NHS

[Jay20cali]

Times like these we all realise how much the nhs do and how much we need the nhs .
If we get Poorly in the uk we can ring a doctor or an ambulance ect and take for granted there’s somebody in the nhs who will help,,,

doctors nurses all of them ........Where all sat at home trying to stay safe while these people are going out putting themselves at risk of catching this deadly virus!!!!!!
So much respect for them it puts a lump in my throat....
If any of you good forum members are part of the nhs god bless you all ,you deserve so much respect!
god bless you all....

 

[calikev]

Here Here we are very lucky to have free healthcare in the uk. Respect to All that work in the NHS inc not often mentioned cleaners, porters, testing staff etc you all make us proud

 

[ArunAlec]

Let’s not forget those nurses and others who work in the non NHS sector, Hospices, Care Homes, Macmillan etc. They are all having to treat covid patients.

 

[Wongo]

But it isn't free, its funded by taxation and its been underfunded as people decided to use the money elsewhere.

 

[2into1]

It would be interesting to see if the forum could have a grown up conversation about having a ‘free to use’ nhs that didn’t need to be provided by a single state run organisation, something akin to the equally important NFS (the National Food Service) we enjoy, yet it’s provided by Tesco, Sainsbury’s, Aldi etc.

The ‘free to use’ bit is easily modelled on many administrative systems in Europe.
Can we separate free at the point of need from Centralised and State run?

Imagine what your daily shopping experience would be like if it was provided by a single, state run National Food Service?
Could we still have health worker hero’s in such a system?
Has the decentralised, market led actual NFS been quicker to adapt to Covid?

 

[Velma's Dad]

It would be interesting to see if the forum could have a grown up conversation about having a ‘free to use’ nhs that didn’t need to be provided by a single state run organisation, something akin to the equally important NFS (the National Food Service) we enjoy, yet it’s provided by Tesco, Sainsbury’s, Aldi etc.

The ‘free to use’ bit is easily modelled on many administrative systems in Europe.
Can we separate free at the point of need from Centralised and State run?

Imagine what your daily shopping experience would be like if it was provided by a single, state run National Food Service?
Could we still have health worker hero’s in such a system?
Has the decentralised, market led actual NFS been quicker to adapt to Covid?

I also hope the current crisis means we end up taking an objective look at our health system and whether it's right for the future.

There is a wide spectrum of models for national health systems. I used to read (only superficially) the annual reports by the US think-tank The Commonwealth Fund which attempts league tables of health systems on various criteria. https://international.commonwealthfund.org/, although from what I can see they haven't updated much since 2017 which is a shame.

The UK has typically done well in those comparisons, especially for 'joined up care' and cost efficiency (the NHS is VERY cheap) although not in a couple of areas eg cancer treatment.

It's interesting to see how other developed countries do it.

But I'm not sure though that supermarkets is a useful comparison, unless you're contemplating that health services should be paid for as they are consumed. The private sector is 'efficient' because it can use pricing signals to calibrate its resourcing. The US system tries to do that but ends up being massively inefficient because of the insurance model. If we all only needed food in huge (say) £2,000 baskets, and only if we got sick, and hence wanted insurance cover for that, what would the supermarket system look like?

 

[2into1]

unless you're contemplating that health services should be paid for as they are consumed.

I tried to make it very clear that I wasn’t contemplating that.
It’s part of the test I suggested. Can we separate how something is PROVIDED from how it’s PAID for?

 

[CaliforniaBen]

Instead of HS2 they should put that £100 Billion into NHS, imagine the new hospitals and equipment we could get for that money

 

[Velma's Dad]

I tried to make it very clear that I wasn’t contemplating that.
It’s part of the test I suggested. Can we separate how something is PROVIDED from how it’s PAID for?

A big part of the NHS is of course tax-funded but privately provided, ie much of the primary care sector, GPs practices being private businesses.

(Sorry, not sure what that means in terms of your ponderings 2into1, but, well innit?)

 

[WelshGas]

I don’t believe the NHS per se is inadequately funded, BUT it is expected to do things it was never designed for when first conceived.
1. Infertility Treatment
2. Bariatric Surgery
3. Drug use/overdose
4. Alcohol misuse
5. Sports injuries
6. Transplant surgery
7. Gender re-alignment
To name but a few. These are mostly lifestyle choices and the NHS is left to deal with the fallout.
If the general opinion is that they should be included then Taxes must increase to pay for them or an alternative system devised.

