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Thread: A&E and ambulance performance worst ever - again

  1. #26

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by SLUDGE FACTORY View Post
    And there are not massive structural issues in England ?

    I think you will find its absolutely on its arse there too
    Yes, there are. The difference is people don't deny it!

  2. #27

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by JamesWales View Post
    Yes, there are. The difference is people don't deny it!
    Who has denied it?

  3. #28

    Re: A&E and ambulance performance worst ever - again

    The issues aren't mutually exclusive - funding has increased from Westminster to Wales but maybe not at the right rate but it has not been well used in Wales - for me everyone is culpable including decision makers in the health boards. But austerity for 10 years or so is the major contributor

    Additionally you cannot seperate the issues being faced in social care not adding to the issues faced by health in terms of bed blocking and not being able to be discharged to social care services.

    Therefore ambulance A takes someone to a and e but has to wait for a someone to be seen because a and e is blocked because they have no beds in the ward to put people in as they are full of people needing discharge but can't. Therefore ambulance a is off the road for x amount of time leading to longer waits for people needing an ambulance

    Don't get me started on GPs and their contracts

  4. #29

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by Nobody's Rep View Post
    The issues aren't mutually exclusive - funding has increased from Westminster to Wales but maybe not at the right rate but it has not been well used in Wales - for me everyone is culpable including decision makers in the health boards. But austerity for 10 years or so is the major contributor

    Additionally you cannot seperate the issues being faced in social care not adding to the issues faced by health in terms of bed blocking and not being able to be discharged to social care services.

    Therefore ambulance A takes someone to a and e but has to wait for a someone to be seen because a and e is blocked because they have no beds in the ward to put people in as they are full of people needing discharge but can't. Therefore ambulance a is off the road for x amount of time leading to longer waits for people needing an ambulance

    Don't get me started on GPs and their contracts
    Top post. Spot on.

  5. #30

    Re: A&E and ambulance performance worst ever - again

    On Wednesday I listened to the Welsh Health Minister being interviewed on 5 Live. The interviewer said that one in four people in Wales are waiting on hospital treatment for various ailments, whereas it’s one in twelve in England. As the Health Minister didn’t correct him on that, I assume she knew the figures were correct - if they are, they’re appalling and reflect badly on Welsh Labour who have to take a big share of the responsibility for that situation. It’s no defence to talk about what’s happening in.England because, in this case, they are significantly better than the Welsh ones, but it’s also fair to say that it’s no endorsement of the UK Government that they presiding over a situation that is bad, but not as bad as in Wales.

    Seems to me that the NHS needs help in terms of organisational management as well as financial help, how far is the average person willing to go to maintain the NHS in the format it was created in or as close to it as is possible now?

  6. #31

    Re: A&E and ambulance performance worst ever - again

    Hand on heart, I can honestly say that few things annoy me more than the politicisation of the NHS. It's deeply unhelpful, and barring some issues at the fringes, healthcare is politics free. Everyone wants the same outcomes.

    This will never happen of course, but I would love to see some kind of formal agreement that healthcare be run on a coalition basis, perhaps with a formal committee to represent parliament (chaired by the Health secretary) so that all decisions are removed from the yah-boo of party politics and all parties are involved in agreeing decisions.

    For me, it's unquestionable; whilst the NHS needs more money (what doesnt?) there are deeps structural issues that need addressing as well as serious questions about what should be provided especially as society generally ages and lives longer.

    In healthcare more than almost anywhere else we need a cross party consensus and the ceasing of it being used as a political football.

    Again, it won't happen, but imagine a formal party policy that said they will specifically reach out to all parties to share management of the NHS? Would be wholly positive in my opinion

  7. #32

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by the other bob wilson View Post
    On Wednesday I listened to the Welsh Health Minister being interviewed on 5 Live. The interviewer said that one in four people in Wales are waiting on hospital treatment for various ailments, whereas it’s one in twelve in England. As the Health Minister didn’t correct him on that, I assume she knew the figures were correct - if they are, they’re appalling and reflect badly on Welsh Labour who have to take a big share of the responsibility for that situation. It’s no defence to talk about what’s happening in.England because, in this case, they are significantly better than the Welsh ones, but it’s also fair to say that it’s no endorsement of the UK Government that they presiding over a situation that is bad, but not as bad as in Wales.

