Couldn't agree more. We have DOUBLED the money being put into the service. The most unreformed public service is by far the NHS. The leaders of the anti-reform movement? Doctors. Why? they have the most to loose financially.
With attitudes like the one rant displays, is there any wonder the patient is seen as a problem and not the customer?
This is a great idea. It's time people began to realise just how bad the service, quality, and competency of the people working in the NHS really is. It is not a problem that has pockets, it is indeed systemic, and will be very hard to change. The only real chance there is to do that is through market based reforms where the money follows the patient, and if you are a crap provider, you go out of business and do something else for a living.
You might want to correct the name of the blog. I think you might have meant to put Even not Event, but I get the meaning and agree with the sentiment!
one of the frustrating things about the drs rant is that they fail to listen, they dont really get it through the patients eyes, and then when you give them an answer they fill in their own prejudices of what you said
and then they start deleting responses to make you look like a dick
sad
and the one mouthy lefty dr rant swamps out some of the good stuff the less active rants come up with occassionally
anyway i think the nhs is our biggest failure as a nation, so much time and energy wasted, as so unresponsive to customers needs
'anyway i think the nhs is our biggest failure as a nation, so much time and energy wasted'
Really? The fact that if you get run over you get whisked to hospital and mended no questions asked no body asking for your credit card or insurance details?
The fact you can see a GP about your fungal nail infection with out handing over £40.
Listen dickheaddumbshitstudentplonker. Yu don't get asked for your credit card in the US if that is what you are referring to. It is illegal to treat a patient based on their ability to pay, you go to jail for 10 years, it's a federal law. So you take that lie and cram it up your ass.
"Whisked to hospital"? Are you really that thick? The ambulance service here is crap it has 20%+ absenteeism. They don't care, response times are APPALLING!
So besides spewing lies, what is your point? We should all be happy as shit you are killing us even though the money that is being spent on our crap service has doubled?
It is an abomination that we all get excited that we ONLY have to wait 18 weeks to get treated! Do you realise how crap that is????? No one else in western Europe wait.
Keep hiding behind a wall of lies, make excuses for the "service" allow doctors and nurses to blame everyone else for their failures. Great system, I am ashamed, the rest of the world avoid our system like the plaque unless they are from a real third world country.
Here is an article about the Canadian health service who, in the western world anyway, have waits for elective surgery that are not dissimilar to our. The reason? It is a carbon copy of our failed system. Like ours, it is a two tiered system where the affluent cross over the border to the US to get high quality quick access. Interesting that the system created by the Labour party is full of inequalities. The most interesting conclusion drawn is that "more money is not the answer". Like the NHS, the Canadians suffer from a lazy and unreformed workforce existing in a place devoid of incentives but clearly in command of the political agenda in deference to the taxpayer and patient. Canadians waited longer than they have in more than a decade for non-emergency surgery this year, despite a multi-billion-dollar effort by governments to speed up medical care, according to a new report from the Fraser Institute. Also, you might notice that the Canadians are upset because the wait has HIT 18 weeks. I would imagine the NHS has once again lied and fiddled the figures but the NHS has just ACHIEVED 18 weeks. What a bunch of plonkers
"Consider:
The average wait between being referred to a specialist and receiving an elective operation was 18.3 weeks in 2006, up from 17.8 the year previous. Ontario had the shortest average surgery wait time, 15 weeks while Saskatchewan had the longest, at 27 weeks. The time between being referred by a general practitioner and seeing a specialist grew to 9.2 weeks from 8.8 weeks in 2006, while the second stage of waiting -- between seeing the specialist and getting the operation -- edged up from nine to 9.1 weeks. Waits in the internal medicine specialty, gynecology, urology and radiation oncology were all up by varying amounts. "Clearly, money is not the solution," said Nadeem Esmail, a Fraser health care analyst and co-author of the report. "We're dumping money into the system; we're piling on cash that the system has available to deliver health care and it is not able to significantly reduce the waiting times. In fact, we're seeing the wait times continue to grow."
As it has in previous years, the Institute argued that the way to solve the backlogs is to introduce competition between private and public providers of government-funded health care and allow a parallel private system.
Source: Tom Blackwell, "Surgery Waits Longest Yet," National Post, October 16, 2007; based upon: Nadeem Esmail and Dr. Michael A. Walker, "Waiting Your Turn: Hospital Waiting Lists in Canada, 17th Edition," Fraser Institute, October 15, 2007."
The American Academy of Home Care Physicians estimates that between 1,000 and 2,000 doctors in the United States have house-call practices. That is not enough to meet the demand of the nation’s aging population. There are 34 million older adults in the United States and that number is likely to double in the next 20 years. Also, by 2020, an estimated 2 million elderly will be chronically homebound,
However, a shortage of primary care physicians looms in the US nation’s future as medical school students are veering away from family medicine and pursuing specialized medicine, where Medicare reimbursements and the overall pay are greater.
US medical students are shying away from family practices because of the stressful work environment. With crowded waiting rooms and the pressing needs of administrative staff, doctors’ offices often are chaotic and hectic.
Don't undervalue NHS primary care which is well placed to deal with the looming demographic problems which face us.
NHS primary care and the associated social care services are in some respects better than their US equivalents, and in others inferior.
However, i disagree that just because doctors are willing to make house-calls the care is necessarily better. I think a lot of the UK "overloading" of GP's is a result more complicated medical world and GP's are struggling to keep up with the 21st century changes.
In most other parts of the worlds there is a medical move as opposed to financial move away from family medicine. Medicare has changed it's reimbursement patterns so fewer generalists treat patients and have incentivised the exact behavior you outline. The reason? The government feel that the patient and the tax payer get better care and value from specialists and are attempting to limit the sometimes unnecessary interfernce by poorly trained medics.
60 years ago when doctors had little in the way of medical technology to keep patients alive, they were glorified hospice workers. The NHS needs to reform how it handles patients. It needs to become accountable to the country for its actions, and until it does there is little reason to compare it to other services because in the round it is far worse.
This was runt's response to factual reporting by respected Canadian newspapers saying that the Canadian system was a failure even though they had dumped millions of extra dollars into the system (full text posted above)
Runt: As a follow up to the comment on Canadian waiting times, I spoke to a Canadian-trained GP yesterday.
Canadian GPs train for a minimum of two years after medical school.
NHS GPs train for a minimum of five years (four before they extended the pre-registration house officer year to two years).
He also pointed out that he far preferred the NHS personal consulting style of taking patients into your consulting room and spending time with them. In Canada the GPs use multiple examining rooms and the initial history is taken by a nurse. The GP then 'pops in' to each room to finish the consultation. Much like A&E doctors do in the UK.
Also, unlike the NHS, GPs are not required to take on, or keep, a patient if they don't want to. Millions of Canadians can't get a GP.
The Fuckwit Epipemia just don't know how good they've got it.
Since runt is deleting any comments on his blog that don't agree with his self-interested and malicious point of view I thought that I would post a copy of my response here so there would be at least a vestige of free speech. However, the behavior of runt is entirely consistent with the way I would imagine he runs his practice. "Accept what I say or fuck off".
Anonymous said:ah, the sidebar rant conversation we are all supposed to accept as gospel! Fuck off rant. So you had a conversation with a doctor! Anecdotal twaddle, the Canadian system is a carbon copy of our own because civil servants from this country created it. The fact that you train for 5 years and appear not to add any value suggests we have an even greater failing than they.
Most other countries leave the history up to trained professionals (physician assistants etc.) who are not the doctor so they can free their time to speak with the patient and diagnose the problem. You have proven that GP's in the UK feel most comfortable doing mundane bookkeeping chores that add little or no value to the patient experience. I am sure it is a comfort zone issue for you and your mates and also a control issue. It is yet another symptom of your inability to move on and modernise your practice.
So you can fuck off runt, all your anecdotal bullshit is wearing thin. You must be asking yourself when the GMC or DofH are going to come knocking on your door and ask for that license you bought online. Very few employers of contractors would allow them to hurl so much abuse and lies at the system that provides them with an income and not want to extract the cancer. I can only think you are on a waiting list to be fucked up your ass runt!!!!!!! Might want to buy some vaseline, and start looking here for your next job www.monster.com. You can push delete now!
I am so glad you have started this site and hope that you continue to update it. I will contribute regularly to the debate. I too have spent the last several months very concerned by the rhetoric on the Dr. Rant site. As a stay at home Mum I can check the site regularly and it has always upset me that most of the Dr. Rant posts appear during the day when he should be working. I have decided to take a different view of the Dr. Rant site as have 5 of my friends. We decided last week to write to our MP. I find it very troubling that a person who makes such a good living off the back of taxpayers can be allowed to write what has been posted on the Dr. Rant blog. My husband is incensed and suggest I write to our MP which I and 5 others have done. We all sent the letter I will post below.
If otheres here would like to do the same, most MP's email addresses are their surname followed by the last initial so David Cameron is camerond@parliament.uk. All email address are on the Parliament website. A solicitor frind of ours is not convinced that Dr. Rant is a doctor. He says that Rant as a contractor has a duty of care under law to the people he contracts with (NHS) and is severely in breach of that given the posts on the blog.