 

[pjm-84]

Do I agree on an NHS. Yes.
Do I agree that it should be properly funded? Yes.
Do I believe that people should take individual responsibility for their own wellbeing / lifestyle choices? Yes.

 

[2into1]

[

GPs practices being private businesses.

Well ‘sort of’. I accept they are private and profit making, but only by comparison with the remaining parts of the nhs. It’s far from free market provision and competition....more like a state administered profit scheme.

Choosing and getting an appointment for a GP was (is still?) a very different experience when I lived in Brussels where it was more akin to choosing a hairdresser.
(I now do my own hair...even before Covid....let’s hope it doesn’t come to that with x rays!).

 

[T6 CFO]

I don’t believe the NHS per se is inadequately funded, BUT it is expected to do things it was never designed for when first conceived.
1. Infertility Treatment
2. Bariatric Surgery
3. Drug use/overdose
4. Alcohol misuse
5. Sports injuries
6. Transplant surgery
7. Gender re-alignment
To name but a few. These are mostly lifestyle choices and the NHS is left to deal with the fallout.
If the general opinion is that they should be included then Taxes must increase to pay for them or an alternative system devised.

Absolutely and as you say that’s just a few things.
I can only imagine the fallout in drawing up a list of those excluded.



Mike

 

[Amarillo]

https://www.facebook.com/video.php?v=2738065119645656

 

[2into1]

https://www.facebook.com/video.php?v=2738065119645656

I’ve only got 44 secs into the video and have stopped. It’s what I mean by a grown up discussion. Do you really think it’s Matt Hancocks’ or Borris’ job to find and deliver PPE to the front line? What about the thousands of NHS procurement and logistics staff who’s very job that is? What about all those NHS managers on £90k who’ve sat in monthly “disaster planning” meetings for years? Does the public look to them now? No, they look to some newly appointed politicians that could easily have seen them replaced with those from other Parties had the election gone the other way.

The people you want to blame Tom have taken all limits off spending. It’s now about how well the 2nd(?) biggest organisation in the world can respond to the crisis.
Believing that Boris, Corbyn, Sturgeon et al can be held responsible is childish (carefully chosen choice).

I know it would all have been different had ‘your people’ been leading us, but show me quotes from even 4 months where those same leaders, or even icu doctors, were telling us to build and distribute stocks of PPE.

As a country we rightly want to celebrate the achievements of the brave staff on the front line, but just look for scapegoats when the less glorified part of the same organisation just can’t respond.

 

[WelshGas]

https://www.facebook.com/video.php?v=2738065119645656

The NHS has it's own Procurement Arm - Nothing to do with the Government. Their comments should be directed in-house to those responsible, and despite your political affiliation, the Government and the Armed Forces are attempting to make up this deficiency . For too long the NHS has promoted the useless up the ladder and now it has come back to roost. The massive increase in in-house ITU capability was down to the nurses and medics thinking outside the box and NOT the managers with bright ideas, likewise the Nightingale Hospitals.
PPE is now all disposable because the managers could then close Hospital Laundries and save a few pence to pay their large salaries, and they went overseas to cheap suppliers and this is the consequence.

 

[Amarillo]

I’ve only got 44 secs into the video and have stopped. It’s what I mean by a grown up discussion. Do you really think it’s Matt Hancocks’ or Borris’ job to find and deliver PPE to the front line? What about the thousands of NHS procurement and logistics staff who’s very job that is? What about all those NHS managers on £90k who’ve sat in monthly “disaster planning” meetings for years? Does the public look to them now? No, they look to some newly appointed politicians that could easily have seen them replaced with those from other Parties had the election gone the other way.

The people you want to blame Tom have taken all limits off spending. It’s now about how well the 2nd(?) biggest organisation in the world can respond to the crisis.
Believing that Boris, Corbyn, Sturgeon et al can be held responsible is childish (carefully chosen choice).

I know it would all have been different had ‘your people’ been leading us, but show me quotes from even 4 months where those same leaders, or even icu doctors, were telling us to build and distribute stocks of PPE.

As a country we rightly want to celebrate the achievements of the brave staff on the front line, but just look for scapegoats when the less glorified part of the same organisation just can’t respond.

It wasn't my video. I was probably as shocked by its content as you - although I did see it out, so maybe not.

