Largest nursing strike in NHS history set to start

[ajohn]

This page has been updated

NHS hospital bed numbers

The number of hospital beds in England has more than halved over the past 30 years. This explainer looks at data on hospital beds, explores the drivers underpinning the changes it shows, and considers whether further reductions to bed numbers are realistic.

www.kingsfund.org.uk

One of the factors it shows is increasing use of the in and out as fast as possible method of keeping fully staffed bed counts as low as possible. That view point influences the reporting.

Read carefully and it indicates that numbers that stay longer are relatively low ~5% and some are super blockers, Nice piece if BBC reporting. Send a camera crew in and listen to talks about patients that could be released but only to care and none is available. Stays in this group are likely to be longer but not always. My mother was a bedblocker for a couple of weeks or so. That's how long it took me to find a place for her. Why was she. Went into hospital and no more can be done to help her. Parkinson's. What a nice name - these evil bedblockers.

The page also mentions reserved beds for private care and also NHS partner costs. Private companies paid by the NHS for various services.

It also points out that some areas handle older more effectively. They have facilities for them. Probably geriatric wings of hospitals. My mom was in one so I do know that people come in and go BACK HOME. Not to care. Many of them. B'ham used to have a rather sizeable geriatric hospital.

There is plenty of talk about % changes in types of beds but fortunately they summarise it,

These need to be fully staffed beds. Covid bed count is lower because staff had to be moved to cope = empty wards.

 

[ajohn]

Compared with France, Germany etc we're a bit low. One interesting one is Ireland. I know they're small, etc, but they pay 2/3rds of what we do as % of GDP. 6.6 vs 10.2%.

% of GDP is not completely relevant. LOL Obscure reasoning from talking to an MP about local parking at shops - we have a lot of shops for a local area. He used to be a counsellor and mentioned that he had thought in the past was that smaller multi story car parks could be built. Not now as they just don't have as much money available as they did. So I wondered why. Best I can come up with.

The governing factor is the tax take and costs of doing things with it. The UK was an entirely different place in the 60;s and 70's and earlier but some changes had arrived and increased 70's onward. What has changed,

Lost a number of larger companies all paying corporation tax and business rates.
I am pretty sure true employment rates were higher. Just about any calibre of school leaver got a job when they left school. That may be a bit B'ham influenced. There has been a huge change in the jobs sphere around here since then.
Many husbands able to support wife and family.

The last one where things have tended to switch round will have an effect on GDP. Usually needed to buy a house or even pay rent in some cases. On house buying just the male income counted. Then 1/2 of the other added. Now all of it. The cost of an essential appears to have increased. Construction etc figures in GDP sums as does what people spend. Just about all money that moves around one way or another.

There are more essentials and desirables. Up goes GDP.
Loss of manufacturing GDP and an increase on import GDP.
Council houses even though some few in those given both adults working could buy but didn't.

Company pensions schemes were all rather similar. Worker paid one half, company the other, The state one went SERPS. They then had money to spend when they retired. One of my nans lived on the state one with some help from family and a landlord that stopped charging rent when her husband died. She eventually went into a council flat and later care. No money so state paid. Private care,

Medical costs keep increasing. More can be treated and more rather expensive gear is desirable, Even Boris reckoned more scanners are needed. C4 listed some amazing price increases on some drugs but don't know if they were carefully selected. They were commonly used,

So afraid I don't think comparing the NHS spend with GDP tells all of the story.

 

[JohnD]

Even Boris reckoned more scanners are needed.

You will not be surpised to learn that UK has fewer scanners per million people than comparable nations

And fewer beds

And fewer unoccupied beds

And invests a lower proportion of GDP.

These facts are not unconnected.

"Safe in our hands" my asre.

 

[ajohn]

The figure that left an impression was (something like) the most expensive5% of patients using 80% of the money. So it's not scans and blood tests.
Need to dig some more.

The age relationship to that might be of interest. Two reasons. Age can rule out some proceedures. Other one bit of a conspiracy theory. A specialised surgeon - nerves talking to my wife before deciding to operate. She said I do think I want you to continue working in the community. It did help her continue to work but why did she say that? It was a procedure that takes hours. Another aspect that can crop up in surgery. Some drugs are extremely expensive.

NICE reading if interested
specifies that a most plausible incremental cost-effectiveness ratio (ICER) of below £100,000 per quality-adjusted life year (QALY) gained for a highly specialised technology is normally considered an effective use of NHS resources. For a most plausible ICER above £100,000 per QALY gained, judgements about the acceptability of the highly specialised technology as an effective use of NHS resources must take account of the size of the incremental therapeutic improvement.

4 Consideration of the evidence | Odevixibat for treating progressive familial intrahepatic cholestasis | Guidance | NICE

www.nice.org.uk

Odevixibat is available as a pack of 30 capsules. The cost per pack of 200 microgram capsules is £3,085, per pack of 400 microgram capsules is £6,170, per pack of 600 microgram capsules is £9,255 and per pack of 1,200 microgram capsules is £18,510 (excluding VAT; company's evidence submission). The company has a commercial arrangement. This makes odevixibat available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.