Sorry this is so long winded. I should also say that I have already received a positive response to my email directly from my MP. Our text is below, sorry this is so long! Dear Sir/Madam, I am writing to you with the utmost urgency to bring to your attention an individual who proclaims to be a GP contracted to the NHS. He writes daily in the www.drrant.com blog usually during office hours that might suggest that the GP’s day is not nearly as “busy” as they tend to complain about. The problem that I have with what is posted on the blog by “Dr. Rant” and others he claims as contributors is that they are generally abusive of the people you, the government, are paying him to take care of. I am angered in the first instance that a person whose entire income is derived from public funds is allowed to espouse the type of abusive insensitive, hateful and destructive views about the people they as supposed to care for and the employer who through my taxes pays their salary without having his/her contract terminated and being disciplined by the appropriate professional body for unprofessional behaviour. If you look through the posting on the dr rant site it becomes very apparent that the person/persons responsible have little regard for either their patients or the department which employees them. One has to be concerned that with such vehemently held negative views about patients and their lack of intellect, openly ridicule the right of the patient to participate in their own treatment through dialog and choice as not being valid, you have to ask if these people are fit to treat patients at all. I am deeply concerned that they are not. A person cannot hold such strong and prejudiced views without these influencing them in day-to-day life. Applied to medicine this almost rabid view of the world might well translate into malpractice. I would also like to copy an extract from one of the blogs posts to illustrate the complete disregard for patients the authors of the blog display, I quote: “More to the point, why the fuck should you NOT have to write a letter to the GP? I'm so fucking fed up of spoilt bastard patients who think that they are getting such a crap service when the GP care in the UK is so fucking amazing. Ignorant, useless, winging, mouthy fuckers. But mainly spoilt. Spoilt. Spoilt. Spoilt bastards.” Paragraphs such as this repeat themselves over and over again in the blog. I hope that you as a member of the government will share my sincere concern as to the fitness of these individuals to continue to be a part of the NHS and the medical profession and hope that you also agree that attitudes like this only undermine the NHS and potentially put patient’s lives at risk. I would ask that you immediately ask the GMC and the Department of Health to determine the individuals responsible identities, ascertain if they are indeed employed by taxpayers, and if they are take immediate action to stop the divisive and dangerous dissemination of inaccurate information by people employed through my tax money, while at the same time determining if patients lives are at risk. I would also like to know why the NHS feels it should contract with people who show such little regard for the patient.
the real spend on a GDP basis on the NHS is north of 9%, you can get the exact number from the HMT website. It really doesn't matter however as your "see how little we are spending to have a shit service?' argument is crap! The only people who dig it up are NHS apologists who can't be bothered to do any work and would rather point to other systems and say look how lucky we are!
Our hospitals are shit. The doctors are crap the system is broken you kill people everyday because you don't care It is FUCKED UP and YOU are the reason.
I am really quite worried about you. I fear you must have had some really bad experiences of the NHS to hold such strong views. Would you care to share?
Our hospitals are shit - really? I've always found they've done the best they can with the funding they have. The doctors are crap - how do you measure that? all of them? All the doctors I know are dedicated to their patients and try to do the best they can with the resources available. I accept there will be bad apples but I honestly believe few. Tarring all doctors on what I think might be your experiences with a few is prejudice. the system is broken - so, what would you do to fix it? you kill people everyday because you don't care - surely you must see how offensive this is? I may not share all the views of dr rant and I don't have his/her/their ablilty with anglo-saxon but this offends me and saddens me.
I do hope you are a stooge of New Labour and so playing a part. If not, I am very sad for you, hope you meet some people in the NHS you can work with and hope you recover soon.
And I have worked in the health care system of the 3rd world and must say you are wrong in the title of your blog. I remember diagnosing an older man with diabetes and only then realising there was nothing I could do about it other than advice on diet. I remember with great sadness diagnosing short-sightedness in a young girl who was academically gifted at a similar age to when I was diagnosed - only to be then told there were no spectacles available and so she would just have to "adapt".
What I would like to know is if any of you guys have had any REAL experience with the NHS. I'm not talking about being sent to A+E for a broken arm/drunkenness. I mean a real disorder.
Having had a relative of the age of 12 spend 4 years in the system, then myself having a long term medical problem, my father having pneumonia, etc, I have never once come across a doctor who didn't care, an incompetent doctor/nurse, or indeed an especially shit hospital.
On the occasions we needed an ambulance, I think the longest we had to wait was twenty minutes - and that was due to a hoax call.
Do you really and honestly think that in a third world country, we'd have had anything like that? Of course there would be chemotherapy, radiotherapy, steroids, MRI machines, the equipment to carry out proper blood tests, all of that on demand... And we thought they were having some issues with the cleanliness of the water...
PS, luke, I admire you for working in a 3rd world country - it's something I'd love to do when I'm older.
I suspect runt has posted the last two posts on this blog. Thanks for admitting you work in a third world health system.
Want some horror stories: friend went into a west london hospital to have a baby. Comment about the staff - "rude and indifferent to needs". Cleanliness of the hospital? - "shared toilet was filthy as was the ward, remained that way the whole of our stay. No one ever attempted to clean it even though there was blood on the toilet and floor. Rubbish in most of the wards, nurses didn't care."
These my friend are not uncommon experiences in the NHS, even runt will tell you it is diabolical. Why do you think we have the highest incidences in Europe of MRSA? Because god doesn't like us? No, it is because the people responsible for keeping the hospital clean don't care. I am speaking about the doctor and nurse. They abdicate their duties to others and allow patients to die rather than act like adults.
Yes, I am pissed off, very pissed off. I hate the fact we have more than doubled the money into health 70% of which has gone to the doctors and nurses, and we have got back NOTHING in return. In fact the NHS has become even less responsive and now buys itself out of the hole it is in with the extra cash using the big bad private sector. Which are maligned by you and yours at every turn in the road until they have to bail your sorry crap ass out of a hole.
Our health system is this countries dirty little secret and the health professions who control it have effectively put a lid on an open and honest debate about its failures. Go to France as I did last year and experience clean, free and efficient hospitals with staff who are yes, a little French, but responsive to your needs. The difference between there and here? 40% provision by the private sector, therefore a functioning market. That would be the market you have been fighting, at the expense of patients lives, to keep out so you can still have your cushy little increasingly meaningless job.
I want my moneys worth, you to behave and treat me with some respect, but most of all, the NHS to start to provide 21st century healthcare. So yes it is crap and that's when it is compared to YUGOSLAVIA.
One last thing about NHS costs; the headline number that is floated by HMT does not include pension costs. When you include the cost of pensions and bureaucratic central costs, the UK spends north of 12% on healthcare. The French? 9%
I am most definitely not dr rant. I have no medical qualifications, I'm not even old enough to go to med school.
But I have a pretty good idea of how the nhs is on the frontline. I have spent almost my entire life in and out of hospital. I think that qualifies me to make a judgement on it from the patient's point of view.
I am sorry you had an unfortunate experience in a nhs hospital. The things you have to remember are that hospitals are understaffed, and the chances are your friend was not the most urgent case in the hospital - what may seem like a nurse not caring could actually be a nurse struggling to deal with a birth with major complications in the next room, while still trying to keep an eye of all of his/her other patients and keep up with the paperwork. If there are no issues with one birth, then the nurse will focus her attentions where it is a matter of life and death. If the government would provide jobs for the 80% of nurses leaving university who can't get jobs, then patients will get more time with nurses and more care. It's not that they don't care about people, it's just they have so much to do. Just out of interest, how many nurses did they see and how many wards were they covering?
Also, the doctors and nurses are not responsible for the cleanliness of the hospitals. That's the job of the senior management who are not employing enough cleaners, and encouraging cleaners to cut corners because it's cheaper. You cannot blame doctors and nurses for this, they hate it as much as anyone. But they have to get on with their jobs as best they can despite these conditions.
By the way, the times I have been in a private hospital - yes it was cleaner, but it was useless in every other respect. It took them 2 months to get a blood sample, and when they were just about to take it, they discovered they couldn't because I was under 18. All it would have taken is a glance at my date of birth.
The way to improve the nhs is to take the money away from the crackpot schemes the government is trying to implement (polyclinics, insecure new data measures etc) and increase the number of staff, especially nurses and cleaners, and replace the beds that the government proudly announced were no longer needed - despite the fact that hospitals are running at 100%+ bed occupancy.
Doctors and nurses are not to blame for the problems with the nhs. You don't become either a doctor or a nurse for the money. If you're smart enough to do either, you're smart enough to do a hell of a lot more things that pay a lot more. Doctors and nurses and other hospital workers are doing their best in a failing system. The care they provide is excellent, but in imperfect surroundings.
I can understand your frustration, but it's misdirected. Doctors and nurses aren't to blame. It's the suits at the top who haven't the first clue about medical care who are setting ridiculous and meaningless targets and running things as cheaply as possible. They are the ones who shoulder the responsibility for the blood in the toilets.
Same lame themes appear in you longwinded dissertation as they do again and again in the runt blog.
We need more money - 220% increase We need more staff - largest ever increase in staff the NHS has ever seen Not paid enough - &)% of all new money went into the the pockets of staff Clean hospital, not my problem - how convenient, not a staffing issue just a grow up and take responsibility for your environment (you would know all about that being 12 and all) It's not the doctors problem - yes it is it has been for 60 years. They control care. Private Sector - only any good if I can rip patients off and support my Porsche and coke habit. But definitely not good enough for the poor people. They can't pay.
Champagne Socialism, you have to love it!
So runt-a-tron I would start looking out you door to see when the establishment police show up and to take you away.
dude, I'm 16. Most people would consider that a little to young to be a doctor.
The reason these statements have been repeated, is because anyone with an inside knowledge of the system knows them to be true.
And Doctors don't control the way the hospitals are run. If they did things would be so much better. But theyre not - theyre run by people with no medical knowledge whatsoever.
But I've made my case. It's up to you whether you whether you listen or not.
I don't know whether to be insulted or flattered that you think I might be Dr Rant in disguise! I have occasionally posted for many months on Dr Crippen and Dr Rant.
If you are saying that your anger is because of a few comments that a friend made when having a baby then that again comes back to prejudice. I had a bad encounter recently with a bank teller - doesn't mean the entire banking system is rotten. It means the lady serving me was probably having a bad day! But maybe I'm a more forgiving person than you.
Doctors and nurses need to improve their personal hygiene - we doctors have historically been particularly bad - but the problem with MRSA is more than just dirty hospitals - much more related to overuse of antibiotics in response to the "I want my moneys worth" brigade. And as the one of the previous posters has already indicated cleanliness of wards is out of the control of clinical staff - most sold off to private companies by the tories in the 90s.
