the nhs disgrace

Cleaver

PrivatisetheNHSnow wrote: »

what do people most complain about with the nhs - probably waiting lists too long, drugs unavailable. how are these solved by more managers? they're solved by more doctors and nurses. but labour aren't listening:

Are you actually this stupid in real life, or is this just an act for a forum? To pick one of your issues, you think that the answer to effective drug availability is it to 'appoint more doctors and nurses?

The way to ensure you have the ample amount of drugs, available at the right time for patients, is to have a joined up, efficient process to ensure that drugs are in the right place at the right time. This will involve a large amount of small things to all be right: good procurment and clinicians working with pharmacy and supplies to ensure there's a process in place to enable notification of low stocks of drugs. You may want IT involved to set up an electronic system to order drugs automatically. Many hospitals now have their clinicians with PDAs to order drugs from pharmacy automatically, so you need trainers and people to make sure this works. An accountant is needed to work with the ward manager / clinicians to ensure that not too much, or to little money, is spent on drugs at the expense of other issues. You may want an R&D team to do the research in to new drugs and work with NICE to ensure that the correct, most up to date, effective and cost-effective drugs are being purchased. You might also want a clinical effectiveness team to work with clinicians to also ensure that drugs are being ordered, used and administered in the same way. The drugs department needs to be manned by trained pharmacists, so these need apointing. So you need a HR department who are hopefully good at getting good pharmacists. Ward staff might want to look at how they use drugs on the ward, so multi-disciplinary teams might want to meet and discuss practice accross clinical areas. I could go on and on. Basically, lots of little events need to happen to ensure you have drug availability for patients.

You still think the answer to patients having access to the right drugs at the right time is to employ more nurses?

PrivatisetheNHSnow

Cleaver wrote: »

Are you actually this stupid in real life, or is this just an act for a forum? To pick one of your issues, you think that the answer to effective drug availability is it to 'appoint more doctors and nurses?

The way to ensure you have the ample amount of drugs, available at the right time for patients, is to have a joined up, efficient process to ensure that drugs are in the right place at the right time. This will involve a large amount of small things to all be right: good procurment and clinicians working with pharmacy and supplies to ensure there's a process in place to enable notification of low stocks of drugs. You may want IT involved to set up an electronic system to order drugs automatically. Many hospitals now have their clinicians with PDAs to order drugs from pharmacy automatically, so you need trainers and people to make sure this works. An accountant is needed to work with the ward manager / clinicians to ensure that not too much, or to little money, is spent on drugs at the expense of other issues. You may want an R&D team to do the research in to new drugs and work with NICE to ensure that the correct, most up to date, effective and cost-effective drugs are being purchased. You might also want a clinical effectiveness team to work with clinicians to also ensure that drugs are being ordered, used and administered in the same way. The drugs department needs to be manned by trained pharmacists, so these need apointing. So you need a HR department who are hopefully good at getting good pharmacists. Lots of little events need to happen to ensure you have drug availability for patients.

You still think the answer to patients having access to the right drugs at the right time is to employ more nurses?

it was a typo, i meant to say more money, changed it. what you've said is irrelevant if the nhs trust cannot afford the drug in question, which is sometimes the case in experiment cancer treatment.

if you work for nhs management, then can you explain how a hospital trust can get top marks for targets but patients dying from inadequate provision of care? that doesn't sound very 'joined up' as labour would say.

Cleaver

PrivatisetheNHSnow wrote: »

it was a typo, i meant to say more money, changed it. what you've said is irrelevant if the nhs trust cannot afford the drug in question, which is sometimes the case in experiment cancer treatment.

Pretty much every single NHS trust can afford any drug they want. What NHS Trusts do, mainly with the help of NICE guidelines, is to decide whether certain drugs are cost-effective.

For example, can I afford a Ferrari? Well, if I pooled all of our savings, sold a load of our possessions I could probably just about buy a second-hand Ferrari. This wouldn't be a cost-effective way to spend my money though, I'd be better off getting a cheaper car so I can spend money on other things.

It's the same with drugs. If a drug company is charging £30,000 for an individual course of cancer drugs that will extend 30 people's lives for around 4 months instead of 2 months, should the NHS be buying it? The PCT can obviously 'afford' it, but they have to ask if the purchase would be cost-effective. This is as much a moral issue as it is an economic issue.

