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NHS vs. Red Cross - a humanitarian crisis?

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  • aliwibble said:


    And Universal Credit - jeez, what a mess..

    UC really isn't too bad. It was a mess 5 years ago but it is now back on track (well a 5 years delayed track) but is rolling out quickly. And is really making a difference. Once the previous system is no longer running there will be significant savings.. Yes money is being wasted all the time both systems run alongside each other but eventually there will be a huge net benefit.

    Studied it in detail for my Uni thesis this year if you're wondering how I know all about it.
    @aliwibble not sure why this warranted a lol. I'm fairly well informed on this particular subject. If you have a counter point feel free to explain.
    Because while the principle of universal credit might be a sound one, I think your assessment that it's now back on track is somewhat optimistic, given the reports of the problems in the pilot areas for the full digital service. I get the impression that (rather like the execrable Universal Jobmatch system) the Universal Credit system has been designed to make things simpler for those processing the claims, rather than those actually doing the claiming.
    Well I did say back on a track but not its original track. I see your point. I don't expect it to proceed from this point to completion with zero hitches bit roll out is sorted far progressing quickly and successfully. There are always teething problems with digital systems like this. And this is the largest one like it in the world. As part of my research I visited job centres and spent days with work coaches. They all thought the digital system and it's interface were huge improvements on the previous counterparts.

    As for being simpler for those behind the scenes it depends on how you look at it. In terms of there will no longer be the need to have admin staff taking details from an input system and manually entering it on an output system, then yes it's simpler. However a system that complex and of that scale I think to run it would be hugely more complex.

    The only place you can say for sure it is more simple is at the point of use.


  • And Universal Credit - jeez, what a mess..

    UC really isn't too bad. It was a mess 5 years ago but it is now back on track (well a 5 years delayed track) but is rolling out quickly. And is really making a difference. Once the previous system is no longer running there will be significant savings.. Yes money is being wasted all the time both systems run alongside each other but eventually there will be a huge net benefit.

    Studied it in detail for my Uni thesis this year if you're wondering how I know all about it.

    Ok, so we had a system that was working pretty well - unemployment benefit (different types) and housing benefit. Then - because housing has become more expensive over the years, with consequent knock on to the housing benefit bill, someone in Government had an idea that it could make it look like it had reduced the housing benefit bill by - in effect - abolishing housing benefit. (UC contains an element which covers claimants' housing costs.) So you roll out UC to all claimants of working age, and - voila - the housing benefit bill goes down (as UC claimants are no longer able to claim HB.) Dress it up as creating something that is "simpler" for claimants, and job done.

    Only, Universal Credit is not actually that "universal", including as it does only 6 benefits ( income based JSA, income based ESA, income support, Child tax credit, working tax credit, housing benefit). This leaves at least 7 other types of benefit which people can claim (contribution based JSA, contribution based ESA, carers allowance, child benefit, DLA, maternity allowance, PIP ), not to mention Council tax support which from April 2013 was changed from a universal national scheme to one devised by individual local authorities (so, 326 different schemes across local authorities just in England - so much for simplicity!).

    Apparently, the DWP estimates the cost of introducing UC to be £15.8 billion. Remember, this is not money spent on something new or that we actually needed. And then add into the mix the switching of dealing with housing benefit from local authority control to the DWP, the 6 week delay until any UC can be awarded from date of claim, and the potential for an increase in rent arrears as a result, it is hard to see any real benefit to the public purse. And of course housing benefit will continue to be paid to all non working age households who are in receipt of benefits/pensions. While the HB bill may well go down as a result of this, the overall cost to the public purse will just go up and up.

    I think you are thinking about UC as something that it is not. UC is a complete overhaul to the entire (almost) benefit system. 97% of benefit claims were to the 6 benefits it replaces. It is not just a replacement for housing benefit and it was not conceived as such.

    The issue with the Current (or legacy) system is that because there as requested on many different benefits there he interactions between these are ridiculously complex. There are huge distortions to the system due to the interactions and random different hours rules. I have done analysis on the Marginal effective tax Rates of these people. Basically for many people they were in a position whereby they earn an extra £10 but due to benefit withdrawals (and tax and NI) they are worse of. The system made people worse off by working more. Due to this low (and often negative) return to work, the issue of welfare dependency was worsened considerably. And this became an intergenerational issue with many having no obvious route out of poverty. There are knock on costs on health services, social services and the police.
    UC changes this with the single taper rate (a more generous rate than all the benefits it replaces) and the smooth withdrawal from benefits mean people will always be better off if they choose to work more. Again can't remember the figures but a large number of people will be moved into work and a large number of people will work extra hours. Assigning a monetary value to the knock on impacts can't accurately be done but these benefits shouldn't be underestimated.