I agree with you about buying in private services (the independent treatment centres etc) - complete waste of money and effort and I know of no doctors who approve - this was an entirely political decision thrust upon local PCT managers by Whitehall. The money would have been much better spent on improving local services.
Our health system is this countries dirty little secret and the health professions who control it have effectively put a lid on an open and honest debate about its failures For goodness sake, please understand health professionals do not control health system anymore. It is a political football and managed by managers and politicians - not doctors. I happen to think the system would be much improved if we were in charge but I'm sure you'd disagree. Look at people like Dr Rant (who I know you admire) and Dr Crippen who are doing all they can to highlight the problems in the NHS. I too am not saying everything is fine but I think your analysis is far from the truth and the way in which you try to put your unhappiness across will not persuade people to your cause.
You say you want respect but respect is a two-way street and I'm not feeling very respected by you - and I don't think anyone working in the health service would either.
You still have not answered my questions but more importantly please get some help, try to relax and think of your blood pressure.
"I agree with you about buying in private services (the independent treatment centres etc) - complete waste of money and effort and I know of no doctors who approve - this was an entirely political decision thrust upon local PCT managers by Whitehall. The money would have been much better spent on improving local services."
I didn't say this was a waste of money. Have you ever been to one? I have. The patients love them, they are clean, efficient, patient friendly and have better outcomes than does a majority of equivalent NHS centres. Doctors don't like them because they represent competition of the worst sort, better outcomes, patient friendly and efficient. Knocks down the waiting list so the bone docs have lower private incomes. They don't just not like it, they scare the crap out of them. One of the best policies the labour boys and girls had, should have done a lot more of them. But they couldn't the NHS stood in the way. Made them look really BAD on their own soil.
If you really are sixteen and not a 49 year old male sexual predator, I don't want your respect, could care less, but demand it of the NHS employees who live on my tax pounds. The problem is that the government and people like you have made it optional. Depends on whether they feel hard done by that day or not. You should know that given your years in hospital. What was it again ilielikeshititis?
Perhaps you are still in puberty. I don't know, but I wouldn't be surprised given the tone of your argument. Why is it so unlikely that I'm 16? What basis do you have for doubting my word? Perhaps I should be flattered that I don't live up to your (I suspect) stereotypical view of a 16 year old? And as for lying about being ill...?
Do you really think that your opinion is so correct that no one in the world will oppose it apart from dr rant? And do you really think dr rant cares enough about this page to assume multiple identities and come up with backstories for them simply to come and dispute this case?
I was trying to have a proper discussion, but seeing as we appear to have dropped to the levels of accusations of being a sex predator, I guess that a sensible discussion is out.
Well yes and no really. There is no ideal system but where I think it HAS suceeded is letting fat fuck Burger King employees like you who spend your days alternating between masturbation and posting your angry comments access to literally world class Doctors and Surgeons without having to pay a pretty penny.
You do like to blather on about how Doctors want to keep the status Quo because we benefit so much financially but in fact under a private system I can guarantee I would be earning three times as much for half the work in a more privatised system - others would do even better. Its a closed market you see - there is far more demand for healthcare than supply - so what exactly is your clever solution to the problem?
You are so fucking stupid that you dont seem to understand one of the main reasons you are paying double the salary for the same amount is because the new contracts are based on performance related pay - and Doctors are STILL vastly UNDERpaid. Yes you read that right.
I have no particular intellectual or political affiliation to the NHS but I recognise that its the cheapest, most cost effective solution for comprehensive healthcare.
The reason doctors are "underpaid" is that they artificially constrain the market. As the use of allied health professionals begins to widen, more doctors being pumped out by medical schools, you will find that your pay will go the way of your American cousins, down. Yes that's a FACT, US docs make less now than they did 10 years ago. Why? because most of healthcare in actual fact is a commodity. And as governments move to outcome based payment systems even for medics, you guys are toast, my milkman will most likely out earn you, and why shouldn't he, he adds more value to society!
If you want to espouse bullshit, please keep it to the runt site where all your little friends will agree with EVERYTHING you say regardless of factual consistency. A bit like referring to your mates when you are a crap doctor really, they cover-up the malpractice!
I think the NHS is a great idea in principle but also agree it is failing.
The main reason is that the politicians seem hell-bent on removing the professionals from any position of influence and replacing them with poorly performing managers.
As an example our local OOH primary care service used to have one and a half fulltime managers when it was run by GPs but since the NHS took it over it now has 17. That sort of figure is replicated throughout the NHS and is the real explanation of why so much money has resulted in little improvement.
As a doctor I would be happy for the NHS to dissolve. I would make a lot more from private practice than the NHS will ever pay and I would be freed from managers interfering in clinical matters of which they know next to nothing. I am absolutely convinced that I would be able to provide a better service than I do now with the financial and managerial constraints of the NHS (£60 a year for all GP services doesn't buy much)
As a patient I am very worried that I will not get "free" and timely medical help when I need it.
And why are some of you posters so unreasonably angry?
Your argument is, as always, flawed. The NHS was broken 15 years ago and remains so today. This "we have too many managers" argument is a smoke screen. The reason there are more managers, if indeed there are, is a direct response to doctors not reforming, and adapting. You created the situation you always complain about. It would also help managerial performance in the NHS if doctors stopped trying to undermine them.
I will ignore your last question as I am sure you have seen the runt site and are aware that this is a reasonably peaceful place in comparison.
I don't pretend to know all the answers but blaming doctors and creating a blog specifically named after another blog to launch personal attacks is pathetic. Of course none of this will get through because I'm sure it will bounce off your massive ego.
what is all this anger shit???? What I said is true you confirm that by saying "oh you are so angry" because you have nothing that refutes it. just another way of trying to control people label them as angry and therefore say their comments have no relevance.
"The reason doctors are "underpaid" is that they artificially constrain the market."
I agree NIKU - the funny thing is that as your "reforms" kick in the market will become less constrained meaning more money for me! Whohoo!! By the way if you think I'm going to work substantially harder than I do now you are greatly mistaken - in fact I will probably be able to take more time off work. Obviously this will be more expensive for you but I will try to find a way to live with that. Probably in the Cayman Islands.
"As the use of allied health professionals begins to widen, more doctors being pumped out by medical schools, you will find that your pay will go the way of your American cousins, down. Yes that's a FACT, US docs make less now than they did 10 years ago. Why? because most of healthcare in actual fact is a commodity. And as governments move to outcome based payment systems even for medics, you guys are toast...."
You may well be right. I dont know whether American Physician salaries have gone down or not with the introduction of allied health professionals - but even if they have gone 5%,10%,15%, 20% down they are still over double what we are paid in the UK so deregulate the market, introduce all the AHPs you want and watch our salaries soar! (Although I take your point they may have soared a bit higher with less AHPS). The only way is UP baby!! WHOHOOO!!
Oh, by the way, your point about producing more doctors doesnt really hold true - this is not the US and there is no easy way of boosting training capacity in the UK. In the past, experienced doctors have been recruited from the subcontinent and massive numbers have made it to consultant level - now overseas applications to train in England have plummeted thanks to New Labours training reforms and it will be DECADES before the new wave of medical schools are providing highly trained consultants. Again, thanks to this effect, trusts are struggling to recruit middle/senior grade staff and are paying SILLY money to fill the gaps - KERCHING!
"...my milkman will most likely out earn you, and why shouldn't he, he adds more value to society!"
He probably adds a lot of value to your community by bringing you Milk so you can make your Burger King milkshakes but one thing I'm sure about is that he won't be outearning me thanks to your taxpaying generosity.
Hey, by the way, I never thanked you for my Gold plated pension. Maybe I could repay you or your family by offering you a job cleaning my Benz?
Ha ha seeya you muppet! *walks off lighting cigar*
BWAHAHHAHAHAH!! Is that it? Is that the best refutation of my argument you've got? What a bunch of shit - you've not addressed a single one of the points I made. Whatever happened to:
"What I said is true you confirm that by saying "oh you are so angry" because you have nothing that refutes it. just another way of trying to control people label them as angry and therefore say their comments have no relevance. Grow Up."
So have you confirmed that I'm right? Because as far as i see you didn't refute a single point.
You are so fucking retarded you make me laugh.
Lets just have a quick reminder of what you've said above.
YOU moan about social inequality of healthcare where:
"...[there] is a two tiered system where the affluent cross over the border to the US to get high quality quick access. Interesting that the system created by the Labour party is full of inequalities."
But YOU want healthcare inequality based on people's ability to pay:
"because most of healthcare in actual fact is a commodity."
YOU say:
"The only real chance there is to [improve things] is through market based reforms"
But in YOUR words market based reforms have so far:
"....more than doubled the money into health 70% of which has gone to the doctors and nurses, and we have got back NOTHING in return."
YOU say:
"The reason doctors are "underpaid" is that they artificially constrain the market."
But YOU also say:
"The leaders of the anti-reform movement? Doctors. Why? they have the most to loose financially."
So which is it? Your ideas are so muddled, lazy, incoherent and contradictory that they're an embarrassment. And that's just in the space of twelve posts. All you do is repeat the lazy conventional wisdom that markets will be the answer to everything - and I'm not even a supporter of the NHS!
For all his swearing at least there is an underlying coherent argument to Dr.Rant's postings.
All you are is an angry fuckwit fantasising that you have a well paid job.
Thanks for the brief diversion and giving me the opportunity to kick your flabby ass but there's more intellectual stimulation to be had over at Dr.Rant.
there is only one argument dick head and that is why is the UK at the bottom of the list when it comes to outcomes, and that includes the old soviet states?
So, why are you such a shit doctor? The data does not lie.
"So, why are you such a shit doctor? The data does not lie.
Well shit-for-brains? Why are you a failure?"
Hahahahahaha once again you have nothing to say about any of your contradictions I've pointed out.
Why am I shit doctor? You don't know who the fuck I am. Maybe I'm shit, maybe I'm brilliant but you have no way of knowing either way. What a fucking stupid point.
Don't you have ANY original or intelligent comments to make?
