The Anonymous Widower

Avoiding The Real Issues In The NHS

All the political parties seem to be promising more and more to the NHS in this election, be it money, drugs, doctors, nurses or midwives.

Money could be the least of the problems, as it will probably come from improvements to the economy or some tax-the-rich measure, depending on your political point of view.

As drugs are not really a drug problem, but usually a money one, we are left with where to we get the tens of thousands of staff we need to provide health-care.

The trouble is that being a health professional, is a skill you can use anywhere in the world, as all human beings are the same under the skin, even if they come in various colours, speak different languages and have certain different diseases governed by genetics or environment. So just as we can recruit paramedics from the Antipodes, nurses from the Philippines and doctors from virtually everywhere, other countries can entice our health professionals away.

We live in an increasingly global society, and working abroad for a few years is often in many peoples desired career profile, be it in health care or not. Healthcare like certain other professions is one of those that gives you a passport to a lot of interesting places.

All manpower planning in the NHS seems to believe that those trained here, will stay here. But all good training does is hand everybody that passport to travel.

To make matters worse, good training for some professions, is an excellent grounding to starting a business or working in the private sector.

So the first issue we must face, is this one of where do we get the staff. The NHS has shown itself to be not very innovative in this area.

Some have suggested in the past, that anybody trained in the NHS must contract to work for the service for so many years. This is just cloud-cuckoo thinking.

The one positive thing that can be done to help staff is to provide better working conditions and rewards for those working in the NHS. Most of the NHS buildings, I’ve seen in the last ten years have been pretty sound, with perhaps the odd exception, so we must look at the problems of staff with respect to organisation, management, pay and pensions.

What I do find interesting is that all of the Practice Nurses I’ve met in GPs surgeries seem to be so much happier in their work than those in hospitals. It’s only a small survey, but it does say something about the difference between GP’s surgeries and hospitals.

When I’ve spent time in hospital in the past few years, it has been been twice in good NHS hospitals and once in an expensive private one in Hong Kong. There was little difference in the equipment or methods used, but as an IT professional of some years experience, I don’t believe that hospital systems are what an engineer or manager would accept if they worked in say a modern car factory in the UK.

So we must get hospital and GP health systems to the levels that patients and staff expect in their personal life.

Where is an on-line copy of my health record, that I can read to get to the bottom of my problems, that seem to occur seasonally in the Spring?

But things are changing and we must create a health communication and information system, that is an order of magnitude better than what we have today.

No political party is saying they’ll fix this important gap in the NHS.

Everything in our lives is going on to our computers or phones, but healthcare in the NHS hasn’t changed that much since I was born in 1947.

Some people rightly worry about such a computer system. But at its best it would only be like an on-line shopping system, where if you don’t see what you need on-line at your favourite store, you go and look at a physical one.

In all the politicians posturing on health, they very much ignore the users of the NHS and what they can do to improve the service and its efficiency.

I would be interested to see an analysis of how much the average patient costs the NHS. I suspect that because of the lack of a fully joined-up computer system, if I had complete access and wanted to find out how much I cost the NHS last year, no accurate value could be calculated.

Many people calculate their motoring costs to the last penny, but even if they wanted to, it’s probably impossible with healthcare, even though all the data is there.

Eventually, everybody will have this figure, as it could be a powerful tool for a GP to classify and better treat their patients and as a motivator to patients to improve their lifestyle.  You’ll never change some patients, but many could be nudged in the right direction.

We must also do more to ease our load on the NHS. On a personal level, I look after my INR, by doing my own tests. A Committee of MPs has stated that all NHS patients who can, should do their own testing to save the NHS a lot of money.

How many other measurements can be taken by patients to ease the load? And are we doing enough to encourage more and better devices?

In no political party’s pontifications on the NHS, can I find anything about bringing the patient more into his or her own healthcare. But many doctors and nurses have said to me that we should take more responsibility for our own health.

After all, many of us now carry a tablet or phone, that has more computing and information accessing capability than existed anywhere ten years ago. Is this being used to give us better healthcare? Not really!

Political parties are not tackling the problems caused by our poor diet, lifestyle and environment.

Where I live, there are more unhealthy takeaways than you need to try a new one every week of the year. Not one sells any gluten-free food, so their chances of seducing me with their crap is non-existent.