    Other problems. Take up was appalling. Many people who were eligible for benefits were only claiming one or not all they were entitled to. This was because they had to do separate often complex claims for each benefit. With UC one claim and you get all elements for your entire household.

    In terms of administration the current system was an absolute mess. 6 benefits run by different departments with no data sharing or information sharing. Huge overlaps in admin work being carried out multiple times. This in itself is estimated as a 0.2bn saving yearly once UC is fully rolled out. There are also horrendous levels of fraud and error taking place because claimants can easily tell one department one thing on an application and tell another department a totally different story. This costs us 2.2bn a year and will effectively be eradicated.

    These two factors will represent huge savings to the exchequer.

    Due to increased take up (as explained above) and targeting a higher proportion of money at those on the lowest income deciles. Poverty will be reduced, estimated 350000 less children in poverty and half at million less adults.

    There is the obvious reduced complexity for the claimant.

    A claimant will have their own work coach who they will see every meeting and will build a relationship with.

    The digital system is quicker to react to changes in income and you will receive an adjusted amount immediately. This compared with the 4 week gap when moving from job seekers allowance to tackle credits. Yes that's right 4 weeks without any benefits just as you start work. You mention the 6 week wait from claim to payment. That was for the test group that were subject to live service (processed manually by a person). That has now ended. Under the digital system it is 4 weeks the same as the current system.

    I refute the claim the current system is working well. There are hundreds of papers doing detailed analysis of it and it is an utter shambles.

    As for the other benefits they are not being brought into UC but they are being considered in the design and so will augment the benefit rather than further complicating it. The previous system was cobbled together over time and didn't work together at all. This will all marry together much better. For example the disability element will reply on DLA/PIP for its information about you rather than having an entirely separate work capability assessment which will check exactly the same thing.

    That 15bn figure is the Marginal cost of UC so the cost of running it on top of the current system as well as the cost of setting up the it systems to run the etc. Once the current system is phased out that cost will shoot down and then become a net saving. Yes housing benefit will be around longer than the rest but that will eventually be replaced by pensions credit rolling out for those above working age and so HB will also be phased out.


    Thanks Canters an interesting read, just one question though. Is there any evidence that what you have written is actually happening with UC now or is this what is predicted to happen?


  • And Universal Credit - jeez, what a mess..

    .


    Thanks Canters an interesting read, just one question though. Is there any evidence that what you have written is actually happening with UC now or is this what is predicted to happen?

    No worries. A bit of both. Some of that is pure prediction from either official impact assessments or ifs/other bodies critical assessments.

    Bits of it are based on evidence from the Pilot scheme of which there is a full evaluation.

    There isn't a huge amount of analysis on the full national roll out which is in full swing! I believe there is a full evaluation of this due by the end of the year...
  • Huskaris said:

    SDAddick said:

    Huskaris said:

    It's long overdue that we reduced the overseas aid budget and spent some of it on the NHS and other care services.

    £12.2 billion pounds per annum is a staggering sum and if only £0.5M was diverted away from foreign causes such as Ethiopian pop groups (it now has), it would make a massive difference.

    I'm all for foreign aid, but not in such massive sums, when our own services are in dire straits.

    Agreed, one thing is for sure, every penny that goes to someone from abroad in NHS services should come out of our foreign aid budget. It might mean that there is less Spice Girl groups in Ethiopia, and for that I can only apologise for being a cold hearted bastard, but sometimes, and this is a cliche, charity begins at home.
    If, as the sixth largest economy in the world, you cannot figure out how to provide proper care to your own citizens, it is ridiculous to blame people in foreign countries who desperately need help (some of which is the result of the empire). This is not a Labour or Toy thing, this is a human decency thing.
    First of all, I would completely disagree with the idea that empire has been a negative influence on these countries. I would argue, as an example, that India would be far, far worse today were it not for the Empire's influence, and don't get me wrong a lot of that was to exploit their natural resources, but no one would deny the Romans did a lot, and I am sure a few hundred years from now once all the self hating people have died away the British Empire will be viewed in a similar way.