Gloomily moaning about "Why is the world shit?" "Why am i treated so badly?""Why is everyone so mean to me?" is SO adolescent and exactly the reason no-one but Burger King will employ you and why hyou undertand so little about life.
you and yours never address the real issue; why do we have one of the worst healthcare systems including those of the old soviet block based on outcomes? Answer?
Well it would be much easier for the NHS's stats to improve if we did things like ban trans fats like Denmark and other European countries. And really we could reduce binge drinking somehow, seeing as we're pretty damn bad at that. And of course the fact that the UK has the highest levels of obesity in Europe has nothing to do with mortality stats either, does it? And the fact that we've only just quite recently had the public places smoking ban, so there's been no time for that to take an effect on the mortality levels either yet, unlike other countries which had the ban long before this.
But it's easier to blame healthcare staff than to think, hey maybe it's our own lifestyles that are killing us, and *shock* the doctors aren't trying to kill us because they like watching us die.
Because people don't like taking responsibility for their own health, do they?
i have just spent the last 5 years of my life training, really quite hard, to qualify as a doctor. Basically my view of people like yourselves ho hate the NHS and think all doctors are crap is one of fear. fear that actually one day that you might actually need one of us.
yes the NHS has problems, what major organisation doesn't?
let me give you a little scenario, oone i have recently seen. a nice healthy lady goes to see her gynaecologist because she has rather painful periods. fairly common. he does his funky stuff and low and beold she has a chunky fibroid uterus. (reasonably common, would definately account for her painful periods). she is offered a hysterectomy. She accepts and goes to theatre out comes the uterus. job done.
until later, when she has quite low blood pressure. its not too bad so could well be just because she is young. it drops a bit lower. alarm bells start ringing. clearly there is a reason for this. she is bleeding. lots.
she is transferred itu and then to theatre and winds up having a bit bit of blood taken out of her abdomen. just for arguements sake lets say it was 4l of blood. she gets fixed and spends a few days in an nhs intensive care department. she survives and is much better despite having been transfsed rather a lot of blood.
do we the associated readers think that:
a - a private hospital would be able to manage this sort of patient? b - would be able to mobilse the kind of resources that were involved in saving this womans life c - would have kept her in their private hospital and not shit themselves and sent them directly to an nhs hospital giving the tax payer the bill for their inabilty to care for sick people (and i mean sick in a medical "oh my god this person is actively trying to die on me" sick not just they are a little bit unwell).
a - a private hospital would be able to manage this sort of patient?
yep, private hosiptals do this routinely abroad when the market is not distorted so badly by mismanaged state intervention, and much better quality of service too
b - would be able to mobilse the kind of resources that were involved in saving this womans life
as above
c - would have kept her in their private hospital and not shit themselves and sent them directly to an nhs hospital giving the tax payer the bill for their inabilty to care for sick people (and i mean sick in a medical "oh my god this person is actively trying to die on me" sick not just they are a little bit unwell).
as above
tell you what its always refreshing to be treated elsewhere in the western world cos the staff dont treat you like a charity case
NIKU since you are still scratching your head with answers to any of the questions posted to you above, let me answer yours.
"Why do we have one of the worst healthcare systems including those of the old soviet block based on outcomes?"
As I said above, I'm not a huge fan of the NHS and recognise it has many weaknesses but what outcomes are you talking about? we actually have pretty good scores on many outcomes and pretty dire scores on others. If you could be a bit more specific we could happily address the exact reason for you.
But lets assume you're right for arguments sake. Lets assume on ALL outcomes we come bottom out of the 190 or so countries in the world.
In YOUR words:
"60 years ago when doctors had little in the way of medical technology to keep patients alive, they were glorified hospice workers."
i.e. You say our interventions had relatively little effect on outcomes - so a bit difficult to subsequently blame us in times past don't you think? Secondly, the point you make is that medical technology has now changed things to "keep patients alive". Again this deficit is plainly little to do with doctors. What do you think, we go around vandalising the CT and MRI scanners? If medical technology makes such a huge difference to mortality then it's society's job to provide that and give us the tools with which we can work.
In other words, if this is the root of the problem that you identify you should be asking YOURSELF why you have failed to provide the tools we need - we will make the best of what we are given.
But YOU think you've got your finger on the problem - British doctors.
"So, why are you such a shit doctor? The data does not lie."
So out of the 190 (or so) countries whereabout do you think British Doctors are rated internationally - and given the size of our population where do you think we should be?
Well I'll tell you - in almost all areas you look at we are almost certainly in the top five nations if not usually the top three.
People send their doctors to train here from all over the world to learn from OUR surgeons, OUR medical doctors, OUR clinical scientists - the same ones you denigrate.
Do a search on ANY medical topic you like - the leading journals in nearly EVERY field will be American or British. The leading authorites and articles IN those journals will probably be American, British, French or Japanese.
Most of the medical interventions that are now essential to medical practice have been invented by BRITISH or American Doctors and Scientists from the discovery of antibiotics to the invention of CT and MRI scanners to the latest techniques in Cancer management.
For God's sake, half the eponymous syndromes and disease are named after British physicians - Addison's disease, Bell's Palsy, Down syndrome - the list is endless.
So maybe you're right. Maybe British doctors are the worst in the world - but we don't think so and the rest of the World doesnt think so either. In fact perhaps you could name another industry/profession where Britain punches so far above its weight (I would think maybe music, possibly advertising, possibly the British Army but little else).
As pointed out above - the things that make a real difference to mortality are not doctors and medical technology but genetics, lifestyle and hygiene. If outcomes are as bad as you say, it is the smoking, alcoholism, diet and industrial disease that has more to do with mortality than anything else.
Why don't you use your fucking brain?
The fact is that healthcare is a rationed commodity. You can either ration it by monetary means so that some people can't afford it -such as in America. Or you can ration it by giving everyone access and having them wait for their treatment. As a nation the public NOT THE DOCTORS have chosen the second option with its consequent weaknesses.
But as I pointed out above one of the main advantages is that slack jawed burger flippers like you have access to World class Physicians and Surgeons when ordinairily you wouldnt be able to afford the consultation fee let alone the treatment.
like the unimaginative, unthinking wanker you are however, you believe market forces will solve everything. But they wont - why not? - because the fact is that you are already getting far more out of doctors and nurses for your money than you are putting in.
The minute you actually try PAYING US FOR WHAT WE DO you will notice that you will be paying far more just to get the same level of service - in fact you may well have noticed this yourself as you note that pay has gone up massively without a corresponding increase in output.
I know this is a very difficult thing for you to grasp since it shatters your lazy ideas and I have no doubt you will ignore what I have written anyway.
But let me give you a example. You want to make a difference so you work hard at school, pass your exams, get a degree and become a nurse. The nurses on the unit I am working on are grossly overworked, pressurised and administer chemotherapy to my patients which can easily maim or kill them (google chemotherapy extravasation injury if you like). Because its a cancer ward it is an intensely emotionally draining job and for all this they are paid less than a mid-level Tesco worker.
So what, you think your stupid fucking contradictory ideas are going to make a difference to people like that? Your market forces are not going to make them work harder or better because they are not motivated by the prospect of earning an extra twenty or thirty pounds a day - if that was their main motivating factor, they would be doing a different job.
People like you dont have the first fucking clue about how things function - thats why your idiot ideas rarely make things better. It's like asking a four year old their opinion about how to run a university physics department.
So don't worry about thinking about posting the answers to any of the questions put to you. Your contradictions and lazy assumptions show you don't have any idea of what you are talking about and I don't particularly give two fucks about your opinion anyway.
I already know whats right and wrong - I do the job every day. Thats the difference between us.
Sorry about the long post - you can resume your adolescent moaning now NIKU about how the world is so hard on you wasting the two thousand or so pounds in tax that you generate every year.
Oh and no one, as I have said before, when I went to a private hospital, they couldn't even do a blood test for an under-18 year old. The idea of them coping with a real medical emergency...
dear no one, whilst i accept your points that in other countries the patient would be able to be dealt with in the private sector, the one bit of information i forgot to mention was the patient is a resident of a god for saken council estate, is in a pporly paid part time job and has 3 children.
yes in theory she would be able to be treated in the private setting but in reality she would be still suffering from periods that leave her almost unable to get out of bed despite taking plenty of analgesia and doubling up (yet still flooding).
ask your wife/girlfriend/mother daughter if they would find this level of disability acceptable simply because they could not afford halth insurance.
I do have family members in extreme pain, and who will die early from late and outdated treatement, who would have much better life chances if in the same social groups, financial standing, etc in any other western nation, and yes I am cheesed off at the crap service from the nhs that puts them in this position
there are many models of healthcare other than state run top down monoploies which ensure women get treatment when they need it, resident of shit social housing or not
So then NIKU, after all your bluster you havent managed to explain a single one of your contradictions. Yoiu said nobody answered your questions - i have done exactly that and you don't have anything sensible to say in return.
So are you man enough to admit you were wrong?
I didn't think so, you fucking coward.
You can go back to complaining about things you don't understand - readers of your blog postings have all the answers they need about your lazy arguments.
47 comments:
Couldn't agree more. We have DOUBLED the money being put into the service. The most unreformed public service is by far the NHS. The leaders of the anti-reform movement? Doctors. Why? they have the most to loose financially.
With attitudes like the one rant displays, is there any wonder the patient is seen as a problem and not the customer?
This is a great idea. It's time people began to realise just how bad the service, quality, and competency of the people working in the NHS really is. It is not a problem that has pockets, it is indeed systemic, and will be very hard to change. The only real chance there is to do that is through market based reforms where the money follows the patient, and if you are a crap provider, you go out of business and do something else for a living.
Let's kick some ass!
You might want to correct the name of the blog. I think you might have meant to put Even not Event, but I get the meaning and agree with the sentiment!
Fuck off!
