NHS - Time to privatise?

JP08

I haven't forgotten Railtrack, my journeys to and from work were horrendous following both the Hatfield and Potters Bar crashes. Regards the operations side of the railways, my experience is mixed.

In theory, it is better. We certainly have longer trains, and yes they have been replaced since I started commuting in 1992.

But I can no longer guarantee a seat on the 7:18am train and hence get up and travel 40 mins earlier. And there was a non stop service from my town to London, whereas it now stops twice (to maximise usage) and hence is slower by 10%. So I don't think that customer experience has kept pace with demand/utilisation.

sheramber

SnowTiger wrote: »

Oh yes, I'd forgotten about Railtrack; but that's been gone for more than ten years and I guess it was part of the learning curve.

I've seen a huge improvement in train service and quality since privatisation began. I don't live in London.

Then you are lucky as our service os abominable.

Trains don't turn up because a driver hasn't turn up for work

Train is freezing cold in winter.Regular passengers come equipped with hot water bottles, flasks with a hot drink, blankets and heavy clothing.
the excuse for the train being cold is that the heater doesn't work unless the train goes over 30 mph BUT our line has a speed restriction of 30 mph. Hmm, Housten we have a problem.

GlasweJen

The cost of a private cataract operation starts at £3500 per eye for a straight forward surgery - if your dad is registered blind or was blind in the eye being treated I doubt he would have been seen in the private sector as it would mess with their statistics. The company I previously worked for would not operate on anyone (LASIK, LASEK or IOL) unless they were damn sure that the patient would have 6/6 vision or better after correction, how else do you think 99% of patients end up with 20/20 vision or better. He would have been out the door within 45 minutes of his surgery regardless to clear the day bed, bums on seats makes money.

If you'd managed to find a hospital that would take him overnight to stay post cataract you'd be looking at £500+ a night plus the cost of the dressing, you'd probably have a 24 hour dressing check by a nurse (gets done on the NHS when clinically required but not in every case) - that's about £300.

If the NHS wanted your dad in overnight he would have been booked onto the ward he would sleep in on check in, he wouldn't go to the day unit. He would have been asked prior to the surgery who was collecting him and given permission for the ward to contact that person when he was ready to discharge.

As someone who worked as a practitioner in the private sector and now have a role in the NHS (not practing but still in the action) I don't see how anyone would have done it differently. Your dad is of sound mind and has capacity. He chose to use the NHS despite being able to afford private treatment and he chose to call his neighbour or have someone call for him despite apparent arrangements for him to be transferred to a bed on a ward post surgery.

p00hsticks

DomRavioli wrote: »

They would not book a patient in for a Friday procedure on a day ward if he was told he needed an overnight stay (because as you have stated, the ward is closed on weekends). They would also not tell a day patient that they could stay overnight unless this was pre-arranged (which it was very clearly not).

Could it be at all possible that he's telling you one thing and telling someone else another (seems very much like that)? Do you have a written formal statement from the neighbour stating clearly what was said?

As per the OP's previous thread, which I provided a link to earlier in this thread - the patient had the op on Thursday and an overnight stay was pre-arranged for that night - the problem was that the patient did not seem to be ready for discharging on the Friday morning following that overnight stay.

milliemonster

Being a nurse myself, I don't believe your dad would have been discharged just because a nurse said it was ok, he would have had to have been deemed medically fit by medical staff first.

I have had plenty of situations in my nursing career where elderly patients I have been concerned about discharging managing on their own have insisted they are ok (and if they are of sound mind to make that decision then we cannot keep them in hospital against their will and have to let them go) yet then have family members complaining we have discharged them unsafely and the patient then comes round to their way of thinking and contradicts what they told us in the first place.

Not all people in their 80s and older need social care, many are completely independent and live fulfilling lives so we can't just presume that just because they are 81 they need extra nights in hospital or help on discharge.

It's totally unrealistic to expect someone who comes in as a day case or an overnight stay to stay in hospital for a few days longer to recuperate, besides for elderly patients especially research has shown they recuperate better in their own home and surroundings than they do in an unfamiliar hospital ward if every patient stayed in for convalescence, we'd never have any beds for emergency admissions at all and waiting lists would grow massively. However, if after an op such as this it becomes clear that something is wrong and they need to stay in a bed should be found on another ward.

Even if your dad had stayed in, from what you've said he has plenty of money as he could have paid to go private but would have refused to do so, well even if some social care could have been arranged, in view of his needs and financial situation he would have had to fund this himself, would he have been prepared to do this?

[Deleted User]

GlasweJen wrote: »

The cost of a private cataract operation starts at £3500 per eye for a straight forward surgery - if your dad is registered blind or was blind in the eye being treated I doubt he would have been seen in the private sector as it would mess with their statistics. The company I previously worked for would not operate on anyone (LASIK, LASEK or IOL) unless they were damn sure that the patient would have 6/6 vision or better after correction, how else do you think 99% of patients end up with 20/20 vision or better. He would have been out the door within 45 minutes of his surgery regardless to clear the day bed, bums on seats makes money.

If you'd managed to find a hospital that would take him overnight to stay post cataract you'd be looking at £500+ a night plus the cost of the dressing, you'd probably have a 24 hour dressing check by a nurse (gets done on the NHS when clinically required but not in every case) - that's about £300.

