Senior Brexiteer Dan Hannan admits leaving EU is not quite going to plan

[Firefly]

Lloyd

"Countless news items" where exactly ? I have not yet seen one.

[Firefly]

Oh dear, more doom and gloom. Never mind Lloyd, you won't be here when all our hospitals close, and the NHS falls apart. So for Heaven's sake cheer up.

I Still stand by my belief that the root of the problem is lack of funds, together with too many chiefs and not enough Indians. Let's ask British nurses what their opinion is, but then we don't want the truth, we just want to blame Brexit. Nurses have in effect had a cut in salaries year on year, then people wonder why British women are choosing a different career. My daughter is a senior midwife employed in the NHS, and I know she doesn't think Brexit is to blame for the NHS Crisis.

Jackie

[Dominic]

Abolish the triple lock on pensions. That would free up plenty of money for the nurses.

[Dominic]

That would be a great speech if anybody had actually blamed Brexit for the woes of the NHS.

There are staff shortages caused by EU nurses going back to their own countries. That is a fact. If you try to deny that fact, then fair enough. But it is a fact nonetheless.

However, the underfunding or otherwise of the NHS is a separate issue.

[tonee]

wow,abolish the triple lock for pensioners whilst sending 0.7% GDP to half the countries around the world,why not go the whole hog and abolish pensions altogether!Perhaps bring the workhouses back.

[Firefly]

Not necessary Tonee, they will have the men fruit picking, and the women nursing

Jackie

[kingfisher]

Jackie, "gender stereotyping"......tut tut!
Next thing the men will want equal pay. Whatever next....

Jon.

[jeba]

wow,abolish the triple lock for pensioners

That would indeed be reasonable. Why should pensions rise faster than wages?

[Jimgward]

It really is an over implication to blame BREXIT for the woes of the NHS and to be honest a cop out....and throwing money at the "Beast" is not the answer either...It needs a root and branch reorganisation to prioritise its workforce and a fundamental review of actually what it is there for...and I would suggest that there are a number of procedures that fall outside of what many would consider the remit of the NHS. I also believe that the RCN over the years has managed, through its instance on degree level education, to effectively exclude a huge number of "home grown" resource who would make perfectly good nursing staff..without having to resort to poaching from abroad...NHS staff, like all public sector workers have suffered over the recent past due to effectively freezes on pay...although the recent pay award for NHS staff has seen significant increases...and more could be done, but I do believe a lot of additional money could come from within, some instances of waste, poor logistics and management have been scandalous. And of course Health Tourism, from both within and outside of the EU puts additional strain on the service. BREXIT has become a convienient parking place for all of the countries woes....an easy way out of facing up to responsibilities and pointing the finger anywhere but at yourself....

While as Dominic said, this diverts from the main point, I agree with much of what you’ve said, except;

“The recent pay award” - what, 1% extra, to take them to 2% per annum for 3 years, less than inflation and after losing effectively 15% over the past 10 years? - significant increases?

Health tourism, while a fact, is very, very minor.

The changes need to be massive. The NHS was built as a sticking plaster over poverty and ill health.

Today, it needs to be an anticipatory wellbeing service, from life to death and today that includes social care - but mainly caring for people in their homes, rather than hospitals. Community integrated care is the future and it’s being blocked by culture alone.

[trevnhil]

Regarding pensioners payments / benefits.. Maybe they should put them on the basic minimum wage... Yes Please !!!

[Firefly]

Jim

Health tourism may well be very minor, but a huge influx of immigrants to the UK, many non English speaking, has put a great strain on the NHS. I know I may well be called a racist for saying that, but I'm not, just speaking the truth, and many people don't like the truth.

Jackie

[Jimgward]

Jim

Health tourism may well be very minor, but a huge influx of immigrants to the UK, many non English speaking, has put a great strain on the NHS. I know I may well be called a racist for saying that, but I'm not, just speaking the truth, and many people don't like the truth.

Jackie

'Deliberate' use of the NHS—use by those who come here specifically to receive free treatment or who come for other reasons but take advantage of the system when they're here—is hard to quantify. It's thought to be very roughly between £110 million and £280 million a year.
'Normal' use of the NHS—by foreign visitors who've ended up being treated while in England—is estimated to cost about £1.8 billion a year.
The majority of these costs aren't currently charged for. Only about £500 million is thought to be recoverable or chargeable at the moment.
Who do you think of when you hear the term 'health tourist'? A Spaniard who breaks a leg while on holiday in the UK? An American travelling here deliberately to use the NHS for free? What about a British expat who comes home every now and then to see their old, trusted GP?

All of them can be seen as 'health tourists' in that they've come from somewhere else and may have received healthcare in the UK for free. But for some the cost of their treatment is recoverable and for others it isn't. Keeping track of these cases is exceptionally difficult and so is working out the cost to the country.