(Love the blog, by the way)
thanks everyone
one of the frustrating things about the drs rant is that they fail to listen, they dont really get it through the patients eyes, and then when you give them an answer they fill in their own prejudices of what you said
and then they start deleting responses to make you look like a dick
sad
and the one mouthy lefty dr rant swamps out some of the good stuff the less active rants come up with occassionally
anyway i think the nhs is our biggest failure as a nation, so much time and energy wasted, as so unresponsive to customers needs
'anyway i think the nhs is our biggest failure as a nation, so much time and energy wasted'
Really? The fact that if you get run over you get whisked to hospital and mended no questions asked no body asking for your credit card or insurance details?
The fact you can see a GP about your fungal nail infection with out handing over £40.
Yup a complete failure.
Listen dickheaddumbshitstudentplonker. Yu don't get asked for your credit card in the US if that is what you are referring to. It is illegal to treat a patient based on their ability to pay, you go to jail for 10 years, it's a federal law. So you take that lie and cram it up your ass.
"Whisked to hospital"? Are you really that thick? The ambulance service here is crap it has 20%+ absenteeism. They don't care, response times are APPALLING!
So besides spewing lies, what is your point? We should all be happy as shit you are killing us even though the money that is being spent on our crap service has doubled?
It is an abomination that we all get excited that we ONLY have to wait 18 weeks to get treated! Do you realise how crap that is????? No one else in western Europe wait.
Keep hiding behind a wall of lies, make excuses for the "service" allow doctors and nurses to blame everyone else for their failures. Great system, I am ashamed, the rest of the world avoid our system like the plaque unless they are from a real third world country.
WAKE THE FUCK UP!
Here is an article about the Canadian health service who, in the western world anyway, have waits for elective surgery that are not dissimilar to our. The reason? It is a carbon copy of our failed system. Like ours, it is a two tiered system where the affluent cross over the border to the US to get high quality quick access. Interesting that the system created by the Labour party is full of inequalities. The most interesting conclusion drawn is that "more money is not the answer". Like the NHS, the Canadians suffer from a lazy and unreformed workforce existing in a place devoid of incentives but clearly in command of the political agenda in deference to the taxpayer and patient.
Canadians waited longer than they have in more than a decade for non-emergency surgery this year, despite a multi-billion-dollar effort by governments to speed up medical care, according to a new report from the Fraser Institute. Also, you might notice that the Canadians are upset because the wait has HIT 18 weeks. I would imagine the NHS has once again lied and fiddled the figures but the NHS has just ACHIEVED 18 weeks. What a bunch of plonkers
"Consider:
The average wait between being referred to a specialist and receiving an elective operation was 18.3 weeks in 2006, up from 17.8 the year previous.
Ontario had the shortest average surgery wait time, 15 weeks while Saskatchewan had the longest, at 27 weeks.
The time between being referred by a general practitioner and seeing a specialist grew to 9.2 weeks from 8.8 weeks in 2006, while the second stage of waiting -- between seeing the specialist and getting the operation -- edged up from nine to 9.1 weeks.
Waits in the internal medicine specialty, gynecology, urology and radiation oncology were all up by varying amounts.
"Clearly, money is not the solution," said Nadeem Esmail, a Fraser health care analyst and co-author of the report. "We're dumping money into the system; we're piling on cash that the system has available to deliver health care and it is not able to significantly reduce the waiting times. In fact, we're seeing the wait times continue to grow."
As it has in previous years, the Institute argued that the way to solve the backlogs is to introduce competition between private and public providers of government-funded health care and allow a parallel private system.
Source: Tom Blackwell, "Surgery Waits Longest Yet," National Post, October 16, 2007; based upon: Nadeem Esmail and Dr. Michael A. Walker, "Waiting Your Turn: Hospital Waiting Lists in Canada, 17th Edition," Fraser Institute, October 15, 2007."
What about US primary care?
The American Academy of Home Care Physicians estimates that between 1,000 and 2,000 doctors in the United States have house-call practices. That is not enough to meet the demand of the nation’s aging population. There are 34 million older adults in the United States and that number is likely to double in the next 20 years. Also, by 2020, an estimated 2 million elderly will be chronically homebound,
However, a shortage of primary care physicians looms in the US nation’s future as medical school students are veering away from family medicine and pursuing specialized medicine, where Medicare reimbursements and the overall pay are greater.
US medical students are shying away from family practices because of the stressful work environment. With crowded waiting rooms and the pressing needs of administrative staff, doctors’ offices often are chaotic and hectic.
Don't undervalue NHS primary care which is well placed to deal with the looming demographic problems which face us.
NHS primary care and the associated social care services are in some respects better than their US equivalents, and in others inferior.
However, i disagree that just because doctors are willing to make house-calls the care is necessarily better. I think a lot of the UK "overloading" of GP's is a result more complicated medical world and GP's are struggling to keep up with the 21st century changes.
In most other parts of the worlds there is a medical move as opposed to financial move away from family medicine. Medicare has changed it's reimbursement patterns so fewer generalists treat patients and have incentivised the exact behavior you outline. The reason? The government feel that the patient and the tax payer get better care and value from specialists and are attempting to limit the sometimes unnecessary interfernce by poorly trained medics.
60 years ago when doctors had little in the way of medical technology to keep patients alive, they were glorified hospice workers. The NHS needs to reform how it handles patients. It needs to become accountable to the country for its actions, and until it does there is little reason to compare it to other services because in the round it is far worse.
This was runt's response to factual reporting by respected Canadian newspapers saying that the Canadian system was a failure even though they had dumped millions of extra dollars into the system (full text posted above)
Runt: As a follow up to the comment on Canadian waiting times, I spoke to a Canadian-trained GP yesterday.
Canadian GPs train for a minimum of two years after medical school.
NHS GPs train for a minimum of five years (four before they extended the pre-registration house officer year to two years).
He also pointed out that he far preferred the NHS personal consulting style of taking patients into your consulting room and spending time with them. In Canada the GPs use multiple examining rooms and the initial history is taken by a nurse. The GP then 'pops in' to each room to finish the consultation. Much like A&E doctors do in the UK.
Also, unlike the NHS, GPs are not required to take on, or keep, a patient if they don't want to. Millions of Canadians can't get a GP.
The Fuckwit Epipemia just don't know how good they've got it.
Since runt is deleting any comments on his blog that don't agree with his self-interested and malicious point of view I thought that I would post a copy of my response here so there would be at least a vestige of free speech. However, the behavior of runt is entirely consistent with the way I would imagine he runs his practice. "Accept what I say or fuck off".
Anonymous said:ah, the sidebar rant conversation we are all supposed to accept as gospel! Fuck off rant. So you had a conversation with a doctor! Anecdotal twaddle, the Canadian system is a carbon copy of our own because civil servants from this country created it. The fact that you train for 5 years and appear not to add any value suggests we have an even greater failing than they.
Most other countries leave the history up to trained professionals (physician assistants etc.) who are not the doctor so they can free their time to speak with the patient and diagnose the problem. You have proven that GP's in the UK feel most comfortable doing mundane bookkeeping chores that add little or no value to the patient experience. I am sure it is a comfort zone issue for you and your mates and also a control issue. It is yet another symptom of your inability to move on and modernise your practice.
So you can fuck off runt, all your anecdotal bullshit is wearing thin. You must be asking yourself when the GMC or DofH are going to come knocking on your door and ask for that license you bought online. Very few employers of contractors would allow them to hurl so much abuse and lies at the system that provides them with an income and not want to extract the cancer. I can only think you are on a waiting list to be fucked up your ass runt!!!!!!! Might want to buy some vaseline, and start looking here for your next job www.monster.com. You can push delete now!
I am so glad you have started this site and hope that you continue to update it. I will contribute regularly to the debate. I too have spent the last several months very concerned by the rhetoric on the Dr. Rant site. As a stay at home Mum I can check the site regularly and it has always upset me that most of the Dr. Rant posts appear during the day when he should be working. I have decided to take a different view of the Dr. Rant site as have 5 of my friends. We decided last week to write to our MP. I find it very troubling that a person who makes such a good living off the back of taxpayers can be allowed to write what has been posted on the Dr. Rant blog. My husband is incensed and suggest I write to our MP which I and 5 others have done. We all sent the letter I will post below.
If otheres here would like to do the same, most MP's email addresses are their surname followed by the last initial so David Cameron is camerond@parliament.uk. All email address are on the Parliament website. A solicitor frind of ours is not convinced that Dr. Rant is a doctor. He says that Rant as a contractor has a duty of care under law to the people he contracts with (NHS) and is severely in breach of that given the posts on the blog.
Sorry this is so long winded. I should also say that I have already received a positive response to my email directly from my MP. Our text is below, sorry this is so long!
Dear Sir/Madam,
I am writing to you with the utmost urgency to bring to your attention an individual who proclaims to be a GP contracted to the NHS. He writes daily in the www.drrant.com blog usually during office hours that might suggest that the GP’s day is not nearly as “busy” as they tend to complain about.
The problem that I have with what is posted on the blog by “Dr. Rant” and others he claims as contributors is that they are generally abusive of the people you, the government, are paying him to take care of. I am angered in the first instance that a person whose entire income is derived from public funds is allowed to espouse the type of abusive insensitive, hateful and destructive views about the people they as supposed to care for and the employer who through my taxes pays their salary without having his/her contract terminated and being disciplined by the appropriate professional body for unprofessional behaviour.
If you look through the posting on the dr rant site it becomes very apparent that the person/persons responsible have little regard for either their patients or the department which employees them. One has to be concerned that with such vehemently held negative views about patients and their lack of intellect, openly ridicule the right of the patient to participate in their own treatment through dialog and choice as not being valid, you have to ask if these people are fit to treat patients at all. I am deeply concerned that they are not. A person cannot hold such strong and prejudiced views without these influencing them in day-to-day life. Applied to medicine this almost rabid view of the world might well translate into malpractice.
