone appointment in 3-4 weeks. The NHS has effectively collapsed.
- bowsamic 4y ago
  > The NHS has effectively collapsed. Yep. A lot of people don't realise it because the loudest voices are often Brits that happen to live in locations where it has not collapsed yet, but there is basically no health service in England for a huge proportion of the population. It is only a matter of time before resources get diverted away from those locations where it still happens to be good to try and patch up the failed areas, but that won't solve the problem. Therefore, it is only a matter of time before total collapse in all locations. Currently there is a lot of ignorance about it. People hear that it's bad but because they happen to live in an area where it happens to be good they can't really accept it. Seriously ill or dead people don't have the energy or motivation to spend time complaining about it on social media or to the press. There is also an ideological problem for both sides. Both Labour supporters and socialists do not want to admit that the NHS is failing, because they know that if it goes then it is very unlikely to ever return, and they want to generally support nationalisation. On the other hand, Tories don't want to admit that the NHS is failing, because even for the pro-Capitalist Tories, the NHS is a patriotic symbol of the UK loved even by hardcore conservatives, and a symbol of the "blitz spirit". They also are aware of the fact that its collapse would be a sign of its own failures, since the Tories have been in power for a vast majority of the time that the NHS has been collapsing, so who else is there to blame? I think most likely the Tories are going to try and blame this on Putin, which is quite comical. Obviously there is this idea going around that this is being done on purpose by the Tories to encourage a move to private medicine, but I don't think this is true because the private medicine in the UK is heavily reliant on the NHS to function and the UK government aren't really doing anything at all to encourage more private hospitals to open either. If the Tories really wanted to move people from the NHS to private healthcare they would offer a statutory insurance system like in France or Germany and tell people to use it at private clinics.

albertopv 4y ago

Welcome to Italy.

deleted 4y ago
[deleted]

langsoul-com 4y ago

Don't worry UK friends, Australia is on its way. In the health care world, you either have private, or wait until your condition worsens. Then get put on a different waiting list for that. There are the haves and have nots. I wonder if going the Singapore route would work? Probs not though, UK is significantly larger than Singapore.

was_a_dev 4y ago
Ironically, one issue with the NHS is retention of staff. A sizeable majority of the new cohorts of junior doctors are steadily migrating to Australia due to the better working conditions.
- StapleHorse 4y ago
  Don't worry spaniards will cover for them and doubling the salary doing so.
inkyoto 4y ago
The UK style healthcare system is fundamentally flawed as it does not attempt to address the root cause of a health problem, and is skewed towards providing a tactical solution to the health problem instead. I.e. fixing up the patient just enough to make them come back later again either with the same or with a new but related health problem. Patients are seen as commercial clients (i.e. cash cows) rather than somebody in a real need. It does not matter who pays (the state or the patient out of the pocket or through a health insurance), as somebody generates the revenue stream for the doctor anyway. Which creates a vicious circle for the patient and adds a unnecessary extra burden on the already strained healthcare system. Australia and New Zealand face the same problem, but Australia is rolling downhill at a faster pace.

bowsamic 4y ago

If you're in the UK, please go private if you can afford it. You cannot rely on the NHS.

hermitcrab 4y ago
This helps the individual, but doesn't do much to help the NHS. The NHS is one of the best things about the UK and we need to fight for it. Making big corporation and the super wealthy pay taxes would be a good start.
- robin_reala 4y ago
  It helps the NHS in as much as it reduces load on them. Though what percentage of people would have to do that to have an appreciable benefit is another matter, and it doesn’t do anything about A&E.
  - was_a_dev 4y ago
    The overlap of people who can go private, and use the NHS is very slim. It really would have an miniscule effect. All complications from private healthcare spill into the NHS. There's no such thing, yet, as private A&E for example.
  - hermitcrab 4y ago
    But the more people go private the more excuse it gives the government to privatise the NHS ("it isn't working, look how many people are going private"). Also many of the private doctors are also NHS consultants. Getting more private work might just mean they reduce the hours they do for the NHS. So it isn't clear to me that going private helps the NHS, possibly the opposite. Also, if you pay your taxes, you shouldn't have to go private. It seems to me the main factors here are: a) Healthcare is getting more expensive due to an ageing population and ever more elaborate and expensive treatments. b) The greed of the wealthy (who would rather have a third card than pay taxes to fund the NHS). Who also control much of the UK media. c) The incompetence and venality of the UK government. How many hospitals could have been built by the money paid out in fraudulent COVID loans or trousered by mates of the government for COVID PPE? d) The lack of long-term thinking and investment. We seem to change ministers like most people change theri underwear. It is beyond shameful that the NHS is hovering up doctors and nurses trained in developing countries to make up the shortfall.

