Darkflame wrote:
The thing with that stat overall though is the NHS is apparently very good despite being given relatively shit people with shit bodies coming in
It's unfair to say that the NHS is given shit people - that's just what the anti-social care and privatisation vultures want you to believe. We have some of the world's best healthcare professionals working in the NHS, but unfortunately a few bad people can tarnish the reputation of the many good.
Remember that the NHS is one of the world's biggest employers and that brings some unique workforce challenges. It's rife with poor middle management, many staff are overworked and unsupported due to increasingly tightened resources, and it's often misdirected at senior levels due to political meddling. But despite all that it can still perform incredibly well. The things the NHS needs most are investment (in people) and modernisation (in process) so that the many great people within it are capable of doing more of what already they're good at.
It would also be easier to reform the NHS if there weren't so many fat people in the UK.
Darkflame wrote:
The thing with that stat overall though is the NHS is apparently very good despite being given relatively shit people with shit bodies coming in
It's unfair to say that the NHS is given shit people - that's just what the anti-social care and privatisation vultures want you to believe. We have some of the world's best healthcare professionals working in the NHS, but unfortunately a few bad people can tarnish the reputation of the many good.
I'm pretty sure the shit bodies/people were the patients.
"My way is the way of not fighting":- the book of Enter the Dragon.
Darkflame wrote:
The thing with that stat overall though is the NHS is apparently very good despite being given relatively shit people with shit bodies coming in
It's unfair to say that the NHS is given shit people - that's just what the anti-social care and privatisation vultures want you to believe. We have some of the world's best healthcare professionals working in the NHS, but unfortunately a few bad people can tarnish the reputation of the many good.
Remember that the NHS is one of the world's biggest employers and that brings some unique workforce challenges. It's rife with poor middle management, many staff are overworked and unsupported due to increasingly tightened resources, and it's often misdirected at senior levels due to political meddling. But despite all that it can still perform incredibly well. The things the NHS needs most are investment (in people) and modernisation (in process) so that the many great people within it are capable of doing more of what already they're good at.
It would also be easier to reform the NHS if there weren't so many fat people in the UK.
I think the fact the NHS was recently rated No.1 national healthcare system despite the enormous pressures it is under lately is testimony to the workers diligence under stress. I hope the coalition don't try and take credit for it though because their austerity measures have driven the NHS to the brink of collapse. Perhaps if a little more was invested there than in HS2, Trident, The Royal Family.. etc
Darkflame wrote:
The thing with that stat overall though is the NHS is apparently very good despite being given relatively shit people with shit bodies coming in
It's unfair to say that the NHS is given shit people - that's just what the anti-social care and privatisation vultures want you to believe. We have some of the world's best healthcare professionals working in the NHS, but unfortunately a few bad people can tarnish the reputation of the many good.
I'm pretty sure the shit bodies/people were the patients.
Indeed.
Sorry for being ambiguous there, didn't mean to slight the workforce.
My mums a fairly high level district nurse, and its clear they are under staffed for many things and have to work hard to compensate.
Its also clear many aren't doing it for the money (many could retire far earlier then they do) but doing it because they genuinely want to improve peoples lives. (even if said people treat them horribly at times)
Blaming old people or fat people for the problems in the NHS is wrong. The NHS is under-funded, because we spend less per head than other leading industrialised countries.
And too much of that money is going on salaries for managers and lawyers.
End the "market", cancel or re-negotiate the PFI debt and stop the Treasury clawing back the budget surplus.
More than 60 NHS trusts are in deficit, yet the Treasury will be get back at least £2 billion in surplus this financial year. That's the wrong way to do things.
Basically, in that table posted earlier, there's a row labelled "healthy lives" and it's the one row where the UK does badly (second only to America).
But the point of this row is not to criticise anyone's healthcare system, it's to properly calibrate and normalise one's interpretation of the other results in the table.
For example, if one lived in a hypothetical country populated by immortal robot people, who never get ill and never died, then it's pretty easy to have perfect healthcare outcomes. Just do absolutely nothing. No-one ever uses the hospitals - they have no need, as their health is always perfect forever - so it's easy for that hospital to score perfect outcomes. No deaths, no-one ever getting ill, no-one ever getting worse, etc. and they don't have to do bugger all for that to happen.
Meanwhile, if you live in a country where you're in the middle of an outbreak of Bubonic Plague and everyone's got AIDS and they're all fat and old, and essentially everyone's got a terminal illness of one kind or another, then it's going to be extremely difficult to get positive outcomes, with such a horribly unhealthy population knocking on your door asking for medical treatment. With such a desperately unhealthy population, even with theoretically perfect healthcare treatment, you're still going to lose a heck of a lot of people because, quite frankly, a population that unhealthy is beyond help. It's beyond the capabilities of medical science itself to save them all.