    And I am not blaming foreign countries at all. My personal opinion is that money that is wasted is money that is wasted. We waste a LOT of money. Claims of £350 million a week are ridiculous when it comes to the EU, but we waste a lot of money that we needn't waste. A lot of money isn't going to blankets for Syrian migrants, or food for the starving, it is going to ridiculous vanity projects... Spending money for the sake of spending money (as we are commited to in our foreign aid budget as it is locked in at a percentage) is ridiculous.

    Huskaris said:

    As is always the case with the NHS, your opinion will be based entirely on your political leanings.

    My personal opinion is that you could quadruple the amount of money the NHS gets and it would still be demanding more. That is not *just* a criticism of how much they love pissing money up the wall but also a comment about the drug companies/equipment manufacturers who will base their prices on what they know the NHS can afford.

    It's the NHS though, so mustn't grumble... Labour good, Tories bad etc... Such an asinine argument.

    I've worked in the NHS under both labour and conservatives. Both equally bad.

    There are some fundamental issues regarding funding that are just not widely understood.

    The NHS of today is about as high tech as you can get and it gets more high tech year on year. It's a fact of life that leading edge medical equipment is expensive and whereas 20 years ago it could adequately perform for a good number of years these days it's more or less obsolete buy the time it's bought and installed. Patients demand the best and why shouldn't they. The level of training required to use the new generations of equipment is enormous. Bright young things are just not interested in doing the highly educated stress filled, target driven under paid jobs the NHS has to offer.

    Again. I could go on forever.

    My point exactly, but instead, any time a Conservative so much as stands for election, they want to privatise the NHS and throw everyones gran out onto the pavement to die, whilst lighting their cigars with crisp £50 notes they have stolen off some poor pensioner somewhere. Like I said it is ridiculous and the arguments about the NHS are much, much more complex than that, especially with regards to things like NHS inflation which you mention. Medical inflation runs at a much higher rate than general inflation, for obvious reasons such as tech and innovation which costs money.

    If you increase the value of the NHS budget year on year by the consumer prices index, in real terms for the NHS, it is getting poorer.
    HS2, for example?
    And Universal Credit - jeez, what a mess..
    UC really isn't too bad. It was a mess 5 years ago but it is now back on track (well a 5 years delayed track) but is rolling out quickly. And is really making a difference. Once the previous system is no longer running there will be significant savings.. Yes money is being wasted all the time both systems run alongside each other but eventually there will be a huge net benefit.

    Studied it in detail for my Uni thesis this year if you're wondering how I know all about it.


    Only, Universal Credit is not actually that "universal", including as it does only 6 benefits ( income based JSA, income based ESA, income support, Child tax credit, working tax credit, housing benefit). This leaves at least 7 other types of benefit which people can claim (contribution based JSA, contribution based ESA, carers allowance, child benefit, DLA, maternity allowance, PIP ), not to mention Council tax support which from April 2013 was changed from a universal national scheme to one devised by individual local authorities (so, 326 different schemes across local authorities just in England - so much for simplicity!).

    Apparently, the DWP estimates the cost of introducing UC to be £15.8 billion. Remember, this is not money spent on something new or that we actually needed. And then add into the mix the switching of dealing with housing benefit from local authority control to the DWP, the 6 week delay until any UC can be awarded from date of claim, and the potential for an increase in rent arrears as a result, it is hard to see any real benefit to the public purse. And of course housing benefit will continue to be paid to all non working age households who are in receipt of benefits/pensions. While the HB bill may well go down as a result of this, the overall cost to the public purse will just go up and up.
    Ohh and the idea that it is only being done to reduce the housing bill is ridiculous as the housing element is the only part of it that has been protected and remains exactly as it was under the current system. Almost every other element has been subject to changes and cuts.

    Take this alongside the more generous taper and spending on housing will actually be increased not cut
    Though the housing element is the bit that will be removed as the income increases and is also removed under the Benefit Cap. And will also not be identified as a "housing" cost per se, because a claimant's UC award is not broken down into constituent parts.
  • edited January 8

    Huskaris said:

    SDAddick said:

    Huskaris said:

    It's long overdue that we reduced the overseas aid budget and spent some of it on the NHS and other care services.

    £12.2 billion pounds per annum is a staggering sum and if only £0.5M was diverted away from foreign causes such as Ethiopian pop groups (it now has), it would make a massive difference.