If the NHS wanted your dad in overnight he would have been booked onto the ward he would sleep in on check in, he wouldn't go to the day unit. He would have been asked prior to the surgery who was collecting him and given permission for the ward to contact that person when he was ready to discharge.

As someone who worked as a practitioner in the private sector and now have a role in the NHS (not practing but still in the action) I don't see how anyone would have done it differently. Your dad is of sound mind and has capacity. He chose to use the NHS despite being able to afford private treatment and he chose to call his neighbour or have someone call for him despite apparent arrangements for him to be transferred to a bed on a ward post surgery.

Yes you're right about the last paragraph. But hes 81 and people this old dont make the right decisions sometimes.

They told him it would be ok within 24 hours apparently - or this is what he thinks. When they sent him home within 24 hours he believed them when they said "it'll be ok".

Yes its is his fault too. I agree. But like I said earlier, hospital staff know its easy to get an old person out of the door because they wont argue in a lot of cases.

[Deleted User]

milliemonster wrote: »

Being a nurse myself, I don't believe your dad would have been discharged just because a nurse said it was ok, he would have had to have been deemed medically fit by medical staff first.

I have had plenty of situations in my nursing career where elderly patients I have been concerned about discharging managing on their own have insisted they are ok (and if they are of sound mind to make that decision then we cannot keep them in hospital against their will and have to let them go) yet then have family members complaining we have discharged them unsafely and the patient then comes round to their way of thinking and contradicts what they told us in the first place.

Not all people in their 80s and older need social care, many are completely independent and live fulfilling lives so we can't just presume that just because they are 81 they need extra nights in hospital or help on discharge.

It's totally unrealistic to expect someone who comes in as a day case or an overnight stay to stay in hospital for a few days longer to recuperate, besides for elderly patients especially research has shown they recuperate better in their own home and surroundings than they do in an unfamiliar hospital ward if every patient stayed in for convalescence, we'd never have any beds for emergency admissions at all and waiting lists would grow massively. However, if after an op such as this it becomes clear that something is wrong and they need to stay in a bed should be found on another ward.

Even if your dad had stayed in, from what you've said he has plenty of money as he could have paid to go private but would have refused to do so, well even if some social care could have been arranged, in view of his needs and financial situation he would have had to fund this himself, would he have been prepared to do this?

Nope. I can categorically say he was not seen by a doctor that morning.

I know what you mean, but as a nurse, its your duty to be the patients advocate. Yes I understand it would be difficult if they insisted BUT my Dad is the sort to go with whatever hes told. If someone had said, you're fine to go he;d go. If they said, wait a minute, we're not sure, perhaps you should stay, he'd stay.

The fact that he is now back in hospital sort of proves that there was something wrong also that, maybe, should have been checked up before he left.

mumps

If a ward is closing and you need to be kept in they find you a bed on another ward, well that is my experience.

GlasweJen

[quote=[Deleted User];69642373]Yes you're right about the last paragraph. But hes 81 and people this old dont make the right decisions sometimes.

They told him it would be ok within 24 hours apparently - or this is what he thinks. When they sent him home within 24 hours he believed them when they said "it'll be ok".

Yes its is his fault too. I agree. But like I said earlier, hospital staff know its easy to get an old person out of the door because they wont argue in a lot of cases.[/QUOTE]

We are not babysitters, your dads eye could have been hanging out his head and as long as he has capacity we need to let him leave when he wants and with whoever he wants.

Hospitals are not prisons, my mum walked off a ward 2 days after a radical hysterectomy against medical advice. No one could do anything as she has capacity.

If you want to make decisions on behalf of your dad you'd need power of attorney granted by a court.

As for old people not arguing - that's nonsense. Have you never heard of the "grumpy old man" stereotype? We've had elderly people complain about everything from not liking the colour of the paint on the wall to demanding a treatment that isn't an eye drop. Outpatient and day patient elderly people aren't necessarily wee, frail push overs, most of them are quite the opposite.

[Deleted User]

GlasweJen wrote: »

We are not babysitters, your dads eye could have been hanging out his head and as long as he has capacity we need to let him leave when he wants and with whoever he wants.

Hospitals are not prisons, my mum walked off a ward 2 days after a radical hysterectomy against medical advice. No one could do anything as she has capacity.

If you want to make decisions on behalf of your dad you'd need power of attorney granted by a court.

As for old people not arguing - that's nonsense. Have you never heard of the "grumpy old man" stereotype? We've had elderly people complain about everything from not liking the colour of the paint on the wall to demanding a treatment that isn't an eye drop. Outpatient and day patient elderly people aren't necessarily wee, frail push overs, most of them are quite the opposite.

But thats my point he did not "want" to leave. He was told he was leaving.

I appreciate some old people are like this but my Dad is not. If you're an "authority" figure in my dads eye you do what they tell you. In the past, hes been given a hospital appointment 3 months in the future which clashes with a holiday and he has cancelled his holiday rather than ask for it to be amended because "they might not like me asking to change it". Really.

If he had decided he was going home then yes thats his fault I will agree.

But then its not for me to decide whether its right or wrong. I don't think its right and I'm pretty sure the correct procedure was not followed.

Im hoping this will be investigated. Anyone who has followed procedure correctly will have nothing to worry about of course.