Archive for the ‘NHS’ Category


Monday, February 12th, 2018

A Royal Commission for the NHS would be totally unnecessary since the man on the Clapham omnibus could tell you what is wrong. There is plenty right with the NHS too but the failures are evident for all to see and have been reiterated by health chiefs, doctors and in the press for months and years. No single policy will work. It has to be a mighty effort from all departments as the health of the nation is inextricably linked to housing, education and the environment, to name but three.

To take the pressure off hospitals the model neds to shift towards preventative rather than reactive medicine. Public health  initiatives are needed such as dealing with cheap alcohol and binge drinking, forcing manufacturers to reduce sugar in their products, restricting sale of such products in schools and hospital and so on. The school day should be lengthened to provide time for games, gym and gardening, all once on the curriculum when Britain was leaner and fitter. The mental health of the nation is linked to a speeded up world, poor housing and general deprivation in many quarters. The differential between the earnings of CEOs and the ordinary worker highlight this. A connection cannot be denied.

In addition there needs to be a big recruitment drive for home grown nurses, doctors and mid-wives, whilst simultaneously improving the working conditions in hospitals and surgeries. The shift patterns need changing. Working for more than eight hours at a stretch is paying for poor practise and endangers the health of the work-force. The current working patterns lead to burn out and wastage. The rise in use of locums has been a consequence of deteriorating working conditions. Full time is unendurable, working as a locum part-time you have a better quality of life and earn the same.  However constantly changing personal, (churn), is very bad for patients. Good departments take years to build up.

IT systems need upgrading, clerical departments should be far less amateurish and ad hoc, the system of radiographer taking pictures then the weeks of waiting for the consultant to read them plus further waiting for them to go back to the GP, (the NHS is full of this nonsense) need to be streamlined in this day of instant technology. There should be less hierarchy, and more teamwork.

Hospitals should be encouraged to spread best practise sharing expertise; competition has not worked. Currently doctors and nurses often don’t know their own colleagues, let alone those on a floor below. Good food in hospitals for both staff and patients and statutory breaks should be the norm. The Dilnot report should be implemented for care for the elderly freeing up beds, (what was the point of commissioning this report for it to be kicked into the long grass?).

I could go on stating the obvious. It is a fact of life that any government in this country stands or falls by the NHS. These changes will be costly but I do not think there is a member of the electorate who would not want to pay for this radical programme of modernisation if they knew the money would be ring-fenced. Theresa May cannot avoid witnessing the demise of the NHS: it is crumbling in front of her very eyes. This is not the time to be lily-livered. If she shows moral courage and mobilizes her troops in cabinet she will not only save the NHS but herself and the current Conservative administration.

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Overweight nurses and stressed doctors

Monday, February 12th, 2018

The issue of overweight nurses and the fact they differ from doctors who apparently lose weight under the stress (not always!) is missing the point, (Letters Dec 6). Besides the fact that nurses are often older and have domestic responsibilities meaning they cannot go out for a run after a long shift, the fact is that the conditions for almost anyone in a NHS hospital are dire and everyone is stressed and overworked. The shift patterns are appalling. Nobody should be working more than eight hours at a stretch; it is deliberately paying for poor performance. There is no slack in the system; in a an emergency nurses having already worked twelve hours cannot be expected to stay on longer and there is no handover time.

By creating these conditions, recruitment is down and staff are not retained; there is far too much churn. Good departments are created over months and years and need stability of personnel on whom they can rely. Many doctors and nurses prefer to work for an agency or as locums to get a better work-life balance. This is expensive and not in the interests of hard-pressed departments and patients.

There are many changes required in the NHS but shift patterns are the first thing that should be radically improved. No patient wants to be seen by an exhausted doctor or nurse at the end of an unreasonably long shift. It is not surprising that nurses reach for a chocolate bar as a quick energy boost to get them through the last two hours of an overlong day or night.

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