    I'm all for foreign aid, but not in such massive sums, when our own services are in dire straits.

    Agreed, one thing is for sure, every penny that goes to someone from abroad in NHS services should come out of our foreign aid budget. It might mean that there is less Spice Girl groups in Ethiopia, and for that I can only apologise for being a cold hearted bastard, but sometimes, and this is a cliche, charity begins at home.
    If, as the sixth largest economy in the world, you cannot figure out how to provide proper care to your own citizens, it is ridiculous to blame people in foreign countries who desperately need help (some of which is the result of the empire). This is not a Labour or Toy thing, this is a human decency thing.

    Huskaris said:

    As is always the case with the NHS, your opinion will be based entirely on your political leanings.

    My personal opinion is that you could quadruple the amount of money the NHS gets and it would still be demanding more. That is not *just* a criticism of how much they love pissing money up the wall but also a comment about the drug companies/equipment manufacturers who will base their prices on what they know the NHS can afford.

    It's the NHS though, so mustn't grumble... Labour good, Tories bad etc... Such an asinine argument.

    I've worked in the NHS under both labour and conservatives. Both equally bad.

    There are some fundamental issues regarding funding that are just not widely understood.

    The NHS of today is about as high tech as you can get and it gets more high tech year on year. It's a fact of life that leading edge medical equipment is expensive and whereas 20 years ago it could adequately perform for a good number of years these days it's more or less obsolete buy the time it's bought and installed. Patients demand the best and why shouldn't they. The level of training required to use the new generations of equipment is enormous. Bright young things are just not interested in doing the highly educated stress filled, target driven under paid jobs the NHS has to offer.

    Again. I could go on forever.

    My point exactly, but instead, any time a Conservative so much as stands for election, they want to privatise the NHS and throw everyones gran out onto the pavement to die, whilst lighting their cigars with crisp £50 notes they have stolen off some poor pensioner somewhere. Like I said it is ridiculous and the arguments about the NHS are much, much more complex than that, especially with regards to things like NHS inflation which you mention. Medical inflation runs at a much higher rate than general inflation, for obvious reasons such as tech and innovation which costs money.

    If you increase the value of the NHS budget year on year by the consumer prices index, in real terms for the NHS, it is getting poorer.
    HS2, for example?
    And Universal Credit - jeez, what a mess..
    UC really isn't too bad. It was a mess 5 years ago but it is now back on track (well a 5 years delayed track) but is rolling out quickly. And is really making a difference. Once the previous system is no longer running there will be significant savings.. Yes money is being wasted all the time both systems run alongside each other but eventually there will be a huge net benefit.

    Studied it in detail for my Uni thesis this year if you're wondering how I know all about it.


    Only, Universal Credit is not actually that "universal", including as it does only 6 benefits ( income based JSA, income based ESA, income support, Child tax credit, working tax credit, housing benefit). This leaves at least 7 other types of benefit which people can claim (contribution based JSA, contribution based ESA, carers allowance, child benefit, DLA, maternity allowance, PIP ), not to mention Council tax support which from April 2013 was changed from a universal national scheme to one devised by individual local authorities (so, 326 different schemes across local authorities just in England - so much for simplicity!).

    Apparently, the DWP estimates the cost of introducing UC to be £15.8 billion. Remember, this is not money spent on something new or that we actually needed. And then add into the mix the switching of dealing with housing benefit from local authority control to the DWP, the 6 week delay until any UC can be awarded from date of claim, and the potential for an increase in rent arrears as a result, it is hard to see any real benefit to the public purse. And of course housing benefit will continue to be paid to all non working age households who are in receipt of benefits/pensions. While the HB bill may well go down as a result of this, the overall cost to the public purse will just go up and up.
    Ohh and the idea that it is only being done to reduce the housing bill is ridiculous as the housing element is the only part of it that has been protected and remains exactly as it was under the current system. Almost every other element has been subject to changes and cuts.

    Take this alongside the more generous taper and spending on housing will actually be increased not cut
    Though the housing element is the bit that will be removed as the income increases and is also removed under the Benefit Cap. And will also not be identified as a "housing" cost per se, because a claimant's UC award is not broken down into constituent parts.
    Well both of those statements can't be true at the same time. Either it is split into parts or not.

    In fact neither of them are quite right. When UC is calculated each element is calculated separately and added together. So whilst it won't appear on the benefit statement as housing element, but the amount would be there as a result of the housing element.

