Pot hole and other bike accidents

mark1a wrote:

Here's a question that has not been answered - the OP says that the paramedic thought to retrieve a Garmin Edge 830 from the damaged bike. Did she stop and save the current ride activity, and make sure it went to Strava?

If she didn't keep it running so that they could pick up some KOMs on the ambulance ride to the hospital, I would give the customer service a 3/10 at best.

Well said.

It's interesting that the OP automatically assumed that the reason for the good care they received was more funds rather than more efficient use of funds.

If we're going to have to put up with this cycling website being hijacked by the right's new hobby of blaming NHS bureaucracy, could we at least be honest about the healthcare systems we are comparing it with please? In Italy for all but the very poorest any visit to a hospital consultant costs around 40 Euros and if diagnostic tests etc are undertaken the patient pays more. 

Also worth noting that both fewer drugs and fewer long term conditions are covered by the Italian Health service. 

Since we're playing Healthcare Top Trumps it's worth reminding everyone how the NHS was doing before the Tories fucked it and social care over. 
 

What's the source for that? Edit: Commonwealth Fund report 2017.

Would be interesting to compare actual health outcomes. Edit. NHS health outcomes 10th out of 11. One example of poor outcomes given below.

IIRC the NHS has performed consistently poorly on that metric for decades.

I know you love a sealion but the sources are literally written at the foot of the table.

Although very noticable the country we should be emulating according to the right were below us by a considerable margin in 2014. Also isn't it 9th out of 11th for the table you used. 

Overall 10th out of 11. On the particular metric in that graph we were at the giddy heights of 9th.

The very tired argument against fundamental NHS reform is to compare us to the US. Realistically universal healthcare is politically non negotiable in the UK so we will never go for the US model. It's simply disingenuous to imply that the 'right want us to emulate' the US model when no significant political party is calling for anything of the sort.

There are many countries that have universal healthcare and achieve far better outcomes than we do, ie more people survive cancer/heart attacks/strokes, they do this on similar budgets to ours.

Why on earth shouldn't we try to emulate those models instead of persisting with a model that has consistently failed to deliver good health outcomes regardless of the party in power?

Wes Streeting appears to be edging us towards that conversation so it may well be that Labour spearhead that movement. That would be welcome and, simultaneously, quite amusing.

So what's really quite amusing, and I'll reshare it as you might delete it as you have done in the past when you've accidentally shared statistics that don't favour your case, is that your chart there shows we have a higher health system performance than Germany, France, Sweden, Switzerland and Canada, of all whom have higher health care spending than us. The only country on that chart that has lower health care spending than us but higher health system performance is Australia. Hope the NHS will be able to get you treatment for that self-inflicted gunshot wound to your own foot.

To be pedantic - NL appears significantly "better" for the same money. I probably shouldn't say that though as I don't want to be a total fanboy for them... oh, wait, their Christmas is possibly racist. Have that, NL!

https://www.opensocietyfoundations.org/voices/parliament-debates-ending-...

To my eye their dot looks slightly to the right of ours on the spending axis, but happy to cede that, making the UK third best of eleven on the performance vs spending comparison, rather than the worst of anyone bar the US as rcb is trying to claim.

The main point I've been trying to make is that Health Outcomes are much better in other countries which spend a similar amount to us.

The graph you were discussing relates to the Commonwealth Fund's own ranking relative to spending.

If you look at the spending axis of that graph and compare it to the attached graph my point should become pretty clear.

Quote:

Avoidable mortality was not intended to serve as a definitive source of evidence of differences in effectiveness of healthcare systems. While a specific condition can be considered avoidable, this does not mean that every death from that condition could be averted. This is because factors such as lifestyle, age, disease progression at diagnosis and potential existence of other medical conditions are not considered. Instead, this measure was designed to highlight areas of potential weaknesses in healthcare that could benefit from further in-depth investigation. Therefore, a degree of caution is recommended when interpreting the data.

(I've marked in bold some bits about using that stat, and italicised the bit you might be using it for).

