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Date: 21 january 2015

Today's Topic: The NHS tottering on the brink of disaster

Triggers: BBC News Report, Pulse Magazine, The Papers

My Grump: I feel really angry about what's happening in the NHS and after years of neglect and incompetence the journey back will be painful and expensive

The downfall of the NHS started with the term 'choice'. Now that reality has set in after successive governments have courted political favour from the 'worried well', we all know that 'choice' actually means more expensive. It is always more expensive because 'choice' means at your convenience and not when there is space or it is cost effective to do so.

Once politicians had hoodwinked us into believing that ‘choice’ will genuinely exist, they started making more and more demands on a system that was not ready or capable of change, like impossible targets for treatment times, and appointments 24hrs a day. All the while tempting private companies in to analyze the business aspects, rip out the cream from our public services and deliver the profits to their shareholders. Contracts that have been signed to provide care at the cheapest costs with increased profits for the private companies of course but limits choice for individuals who need and rely on these services.

So here we are several years down the line with patients unable to get a GP appointment anytime in the next fortnight, A and E at bursting, and put into emergency measures because of excessive demand. Wards left empty because of insufficient funding, which is going to agencies that supply nurses and doctors on a 2 or 3 for 1 basis. That's not buy one get one free you understand. That means 1 at 2 or 3 times the price. This, to make up the shortfall of doctors and nurses who are off with stress because of the excessive hours they are working.

Have you noticed that every news report talks about the NHS in crisis? NHS leaders may object to the word crisis, as do politicians in power, but there is certainly an air of blind panic around the health service at the moment.

Now politicians want doctors (GP's) to stand in and take up the slack in hospitals, or divert some of the excess to their surgeries. Where does it end? The numbers of medical students going through the universities and wanting to become GP's is at an all time low. And as for joining a practice, well it's getting so you have to blow the cobwebs off the practice aggreements, they've become so unpopular.
Ambulance parked outside of A&E
The NHS is in crisis, and nobody seems to be doing anything about it except apportioning blame, coming up with some re-hash that costs twice as much as the old-hash, telling us that they are spending more and more, when in reality the whole thing is costing so much, no one can keep up. And in any case, the new money is coming from money taken from some other service that the NHS relies on, such as what to do with people when they leave hospital. This means you keep people in hospital longer than necessary, using up the cash that would otherwise be used to clear them out.

I don't have any answers for this. I'm just a lowly therapist who tries to help those that wish to use complementary therapy and help themselves, so I'm somewhat removed from the trauma of working in that environment. But of course, the patients I see are in some kind of medical trouble, and therefore subscribers to the NHS bigtime. The stories they tell me are horrifying.

But, what's all this nonsense I hear on the news about ambulances being tied up outside the A&E entrances for hours at a time because there is no room inside? Come on paramedics, you must be complicit in this. If your patient is an emergency, you get them inside no matter what is going on currently. If your patient is still sitting in the back of your ambulance drinking cups of tea and talking about the weather after three-quarters, or an hour of waiting, surely they probably didn’t need the ambulance in the first place.

Now the A&E crisis has spread to the other emergency services as fire engines and police cars are being used as makeshift ambulances. Some ambulance services are even resorting to simply dropping passengers off at the door of A&E rather than handing them over to staff to save time, shadow health secretary Andy Burnham has claimed. Andy, its not working now because you listened to some lame-brained political advisor who once suggested that patients who “think they might be ill” for whatever ludicrous reason, and who couldn't or wouldn't help themselves, should have the right to be seen, treated and streeted within four hours. Plus they get a free taxi to the door if they dial 999.

However, I have a different idea.
Here's my solution to the current A&E crisis. Put up a big marquee nearby with lots of windows, and fill it full of chairs. Put a big sign pointing at the entrance which says, 'The Trivial Complaints, Self Inflicted, Time Wasters and Lame Excuses Entrance and Waiting Room'. Drop the time wasters off here and make them wait!

Of course, I'd put in CCTV so that someone on reception can keep an eye open in case any of them keel over, or choke on their own vomit. But make them wait and watch videos of how NHS money is being wasted by lame brains who dial 999 because they have run out their prescription and think they'll get it for free if they go to A&E, rather than the chemist. Or let them look out of the windows at ambulances dropping off the RTC's, the heart attack patients and the proper emergencies, like it was designed for.

Notice I have made no mention of calling NHS 111. Even I am not heartless enough to inflict that much incompetence on anyone, however unforgiving I feel. But in any event, most of the Friday and Saturday night marquee brigade, after an 8, or 12 hour wait will have sobered up and they can piss off home.

I think the truth is much more sinister. The government is trying to run the NHS into the ground, to get it to collapse or go bankrupt, so they can privatise it all. That time is nearly upon us I fear. And why should they care? No politician, with an income as high as they enjoy, plus a bottomless expenses account, need ever visit the NHS, because they can all afford to go private. Never once considering that because they go private, or have insurance, they can jump the queue and push those on the NHS waiting list, back ever further and further into pain and suffering.

Any moron can work out that if everyone goes private, without ramping up capacity, you would still have waiting lists as long as you do now.

I don't expect you to be as cynical as me, but please share your thoughts below, thank you.



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