I imagine your simplistic response may be 'well, if they have less managers they could afford more drugs', right?

Cleaver

PrivatisetheNHSnow wrote: »

if you work for nhs management, then can you explain how a hospital trust can get top marks for targets but patients dying from inadequate provision of care? that doesn't sound very 'joined up' as labour would say.

I'm not an NHS manager.

Are you referring to North Staffs? I fully agree with you. Their management was woeful, they didn't focus on patient care, they weren't 'joined up', they probably needed to sack managers and get more nurses and doctors in to care for patients. Labour would be best to learn from North Staffs that introducing target after target doesn't work. Listening to clinicians on how best to care for patients, then management and all other staff working with them to do that is the best way to work. We don't disagree on this.

Where we seem to disagree is on your simplistic approach of sack all the managers, employ more nurses and doctors and privatise the NHS. That wouldn't achieve the goals you appear to be after.

Exocet

Jonbvn wrote: »

I luurve to read the Gruniad non-job ads just before I do anything competitive;)

Here's a doozy:
http://jobs.guardian.co.uk/job/982753/womens-diversion-case-manager-prostitution-female/

This post provides an exciting opportunity to provide a specialist role within Lambeth’s System Change Pilot Programme as the lead Case Manager supporting women involved in street prostitution, substance misuse and the criminal justice system to receive support and diversion opportunities as part of the new Case Management Team (‘End2End’).

As the overall Case Manager for this client group you will ensure that women experience clear pathways and appropriate support from first point of contact with the criminal justice system and throughout the treatment journey and aftercare. You will also oversee the management and delivery of the ‘Support & Engagement Orders’ (April 2010) for women involved in street prostitution, coordinating referrals and monitoring outcomes.

Helping young and vulnerable women break free of the cycle of prostitution and drugs by offering guidance, counselling, etc.? Surely an excellent use of taxpayers money, and a thousand times more worthwhile than most jobs. Maybe the wording is a bit OTT, but I managed to understand the gist of it after reading it twice.

ninky_2

Exocet wrote: »

Helping young and vulnerable women break free of the cycle of prostitution and drugs by offering guidance, counselling, etc.? Surely an excellent use of taxpayers money, and a thousand times more worthwhile than most jobs. Maybe the wording is a bit OTT, but I managed to understand the gist of it after reading it twice.

in actual fact it is a charity job so not sure it counts as public sector (taxpayers money). and it does actually sound like a very worthwhile job.

princeofpounds

in actual fact it is a charity job so not sure it counts as public sector

A surprising amount of 'corporate' charities are now funded by government cash. It's been a big stealth change in the sector, to the point that some of them are almost quangos.

vaporate

marklv wrote: »

!!!! off and die, moron.

marklv take a hike.

Trash

ninky_2

princeofpounds wrote: »

A surprising amount of 'corporate' charities are now funded by government cash. It's been a big stealth change in the sector, to the point that some of them are almost quangos.

you could say the same of many banks these days. does that make them public sector workers?

isn't the tory 'big society' idea based on giving more public money to charities and the private sector?

princeofpounds

you could say the same of many banks these days. does that make them public sector workers?

Depends what you mean by public sector workers. There are multiple definitions that could apply. In terms of being an employee of a state-controlled entity, yes. And some are now included in the state statistics in such a manner.

But they are not workers employed to pursue policy-maximisation, they are still operating as commercial entities with profit-maximisation in their charter. The government might change this if they institute directed lending, but so far they haven't.

So I guess in letter they are, in spirit not (yet, anyway).

isn't the tory 'big society' idea based on giving more public money to charities and the private sector?

yep. I think it's a legitimate debate which sector is best-equipped to deliver public services. And it probably depends a lot which service you are looking at. I can't imagine private sector care for vulnerable children would work well but private sector job centres might.

The point about charities is that charities often become spoiled by government cash. Their focus then moves from being publicly perceived as doing enough good deeds to justify donation, to being perceived as supportingenough government policy to justify funding. And government policy is not always the same thing as charitable actions! What happens in effect is that public money is channeled into vehicles run by a board of trustees who are effectively self-selecting (no voters, no shareholders in charities!), so oversight is poor.

It's not produced any big muck-ups yet and labour extended a lot of funding this way. The tories might increase it, and might do that at public sector expense. But it's still an experiment and there have been worrying signs where charities have become political instruments.