    Seems to me that the NHS needs help in terms of organisational management as well as financial help, how far is the average person willing to go to maintain the NHS in the format it was created in or as close to it as is possible now?
    Wales has an older population on average than England, and it has a poorer population on average than England. 21% of people in wales are of pensionable age - most English regions are around 18% with london 12%!. The South West has 22% but a higher proportion of those are wealthy retirees than in Wales. This stuff does make a difference - I'm sure people on here in their 60s or 70s will be aware how much more they or their friends have to rely on the NHS than when they were younger.

  8. #33

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by Rjk View Post
    Wales has an older population on average than England, and it has a poorer population on average than England. 21% of people in wales are of pensionable age - most English regions are around 18% with london 12%!. The South West has 22% but a higher proportion of those are wealthy retirees than in Wales. This stuff does make a difference - I'm sure people on here in their 60s or 70s will be aware how much more they or their friends have to rely on the NHS than when they were younger.
    None of which fully explains why the situation is so much worse in Wales in the example I quoted. It’s never happened before when it comes to politics, but I agree with James Wales in the post above - some sort of cross party approach is needed here.

  9. #34
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    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by JamesWales View Post
    Hand on heart, I can honestly say that few things annoy me more than the politicisation of the NHS. It's deeply unhelpful, and barring some issues at the fringes, healthcare is politics free. Everyone wants the same outcomes.
    What do you mean by 'politicisation'? And how do you conclude that 'everyone wants the same outcomes'?

    Pro or anti privatisation is a political question - and not just about efficiency/exploitation, management of costs and risks, and whether or not you are happy with public money going into private profit.

    Choices about local or centralised priorities and decision making are political. So are questions about what is treated and what is not by the NHS (especially around fertility, gender realignment and 'lifestyle' diseases - which are often more about poverty). So are relationships with drug companies. Choices about recruitment into the NHS from other countries, and collaboration (or not) with other health services are also political. Maybe the objective (shared by all major parties according to their manifestos) of joining up of health and social care is more about management and administration - but it also includes clashes of priorities and cultures between public and private sector organisations and resolving that is a political issue - as are the choices about personal care funding.

    I assume from your previous posts that the thing that annoys you most is the 'politicisation' of procurement practices - where the opposition have pointed out the greed, corruption and waste of the government handing out PPE contracts to their mates? Of course that should never be politicised! No that is 'deeply unhelpful'!

  10. #35

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by the other bob wilson View Post
    None of which fully explains why the situation is so much worse in Wales in the example I quoted. It’s never happened before when it comes to politics, but I agree with James Wales in the post above - some sort of cross party approach is needed here.
    I think it does go part of the way to explaining it - the region of England with the longest waits for hospital handover times by far is the south West - which is the region with the most similar demographics to Wales . There will also be the more demands on home care being in place in these regions that causes a delay on patients being released from hospital. The Elderly need exponentially more care from the NHS than the working age population. I think Wales and the South West should get a lot more health and social care funding proportionally in order to be able to deal wth it.

  11. #36

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by jon1959 View Post
    What do you mean by 'politicisation'? And how do you conclude that 'everyone wants the same outcomes'?

    Pro or anti privatisation is a political question - and not just about efficiency/exploitation, management of costs and risks, and whether or not you are happy with public money going into private profit.

    Choices about local or centralised priorities and decision making are political. So are questions about what is treated and what is not by the NHS (especially around fertility, gender realignment and 'lifestyle' diseases - which are often more about poverty). So are relationships with drug companies. Choices about recruitment into the NHS from other countries, and collaboration (or not) with other health services are also political. Maybe the objective (shared by all major parties according to their manifestos) of joining up of health and social care is more about management and administration - but it also includes clashes of priorities and cultures between public and private sector organisations and resolving that is a political issue - as are the choices about personal care funding.

    I assume from your previous posts that the thing that annoys you most is the 'politicisation' of procurement practices - where the opposition have pointed out the greed, corruption and waste of the government handing out PPE contracts to their mates? Of course that should never be politicised! No that is 'deeply unhelpful'!
    Thanks for so quickly demonstrating how what I suggest would never work.

  12. #37
    International jon1959's Avatar
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    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by JamesWales View Post
    Thanks for so quickly demonstrating how what I suggest would never work.
    Zarah Sultana MP @zarahsultana

    It’s been revealed that the Health Secretary, @SajidJavid, has shares in an AI company that operates in healthcare.

