NHS Problems

[cyprusgrump]

Just read the most amazing article from a blogger that I respect very much and was lucky enough to meet in London many years ago...

In 1948, in a country ravaged by years of war in Europe, a remarkably simple idea was born. Doctors, nurses, and hospitals would come together under one umbrella, to provide health care, free at the point of delivery, to every citizen of the United Kingdom, regardless of their means. It was to be financed by a levy on every working citizen, called the national insurance stamp.

What we call ‘the National Health Service’ today is made up of a complex range of organisations with different functions and responsibilities that have been turned into a political football that neither Labour nor Conservative politicians are prepared to speak the truth about.

One of those functions is to pay compensation to those who sue the NHS for ‘poor service’. This can range from life changing surgical mistakes, to those who consider that the receptionist in A & E has been ‘rude and off hand’ or they have had to wait too long. We expect the NHS to behave like Ryanair, or Vodophone, or other profit-making enterprises, and if it doesn’t give us exactly what we want, in a timely manner, then we pick up the phone to a lawyer, and expect compensation.

That is not to minimise the devastating effect that mistakes by Doctors or nurses can have. I have personally been the ‘victim’ (though I hate that word!) of acts of medical negligence for which I could have sued the NHS – but doing so would not have changed the fact that my body was damaged by those mistakes, it would only have ‘fined’ the NHS budget – and ensured that the NHS was even shorter of money than it is.

This year the Department of Health will transfer around £95 billion to NHS England. A staggering £56 billion of that sum is already allocated to the NHS Litigation fund in order to fund compensation claims.

Whilst it is absolutely true that some areas of the NHS are chronically under funded; junior Doctors are under paid, wards are under staffed, access to new drugs is being restricted, waiting times for serious illnesses such as cancer have increased, the ambulance service are creaking at the seams – no politician is explaining to you why £95 billion is insufficient to provide the service that was offered to the British people in 1948.

Do please read the whole thing...

[Rita Sherry]

CG

I have read the whole article and find it a very thought provoking article. It would be very interesting to hear the reaction from the NHS lawyers dealing with the other side of the coin relating to the charges made of dragging out medical negligence claims. I dealt with quite a few medical negligence claims during my Government Service and I dont recall "dragging out cases" rather than "rolling over and admitting liability" Those lawyers know perfectly well medical negligence cases are, to say the least in certain cases,very complex. They are correct in saying only a relatively small percentage actually go to court - thats usually when both sides are at odds with each other as to the level of compensation rather than a liability issue. In my opinion no litigation lawyer worth his/her salt goes to court rather than negotiate a fair and reasonable settlement but, unfortunately, there are those who will push to the limit their claims.

For what it is worth if I had recommended to my client departments to make payment at whatever figure I deemed appropriate and this was rejected by the Claimant, I would pay that sum into court, inform said claimant's lawyer together with a statement to the effect that if I had to deliver my brief to Counsel there would be no last minute court room door settlements we would be going into court and thus put the costs question at risk. Amazing how that could exercise some lawyers' minds. I find it difficult to believe, or possibly understand, why that is still not the case. Of course I have to say I dont believe there was such a thing as a "Litigation Fund" in my day the responsible department had to fund any damages out of their budget.

As I say very thoughtful article.

Rita

[outasite]

£56billion? £56 BILLION????? To cover litigation???? If that amount is correct then there is absolutely no hope whatsoever for the NHS. And doesn't that smack of the greed prevalent in the UK nowadays???? My God, you couldn't make it up, the way the UK is going.

[Jimgward]

What a load of tosh. Typical grump reporting the 'findings' of a blog!!!!!!

The blogger might be mentally deranged them self!

I think I'll believe official reports.

I have a relative a deputy CEO of a Health Board and KNOW that they still talk about the ONE massive claim settled against them of damages relating to negligence 20 years ago in a diabetic birth resulting in brain injury of around £2m.