Even the Sainsburys Local that I use is not a store,where you can always get the staples you need to create a healthy meal. Yesterday, I needed a couple of haddock fillets for supper, but except for some very bedraggled and unappetising cod, there was no uncoated fish. So I had to take a bus to the Angel to get some from Waitrose. Does a lack of healthy food locally mean that many don’t eat as healthily as I do? I am out and about in London most days using my Freedom Pass, so it is not difficult for me to pick up what I need on the go. But a young mother with an infant in a buggy doesn’t have that luxury. It’s not the shops’ fault, as they only stock what the shop sells!

The only positive thing government can do in this area, is to give local authorities more power to decide what shops they allow in their area.

I haven’t seen anything like this in any manifesto.

We should also do things to curb air pollution, which can get bad at times. All city centre transport, should either be electric or very low emission vehicles.

But again, no-one wants to annoy people, except the Greens, who won’t win anyway.

I suppose smoking comes into this area. Any candidate for London Mayor, who decides to ban it in public parks, squares and in the vicinity of bus stops gets my vote next time.

Perhaps candidates for the election, should have to declare if they smoke or not and what car they drive on the ballot paper!

Do we also give our children an education that will help them get through the minefield that is health? We give sex education in schools, but surely health education is just as, if not more important!

We need to think radically, about how we deliver healthcare and before we throw money at it, we should sort out the details on how it is delivered, how it interacts with patients and the fasctors that affect it.

Conservative 1940s thinking has failed and we must bring the NHS into the twenty-first century.

 

 

April 11, 2015 - Posted by | Computing, Health | , ,

2 Comments »

  1. You make a lot of interesting points James. The one that is really making me smile today is the Labour plan to guarantee a one to one midwife for every woman in in labour or giving birth. Since no-one can possibly predict when a woman will go into labour, or how long the labour will last, I am fascinated how they will achieve that without having a great many midwives sat around waiting for patients!

    We have insurance, and when I injured my shoulder, my GP suggested physio because a good physio would know very quickly whether I needed to see a consultant or not. 3 – 4 months wait for physio, followed by another 3 – 4 months at least before I saw a consultant. But I was able to see the physio a couple of days after GP appointment, and when she decided 2 weeks later, after 3rd session, that I needed it looking at by consultant, I waited 5 days for the appt. I was expecting a basic assessment. However the consultant looked at my range of movement, sat me down next to small ultrasound machine and scanned it, then sent me across the corridor for a series of x-rays. He then explained what the problem was and the two treatments available, and which he recommended. I agreed to what he said, and was then truly amazed when he said that I could have it done there and then if the specialist radiologist was available!!! So I went into a treatment room, area was cleaned up, radiologist scrubbed up, and proceeded to give me a local anaesthetic, an anti inflammatory, and then reshape the capsule of my shoulder joint using a saline solution! Took 25 minutes, had first physio the next day, and am having physio every few days now for six weeks. WHY CANT THE NHS DO THIS! If I worked and had a job which required a healthy shoulder, I would be off sick for at least 6 months whilst waiting for treatment, with condition worsening, and perhaps needing to claim sickness benefits. It cost around £700, but the NHS docs wouldn’t paid as much as private ones, so would cost less for NHS. And there must be many other health issues which could be treated by this model. And another cost saving would be admin – the writing out of letters with appt times and the hassle of changing them if they are inconvenient, and dealing with the no shows – in most NHS hospitals the the scan and X-ray would not be on the same day.

    Comment by nosnikrapzil | April 11, 2015 | Reply

  2. As for diet – as you know I am a big lady. I go to the gym, 4 or 5 times a week, and I eat a very healthy diet. I had often assumed that my diet wasn’t really as good as I said it was because I was still fat (although have lost some since joining gym). But I am now realising how good it actually is. The things people eat for meals is worrying. Chips and gravy is NOT a good meal. A meat pie is not a good lunch – ok as a one off every few weeks, but not every day. And a muffin is definitely not a good breakfast. I was shocked to realise that so many people not only don’t have “5 a day”, they don’t have more than 2 or 3 a day. I do a lot of this is to do with the lack of teaching of basic cookery skills in school – they seem to do daft things like have to design a dessert and work out the costing and marketing plan for it! And so, not knowing how to cook, people watch the many TV cookery shows, which show them how to bake exotic high fat, high sugar, high cost dishes, including lots of cakes, veg etc “seared” in butter, etc etc. I am proud that my girls cook from scratch, batch cook in slow cooker and freeze extra portions, make healthy soups for work lunches etc. They pointed out that they do it because they assumed everyone did it, because I always did it when they were growing up – it was rare for me to make a meal from scratch which would only do one meal.

    Comment by nosnikrapzil | April 11, 2015 | Reply


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