    Javid has recently promoted AI being used more in healthcare. This would benefit shareholders of AI companies.

    I told you they were dodgy.

    11:16 AM · Nov 19, 2021



    More outrageous 'politicisation' of the NHS!

    https://www.theguardian.com/politics...alth-tech-firm

  13. #38
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    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by Croesy Blue View Post
    Almost like an underfunded health service can't keep up with a global pandemic going on.
    So we get more funding per head than England and performance is worse, but its all down to funding and not management.

    I see.

  14. #39

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by jon1959 View Post
    What do you mean by 'politicisation'? And how do you conclude that 'everyone wants the same outcomes'?

    Pro or anti privatisation is a political question - and not just about efficiency/exploitation, management of costs and risks, and whether or not you are happy with public money going into private profit.

    Choices about local or centralised priorities and decision making are political. So are questions about what is treated and what is not by the NHS (especially around fertility, gender realignment and 'lifestyle' diseases - which are often more about poverty). So are relationships with drug companies. Choices about recruitment into the NHS from other countries, and collaboration (or not) with other health services are also political. Maybe the objective (shared by all major parties according to their manifestos) of joining up of health and social care is more about management and administration - but it also includes clashes of priorities and cultures between public and private sector organisations and resolving that is a political issue - as are the choices about personal care funding.

    I assume from your previous posts that the thing that annoys you most is the 'politicisation' of procurement practices - where the opposition have pointed out the greed, corruption and waste of the government handing out PPE contracts to their mates? Of course that should never be politicised! No that is 'deeply unhelpful'!

  15. #40

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by jon1959 View Post
    Zarah Sultana MP @zarahsultana

    It’s been revealed that the Health Secretary, @SajidJavid, has shares in an AI company that operates in healthcare.

    Javid has recently promoted AI being used more in healthcare. This would benefit shareholders of AI companies.

    I told you they were dodgy.

    11:16 AM · Nov 19, 2021



    More outrageous 'politicisation' of the NHS!

    https://www.theguardian.com/politics...alth-tech-firm
    Again, thanks for demonstrating that some are forever interested in using the NHS as a political football.

  16. #41
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    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by The Bloop View Post
    True, but the amount of money received by the Welsh Government from Westminster to run the NHS is determined by the Barnett formula, which doesnt take into account anything other than population size. Demographics pay no part in how much block grant awarded is to the devolved nations.
    Ita a block grant. It's up to Welsh Labour how they spend it. A few less zebra crossings up the valleys and a bit more on healthcare would do wonders.

  17. #42

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by chrisp_1927 View Post
    The way that some are happy to give the Welsh government a free pass on the Welsh NHS is quite frankly shocking. Our ambulance service in particular has been in tatters for years.
    Indeed indeed and at least we forget the cuts by a certain person back in 2013

    Welsh NHS: Health minister defends tough budgets

    Welsh NHS: Health minister defends tough budgets

    The NHS in Wales is still receiving investment despite cut backs, Health Minister Mark Drakeford insists.

    He spoke out after it was revealed that top civil servants issued a stark warning about the impact of cash shortages facing the health service.

    They say ministers' decision to impose a tough budget settlement on the Welsh NHS in recent years is making the delivery of current services "exceptionally difficult".

    Mr Drakeford told BBC Wales political reporter Daniel Davies that a review taking place this summer would determine whether the health service needed more money.

    Published30 July 2013SectionBBC News

  18. #43

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by Feedback View Post
    Ita a block grant. It's up to Welsh Labour how they spend it. A few less zebra crossings up the valleys and a bit more on healthcare would do wonders.
    What are you talking about?

  19. #44

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by JamesWales View Post
    Again, thanks for demonstrating that some are forever interested in using the NHS as a political football.
    You aren't going to win anyone over by being sanctimonious Mr J.

  20. #45

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by Citizen's Nephew View Post
    You aren't going to win anyone over by being sanctimonious Mr J.
    It's not sanctimonious, far from it.

    I think a cross-party approach to the NHS is the way forward, but acknowledged it would never happen.

    Soon after comes a response that is basically a polemic of party politics, quoting the guardian and Zarah Sultana.

    I think highlighting that is fair enough tbh, because it perfectly demonstrated my point.

  21. #46

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by jon1959 View Post
    What do you mean by 'politicisation'? And how do you conclude that 'everyone wants the same outcomes'?