Have a read at a proper source.....

http://www.nhsla.com/aboutus/Documents/ ... 014-15.pdf

This is an NHS site.... now grumpy person will probably say its old (2014) and propoganda..... but then his tinfoil hat has probably overheated.....

[cyprusgrump]

What a load of tosh. Typical grump reporting the 'findings' of a blog!!!!!!

The blogger might be mentally deranged them self!

I think I'll believe official reports.

I have a relative a deputy CEO of a Health Board and KNOW that they still talk about the ONE massive claim settled against them of damages relating to negligence 20 years ago in a diabetic birth resulting in brain injury of around £2m.

Have a read at a proper source.....

http://www.nhsla.com/aboutus/Documents/ ... 014-15.pdf

This is an NHS site.... now grumpy person will probably say its old (2014) and propoganda..... but then his tinfoil hat has probably overheated.....

I'm pleased I posted it in politics now and not elsewhere.

As expected, some people are incapable of adult discussion and need to resort to insults. Shame.

[cyprusgrump]

£56billion? £56 BILLION????? To cover litigation???? If that amount is correct then there is absolutely no hope whatsoever for the NHS. And doesn't that smack of the greed prevalent in the UK nowadays???? My God, you couldn't make it up, the way the UK is going.

It seems an impossibly high number!

I suspect there might be a decimal point missing there but even £5.6Bn would be an outrageous amount.

What really struck me about the article was the way the money was spent. The claimant could essentially pocket the cash and then rely on the NHS to provide the care that the compo was meant to pay for...

[Jimgward]

What a load of tosh. Typical grump reporting the 'findings' of a blog!!!!!!

The blogger might be mentally deranged them self!

I think I'll believe official reports.

I have a relative a deputy CEO of a Health Board and KNOW that they still talk about the ONE massive claim settled against them of damages relating to negligence 20 years ago in a diabetic birth resulting in brain injury of around £2m.

Have a read at a proper source.....

http://www.nhsla.com/aboutus/Documents/ ... 014-15.pdf

This is an NHS site.... now grumpy person will probably say its old (2014) and propoganda..... but then his tinfoil hat has probably overheated.....

I'm pleased I posted it in politics now and not elsewhere.

As expected, some people are incapable of adult discussion and need to resort to insults. Shame.

[cyprusgrump]

I think I'll believe official reports.

Here is an official NHS report which shows the £56Bn provision in the accounts...

http://www.nhsla.com/AboutUs/Documents/ ... 5-2016.pdf

[Dominic]

I don't think that is per annum though. That is the total cost of damages stretching out into the future, that they will have to pay.

[cyprusgrump]

I don't think that is per annum though. That is the total cost of damages stretching out into the future, that they will have to pay.

Agreed.

She doesn't claim it is a PA fee but it is apparently the amount in the accounts. It is a staggering number!

But the real point of the article is the way the cash is spent and the monstrous salaries of those that control it.

And as an aside, those in IT that have allowed this recent cyber attack are almost certainly on similar packages.

Central government control eh...?

[Rita Sherry]

Jimgward

Thank you for the link you kindly provided very informative.

As I said in my earlier reply I was interested in any information regarding the NHS lawyers take on the claims being made against them or rather the NHS. I have not had the opportunity of reading all the report as yet but that that I have read gives me confidence that the allegations made were not going unchallenged and clearly demonstrates an awareness and indeed challenges regarding the legal costs as well as the amount of claims involved in medical negligence cases.

I have to go out now but I will return to take a more detailed study of the report. Please do not consider the report to be old because often these do not necessarily come to light (to the general populance at least) as and until some other report, as in this case, comes to light.

As the report does say claims have risen due in part to the litigious attitude now ever present in the UK since it crossed the Atlantic particularly so when the "no win no fee" legal firms became so involved. Medical Negligence claims are particularly complex due to the very nature of the allegation and the need to ensure fair settlements are reached which, in the more serious cases, can affect the rest of the claimants' lives. They require expert medical advice and legal representatives well versed in the discipline and clearly the latter is not always the norm.