    As for the impact of the taper or benefit cap, under the current system it's the HB that is taken first. Under UC the taper and benefit cap are applied at the last stage of calculation and so after all the elements have been added up. So the tapered amount or benefit capped amount will be taken off a total amount and so comes from no particular element but actually it is assumed pound for pound from each element
  • See I'm not sure it _is_ more simple at the point of use. It may mean you don't have to enter the same data over and over again to claim different benefits, but it also means that you have to have ALL the evidence for all your claims to hand, rather than being able to prioritise the most important ones or the ones you know where the documents required are. And is the "I've forgotten my password, please reset it" process as horrifically byzantine as the Universal Jobmatch one used to be, or have they learnt their lesson by now?

    You can't just look at it in terms of the technical system, you also have to look at the business processes that surround it, and there are all sorts of issues with those. The big one is the conditionality regime, and that's going to put the kibosh on the "building a relationship with your jobcoach" ideal, because the risk of getting sanctioned if they don't like what you're doing does not make for a constructive relationship. It's bad enough with JSA, but in-work conditionality is likely to cause all sorts of grief. There have already been people in work getting sanctioned because their job coach scheduled a meeting for when they were rostered to work.

    Oh, and you can't combine the PIP and ESA tests, as they test entirely different things - one provides for the additional costs of disability and long term illness, while the other provides you with an income while you are unable to work. There's some overlap between the two, but you can be disabled and still able to work, or unfit for work but not eligible for PIP.
  • edited January 8
    Canters. I appreciate your input. It is almost impossible to make sense of as you have not differentiated between your lengthy statements and those you are replying to. The "quote" button helps.

    Also the intention of the UC implementation is one thing but there is simply no reliable evidence to support claims that it is effective yet. Social impacts take much longer to appreciate, as you will of course know.
  • I know this is off topic slightly but the universal credit we are implementing, is it different from the type of UC I keep seeing prominent people such as Elon Musk talking about? It certainly sounds like it is.
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  • Your first point is one I hadn't considered as such. Supporting evidence all at once could well be an issue.

    I have no idea about the reset your password process but I'm sure that in the scheme of the whole policy it's a pretty insignificant factor.

    Yes the conditionality regime is a potential catastrophe but there are a retract rules about when a section can be applied and when it can't. And it has to be agreed by 2 people so it can't just be applied case of them 'not liking what you are doing'. A sanction for missing applied reread meeting only occurs on the second time it happens and only if there is no warning of such. I.e. a phone call to say you can't make it can we rearrange would suffice. Simple communication, the 'relationship' goes both ways.

    In work conditionality isn't a new thing it was around under the current system for many years and has been extended 3 times in the last 7 years. It is being extended and gain under UC and but it is called the 'light touch group'. Some are expected to do as little as ask their boss if they can do more hours.

    I believe the plan was to have 2 parts to the same test to allow for one appointment, and one visit to the doctor rather than having 2 separate ones for the benefits. A thoroughly sensible idea of you ask me.
  • Canters. I appreciate your input. It is almost impossible to make sense of as you have not differentiated between your lengthy statements and those you are replying to. The "quote" button helps.

    Also the intention of the UC implementation is one thing but there is simply no reliable evidence to support claims that it is effective yet. Social impacts take much longer to appreciate, as you will of course know.

    Apologies.. there were so many previous coments quoted that the text became too long for the dialog box and so the quotes were messed up and it was simply easier to delete the previous comments.

    Absolutely. I believe 100% in the policy principles and design.

    I have above criticised the civil service for their ability to implement it. And said that there is no full evaluation of the roll out yet. I also said that it was impossible to estimate the knock on impacts on society. I agree this is just as difficult after the impacts have actually happened. We will never know the full social impacts.

    I must sound like some kind of UC salesman here. Probably got a bit carried away.

    But I really do believe that for once this government has got something right and it needs to be backed even with hiccups. The previous system was a disaster and something was desperately needed.
  • edited January 8
    Anyways this threads gone wayyy off topic and I got way too into it. I'm sure no one else gives a shit so I'll probably leave it there...

    That's what happens when there is a weekend with no football to talk about...

    And it's affecting my like to comments ratio (because no one gives a shit). So I'll shut up.
  • Currently sitting in Lewisham A&E with my father-in-law.

    Called an Ambulance at 6pm, waited, waited and waited. Got to 9pm and we were told to drive him here.