    Pro or anti privatisation is a political question - and not just about efficiency/exploitation, management of costs and risks, and whether or not you are happy with public money going into private profit.

    Choices about local or centralised priorities and decision making are political. So are questions about what is treated and what is not by the NHS (especially around fertility, gender realignment and 'lifestyle' diseases - which are often more about poverty). So are relationships with drug companies. Choices about recruitment into the NHS from other countries, and collaboration (or not) with other health services are also political. Maybe the objective (shared by all major parties according to their manifestos) of joining up of health and social care is more about management and administration - but it also includes clashes of priorities and cultures between public and private sector organisations and resolving that is a political issue - as are the choices about personal care funding.

    I assume from your previous posts that the thing that annoys you most is the 'politicisation' of procurement practices - where the opposition have pointed out the greed, corruption and waste of the government handing out PPE contracts to their mates? Of course that should never be politicised! No that is 'deeply unhelpful'!
    I used to work in the commercial sector of a pharmaceutical company and much of my time was spent with DoH/ NHS and procurement contracts. Without exception the procurement processes were always robust and in emergency situations, where there was no time to go out to tender, the unsuccessful companies always had the option of challenging the decision.
    In my experience the weakness in the system was the failure to manage the market, particularly with specialist pharmaceuticals. It was common practice to go with the cheapest and before you know it all the business in the UK regions ended up with one company, the competition withdrew as they had minimal/no business...,so you can guess what happened next.

  22. #47

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by lisvaneblue View Post
    I used to work in the commercial sector of a pharmaceutical company and much of my time was spent with DoH/ NHS and procurement contracts. Without exception the procurement processes were always robust and in emergency situations, where there was no time to go out to tender, the unsuccessful companies always had the option of challenging the decision.
    In my experience the weakness in the system was the failure to manage the market, particularly with specialist pharmaceuticals. It was common practice to go with the cheapest and before you know it all the business in the UK regions ended up with one company, the competition withdrew as they had minimal/no business...,so you can guess what happened next.
    Isn't it important though to make a distinction between PPE and specialist pharmaceuticals? We've had discussions about our backgrounds so we're speaking the same supply chain language but PPE is a lot easier to manufacture than sterile catheters, for example. You're absolutely right in what you're saying, however it doesn't mean that the wholly inappropriate contracts handed out regarding PPE (or rather the way they were granted) is something a government shouldn't be held accountable for, as Jon's post illustrated.

    For what its worth I've been on both sides of the NHS and these days have first hand experience of what the management problems are like as an end user and there's no doubt that - to state the bleeding obvious - it's a mess. I'm not sure any discussion can take place that's going to end in truly practical solutions without the spectre of financial argument, whether cross-party or not. People are going to have re-prioritse their financial management and we have to address the true costs of attempting to offer an free service in the 21st century. To put it simply, people will happily pay £1K+/yr on coffee in Pret than on their healthcare. It can't go on like this.

  23. #48
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    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by Citizen's Nephew View Post
    What are you talking about?
    The Welsh NHS is funded by the block grant. The priorities of Wales are set by the Welsh Government. If the Welsh wanted change they'd remove Welsh Labour. They haven't so they don't.

  24. #49

    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by Feedback View Post
    The Welsh NHS is funded by the block grant. The priorities of Wales are set by the Welsh Government. If the Welsh wanted change they'd remove Welsh Labour. They haven't so they don't.
    No. You've shifted the goalposts. What has this got to do with Welsh Labour? You're allowing your politics to spill over. It's about a pot of money. Is that pot large enough? Where do we prioritise? You talked about zebra crossings as if these aren't important. They are. How can you possibly know how and where any Senedd government should spend the money unless you're actively involved?

  25. #50
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    Re: A&E and ambulance performance worst ever - again

    Quote Originally Posted by JamesWales View Post
    It's not sanctimonious, far from it.

    I think a cross-party approach to the NHS is the way forward, but acknowledged it would never happen.

    Soon after comes a response that is basically a polemic of party politics, quoting the guardian and Zarah Sultana.

    I think highlighting that is fair enough tbh, because it perfectly demonstrated my point.
    It demonstrates the stupidity of your point - which 'is fair enough tbh'.

    My response was not party political - Labour gave privatisation a kick start under Blair - it was pointing out that the NHS is bound up in political choices and constraints. Pious appeals to keep politics out of the various debates about the NHS is either naive or dishonest.

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