Your statement, Jackie, regarding immigrants, legally here, but struggling with language, does indeed cause a concern to all public sectors. I would, however, defend the right of the country to be diverse, as the UK has boomed on the back of immigration.

AS to the cost;

"The National Health Service is currently catching some flak for the costs of its interpreting and NHS translation services. As the BBC reports, a group called 2020Health made a Freedom of Information request to determine the cost of these services to the NHS, and found that last year’s bill came to over £23m."

So, while you may, locally, hear a lot of 'talk' of the issues caused, the extra cost is more likely to be in resource caused by waiting for translators to help etc. The actual cost is minor.

[jeba]

Wouldn´t the cost of treatment be charged to the EU country the visitor is coming from? At least here in Cyprus my German public health insurance is reimbursing the Cypriot public health service for any treatment I receive. As I understand it that´s an EU-wide rule. Why should that be different in the UK?

[Dominic]

UK hospitals can't be arsed to deal with the paperwork. That's the bottom line, jeba.

[Jimgward]

Dominic’s right. It is not that they cannot claims the money back....

[Jimgward]

I think all would approve that we need to fund the NHS properly (we are one of the lowest per capita costs for an NHS in the Western world)

I also think we should make the system much more efficient.

We also need money diverted from Hospitals to Social Care - to keep people in their now homes, more safely, for longer and to provide a satisfying and health environment for them.

Bed blocking and having 70% of beds occupied by the over 70's isn't doing anyone any good.

[trevnhil]

Here is a serious question.. In the UK are there still District nurses.. and Home Helps ??

[Jimgward]

Community Healthcare is an NHS service, with District Nurses, Midwifes, Physiotherapists and much more. It is a growing service to meet the needs of people in their homes, albeit not enough yet.

Social Care is funded by Councils and they have social workers who assess and assign packages of care, where they have funding available. Most council services in providing care, were hived off as private, not for profit, or charitable organisations and they employ staff on minimum contract, zero hour and with no travel time paid (mostly) In the North of England, the councils pay the Providers around £13 per hour - often for 30 minute and sometimes 15 minute visits. It is therefore almost impossible for a Provider to run a service on these rates, unless they do private work as well. I.e. where service users add to their council provisions with their own money - usually around £18 - £20 per hour.

Residential care costs in the region of £700 - £1200 per week. Again, councils cant fund enough places and there aren’t enough homes to meet demands.

Hospitals in England are now tasked to move 5% of their budgets into social care - usually termed Reablement services, to move patients from bed blocking back to their homes and enable them to live as independently as possible through intense support for short periods of recovery. However, most hospitals resist this intensely, claiming that there is no evidence it works.

Health and Social Care in the UK is combining, Manchester, for example, was the first area to have total autonomous control over all budgets in the area, including health. However, social care provision hasn’t yet inproved as ra†es are the same and providers are declining contracts.

I think we will get it right, in time, but we need to intensely target community and social care over urgent care.

[Firefly]

At present it's all very confusing regarding who cares for whom. A friend who lives near me has recently had to find a care home for her husband, but it has been a roller coaster ride for her, being pushed around from hospitals, social workers, occupational therapists, temporary care homes, husband returned home, even though she is in unable to manage him, she has no nursing experience, but has been expected to care for him, even though he's incontinent. She paid for a carer to help her, but she works herself not being retirement age and has tried to juggle carers with her work hours. She has lost weight and is very stressed.

At last she has managed to find a permanent care home for him, but this has also been a nightmare for her, finding a good one for him. Sadly they are not all of the desired standard. This will cost around £900 a WEEK, and even though they are self funding, their savings won't last forever.

It's a disgrace to say that if you have saved all your life, paid to own your own home, at the end the powers that be will have it all anyway.

Jackie

[Jimgward]

Jackie, I have a great sympathy with your friend. It is indeed an exceptionally stressful tim and unfortunately none of us went to prepare for that eventuality when fit. Care Homes vary greatly and over 25% in England are Inadequate or Require Improvement (CQC statistics from inspections) - leaving 75% OK with few graded as excellent.

As to paying for it, if you have savings of over something like £10k, you pay for it yourself. If you have a pension, it pays towards it. If you have property, a value of that can be reclaimed eventually to pay for the care.

It's why we need a Social Care fund - or huge sums diverted from NHS to social and community care, with Anticipatory monitoring to predict when something might go wrong and intercede before it's too late.

7 days in hospital bed, over 70 age, will age your muscles 10 years. Unless serious reablement occurs, your on a downward spiral.

In Liverpool, the average age of hospital inpatient is 80!

So, the huge outcry over funding the NHS, should also be about properly funding social care.