Thank you once more.

Rita

[Dominic]

Part of the problem with claims stems from insurance companies. If you have insurance and are injured, I believe the insurance company will push for compensation as it reduces what they have to pay out themselves.

Now, I read this somewhere a few years ago, so if anybody can confirm it that would be helpful.

[Jimgward]

The figure at this time would be around £2b a year, with much used until up in legal costs. A staggering figure, none the less, but the notion that nearly 75% of the NHS budget goes in litigation doesn't nothing to help....

The NHS is a wonderful instituion, badly run in many respects and with many problems.

It was designed in the 40's to replace charity-run hospitals, most operated by Churches. Frankly, before that, the Governments were blind to the needs for the health for the general population and it is what annoys me about hospitals being called the "Queen Elizabeth" etc. since royalty played a large part in making no provision for health, care, orphanages etc.

The present NHS, as designed by Bevan, was a world leader. It was a sticking plaster approach to health. When a problem came around, treat it. Nowadays, we need to pro-actively treat wellbeing to prevent problems with health. Care has also become a problem. Increasingly, elderly not looked after by lack of siblings, or lack within their area. We need a care insurance/tax to cope. Many countries pay that, such as Spain (relatively recently) Finland, Germany and many more.

If you has to take a multi-party approach to health and care, then you would redesign it, keep people out of hospitals and largely in their own homes. Full-time care costs around £800 per week, A hospital bed £500 per night. Care in you home, with a few scheduled visits per day, costs around £15 per hour.

In addition, there are digital technologies to not only monitor people's health and wellbeing at home, but tracking them as they leave.... settting off alerts if they fall, leave an area, don't get up out of bed etc. The smart systems can also monitor behaviour and predict problems, they can monitor someone's gait and realsise they are become unsteady (or more so) and this type of digital care is needed on top of social care. However, we would never leave an infant to relatively untrained and little-supervised individuals on minimum wage, often not speaking good English or heavily accented, so why do we do this for people with disabilities, elderly, people with Alzheimer's. We need to make the caring a profession....

Not privatising does not mean not using private companies to fix it. I am such a private company and I believe I can help. Private technologies are what's needed, but not privately run whole scale services. Otherwise, it will be greate for the few and terrible for the many.

That means more money and needs to be a combination of split of the NHS budget, council budget and private funds from a tax on income earners to a care insurance fund. Controversial to some but necessary.

I am obviously passionate about the NHS for a number of reasons. They are my customer and Ive seen the good and bad from both sides of the fence.

70%+ of the NHS is still on windows XP, where support stopped 2 1/2 years ago. No wonder problems with attacks happened.

The country needs a large debate on the future, cross-party and with eyes wide open and transparent.

It should NOT be about how we can privatise elements of it. When that happens, the less attractive parts, like Mental Health, Care, Cancer, long-term conditions will suffer as the poor relations. We take away the parts attractive to private companies and we leave the unattractive parts, unable to be sustained. Like a postal service across the UK, we can't split it regionally, otherwise a letter to rural Wales will cost £5.

There is much wrong and lots good about the NHS and don't kid yourself that politicians want it fixed. Almost every cabinet minister is involved with private healthcare companies. Theresa May herself, unprompted within her meeting with Trump., invited US companies to come and talk about Health.

Selling off parts wont solve the problem for all. That needs dedicate and passionate people, invested in a proper future for health and care. Stripping the NHS will kill Britain and turns us into another US, selfish, uncaring and with some people dying of the simplest problems.

[Royal]

Excellent post Jimgward,

I agree with everything you said. The only thing that I would add is that I believe the NHS should not be providing any free service which is a lifestyle choice rather than a medical problem. This includes breast enhancement/reduction, IVF and vasectomies amongst others.