ZeroGravitas 4y ago

I believe the new policy document from the Labour party is trying to put healthcare in the constitution, which would help with this.

hermitcrab 4y ago
The UK doesn't have a constitution in the sense that countries like the US do. Are they going create a constition as well?
- ZeroGravitas 4y ago
  Yes, and get rid of the House of Lords etc. It seems quite a smart strategy, they're effectively talking about Brexiting from the Westminster elites and "taking back control". https://www.instituteforgovernment.org.uk/explainers/labour-constitutional-proposals https://www.instituteforgovernment.org.uk/explainers/labour-...
  - hermitcrab 4y ago
    >"taking back control" I never want to hear that phrase again.
  - hermitcrab 4y ago
    Clearly something has to change.
- was_a_dev 4y ago
  We have a constitution - it just isn't codified [1]. Therefore doing so would just mean having a set of written laws that effectively make public healthcare part of the UK political structure. [1] https://en.wikipedia.org/wiki/Constitution_of_the_United_Kingdom https://en.wikipedia.org/wiki/Constitution_of_the_United_Kin...
jmyeet 4y ago
Labour (under Jeremy Corbyn) shares a lot of blame for this situation. Why? In the last election, Labour refused to take a stance on remaining in the UK [1]. To be fair, there was also a massive, coordinated and successful smear campaign against Corbyn. Brexit won by a narrow majority (52-48) and there was no party to vote for to vote against it in the election. The Conservatives went from having a narrow majority (and requiring DUP support for that) to having a massive majority not seen in 40+ years. [1]: https://www.reuters.com/article/uk-britain-election-corbyn-brexit/corbyn-i-would-stay-neutral-in-a-second-brexit-referendum-idUSKBN1XW26K https://www.reuters.com/article/uk-britain-election-corbyn-b...

jmyeet 4y ago

Remember how Brexit was going to save the NHS [1]? It has instead worsened the situation [2]. Remember how the previously short-lived PM Liz Truss wanted to drive up the deficit with massive tax cuts [3] instead of, oh I don't know, spendin gmoney on the NHS backlog and staff shortages? Here's something you may not know: the cost of living situation is a genuine crisis in the UK, Russia's unjustifiable war on Ukraine and the resulting cut in gas supply and rising energy costs have led to the creation of Warm Hubs in the UK [4]. What's a Warm Hub? It's somewhere warm people can go because they literally cannot afford to heat their homes. This is no doubt contributing to demands on the NHS. It's wild to see comments even here suggesting Covid lockdowns were the problem. No, the collapses we're seeing in the NHS were the very thing lockdowns avoided. [1]: https://www.healthjobs.co.uk/health-care-uk/blog/what-happened-to-brexit-s-350m-nhs-pledge/ https://www.healthjobs.co.uk/health-care-uk/blog/what-happen... [2]: https://www.theguardian.com/society/2022/nov/27/brexit-worsened-shortage-nhs-doctors-eu https://www.theguardian.com/society/2022/nov/27/brexit-worse... [3]: https://www.npr.org/2022/10/23/1130782408/how-liz-truss-aggressive-tax-cutting-policy-led-to-her-downfall https://www.npr.org/2022/10/23/1130782408/how-liz-truss-aggr... [4]: https://www.lep.co.uk/news/people/cost-of-living-crisis-warm-hubs-what-are-they-who-set-them-up-where-are-they-who-is-welcome-3897725 https://www.lep.co.uk/news/people/cost-of-living-crisis-warm...

was_a_dev 4y ago
> Russia's unjustifiable war on Ukraine and the resulting cut in gas supply and rising energy costs While true, Putin's war is being used as a scapegoat in the UK for poor policy decisions. For a country in Europe with the lowest reliance on Russian gas, we have seen some of the largest increases in energy prices.
- jmyeet 4y ago
  It doesn't really matter where the UK's gas comes from. That's not how global commodities markets work. If it was domestically produced you could legislatively do something about it but the UK's gas seems to primarily come from Norway. Also, the UK has the second-highest dependence on natural gas in their energy mix (after Italy; ignoring Belarus and Russia) [1]. [1]: https://www.aljazeera.com/news/2022/9/6/infographic-how-much-of-europes-energy-gas https://www.aljazeera.com/news/2022/9/6/infographic-how-much...

robga 4y ago

Much better source than some schlocky tv channel copy https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis https://www.bma.org.uk/advice-and-support/nhs-delivery-and-w...

cosmodisk 4y ago

We left the UK last year. I liked many things there, but the NHS was never one of them. The GPs who are often borderline incompetent. The administrative staff and their endless errors. Wait times were always bad. A few years ago we waited 9 months so for an appointment with a pediatrician. I recently had to make a couple of appointments with specialists, cardiologist was one of them. Less than two weeks wait time+ multiple doctors to choose from. In the UK I would have waited for month for this to happen.

zelos 4y ago
It seems like there's a massive cognitive dissonance in the UK. Everyone 'loves' the NHS, says nurses are underpaid and decries any attempt to privatise provision. But everyone also has endless complaints about it. Useless doctors/nurses, appalling administrators and reception staff, mistakes with test results and communication and so on.
- cosmodisk 4y ago
  I think for an average Brit the NHS is the same as the queen used to be: you may not like it, but if anyone says something negative about it, you are absolutely ready to die for it. At least this was the impression I used to get whenever I brought up the subject.

usedtoprog 4y ago

Glad to see the leftist lilt on HN downvotes and flags anything contrary to the narrative.