I know my nan could have lived longer if she had decided to tell her GP or even her family she had bad stomach pains. However she was afraid of hospitals so when she did end up there, the twisted intestine (volvulvus) had burst and atrophied due to lack of blood so not much could have been done. I'm guessing that probably comes under Avoidable Mortality. I'm mentioning it as I'm sure as a population, too many of us decide to "soldier through" issues instead of going to a GP etc compared to other countries.

I would also point out that we are one of the highest in europe for obesity which might have a knock on to some preventable deaths, although I'm sure Europe beats us in other high risk activities. 

Firstly, I'm sorry to hear about your nan and I agree that culturally we, in the UK, probably don't engage with healthcare as much as we should.

How much of that is due to messaging like 'Protect the NHS' is hard to know but I don't think it helps.

Secondly, no measure of health outcomes is perfect but if you look at most measures of health service outcomes the NHS performs very poorly compared to our peers. This is true even when compared to systems that spend less than we do.

The Commonwealth Fund tries to aggregate the different measures of Outcomes together and, whilst this is not perfect either, the NHS tends to rank bottom or near bottom out of those systems that have universal health care.

If we could emulate Australia, New Zealand or The Netherlands we could save thousands of lives per year without spending any more.

All other countries in the ranking have a mix of private and public health provision yet in the UK private health care is vilified. See Sunak and Starmer's recent exchanges as an example.

If we want to see an improvement in our health service we need to look at those countries which are significantly outperforming and emulate their systems.

That means a far greater role for the private sector.

Rich_cb wrote:

If we want to see an improvement in our health service we need to look at those countries which are significantly outperforming and emulate their systems.

That means a far greater role for the private sector.

Ah, privatisation! That wonderful treatment that has worked miracles with our energy supplies, water and sewage treatment systems, trains, bus services, social housing, care sector and more... at least it has for the fat cat shareholder. But not for the staff, the end users or the country as a whole.

Perhaps instead of merely trying to emulate another country's apparent performance, however you care to measure it, we look at what can be improved. The increasing use of agency staff, for instance. Instead of consultants and privatisation hawks we ask people who work/have worked in the system. It's an old-fashioned idea but one that invariably works better than being ripped off by snakes in suits who borrow your watch to tell you the time.

Simon E wrote:

Ah, privatisation! That wonderful treatment that has worked miracles with our energy supplies, water and sewage treatment systems, trains, bus services, social housing, care sector and more... at least it has for the fat cat shareholder. But not for the staff, the end users or the country as a whole.

Perhaps instead of merely trying to emulate another country's apparent performance, however you care to measure it, we look at what can be improved. The increasing use of agency staff, for instance. Instead of consultants and privatisation hawks we ask people who work/have worked in the system. It's an old-fashioned idea but one that invariably works better than being ripped off by snakes in suits who borrow your watch to tell you the time.

I'd consider the staffing/agency staff problem should be given a higher priority to fix as it's surely a huge waste of money. The NHS has been hit very hard with a combination of COVID burn-out of staff and also the Brexit shenanigans (a sizable proportion of NHS employees were from other countries), so in order to provide their mandated staffing levels, they have to pay for expensive agency staff. That money is essentially wasted as ideally the staff would be compensated sufficiently that there's a big enough pool of employees to draw from, but why would people want to work for the NHS when they're not being paid enough? (For the record, Mrs HawkinsPeter is an NHS employee).

hawkinspeter wrote:

.. but why would people want to work for the NHS when they're not being paid enough?

As a communist shurely that is simple - people should be inspired by the cause, Comrade! Perhaps your communism is misdirecting you though - after all under capitalism the idea is to motivate lower-wage workers by paying them *less*! (You just need to increase the competition / make them more easily replaceable).

I'd argue that the inflexible, one size fits all, NHS staffing contracts are to blame for the agency staff issue.

Staff who want to work flexibly cannot do so easily within an NHS contract. If you want flexibility or to.fit work around childcare an agency is your best bet.

It's also worth noting that agency staff aren't entitled to an NHS pension so the NHS saves the 20% employer contribution which goes some way to mitigating the additional costs of the agency staff.

As a final note, in my experience, very few NHS staff are from the EU (excluding Ireland), most staff who trained abroad are from India, Pakistan and the Philippines.