I did think it was worth sharing. The thought of a final year medical student preparing to start work early, not knowing if they would be adequately protected was quite humbling. But I agree with you, putting all the blame onto the Government for lack of protection is probably unfair.

I was also quite surprised at the audacity of projecting it onto the Houses of Parliament. It was clearly a political move.

 

[WelshGas]

Most of the PPE comes from China , or Chinese owned companies, is not re - useable and has therefore led to the closure of such manufacturers in the U.K. and Europe.
Is this business practice one we should move away from, in general?
An extract from an article on China’s growing global influence and business practices.


“ My favourite Chinese legend is that of Duke Huan of Qi, who lived in the 7th century BC. To conquer the neighbouring merchant states of Lu and Liang, which specialised in brocade weaving, Huan made brocade his land’s official dress. Lu and Liang stopped making all other things to meet the orders, including grain. One day, the Duke banned brocade clothes, in favour of silk. With no export revenue and no grain to feed their people, Lu and Liang collapsed. The story speaks to CCP’s belief in self-sufficiency, and the vulnerability of those who prize fantasy riches over internal strength. It is a lesson the West must learn fast. “

 

[T6 CFO]

Most of the PPE comes from China , or Chinese owned companies, is not re - useable and has therefore led to the closure of such manufacturers in the U.K. and Europe.
Is this business practice one we should move away from, in general?
An extract from an article on China’s growing global influence and business practices.


“ My favourite Chinese legend is that of Duke Huan of Qi, who lived in the 7th century BC. To conquer the neighbouring merchant states of Lu and Liang, which specialised in brocade weaving, Huan made brocade his land’s official dress. Lu and Liang stopped making all other things to meet the orders, including grain. One day, the Duke banned brocade clothes, in favour of silk. With no export revenue and no grain to feed their people, Lu and Liang collapsed. The story speaks to CCP’s belief in self-sufficiency, and the vulnerability of those who prize fantasy riches over internal strength. It is a lesson the West must learn fast. “

“PPE is coming home” ?

Mike

 

[2into1]

“PPE is coming home” ?

Mike

Accusations of xenophobia will be along shortly...

 

[WelshGas]

Accusations of xenophobia will be along shortly...

Probably.

 

[GrannyJen]

The NHS has it's own Procurement Arm - Nothing to do with the Government. Their comments should be directed in-house to those responsible, and despite your political affiliation, the Government and the Armed Forces are attempting to make up this deficiency . For too long the NHS has promoted the useless up the ladder and now it has come back to roost. The massive increase in in-house ITU capability was down to the nurses and medics thinking outside the box and NOT the managers with bright ideas, likewise the Nightingale Hospitals.
PPE is now all disposable because the managers could then close Hospital Laundries and save a few pence to pay their large salaries, and they went overseas to cheap suppliers and this is the consequence.

This is the same people at PHE who launched the very expensive one-you programme aimed at getting people off their butts. It was so well directed at individuals that for months I received exhortations to commence a couch to 5k programme, and they continued with such exhortations long, long after I sent them a photo of me finishing the London marathon!

This is the same people that 60 years after we stopped giving kids malt in schools still promote the idea that 50nlmol/l is an ideal measurement of vitamin D, long after its importance to the immune system and inflammatory response became well known, at least in sports medicine, and the 75-100 Nmol/l measurement became the standard.

The same people that told me I could no longer contribute my uncommon blood group plasma to the general pool because it might give me migraine, The total nannying of people rather than give people some responsibility for looking after themselves.

I think we have just seen a prime example of Empire building and ivory towers where it almost took dynamite for the NHS mandarins to approach the private sector to increase testing capacity.

Without any evidence and only my internal disquiet with what I have seen over the years I have wondered just how much has been down to slow government reaction and now much has been down to tearing down internal empire walls of the mandarins at the top of the DoH.

 

[WelshGas]

This is the same people at PHE who launched the very expensive one-you programme aimed at getting people off their butts. It was so well directed at individuals that for months I received exhortations to commence a couch to 5k programme, and they continued with such exhortations long, long after I sent them a photo of me finishing the London marathon!

This is the same people that 60 years after we stopped giving kids malt in schools still promote the idea that 50nlmol/l is an ideal measurement of vitamin D, long after its importance to the immune system and inflammatory response became well known, at least in sports medicine, and the 75-100 Nmol/l measurement became the standard.

The same people that told me I could no longer contribute my uncommon blood group plasma to the general pool because it might give me migraine, The total nannying of people rather than give people some responsibility for looking after themselves.