So, you see, the point of the "unhealthy lives" row is to calibrate how we interpret the other results. It's giving us a measure of how unhealthy the population walking into the hospitals are, so that we can judge how well the healthcare system is doing in turning that around and sending healthy people back out of their doors after treatment.
And, in fact, for the UK to have the second most "unhealthy lives" after America, but yet still hit the #1 spot on most measures is not a negative criticism of the NHS at all, but rather an even more impressive feat. That they've got a rather unhealthy population to work with (which is what darkflame actually meant by "shit people with shit bodies"), but yet can still turn it all around and hit the #1 spot regardless.
That's not saying the NHS is bad at all. It's saying that it's damned good.
Because that #1 spot is not coming from having a generally healthy population to begin with, so it's fairly easy to keep them healthy by just treading water. No, it's in the thick of it, struggling hard against a lot of unhealthiness, and it's earning that #1 spot by just being brilliant at what it does.
(It's not good, as a country, to have a big number in that row - because that means you've got an unhealthy population - but, in terms of judging the NHS, the fact that we've got a big number there, but yet still pull off the lowest numbers in all the other rows is very high praise, not criticism, of the NHS.)
Think of it like a race. The other numbers are the finishing positions - so #1 means you won gold - but that "unhealthy lives" number is measuring the order in which the runners started running. So, to still win the gold medal, even though you were the second last to start running, implies you're running far faster than anyone else because you're making up for your disadvantage of starting running after everyone else (bar America), but you still got to the finish line first.
And the point of the "unhealthy lives" row in that table is because, if different countries are starting to run at different times, that does affect how one should interpret the finishing positions.
If Usain Bolt started running 2 seconds after everyone else, but still took the gold regardless, despite that major disadvantage, it tells you that he's an even faster runner than you might initially imagine from just knowing he got gold. Just saying "he got #1" tells you he's fast, but properly calibrating it with "he started 2 seconds behind everyone else and yet he still got the gold regardless" tells you that he's not just fast, he's inhumanly fast (in fact, in reality, that would, I'm sure, actually be physically impossible for anyone to do that, but this race thing is just an analogy and you hopefully get the point I'm making through it).
That row isn't saying that the NHS is bad, it's saying that it's even better again. It's got the second hardest situation to deal with, yet still hits the #1 in spite of that.
"Words ought to be a little wild - for they are assaults of thought on the unthinking."
- John Maynard Keynes
My interpretation, simply as it's been included, is 'healthy lives' is a measure of heath system effectiveness. Note health system not health service, as much of what needs to be done is beyond the scope of the NHS. Things like encouraging healthier diets, which might include education, better labelling, taxes and subsidies. Encouraging exercise, so more walkable and cycleable towns and cities, again better education, subsidies (for baths, leisure centres) and taxes (on e.g. cars).
Because it's beyond the scope of the NHS it's harder to tackle but far from impossible. You need only look at the countries that do better with healthier diets, more active lifestyles, less smoking and drinking. We're moving in the right direction on many parts of it but there's still a long way to go.
But, as you've acknowledged, that's not so much a criticism of the NHS itself, but more an overall criticism of how we run the country.
It is potentially saying that we're perhaps not doing enough on the preventative side of things - educating people, eating well, exercising often and generally not letting people get ill or injured in the first place.
But that's really a different kind of argument altogether.
Because that's about asking whether we should expand the remit of the NHS. Whether it should start intruding on political policies like provision for cycling paths and what-not. Should we have the smoking ban and are we crossing the line, in terms of being a free country, if we started telling people, for example, they can't smoke in their own cars?
It starts treading on political and philosophical toes. We can tell people to stop smoking but what if they choose to continue? What is the social priority here? Is it to remain a free country, where people are allowed to choose unhealthy lifestyles, or should the government start interfering in people's lives to improve things on the "preventative medicine" side?
Indeed, this is actually a fairly unique perspective for the UK too. One not comparable to many other countries. Because the State runs the NHS, so the lines can become blurred.
Elsewhere, such as America, healthcare is entirely private, so they have no rights nor powers (nor commercial interest) to do anything like that. I can do whatever I want to do and, if I get ill, here's my money, so treat me. There is no "but should taxpayers fund your unhealthy lifestyle?" - the taxpayers don't fund it, so they can fuck off, as it's none of their business what I choose to do.
Which begs the question of whether, indeed, we've actually got an advantage or a disadvantage from the fact that we run things differently, so we have opportunities for preventative medicine that doesn't even present itself in many other countries.
But, then again, too much government interference in how people live their lives? That's, of course, potentially threatening tyranny and jeopardising our status as a free country, if, for example, the government decide that preventative medicine should go as far as prohibiting alcohol and tobacco and coffee and forcing everyone to go for a mandatory five mile jog every morning...