I would also like to copy an extract from one of the blogs posts to illustrate the complete disregard for patients the authors of the blog display, I quote:
“More to the point, why the fuck should you NOT have to write a letter to the GP? I'm so fucking fed up of spoilt bastard patients who think that they are getting such a crap service when the GP care in the UK is so fucking amazing. Ignorant, useless, winging, mouthy fuckers. But mainly spoilt. Spoilt. Spoilt. Spoilt bastards.”
Paragraphs such as this repeat themselves over and over again in the blog.
I hope that you as a member of the government will share my sincere concern as to the fitness of these individuals to continue to be a part of the NHS and the medical profession and hope that you also agree that attitudes like this only undermine the NHS and potentially put patient’s lives at risk. I would ask that you immediately ask the GMC and the Department of Health to determine the individuals responsible identities, ascertain if they are indeed employed by taxpayers, and if they are take immediate action to stop the divisive and dangerous dissemination of inaccurate information by people employed through my tax money, while at the same time determining if patients lives are at risk. I would also like to know why the NHS feels it should contract with people who show such little regard for the patient.
Sincerely Yours,
A Taxpayer
2005 OECD Data http://www.oecd.org/dataoecd/46/36/38979632.xls
Percentage of GDP spent on healthcare
USA 15%
UK 8%
Dear Taxpayer (cunt)
Cunt off you cunting cunt.
Yours,
An enemy
PS Has anyone ever told you, you're a cunt - cunt. Now get a job you lazy fucking cunt.
Limited vocabulary
Nothing to say of value
Abusive
Can't stand applicable critisism?
It must be runt!!!!!!!
the real spend on a GDP basis on the NHS is north of 9%, you can get the exact number from the HMT website. It really doesn't matter however as your "see how little we are spending to have a shit service?' argument is crap! The only people who dig it up are NHS apologists who can't be bothered to do any work and would rather point to other systems and say look how lucky we are!
Our hospitals are shit.
The doctors are crap
the system is broken
you kill people everyday because you don't care
It is FUCKED UP and YOU are the reason.
Go back to killing innocent people
NIKU (01 June 2008 07:49)
I am really quite worried about you. I fear you must have had some really bad experiences of the NHS to hold such strong views. Would you care to share?
Our hospitals are shit - really? I've always found they've done the best they can with the funding they have.
The doctors are crap - how do you measure that? all of them? All the doctors I know are dedicated to their patients and try to do the best they can with the resources available. I accept there will be bad apples but I honestly believe few. Tarring all doctors on what I think might be your experiences with a few is prejudice.
the system is broken - so, what would you do to fix it?
you kill people everyday because you don't care - surely you must see how offensive this is? I may not share all the views of dr rant and I don't have his/her/their ablilty with anglo-saxon but this offends me and saddens me.
I do hope you are a stooge of New Labour and so playing a part. If not, I am very sad for you, hope you meet some people in the NHS you can work with and hope you recover soon.
And I have worked in the health care system of the 3rd world and must say you are wrong in the title of your blog. I remember diagnosing an older man with diabetes and only then realising there was nothing I could do about it other than advice on diet. I remember with great sadness diagnosing short-sightedness in a young girl who was academically gifted at a similar age to when I was diagnosed - only to be then told there were no spectacles available and so she would just have to "adapt".
*agrees with luke*
What I would like to know is if any of you guys have had any REAL experience with the NHS. I'm not talking about being sent to A+E for a broken arm/drunkenness. I mean a real disorder.
Having had a relative of the age of 12 spend 4 years in the system, then myself having a long term medical problem, my father having pneumonia, etc, I have never once come across a doctor who didn't care, an incompetent doctor/nurse, or indeed an especially shit hospital.
On the occasions we needed an ambulance, I think the longest we had to wait was twenty minutes - and that was due to a hoax call.
Do you really and honestly think that in a third world country, we'd have had anything like that? Of course there would be chemotherapy, radiotherapy, steroids, MRI machines, the equipment to carry out proper blood tests, all of that on demand... And we thought they were having some issues with the cleanliness of the water...
PS, luke, I admire you for working in a 3rd world country - it's something I'd love to do when I'm older.
I suspect runt has posted the last two posts on this blog. Thanks for admitting you work in a third world health system.
Want some horror stories: friend went into a west london hospital to have a baby. Comment about the staff - "rude and indifferent to needs". Cleanliness of the hospital? - "shared toilet was filthy as was the ward, remained that way the whole of our stay. No one ever attempted to clean it even though there was blood on the toilet and floor. Rubbish in most of the wards, nurses didn't care."
These my friend are not uncommon experiences in the NHS, even runt will tell you it is diabolical. Why do you think we have the highest incidences in Europe of MRSA? Because god doesn't like us? No, it is because the people responsible for keeping the hospital clean don't care. I am speaking about the doctor and nurse. They abdicate their duties to others and allow patients to die rather than act like adults.
Yes, I am pissed off, very pissed off. I hate the fact we have more than doubled the money into health 70% of which has gone to the doctors and nurses, and we have got back NOTHING in return. In fact the NHS has become even less responsive and now buys itself out of the hole it is in with the extra cash using the big bad private sector. Which are maligned by you and yours at every turn in the road until they have to bail your sorry crap ass out of a hole.
Our health system is this countries dirty little secret and the health professions who control it have effectively put a lid on an open and honest debate about its failures. Go to France as I did last year and experience clean, free and efficient hospitals with staff who are yes, a little French, but responsive to your needs. The difference between there and here? 40% provision by the private sector, therefore a functioning market. That would be the market you have been fighting, at the expense of patients lives, to keep out so you can still have your cushy little increasingly meaningless job.
I want my moneys worth, you to behave and treat me with some respect, but most of all, the NHS to start to provide 21st century healthcare. So yes it is crap and that's when it is compared to YUGOSLAVIA.
One last thing about NHS costs; the headline number that is floated by HMT does not include pension costs. When you include the cost of pensions and bureaucratic central costs, the UK spends north of 12% on healthcare. The French? 9%
I am most definitely not dr rant. I have no medical qualifications, I'm not even old enough to go to med school.
But I have a pretty good idea of how the nhs is on the frontline. I have spent almost my entire life in and out of hospital. I think that qualifies me to make a judgement on it from the patient's point of view.
I am sorry you had an unfortunate experience in a nhs hospital. The things you have to remember are that hospitals are understaffed, and the chances are your friend was not the most urgent case in the hospital - what may seem like a nurse not caring could actually be a nurse struggling to deal with a birth with major complications in the next room, while still trying to keep an eye of all of his/her other patients and keep up with the paperwork. If there are no issues with one birth, then the nurse will focus her attentions where it is a matter of life and death. If the government would provide jobs for the 80% of nurses leaving university who can't get jobs, then patients will get more time with nurses and more care. It's not that they don't care about people, it's just they have so much to do. Just out of interest, how many nurses did they see and how many wards were they covering?
Also, the doctors and nurses are not responsible for the cleanliness of the hospitals. That's the job of the senior management who are not employing enough cleaners, and encouraging cleaners to cut corners because it's cheaper. You cannot blame doctors and nurses for this, they hate it as much as anyone. But they have to get on with their jobs as best they can despite these conditions.
By the way, the times I have been in a private hospital - yes it was cleaner, but it was useless in every other respect. It took them 2 months to get a blood sample, and when they were just about to take it, they discovered they couldn't because I was under 18. All it would have taken is a glance at my date of birth.
The way to improve the nhs is to take the money away from the crackpot schemes the government is trying to implement (polyclinics, insecure new data measures etc) and increase the number of staff, especially nurses and cleaners, and replace the beds that the government proudly announced were no longer needed - despite the fact that hospitals are running at 100%+ bed occupancy.
Doctors and nurses are not to blame for the problems with the nhs. You don't become either a doctor or a nurse for the money. If you're smart enough to do either, you're smart enough to do a hell of a lot more things that pay a lot more. Doctors and nurses and other hospital workers are doing their best in a failing system. The care they provide is excellent, but in imperfect surroundings.
I can understand your frustration, but it's misdirected. Doctors and nurses aren't to blame. It's the suits at the top who haven't the first clue about medical care who are setting ridiculous and meaningless targets and running things as cheaply as possible. They are the ones who shoulder the responsibility for the blood in the toilets.
Yeah right, you are too young to be a doctor.
Same lame themes appear in you longwinded dissertation as they do again and again in the runt blog.
We need more money - 220% increase
We need more staff - largest ever increase in staff the NHS has ever seen
Not paid enough - &)% of all new money went into the the pockets of staff
Clean hospital, not my problem - how convenient, not a staffing issue just a grow up and take responsibility for your environment (you would know all about that being 12 and all)
It's not the doctors problem - yes it is it has been for 60 years. They control care.
Private Sector - only any good if I can rip patients off and support my Porsche and coke habit. But definitely not good enough for the poor people. They can't pay.
Champagne Socialism, you have to love it!
So runt-a-tron I would start looking out you door to see when the establishment police show up and to take you away.
dude, I'm 16. Most people would consider that a little to young to be a doctor.
The reason these statements have been repeated, is because anyone with an inside knowledge of the system knows them to be true.
And Doctors don't control the way the hospitals are run. If they did things would be so much better. But theyre not - theyre run by people with no medical knowledge whatsoever.
But I've made my case. It's up to you whether you whether you listen or not.
I don't know whether to be insulted or flattered that you think I might be Dr Rant in disguise! I have occasionally posted for many months on Dr Crippen and Dr Rant.
If you are saying that your anger is because of a few comments that a friend made when having a baby then that again comes back to prejudice. I had a bad encounter recently with a bank teller - doesn't mean the entire banking system is rotten. It means the lady serving me was probably having a bad day! But maybe I'm a more forgiving person than you.
Doctors and nurses need to improve their personal hygiene - we doctors have historically been particularly bad - but the problem with MRSA is more than just dirty hospitals - much more related to overuse of antibiotics in response to the "I want my moneys worth" brigade. And as the one of the previous posters has already indicated cleanliness of wards is out of the control of clinical staff - most sold off to private companies by the tories in the 90s.