    Standing room only, not a seat free. On a Sunday night at 11pm. I have never seen an A&E department so packed and I worked at Queen Mary's at Sidcup for nearly 4 years and have worked with an honorary contract at the Royal London for the last 5.

    The FIL called his GP for an appointment on Friday. Was told 25th Jan earliest appointment. Absolute joke for an urgent problem which needs attention.

    The FIL said he would pay to go private but you cant until referred by your GP. Its a vicious circle of delay after delay. The NHS is royally screwed.

    I've seen years of waste. Its currently 120 degrees in here. If they want to start saving some money, they should turn the bloody heating down!
  • Hope he gets seen soon, and it's sorted out without any further faff.
  • Hope sorted soon JBUK
  • Just waiting for blood test/urine results now. He's comfortable thats the main thing. Wife and mother-in-law doing the crossword and I'm on here and drifting in and out of sleep as its no bloody warm in here. Have been told results is at least a 2-3 hour wait from now so its going to be a late one.
  • JohnBoyUK said:

    Just waiting for blood test/urine results now. He's comfortable thats the main thing. Wife and mother-in-law doing the crossword and I'm on here and drifting in and out of sleep as its no bloody warm in here. Have been told results is at least a 2-3 hour wait from now so its going to be a late one.

    Good luck with it Johnboy and I agree about he heating. Same in schools.
  • Never mind. When May pushes button for Brexit there will be £350m a day invested in NHS.
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  • Good post Cordoban, I agree with many of those points. And perhaps that's the problem. When anyone talks about the NHS it's not just one or two problems, you ask 100 people what's wrong and you'd get 100 different answers. The whole thing is a massive fuck up and personally I can't see what the future is for it. I imagine in the next 10 years we'll have a Government who finally says "We can't solve this problem" and it goes into private hands. Whether that's good or bad I don't know but having worked for two private medical insurers in the past I know that it would take a long time before they're ready to deal with the whole population. This is going to run and run for a very long time.
  • My knowledge of the NHS workings is limited but I seem to have been outrageously unlucky with my health and have had in excess of fifteen operations, for various things, and I couldn't find fault with any of those working for it. The waiting lists for some operations are so long, especially when one is in constant pain, but I appreciate that there is limited money and, virtually, unlimited demands for treatment.

    My worry stems from the fact that a former colleague of mine is a sales person for a health supply company (after training for three years to be an anaesthetist before leaving) and she earns close to six figures encouraging NHS managers to buy her company's products that are much more expensive than their competitors. Apparently her company run week long seminars every year for NHS staff in five star hotels in the Caribbean (or other luxury venues).

    If this is happening for things like face masks and theatre bibs I hate to think how much money is 'disappearing' while private individuals are getting rich and patients are waiting for treatments.

    Sadly any large organisation spending someone else's money is going to be at risk of this kind of 'fraud'!
  • I have no idea about the reset your password process but I'm sure that in the scheme of the whole policy it's a pretty insignificant factor.

    Well, as I understand it, the idea of the digital system is that everything apart from meetings with your jobcoach is supposed to go through the system rather than them sending letters out, so if you can't log in to the damn thing in the first place, you're screwed.

    Yes the conditionality regime is a potential catastrophe but there are a retract rules about when a section can be applied and when it can't. And it has to be agreed by 2 people so it can't just be applied case of them 'not liking what you are doing'. A sanction for missing applied reread meeting only occurs on the second time it happens and only if there is no warning of such. I.e. a phone call to say you can't make it can we rearrange would suffice. Simple communication, the 'relationship' goes both ways.

    That may be how it's supposed to work in principle, but it's not how it's working in practice. See here for just one example: http://www.rightsnet.org.uk/forums/viewthread/10140/

    [snip]

    I believe the plan was to have 2 parts to the same test to allow for one appointment, and one visit to the doctor rather than having 2 separate ones for the benefits. A thoroughly sensible idea of you ask me.

    But it's not just a question of the appointment (which isn't necessarily with a doctor btw), it's also the other processes surrounding administration of the claim before and after the assessment that are different, because they serve different purposes. It will also make it more difficult for claimants who need to dispute the outcome of an assessment, as it'll potentially mean entitlement to two benefits is in the balance, not just one.
  • edited January 9
    I don't know how to delete this comment. Apologies

  • Anyone used the Calais Hospital, all geared up for the NHS with all English speaking staff? Looks a good option

    Calais-Cote d'Opale.
  • JohnBoyUK said:

    Currently sitting in Lewisham A&E with my father-in-law.