The NHS is in a good position to negotiate discounts, Upsets the USA. Does this cost aspect figure in GDP?

 

[Notch7]

Brexit, one of the reasons for NHS failure

 

[ajohn]

Sunak on independent pay rise settlement. As I had picked out from the news. Based on forecast inflation but he added what we can afford.
They have been dictated for a while as some other areas have. Under fund for a while and then increase more without accounting for that fact.

Seems 1/3 of families are on benefits. Off topic though.

 

[JohnD]

If there was something he wanted to do, he could "afford" it.

Nobody said "can't afford" to pay Baroness Mone's buddies £200million for PPE that was not fit fir puroose

Even though £60million of it ended up in the greasy palms of her and her family. Or should I say, in their greasy off-shore accounts.

I can't help thinking they didn't even pay tax on it.

The nurses will pay tax and NI on their pay rise, though.

 

[Nige F]

what happened to the Boris Bus ? How much £ to the NHS after brexit

 

[fillyboy]

what happened to the Boris Bus ? How much £ to the NHS after brexit

About £400 million a week extra.

 

[ajohn]

About £400 million a week extra.

The department of health and etc spend in a number of areas,. Provide a break down of where it went also % of total budget for each.

 

[Old Salt]

The NHS is a bottomless pit it needs a total overhaul that wont be achieved by nurses going on strike. They need to find some breathing space by making nurses training free with some form of legally binding pay back period such as 5 years on completion of training, 10 years for doctors. Then stop all agency nurses and form their own roster for standby in case of illness etc.

Get rid of top heavy management and excess salaries for chief execs.

Stick to one pay award a year as a result of the pay review body recommendations.

Stop cosmetic surgery for all unless as a result of illness,accidents etc.
No ivf for transgender whatevers, one round of ivf for others, any more and you pay.
No sex change operations on the nhs.

I have 2 sons who work in the health sector so I have some knowledge of the issues but dont profess to know all the in’s and out’s.

As an ex serviceman I do not support strike action where the people providing some form of emergency stand in alternative are paid less than those taking strike action.

If you don't like the t&c’s go and work somewhere else.

I also think we should charge something for a GP appointment and emergency ambulance to cut out the time wasters and those who cant find their house keys after a night on the p*ss.

My ‘tuppenorth, over and out

 

[JohnD]

The NHS is a bottomless pit ...

Get rid of...

If you seriously wanted to cut spending you'd get rid of the ageing population, whose increasingly long list of ailments and care needs cost far more than people of working age

Johnson and Hancock had a go at thinning out the numbers by sending infected Covid patients back to care homes where they could seed the pandemic among more older, frail, vulnerable people.

Is that what you really want to do?

If not, you have to accept that our public services have been starved of resource and given greater loads, and that you need to improve services, and pay the cost.

Alternatively, you might say the nation "can't afford" the Triple Lock for pensioners, in tbe same way it "can't afford" to prevent Essential Workers getting poorer every year by holding their wages below inflation.

 

[carmanmemoranda]

The NHS is a bottomless pit it needs a total overhaul that wont be achieved by nurses going on strike. They need to find some breathing space by making nurses training free with some form of legally binding pay back period such as 5 years on completion of training, 10 years for doctors. Then stop all agency nurses and form their own roster for standby in case of illness etc.

Get rid of top heavy management and excess salaries for chief execs.

Stick to one pay award a year as a result of the pay review body recommendations.

Stop cosmetic surgery for all unless as a result of illness,accidents etc.
No ivf for transgender whatevers, one round of ivf for others, any more and you pay.
No sex change operations on the nhs.

I have 2 sons who work in the health sector so I have some knowledge of the issues but dont profess to know all the in’s and out’s.

As an ex serviceman I do not support strike action where the people providing some form of emergency stand in alternative are paid less than those taking strike action.

If you don't like the t&c’s go and work somewhere else.

I also think we should charge something for a GP appointment and emergency ambulance to cut out the time wasters and those who cant find their house keys after a night on the p*ss.

My ‘tuppenorth, over and out

I have highlighted the only part of your post that I can agree with.

Some of the other points need some discussions and limitations, but not an outright refusal.

But the majority, certainly the last half of your post, is just wrong. There should not even be a need for the services to provide cover. Realistic talks 1st would be a better approach.

 

[ajohn]

If you don't like the t&c’s go and work somewhere else.

They are.

 

[ajohn]

There should not even be a need for the services to provide cover

It can be economic in busy periods so even that isn't so simple. 3 or 4 months of bank nurse usage in winter costs less than 12 of permanent staff, Fine bit the problem is that they are understaffed all of the time.

I loved the time taken to pay back tuition fees etc post - it takes a long time and a % comes out of salary. At a commercial interest rate according to Cameron on the subject.