I agree with you about buying in private services (the independent treatment centres etc) - complete waste of money and effort and I know of no doctors who approve - this was an entirely political decision thrust upon local PCT managers by Whitehall. The money would have been much better spent on improving local services.
Our health system is this countries dirty little secret and the health professions who control it have effectively put a lid on an open and honest debate about its failures For goodness sake, please understand health professionals do not control health system anymore. It is a political football and managed by managers and politicians - not doctors. I happen to think the system would be much improved if we were in charge but I'm sure you'd disagree. Look at people like Dr Rant (who I know you admire) and Dr Crippen who are doing all they can to highlight the problems in the NHS. I too am not saying everything is fine but I think your analysis is far from the truth and the way in which you try to put your unhappiness across will not persuade people to your cause.
You say you want respect but respect is a two-way street and I'm not feeling very respected by you - and I don't think anyone working in the health service would either.
You still have not answered my questions but more importantly please get some help, try to relax and think of your blood pressure.
Dude, if you are sixteen I'm still in puberty.
"I agree with you about buying in private services (the independent treatment centres etc) - complete waste of money and effort and I know of no doctors who approve - this was an entirely political decision thrust upon local PCT managers by Whitehall. The money would have been much better spent on improving local services."
I didn't say this was a waste of money. Have you ever been to one? I have. The patients love them, they are clean, efficient, patient friendly and have better outcomes than does a majority of equivalent NHS centres. Doctors don't like them because they represent competition of the worst sort, better outcomes, patient friendly and efficient. Knocks down the waiting list so the bone docs have lower private incomes. They don't just not like it, they scare the crap out of them. One of the best policies the labour boys and girls had, should have done a lot more of them. But they couldn't the NHS stood in the way. Made them look really BAD on their own soil.
If you really are sixteen and not a 49 year old male sexual predator, I don't want your respect, could care less, but demand it of the NHS employees who live on my tax pounds. The problem is that the government and people like you have made it optional. Depends on whether they feel hard done by that day or not. You should know that given your years in hospital. What was it again ilielikeshititis?
Perhaps you are still in puberty. I don't know, but I wouldn't be surprised given the tone of your argument.
Why is it so unlikely that I'm 16? What basis do you have for doubting my word? Perhaps I should be flattered that I don't live up to your (I suspect) stereotypical view of a 16 year old? And as for lying about being ill...?
Do you really think that your opinion is so correct that no one in the world will oppose it apart from dr rant? And do you really think dr rant cares enough about this page to assume multiple identities and come up with backstories for them simply to come and dispute this case?
I was trying to have a proper discussion, but seeing as we appear to have dropped to the levels of accusations of being a sex predator, I guess that a sensible discussion is out.
Hmm "the NHS is a failed experiment"
Well yes and no really. There is no ideal system but where I think it HAS suceeded is letting fat fuck Burger King employees like you who spend your days alternating between masturbation and posting your angry comments access to literally world class Doctors and Surgeons without having to pay a pretty penny.
You do like to blather on about how Doctors want to keep the status Quo because we benefit so much financially but in fact under a private system I can guarantee I would be earning three times as much for half the work in a more privatised system - others would do even better. Its a closed market you see - there is far more demand for healthcare than supply - so what exactly is your clever solution to the problem?
You are so fucking stupid that you dont seem to understand one of the main reasons you are paying double the salary for the same amount is because the new contracts are based on performance related pay - and Doctors are STILL vastly UNDERpaid. Yes you read that right.
I have no particular intellectual or political affiliation to the NHS but I recognise that its the cheapest, most cost effective solution for comprehensive healthcare.
The reason doctors are "underpaid" is that they artificially constrain the market. As the use of allied health professionals begins to widen, more doctors being pumped out by medical schools, you will find that your pay will go the way of your American cousins, down. Yes that's a FACT, US docs make less now than they did 10 years ago. Why? because most of healthcare in actual fact is a commodity. And as governments move to outcome based payment systems even for medics, you guys are toast, my milkman will most likely out earn you, and why shouldn't he, he adds more value to society!
If you want to espouse bullshit, please keep it to the runt site where all your little friends will agree with EVERYTHING you say regardless of factual consistency. A bit like referring to your mates when you are a crap doctor really, they cover-up the malpractice!
I think the NHS is a great idea in principle but also agree it is failing.
The main reason is that the politicians seem hell-bent on removing the professionals from any position of influence and replacing them with poorly performing managers.
As an example our local OOH primary care service used to have one and a half fulltime managers when it was run by GPs but since the NHS took it over it now has 17.
That sort of figure is replicated throughout the NHS and is the real explanation of why so much money has resulted in little improvement.
As a doctor I would be happy for the NHS to dissolve. I would make a lot more from private practice than the NHS will ever pay and I would be freed from managers interfering in clinical matters of which they know next to nothing. I am absolutely convinced that I would be able to provide a better service than I do now with the financial and managerial constraints of the NHS (£60 a year for all GP services doesn't buy much)
As a patient I am very worried that I will not get "free" and timely medical help when I need it.
And why are some of you posters so unreasonably angry?
Your argument is, as always, flawed. The NHS was broken 15 years ago and remains so today. This "we have too many managers" argument is a smoke screen. The reason there are more managers, if indeed there are, is a direct response to doctors not reforming, and adapting. You created the situation you always complain about. It would also help managerial performance in the NHS if doctors stopped trying to undermine them.
I will ignore your last question as I am sure you have seen the runt site and are aware that this is a reasonably peaceful place in comparison.
OMG what an angry person you are!
I don't pretend to know all the answers but blaming doctors and creating a blog specifically named after another blog to launch personal attacks is pathetic. Of course none of this will get through because I'm sure it will bounce off your massive ego.
Cheers
what is all this anger shit???? What I said is true you confirm that by saying "oh you are so angry" because you have nothing that refutes it. just another way of trying to control people label them as angry and therefore say their comments have no relevance.
grow up
Actually I was talking about Australia, where I couldn't afford to see a GP when I was there last summer.
oh well....
"The reason doctors are "underpaid" is that they artificially constrain the market."
I agree NIKU - the funny thing is that as your "reforms" kick in the market will become less constrained meaning more money for me! Whohoo!! By the way if you think I'm going to work substantially harder than I do now you are greatly mistaken - in fact I will probably be able to take more time off work. Obviously this will be more expensive for you but I will try to find a way to live with that. Probably in the Cayman Islands.
"As the use of allied health professionals begins to widen, more doctors being pumped out by medical schools, you will find that your pay will go the way of your American cousins, down. Yes that's a FACT, US docs make less now than they did 10 years ago. Why? because most of healthcare in actual fact is a commodity. And as governments move to outcome based payment systems even for medics, you guys are toast...."
You may well be right. I dont know whether American Physician salaries have gone down or not with the introduction of allied health professionals - but even if they have gone 5%,10%,15%, 20% down they are still over double what we are paid in the UK so deregulate the market, introduce all the AHPs you want and watch our salaries soar! (Although I take your point they may have soared a bit higher with less AHPS). The only way is UP baby!! WHOHOOO!!
Oh, by the way, your point about producing more doctors doesnt really hold true - this is not the US and there is no easy way of boosting training capacity in the UK. In the past, experienced doctors have been recruited from the subcontinent and massive numbers have made it to consultant level - now overseas applications to train in England have plummeted thanks to New Labours training reforms and it will be DECADES before the new wave of medical schools are providing highly trained consultants. Again, thanks to this effect, trusts are struggling to recruit middle/senior grade staff and are paying SILLY money to fill the gaps - KERCHING!
"...my milkman will most likely out earn you, and why shouldn't he, he adds more value to society!"
He probably adds a lot of value to your community by bringing you Milk so you can make your Burger King milkshakes but one thing I'm sure about is that he won't be outearning me thanks to your taxpaying generosity.
Hey, by the way, I never thanked you for my Gold plated pension. Maybe I could repay you or your family by offering you a job cleaning my Benz?
Ha ha seeya you muppet! *walks off lighting cigar*
head up ass, in the sand really doesn't matter, incomes can go nowhere but down for you so I hope you enjoy the glory days.
You won't ever out earn me, but there isn't anything wrong with fantasising.
BWAHAHHAHAHAH!! Is that it? Is that the best refutation of my argument you've got? What a bunch of shit - you've not addressed a single one of the points I made. Whatever happened to:
"What I said is true you confirm that by saying "oh you are so angry" because you have nothing that refutes it. just another way of trying to control people label them as angry and therefore say their comments have no relevance. Grow Up."
So have you confirmed that I'm right? Because as far as i see you didn't refute a single point.
You are so fucking retarded you make me laugh.
Lets just have a quick reminder of what you've said above.
YOU moan about social inequality of healthcare where:
"...[there] is a two tiered system where the affluent cross over the border to the US to get high quality quick access. Interesting that the system created by the Labour party is full of inequalities."
But YOU want healthcare inequality based on people's ability to pay:
"because most of healthcare in actual fact is a commodity."
YOU say:
"The only real chance there is to [improve things] is through market based reforms"
But in YOUR words market based reforms have so far:
"....more than doubled the money into health 70% of which has gone to the doctors and nurses, and we have got back NOTHING in return."
YOU say:
"The reason doctors are "underpaid" is that they artificially constrain the market."
But YOU also say:
"The leaders of the anti-reform movement? Doctors. Why? they have the most to loose financially."
So which is it? Your ideas are so muddled, lazy, incoherent and contradictory that they're an embarrassment. And that's just in the space of twelve posts. All you do is repeat the lazy conventional wisdom that markets will be the answer to everything - and I'm not even a supporter of the NHS!
For all his swearing at least there is an underlying coherent argument to Dr.Rant's postings.
All you are is an angry fuckwit fantasising that you have a well paid job.
Thanks for the brief diversion and giving me the opportunity to kick your flabby ass but there's more intellectual stimulation to be had over at Dr.Rant.
there is only one argument dick head and that is why is the UK at the bottom of the list when it comes to outcomes, and that includes the old soviet states?
