I am thoroughly tired of politicians all vying with each other to chuck more money at the health service, when what they really need todo is to get inside it and look for solutions there. So here are my own ideas (and I've spent most of my life working in the health service):
1. Missed appointments. Everyone should be asked to pay a reasonable registration fee (say £10. Maybe less for a whole family) to register with a GP. If they missed two appointments, either with their own doctor or a hospital, they would have to re-register (and pay again).
2. Prescription charges. I know from visiting elderly patients in their own homes that many hoard their drugs when they are free. I have seen cupboards full of unused drugs and dressings, destined never to be used, because after all, they were free, so the patient had nothing to lose. The majority of patients are entitled to free prescriptions, so this is a huge problem. If all those entitled to free prescriptions had to pay just a token fee - say £1 - per prescription, then people might think twice before reordering their medicines, and the NHS drug bill would be vastly reduced.
3. If we have to have graduate nurses (it costs £20,000 to train a nurse, whereas time was when nurses earned their passage from the beginning of their training), then at least lets bring back the wonderful State Enrolled Nurses. These, as before, could be trained on the wards as they worked, and would go on to form a valuable part of the ward team. At a time when as much as £1800 a day has been paid for an agency nurse, something needs to be done. Ed Milliband has promised an extra 20,000 nurses if his party get in next year. Yeah, right, Ed. And how exactly to you propose to raise the money?
None of these ideas would be popular, but then cuts in other services and tax increases aren't exactly welcome, either. And we have to do something...don't we?
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I think your sums are too small. A registration fee could be far higher, as could a basic prescription charge. My problem with graduate nurses was that if someone had the right university entrance qualifications, why not study medicine rather than nursing?
ReplyDeleteRegistration fees should have to be affordable, and I think charging for prescriptions wouldn't make money so much as save money. People value what they have to pay for!
DeletePS Cro, nursing and medicine are two very different professions, and in being a nurse, I never considered myself second best to the doctors.as for degrees, they ARE NOT necessary in nursing (in my opinion)! Nursing is a practical profession, and most it if cant be learned in the classroom (that's my soapbox finished with for the day...)
DeleteArtisans are what nurses are. It's an apprenticeship job. Look at the 'inspired' art from Art Schools and look at Constable he was an apprentice and learned his craft.
DeleteMost decorators can apply paint better than art school graduates. Scupture is a medium I enjoy. I'm not without taste or an opinion.
You are better qualified than I am to find a solution. I am an infrequent customer and can only say that nurses and all the staff have done a pretty good job when putting me back together.
ReplyDeleteI can see why they have graduate nurses as some of the equipment I have been plumbed into looked both expensive and complicated.
Adrian, trust me. You don't have to be a graduate to work the equipment. It actually makes the job easier.
DeleteFrances, I am used to complicated and the wee thingy that went into my back was brilliant. A high on demand but if I have one complaint about nurses it's that the one I had was a spoilsport and shut the thingymy down. She said you are abusing the system. I thought they were abusing me I had a big pipe through my mouth into my left lung. An awful job. It went on for a week or more. Sucking and blowing fit to bust it was. Worth it for me. I'm still here.
DeleteThis was in the Azores and the Portuguese flew a couple of English speaking nurses out. Not that I could say much with that bloody great pipe down my throat.
When I worked on the wards (okay it was over half a century ago!!) we were trained on the job but the hospital was also an educational establishment with the nurses homes and a full academic wing with teaching staff where nurses went for three months at a time as they reached each level of qualification and fought their way through the ranks. I thought it was a superb system. It wasn't, however, a cheap system.
ReplyDeleteI totally agree with you that there should be a penalty for non-attendance. I cannot believe just how many appointments are missed each month. In our practice alone it's in the 100s.
Graham, I am the same generation as you, and while I'm sure our training did cost something,at least we spent most of our time actually working as part of the ward staff
DeleteLots of sound suggestions there, Frances - can you not send them out to the relevant person/people? I'm sure you're right about all those free medicines lying unused.
ReplyDeleteI don't suppose anyone would take any notice, Rosemary!
DeleteTotally agree with you Frances. I also think there should be more preventative medicine. I recently broke my femur and consequently discovered that I have osteoporosis. This is so common in older women that there should be some screening after the menopause. Why wait until you break a bone? The ward was full of elderly women with broken hips and legs, some of whom will never recover fully and will cost the NHS even more money. I'm glad I broke mine in my 60s and not my 80s, so at least I know what to be wary of.
ReplyDeleteGood point, Maggie.
DeleteI certainly agree with the elderly " stockpiling" in their own homes. My mother ( and father in law) used to have their medications and incontinence pads on regular order, and they just kept coming regardless of whether or not they needed more, and both used to have boxes and boxes of " movicol" for instance as they never took it!! My Mum preferred Sennacot, which I bought for her! When she died there were lots of pads etc, but apparently they couldn't be taken away to be used elsewhere. Cant remember the reason now.(they were in sealed packets) Mum was in no fit state to stop things arriving, and I had more important things to worry about regarding her care etc and didn't live nearby either, which might have helped!
ReplyDeleteA financial penalty for a missed appointment sounds like a good idea. Even calling to cancel a few hours beforehand would allow someone else the chance to see the doctor.
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