....yeah, there's obviously some kind of line in the sand that needs to be drawn there. A wider discussion about where we want to be as a country. And, indeed, how far we'll tolerate the idea that, if someone wants to be morbidly obese and smoke and drink, despite our education advising them it's not the greatest idea, then, as long as they're fully paid up on their NI contributions, then we stick to the principle that everyone automatically gets universal treatment, no questions asked. But how much can we actually afford to do that, as treatments get more expensive?
Anyway, point is, that's a much wider political discussion, well beyond the realms of that simple table to list.
You're not wrong to bring it up, but it's an entirely different and bigger discussion to be had. I was just concentrating on the table and the current discussion about it.
"Words ought to be a little wild - for they are assaults of thought on the unthinking."
- John Maynard Keynes
pogo wrote:My interpretation, simply as it's been included, is 'healthy lives' is a measure of heath system effectiveness. Note health system not health service, as much of what needs to be done is beyond the scope of the NHS.
NHS stands for National Health Service.
pogo wrote:Things like encouraging healthier diets, which might include education, better labelling, taxes and subsidies. Encouraging exercise, so more walkable and cycleable towns and cities, again better education, subsidies (for baths, leisure centres) and taxes (on e.g. cars). Because it's beyond the scope of the NHS...
This is codswallop. Addressing lifestyle issues (as far as they can be addressed - personal responsibility is the final arbiter) is within the scope of the NHS and there has been a paradigm shift toward preventative care that began about a decade ago with the Wanless report. Indeed it's essential for this shift to take place for the NHS to be sustainable. Here's just one of a gazillion such articles discussing the imperative need for this paradigm shift :
Example of recent efforts include the NHS Stop Smoking initiative - which has saved tens of thousands of lives - and the Let's Get Moving initiative - to encourage physical activity.
You'll be pleased to know I'm doing my own bit by seeking NHS funding for a venture which provides dietary education, encourages people to cook for themselves, with a focus on plant based nutrition.
Stuff like TTIP does threaten the good work being done as it will inevitably lead to profit-driven US companies using brute force to impregnate the NHS by using economies of scale to undercut local service provisions - and suing the government for loss of profit if denied the opportunity to bid on those services. I've mentioned this about four times already when is the penny going to drop?
(o)(o) wrote:This is codswallop. Addressing lifestyle issues (as far as they can be addressed - personal responsibility is the final arbiter) is within the scope of the NHS
It is to some extent. But there are big constraints on what the NHS can do. Not only financial constraints but the fact that many people don't respond well to being lectured by their doctor. If they let it happen at all: there are letters around here from our GP suggesting members of our household come in for a checkup, which have been simply ignored.
But the largest part of healthy lifestyles has nothing to do with the NHS. It's things like what we eat, drink and smoke and how much we exercise. The NHS can't do much about these, and many people don't think we should do anything, as they're all matters of choice and responsibility. But there are things that can be done, to encourage people to make better choices.
Education for one: physical and health education should be part of all school curricula but it's unclear how effective this is. Targeted subsidies for healthy activities, taxes on unhealthy ones (which can help pay for the health costs and the subsidies). Perhaps most effective would be using the planning system, to improve our poor cycle networks and eliminate cars from more town and city centres, as well as green taxes to make driving more expensive.
(o)(o) wrote:This is codswallop. Addressing lifestyle issues (as far as they can be addressed - personal responsibility is the final arbiter) is within the scope of the NHS
It is to some extent. But there are big constraints on what the NHS can do. Not only financial constraints but the fact that many people don't respond well to being lectured by their doctor. If they let it happen at all: there are letters around here from our GP suggesting members of our household come in for a checkup, which have been simply ignored.
But the largest part of healthy lifestyles has nothing to do with the NHS. It's things like what we eat, drink and smoke and how much we exercise. The NHS can't do much about these, and many people don't think we should do anything, as they're all matters of choice and responsibility. But there are things that can be done, to encourage people to make better choices.
Education for one: physical and health education should be part of all school curricula but it's unclear how effective this is. Targeted subsidies for healthy activities, taxes on unhealthy ones (which can help pay for the health costs and the subsidies). Perhaps most effective would be using the planning system, to improve our poor cycle networks and eliminate cars from more town and city centres, as well as green taxes to make driving more expensive.
Allowing car free bike routes through city centres would be a very big thing, they might have to be above ground level, to avoid breaking the road network, but they are possible, but not so far done.
"My way is the way of not fighting":- the book of Enter the Dragon.
Tech can effect health as well.
For example imho, lifestyles will get healthier if AR gaming catches on.
You want kids to run about more, lets make Pokemon work in the real world
Exercise is boring. Gamify it.
And, yeah, TTIP is a load of scary crap though.
There was a protest thing about it in my email asking for funds because they moved a meeting to avoid a protest or something. Ashamed to say I didnt get around to donating to help move the protest.
Grrr.