So, why are you such a shit doctor? The data does not lie.
Well shit-for-brains? Why are you a failure?
"So, why are you such a shit doctor? The data does not lie.
Well shit-for-brains? Why are you a failure?"
Hahahahahaha once again you have nothing to say about any of your contradictions I've pointed out.
Why am I shit doctor? You don't know who the fuck I am. Maybe I'm shit, maybe I'm brilliant but you have no way of knowing either way. What a fucking stupid point.
Don't you have ANY original or intelligent comments to make?
Gloomily moaning about "Why is the world shit?" "Why am i treated so badly?""Why is everyone so mean to me?" is SO adolescent and exactly the reason no-one but Burger King will employ you and why hyou undertand so little about life.
Poor diddums.
Hahahhaha muppet.
you and yours never address the real issue; why do we have one of the worst healthcare systems including those of the old soviet block based on outcomes? Answer?
Well it would be much easier for the NHS's stats to improve if we did things like ban trans fats like Denmark and other European countries.
And really we could reduce binge drinking somehow, seeing as we're pretty damn bad at that.
And of course the fact that the UK has the highest levels of obesity in Europe has nothing to do with mortality stats either, does it?
And the fact that we've only just quite recently had the public places smoking ban, so there's been no time for that to take an effect on the mortality levels either yet, unlike other countries which had the ban long before this.
But it's easier to blame healthcare staff than to think, hey maybe it's our own lifestyles that are killing us, and *shock* the doctors aren't trying to kill us because they like watching us die.
Because people don't like taking responsibility for their own health, do they?
And you are yet to come up with a decent answer to hawkeye pierce, either, I notice.
Your argument is falling apart NIKU.
Hawkeye, i am in Awe.
Brilliant postings, stay and play a bit longer please.
Dr Rant can do without you for a few more days.
i have just spent the last 5 years of my life training, really quite hard, to qualify as a doctor. Basically my view of people like yourselves ho hate the NHS and think all doctors are crap is one of fear. fear that actually one day that you might actually need one of us.
yes the NHS has problems, what major organisation doesn't?
let me give you a little scenario, oone i have recently seen. a nice healthy lady goes to see her gynaecologist because she has rather painful periods. fairly common. he does his funky stuff and low and beold she has a chunky fibroid uterus. (reasonably common, would definately account for her painful periods). she is offered a hysterectomy. She accepts and goes to theatre out comes the uterus. job done.
until later, when she has quite low blood pressure. its not too bad so could well be just because she is young. it drops a bit lower. alarm bells start ringing. clearly there is a reason for this. she is bleeding. lots.
she is transferred itu and then to theatre and winds up having a bit bit of blood taken out of her abdomen. just for arguements sake lets say it was 4l of blood. she gets fixed and spends a few days in an nhs intensive care department. she survives and is much better despite having been transfsed rather a lot of blood.
do we the associated readers think that:
a - a private hospital would be able to manage this sort of patient?
b - would be able to mobilse the kind of resources that were involved in saving this womans life
c - would have kept her in their private hospital and not shit themselves and sent them directly to an nhs hospital giving the tax payer the bill for their inabilty to care for sick people (and i mean sick in a medical "oh my god this person is actively trying to die on me" sick not just they are a little bit unwell).
cheers
a - a private hospital would be able to manage this sort of patient?
yep, private hosiptals do this routinely abroad when the market is not distorted so badly by mismanaged state intervention, and much better quality of service too
b - would be able to mobilse the kind of resources that were involved in saving this womans life
as above
c - would have kept her in their private hospital and not shit themselves and sent them directly to an nhs hospital giving the tax payer the bill for their inabilty to care for sick people (and i mean sick in a medical "oh my god this person is actively trying to die on me" sick not just they are a little bit unwell).
as above
tell you what its always refreshing to be treated elsewhere in the western world cos the staff dont treat you like a charity case
Why, thanks guys!
NIKU since you are still scratching your head with answers to any of the questions posted to you above, let me answer yours.
"Why do we have one of the worst healthcare systems including those of the old soviet block based on outcomes?"
As I said above, I'm not a huge fan of the NHS and recognise it has many weaknesses but what outcomes are you talking about? we actually have pretty good scores on many outcomes and pretty dire scores on others. If you could be a bit more specific we could happily address the exact reason for you.
But lets assume you're right for arguments sake. Lets assume on ALL outcomes we come bottom out of the 190 or so countries in the world.
In YOUR words:
"60 years ago when doctors had little in the way of medical technology to keep patients alive, they were glorified hospice workers."
i.e. You say our interventions had relatively little effect on outcomes - so a bit difficult to subsequently blame us in times past don't you think? Secondly, the point you make is that medical technology has now changed things to "keep patients alive". Again this deficit is plainly little to do with doctors. What do you think, we go around vandalising the CT and MRI scanners? If medical technology makes such a huge difference to mortality then it's society's job to provide that and give us the tools with which we can work.
In other words, if this is the root of the problem that you identify you should be asking YOURSELF why you have failed to provide the tools we need - we will make the best of what we are given.
But YOU think you've got your finger on the problem - British doctors.
"So, why are you such a shit doctor? The data does not lie."
So out of the 190 (or so) countries whereabout do you think British Doctors are rated internationally - and given the size of our population where do you think we should be?
Well I'll tell you - in almost all areas you look at we are almost certainly in the top five nations if not usually the top three.
People send their doctors to train here from all over the world to learn from OUR surgeons, OUR medical doctors, OUR clinical scientists - the same ones you denigrate.
Do a search on ANY medical topic you like - the leading journals in nearly EVERY field will be American or British. The leading authorites and articles IN those journals will probably be American, British, French or Japanese.
Most of the medical interventions that are now essential to medical practice have been invented by BRITISH or American Doctors and Scientists from the discovery of antibiotics to the invention of CT and MRI scanners to the latest techniques in Cancer management.
For God's sake, half the eponymous syndromes and disease are named after British physicians - Addison's disease, Bell's Palsy, Down syndrome - the list is endless.
So maybe you're right. Maybe British doctors are the worst in the world - but we don't think so and the rest of the World doesnt think so either. In fact perhaps you could name another industry/profession where Britain punches so far above its weight (I would think maybe music, possibly advertising, possibly the British Army but little else).
As pointed out above - the things that make a real difference to mortality are not doctors and medical technology but genetics, lifestyle and hygiene. If outcomes are as bad as you say, it is the smoking, alcoholism, diet and industrial disease that has more to do with mortality than anything else.
Why don't you use your fucking brain?
The fact is that healthcare is a rationed commodity. You can either ration it by monetary means so that some people can't afford it -such as in America. Or you can ration it by giving everyone access and having them wait for their treatment. As a nation the public NOT THE DOCTORS have chosen the second option with its consequent weaknesses.
But as I pointed out above one of the main advantages is that slack jawed burger flippers like you have access to World class Physicians and Surgeons when ordinairily you wouldnt be able to afford the consultation fee let alone the treatment.
like the unimaginative, unthinking wanker you are however, you believe market forces will solve everything. But they wont - why not? - because the fact is that you are already getting far more out of doctors and nurses for your money than you are putting in.
The minute you actually try PAYING US FOR WHAT WE DO you will notice that you will be paying far more just to get the same level of service - in fact you may well have noticed this yourself as you note that pay has gone up massively without a corresponding increase in output.
I know this is a very difficult thing for you to grasp since it shatters your lazy ideas and I have no doubt you will ignore what I have written anyway.
But let me give you a example. You want to make a difference so you work hard at school, pass your exams, get a degree and become a nurse. The nurses on the unit I am working on are grossly overworked, pressurised and administer chemotherapy to my patients which can easily maim or kill them (google chemotherapy extravasation injury if you like). Because its a cancer ward it is an intensely emotionally draining job and for all this they are paid less than a mid-level Tesco worker.
So what, you think your stupid fucking contradictory ideas are going to make a difference to people like that? Your market forces are not going to make them work harder or better because they are not motivated by the prospect of earning an extra twenty or thirty pounds a day - if that was their main motivating factor, they would be doing a different job.
People like you dont have the first fucking clue about how things function - thats why your idiot ideas rarely make things better. It's like asking a four year old their opinion about how to run a university physics department.
So don't worry about thinking about posting the answers to any of the questions put to you. Your contradictions and lazy assumptions show you don't have any idea of what you are talking about and I don't particularly give two fucks about your opinion anyway.
I already know whats right and wrong - I do the job every day. Thats the difference between us.
Sorry about the long post - you can resume your adolescent moaning now NIKU about how the world is so hard on you wasting the two thousand or so pounds in tax that you generate every year.
*cheers Hawkeye Pierce*
Oh and no one, as I have said before, when I went to a private hospital, they couldn't even do a blood test for an under-18 year old. The idea of them coping with a real medical emergency...
dear no one, whilst i accept your points that in other countries the patient would be able to be dealt with in the private sector, the one bit of information i forgot to mention was the patient is a resident of a god for saken council estate, is in a pporly paid part time job and has 3 children.
yes in theory she would be able to be treated in the private setting but in reality she would be still suffering from periods that leave her almost unable to get out of bed despite taking plenty of analgesia and doubling up (yet still flooding).
ask your wife/girlfriend/mother daughter if they would find this level of disability acceptable simply because they could not afford halth insurance.
rob
I do have family members in extreme pain, and who will die early from late and outdated treatement, who would have much better life chances if in the same social groups, financial standing, etc in any other western nation, and yes I am cheesed off at the crap service from the nhs that puts them in this position
there are many models of healthcare other than state run top down monoploies which ensure women get treatment when they need it, resident of shit social housing or not
So then NIKU, after all your bluster you havent managed to explain a single one of your contradictions. Yoiu said nobody answered your questions - i have done exactly that and you don't have anything sensible to say in return.
So are you man enough to admit you were wrong?
I didn't think so, you fucking coward.
You can go back to complaining about things you don't understand - readers of your blog postings have all the answers they need about your lazy arguments.
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