The NHS

[BobKowalski]

Hmm, not entirely but I couldn't begin to have an answer as to when you might start charging and where you would draw the line. NHS dentists aren't free. The nations health bill is likely to keep rising, not sure where the money is going to come from.

Scrap Trident. It’s little more than a vanity project.

 

[Ban-jani]

Scrap Trident. It’s little more than a vanity project.

No it isn’t.

Trident is integral.

 

[BobKowalski]

No it isn’t.

Trident is integral.

Integral to what?

 

[Rascal]

Nail on head.

My sister in law is at a very high level of management in the NHS.

As a family we have spent pretty much the last 3 years watching the deterioration and ultimate passing of my elderly mother.
The care , compassion and friendship she received from the nurses and doctors and all the staff at Stepping Hill and The Christie has been nothing short of amazing and extremely moving. I can honestly say I am very proud of our NHS and you can see why it is envied accross most of the world.

Coming to the point , her opinion is that the interaction between all medical departments is being sevely disrupted by the lack of an intergrated computer system.
It is not a simple fix this one in any shape or form and would also be massively affected by our personal data protection laws.
It is the one thing that stood out for me .Generally it seems each department has literally no bloody idea what another may have found or what has been treated previously.
It is both very frustrating and equally alarming.

Data protection is the biggest hinderance in my opinion.

I attended a future technology exhibition at SRFT and I was really impressed with one idea. I spoke to the people behind it at length, with me being a technophobe I wondered how easy there idea would be for me to use. The majority of people only interact with one department, some though with co-morbidities such as myself interact with several. The idea they were working on was an app for your phone that held your medical records. It may not be practical at the moment but at some time in the future everyone will have a mobile phone/device and it would negate the need for a huge infrastructure for medical records. Now bear in mind I am a technophobe but as I understood it everyones records could be kept in one of these cloud things and the app could be used to keep your details updated and instantly transferable between departments. Blood results, test results, clinical outcomes would all be on the app. Nowadays we trust apps to do our banking so why not at some point trust them with our health records. They are doing a small trial as far as I know with people who have diabetes, they can upload daily results which alerts there doctors to any changes.

The app if it is developed and becomes available makes perfect sense for me, I visit numerous departments who at the moment use a paper trail to keep each other informed of where I am at. Of course there will be glitches in a paper trial and I have just had a glitch in my care, but because I am educated in how the system works I navigated it easily and the issue was quickly addressed. For people unsure of how the system works an app could well be a brilliant solution.

As for departments not working well together I get that, some departments do work very well due to close proximity of symptons.For instance, Dermatology and Rheumatology work very closely, Neurology stands apart. Generally I have had no issues that have affected me personally but again it is because I know the system and more importantly have a great relationship with my Prof despite him being a Liverpool fan

 

[Ban-jani]

Integral to what?

Our commitments to NATO, our defence, our strength on the world stage etc. etc.

 

[yerwot?]

Our commitments to NATO, our defence, our strength on the world stage etc. etc.

only if M.A.D. is fictitious...conflicts of the future will not be resolved by nuclear strikes, the heads of our armed forces need to have trident to be relevant in their top-table world of war games and tub-thumping, but the price is scandalous and we DONT have the final say in it's deployment, that is solely in the hands of TRUMP, eeek

 

[BobKowalski]

Our commitments to NATO, our defence, our strength on the world stage etc. etc.

Our commitments to NATO are not dependent on Trident. The money from Trident would in part be better used to repair the damage done to our conventional forces through lack of proper funding which in turn would be far more useful in projecting ourselves on the world stage.

We are a nuclear power because we wanted to sit with the big boys and needed some conkers to do so which we rented off the US. During the Cold War and two superpowers facing off maybe you could make a case although it is arguable what difference a few extra subs made but today not so much. We would be much better served ditching Trident and concentrating our rescources into conventional forces.

 

[Chippy_boy]

A model similar to the privatisation of the railways could work. As long as we set aside some taxpayers money to bail it out when it's failing

I know you're being sarcastic, but the privitisation of the railways is a balls up since what it needs to work is competition, whereas they introduced none.

The problem with monopolistic privatisations is that it's reliant upon a regulator and they are universally useless. Apart from anything else, they have to be "reasonable", such as only allowing a 3% fare increase when the train company proposes a 5% increase. Because 3% is reasonable. What they do not tend to do, is to say "actually you are to cut your fares by 50%" because that would be deemed unreasonable. And yet that is exactly what *does* happen when you have a proper competitor. Look at air fares and how they have fallen dramatically over the last 20 years. Air travel is a similarly asset intensive business with very high investment requirements, and yet over that period, air fares have fallen by maybe 50% or more, whereas train fares - without competition - have probably doubled.

 

[Chippy_boy]

I am not saying all privatisation in the NHS is bad , but your belief that the private sector will always improve service is not always true. My partner works as a heart failure nurse and one area in her dept has been privatised and the service has been appalling and they are now referring patients back to the NHS because they can not provide an adequate service.

I'm sure that's true and privitisation is certainly no panacea and if done badly would I am sure make things worse. Even if done well, I suspect there's services for which we shouldn't even be considering it. What cannot be allowed to happen is that private companies pick off the "profitable" work and then leave the NHS to pick up the pieces (and cost) with the difficult stuff. And I think that is a bit of an issue at the moment.

But the level of privatisation at the moment is low - IIRC it's 7% or 8% of NHS spend - something like that, and yet the objectors to privatisation - mainly those on the left of the political spectrum as far as I can make out - think even this is too much and that 100% of activity should be state-owned and run. I do not subscribe to that view at all.

People compare us to the US and suggest what a disaster a privately-run health service would be, but the US is the very worst of the lot and no-one would aspire to that. Fewer objectors consider comparisons with the Netherlands, or perhaps Singapore. In Singapore they have a government run universal healthcare system which is subsidised through taxation but funded by compulsory saving, insurance, and optional individual contributions, depending on the level of cover you decide you want. I am not advocating the Singaporean system - merely describing it. But it works incredibly well - the hospitals are spectacular; the service ranked amongst the highest in the world and the clinical outcomes ditto. The government system competes with private providers as well, so you have more choice, yet still without getting a bill at the end.

We should be looking at all sorts of options like this IMO.

 

[Ban-jani]

Our commitments to NATO are not dependent on Trident. The money from Trident would in part be better used to repair the damage done to our conventional forces through lack of proper funding which in turn would be far more useful in projecting ourselves on the world stage.

We are a nuclear power because we wanted to sit with the big boys and needed some conkers to do so which we rented off the US. During the Cold War and two superpowers facing off maybe you could make a case although it is arguable what difference a few extra subs made but today not so much. We would be much better served ditching Trident and concentrating our rescources into conventional forces.

I disagree.

I get the point about defence spending but just that and I believe NATO commitments mean you just have to spend the money somewhere but I feel the removal of Trident won’t got down well with our allies and will be a loss of confidence in us, in a time when we’re not exactly popular with our allies in Europe.

Trident is the ultimate deterrent (don’t like that word as it’s used so often but it’s true) and to use an example, no matter how much Russia prod at us and try and take the piss, what stops them doing anything serious is that they know that within minutes we could turn the entirety of Moscow into a radioactive wasteland.

I hope we never ever have to use it but I genuinely believe the fact we do have it, will mean less conventional conflicts in future, as it will put others off “trying it”.