Given the huge number of steps required to recruit somebody who qualified abroad whether EU or non-EU (I was recently told it costs £15000 per nurse) I doubt Brexit will have any significant impact on recruitment.

Rich_cb wrote:

I'd argue that the inflexible, one size fits all, NHS staffing contracts are to blame for the agency staff issue. Staff who want to work flexibly cannot do so easily within an NHS contract. If you want flexibility or to.fit work around childcare an agency is your best bet. It's also worth noting that agency staff aren't entitled to an NHS pension so the NHS saves the 20% employer contribution which goes some way to mitigating the additional costs of the agency staff. As a final note, in my experience, very few NHS staff are from the EU (excluding Ireland), most staff who trained abroad are from India, Pakistan and the Philippines. Given the huge number of steps required to recruit somebody who qualified abroad whether EU or non-EU (I was recently told it costs £15000 per nurse) I doubt Brexit will have any significant impact on recruitment.

There's a nice graph available here: https://www.theguardian.com/society/2022/nov/27/brexit-worsened-shortage-nhs-doctors-eu

Also a study reported on here: https://www.nursinginpractice.com/community-nursing/nhs-staff-crisis-most-pressing-concern-post-brexit-report-finds/

Don't believe the guardian report. They commissioned a report to find the results they wanted.

In reality there's been barely any change in EU staff numbers. There has been a big increase in non-EU staff which is not surprising as Brexit removes any requisite to favour EU staff. EU applicants now have to compete with applicants from all over the world and, as you would expect, this has led to more recruitment from outside the EU and a commensurate drop in EU recruitment.

Post Brexit we're recruiting more foreign trained staff not less.

Rich_cb wrote:

Don't believe the guardian report. They commissioned a report to find the results they wanted.

The report is from Nuffield Trust: https://www.nuffieldtrust.org.uk/news-item/has-brexit-affected-the-uk-s-medical-workforce

Commissioned by the guardian.

EU applicants have to compete with global applicants post brexit.

The decrease in EU recruitment merely reflects this added competition.

Rich_cb wrote:

Commissioned by the guardian. EU applicants have to compete with global applicants post brexit. The decrease in EU recruitment merely reflects this added competition.

So you think that Nuffield Trust have misrepresented the numbers and/or are lying? Just because an organisation asks a question, it doesn't mean that the answer is necessarily compromised.

It seems fairly obvious to me that introducing extra paperwork and hurdles for EU staff is going to reduce that number. Whether or not those numbers can equally well be replaced from elsewhere is another question and it certainly appears that the NHS is facing staff shortages despite what you claim.

No I think the guardian asked them to look at a very narrow question. They answered this narrow question honestly but given the narrow remit the answer is itself misleading.

The guardian knew this would be the case and they spun the report into an attack article.

The reality is that EU applicants used to be able to apply for NHS jobs as soon as they were advertised. They only had to compete with UK applicants. Now EU applicants are only invited to apply if there are no suitable UK applicants and then they have to compete with the rest of the world.

They are now subject to increased competition and they aren't always succeeding against the increased competition as the numbers clearly show.

The NHS now has access to a wider pool of potential candidates and the best applicants seem to increasingly be from Asia and Africa rather than Europe.

Ironically, in other circumstances I'm sure the Guardian would be applauding merit based appointments leading to increased diversity in the workforce.

Rich_cb wrote:

As a final note, in my experience, very few NHS staff are from the EU (excluding Ireland), most staff who trained abroad are from India, Pakistan and the Philippines.

5.3% of NHS staff are EU nationals (71,000 people) and 7.3% are nationals of Asian countries. "In my experience" meaning "what I want to see that supports what I want to believe."

The NHS is the worst performing universal healthcare system in terms of healthcare outcomes. To put it simply if you get ill here you're far less likely to be successfully treated.

Instead of trying to emulate the best performing systems you suggest we try a few tweaks here and there.

The NHS model has failed. No other advanced country uses it for very good reason. It simply doesn't work. Our health care outcomes have been awful for decades regardless of the political party in power.

Let's try a model that does work.