I think we have just seen a prime example of Empire building and ivory towers where it almost took dynamite for the NHS mandarins to approach the private sector to increase testing capacity.

Without any evidence and only my internal disquiet with what I have seen over the years I have wondered just how much has been down to slow government reaction and now much has been down to tearing down internal empire walls of the mandarins at the top of the DoH.

The latter.

 

[Velma's Dad]

This is the same people that 60 years after we stopped giving kids malt in schools still promote the idea that 50nlmol/l is an ideal measurement of vitamin D, long after its importance to the immune system and inflammatory response became well known, at least in sports medicine, and the 75-100 Nmol/l measurement became the standard.

I find this bit of your post particularly interesting. I just heard someone on the radio talking about the BAME deaths anomaly and she, for the first time that I'd heard in a general context, mentioned the issue of low vitamin D in that group, alongside the more highlighted risk factors like incidence of diabetes and hypertension.

On another forum I follow there's a retired molecular biologist whose hobby horse (well it's more like a cracked record) for years has been vitamin D3, and now of course he is all over the issue in relation to Covid.

I'm not in any sense a vitamin tablet popper, actually I tend to be a bit dismissive on stuff like that and I just don't understand any of the detail. But I wondered whether vit D will actually turn out to be a significant factor with Covid and we'll all be advised to start taking the tabs (if they haven't all got panic-bought in bulk).

On checking, I was also surprised to read that PHE has in any case since 2016 advised that all adults "should consider taking a daily supplement containing 10 micrograms of vitamin D in autumn and winter". I'd never realised that. Although I guess if we don't read the advice, that's our fault.

 

[GrannyJen]

I find this bit of your post particularly interesting. I just heard someone on the radio talking about the BAME deaths anomaly and she, for the first time that I'd heard in a general context, mentioned the issue of low vitamin D in that group, alongside the more highlighted risk factors like incidence of diabetes and hypertension.

On another forum I follow there's a retired molecular biologist whose hobby horse (well it's more like a cracked record) for years has been vitamin D3, and now of course he is all over the issue in relation to Covid.

I'm not in any sense a vitamin tablet popper, actually I tend to be a bit dismissive on stuff like that and I just don't understand any of the detail. But I wondered whether vit D will actually turn out to be a significant factor with Covid and we'll all be advised to start taking the tabs (if they haven't all got panic-bought in bulk).

On checking, I was also surprised to read that PHE has in any case since 2016 advised that all adults "should consider taking a daily supplement containing 10 micrograms of vitamin D in autumn and winter". I'd never realised that. Although I guess if we don't read the advice, that's our fault.

I am sure that many of the eminent health professionals on this forum would correct me if wrong but I believe that VitD is the only vitamin transported to every cell in the body.

Being fat soluble, unlike other vitamins that are water soluble, it does not need to be replenished daily as it is stored and the range between "adequate" and "toxicity" is massive .... from 50 Nmol/L to 220 Nmol/L so taking supplements, especially in winter time when the sun's rays are not long enough to produce VitD in the skin, is really quite a safe procedure.

Vitamin D is currently being researched for it's role in controlling the inflammatory processes in respiratory conditions. The research studies using COPD patients to research VitD reactions and efficacy is a very busy sector.

It's role in controlling inflammatory conditions in sports has been known for a long time. In 2016 after suffering with a nagging muscular/ligament problem in my legs I was told to increase my blood levels to 100 Nmol/L. No problems since.

I have just finished a trial (as a healthy volunteer) with University of Glasgow Medical school examining the possible role of VitD in Sarcopenia, this time looking at krill oil as a dietary source and astaxanthin as a unique anti-oxidant.

I measure my VitD levels every three months. This allows me to calculate what my consumption is and how much in supplements I need to take to maintain 100Nmol/L. (my last measurement, sample taken on 2nd April was 100.7)

10 micrograms recommended by PHE is equivalent to 400 micro units. How useful that advice is can be illuminated by the fact my calculated daily consumption is 2,000 micro units. Admittedly I do more impact exercise than most but according to WHO estimates around 50% of the population in the northern latitudes are VitD deficient in winter time (between October to March). The recommendation elsewhere other than PHE is for 1,000 micro-units supplements. The 10 micro gram measurement dates back to when we were given cod liver oil in school to prevent rickets, 10 microgram being roughly how much VitD is contained in a tea spoon.