    Called an Ambulance at 6pm, waited, waited and waited. Got to 9pm and we were told to drive him here.

    Standing room only, not a seat free. On a Sunday night at 11pm. I have never seen an A&E department so packed and I worked at Queen Mary's at Sidcup for nearly 4 years and have worked with an honorary contract at the Royal London for the last 5.

    The FIL called his GP for an appointment on Friday. Was told 25th Jan earliest appointment. Absolute joke for an urgent problem which needs attention.

    The FIL said he would pay to go private but you cant until referred by your GP. Its a vicious circle of delay after delay. The NHS is royally screwed.

    I've seen years of waste. Its currently 120 degrees in here. If they want to start saving some money, they should turn the bloody heating down!

    Sadly the reality is people do not choose when they fall ill, and since virtually all GPs shut up shop from 4pm Friday to 9am Monday, those that fall ill at the weekend have no choice but to attend their local A&E. The idea that such departments are staffed in a similar fashion to a call centre (i.e. majority of staff, including the best trained, work during normal office hours ie daytime Monday to Friday and skeleton at other times) does not reflect the reality of our 24-hour economy. In particular, when this model was devised back in the 1950s, they did not envisage that Britain would turn into a place where the goal of every 18 to 40 year old would be to get as drunk as humanly possible from Friday afternoon and sober up by Sunday evening, and the effects such action would have on the NHS.

    However, the solution is not Hunt's 24/7 NHS where the already skeleton staff should be spread even thinner and inexperienced doctors making decisions that are normally kept for experienced consultants. And as others have said, doctors and nurses are already working well over their contracted hours; if the NHS would work to rule, the morgues would quickly fill up.

    I hope your FIL gets the help he needs, it sounds truly desperate in your area. Having been in and out of hospital myself over the past 3 years, I am very grateful for the professionalism and service the NHS in the two trusts I have been seen by have shown me in these times of immense pressure.
  • Sadly having worked last night I can tell you that Lewisham was far from the exception. Every call I went to was at least an hour old. Including finishing my shift for a 3 hour old job that tied up police officers in scene waiting. For us. The out of hours gp's were also overworked with me waiting an hour for a callback for a patient I referred to them so I did not need to take them to hospital. Every hospital I went to was basically full and in some cases patients were stuck on beds in corridors.

    Any solution needs to work on reducing demand for a/e and ambulance and dealing with issues at home before they become an emergency (real or otherwise). But I have no idea what shape that solution needs to take.
  • A private insurance-based system with suitable protections for the very poorest is the only solution. Anything which is provided free will be abused - plastic carrier bag usage fell 85% when the govt applied just a token 5p charge.
  • It is difficult as there is a fine balancing act between needing emergency help and needing something more routine but being too impatient to wait for it.

    When the NHS complain about A&E being 'abused' they always refer to the Mum that takes her child into A&E twice a week with a tummy ache because it's more convenient than waiting outside the surgery at 8am in the morning to queue for an emergency appointment. What they fail to appreciate, however, is that A&E is, literally, the only part of the NHS that cannot turn you away - or be too busy so it is, by default, where people go when they need or want immediate treatment, even if it's not an emergency.

    Like everything else though, it needs to be paid for and we are, as a country, spending more than we are making so sacrifices need to be made or more taxes need to be paid. People's politics determine whether they believe this cost should be met by the population, as a whole, or a handful of super rich people that often get blamed for lack of public services, but the problem still remains that health provision can be expensive, and as new technologies come along that can 'enrich' peoples lives the demand keeps growing.

    I believe that breast enhancements and reductions can be done on the NHS and people can have NHS funded IVF, neither of these were envisaged back in the 1950s and it could be argued that they are not treating ill health. All the time the scope of what the NHS is doing increases, the only control on the services that are offered is going to be how they can be funded. Sadly, like many individuals, the NHS only, really, reduce spending when the money has run out so it will, by its very nature, stumble along from crisis to crisis.
  • A private insurance-based system with suitable protections for the very poorest is the only solution. Anything which is provided free will be abused - plastic carrier bag usage fell 85% when the govt applied just a token 5p charge.

    ...so we need these companies, run by very very rich and powerful people, to take your money in exchange for your health, as a result of which those people will get even richer and more powerful, and both your wealth and health are increasingly at their mercy...
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