[Devil]

The present NHS, as designed by Bevan, was a world leader.

The designer was William Beveridge. It was implemented, with modifications (less regionalisation), by the Labour Government under Attlee in 1948. It was opposed by Ernest Bevin but Aneurin Bevan was Minister of Health and his National Health Service Act 1946 took 2 further years of wrangling before it was promulgated to become the NHS. The present NHS bears no resemblance to the Beveridge Plan, the 1946 Act or the 1948 infant NHS.

[Rita Sherry]

Devil

You beat me to it. Lest there be any doubt Lord Beveridge was a Liberal.

That being said your last detailed post Jimgward contains some excellent views particularly for a cross party committee or otherwise to look into the whole area and I myself have said this before in several posts. Ann Widdecombe has also been an avid supporter of such a move for years rather than leave the question of reform to the two party machine. Something will really have to be done as clearly the present format is unsustainable and suggestions of making the "rich" pay more in taxes will only lead to more in the so called middle footing the bill as usual.

Rita

[Pete G]

Part of the problem with claims stems from insurance companies. If you have insurance and are injured, I believe the insurance company will push for compensation as it reduces what they have to pay out themselves.

Now, I read this somewhere a few years ago, so if anybody can confirm it that would be helpful.

Yes, sort of. It's more like if you are injured due to someone's negligence and it falls within the insurance companies parameters for payment then they will pay out, as is the claimants due.

At that moment they have effectively suffered a loss [the money they paid you] as a result of the negligence of another party, and even though the negligent party did not owe a direct duty of care to the insurance company, as they have indemnified the claimant, that duty is transferred to them from the party who committed the negligence, and therefore they can effectively sue them as if they were the claimant. This is obviously important in the case where the damages involves potentially unlimited ongoing care, where the insuring company will need to get relief for any provisional or periodical payments they are obliged to make to the original claimant [against which, hopefully, they will have insured themselves].

This is not the central concern of the NHS's insurers of course [for those elements independently insured] or their own lawyers. Injuries can often have multiple causes, and multiple people responsible, but the main concern of the court is that restitution is made to the claimant. The claimant obviously seeks damages from the defendant with the deepest pockets [as is his right] usually the NHS [i.e. the Government] . If this happens then the NHS will seek to partially indemnify itself against this payment, either directly, by subsequently suing the other responsible parties to cover a fair proportion of their loss, or by insurance, in which case the insurers will do the same

[Dominic]

Excellent post Jimgward,

I agree with everything you said. The only thing that I would add is that I believe the NHS should not be providing any free service which is a lifestyle choice rather than a medical problem. This includes breast enhancement/reduction, IVF and vasectomies amongst others.

I wouldn't restrict vasectomies. Unwanted pregnancies would be more of a drain on the NHS in the long run.

[Dominic]

Yes, sort of.

...

Thank you for the explanation.

[Pete G]

The NHS problems will never be solved as long as a majority of voters in the UK treat it as a religious experience rather than a government service.

Anybody who actually thinks that the NHS' problems can be solved by continually throwing money at it is clearly a few bandages short of a first aid kit, and it is as if the entire sane portion of the electorate [i.e. excluding Momentum supporters, obvs], fully realise this but either consider it impolite or an act of heresy to mention it. Universal healthcare being, of course, an act of religious devotion.

The Germans and [to our continual shame] EVEN THE FRENCH understand this, and offer a publically funded but privately provided [in the main] service for those who actually need it, directly funded by specific employer and employee contributions, and actively encourage people to make their own independent provision via private health insurance. Therefore their system costs less overall, employs way less people but [and here's the kicker], actually end up spending more per person on those they actually do treat [and therefore offer a better service] than the NHS.

Though to be fair, watching Corbyn explain how he was going to ease pressure on the NHS, by punitively taxing people who have private healthcare [and therefore reduce the pressure on the NHS] has definitely become a candidate for the top 10 comedy routines of 2017