The NHS is broken, what should happen?

[Shechemite]

Social care is where the focus needs to be. It’s far worse funded than the NHS, it’s staff are paid a pittance and have limited career trajectory, the sparsity of ‘care in the community’ results in people becoming ill and needing inpatient/medical care.

the NHS does need a lot more funding. But it also needs a change in culture and needs to be democratised.

 

[ska invita]

the NHS does need a lot more funding. But it also needs a change in culture and needs to be democratised.

what do you mean by democratised?

 

[Shechemite]

Amongst other things

1) an end to the huge inequality of arms when it Comes to inquests

2) a greater role for oversight by elected bodies (eg council of governors in foundation trusts)

3) elected bodies (And boards) To have more patients/Carers. My CoG only had 4 patients sitting on a council of 36 people. I’ve managed to get this increased to 7 patients (out of 36)

 

[Shechemite]

I dunno if this counts as ‘democratisation’, but the treatment of ‘low status’ patients (and their families) - eg those with a learning disability or with severe mental illness - by the NHS is really fuckkng dire. Obviously privatisation hasn’t helped (and further privatisation should be resisted), but so much of this comes down to some lives being seen as less valuable than others.

oh and the complaints system is a joke. Just further traumatises harmed patients and their families

 

[Sasaferrato]

Revolving doors and lack of care like this does not help
BBC News - Dementia patients being 'dumped in hospital'

Dementia patients being 'dumped in hospital'

One in 10 dementia patients spends over a month in hospital after being admitted as an emergency.

www.bbc.co.uk

A major problem is that people do not want to work in social care, as evidenced by the number of people from Eastern Europe who were employed in the system. A lot of those people have gone home, on the perfectly reasonable basis that they do not feel welcome.

How do you suggest that the appalling situation is remedied?

 

[Shechemite]

I’m actually a lot more supportive of the nhs than I come across, but it’s beyond frustrating that any attempt to make it more universal are seen as attacks on the concept of universal healthcare/part of a plot to further privatise

 

[ska invita]

A major problem is that people do not want to work in social care, as evidenced by the number of people from Eastern Europe who were employed in the system. A lot of those people have gone home, on the perfectly reasonable basis that they do not feel welcome.

How do you suggest that the appalling situation is remedied?

pay better wages for such skilled and demanding work

 

[Shechemite]

A major problem is that people do not want to work in social care, as evidenced by the number of people from Eastern Europe who were employed in the system. A lot of those people have gone home, on the perfectly reasonable basis that they do not feel welcome.

How do you suggest that the appalling situation is remedied?

Pay staff more. Make the career ladders better.

 

[Sasaferrato]

I dunno if this counts as ‘democratisation’, but the treatment of ‘low status’ patients (and their families) - eg those with a sleeping disability or with severe mental illness - by the NHS is really fuckkng dire. Obviously privatisation hasn’t helped (and further privatisation should be resisted), but so much of this comes down to some lives being seen as less valuable than others.

oh and the complaints system is a joke. Just further traumatises harmed patients and their families

I know three people with sleep apnoea, all diagnosed quite quickly, all with CPAP devices. I'm unsure though, if that is what you mean by sleeping disability.

 

[Shechemite]

I live in social care supported flats. The staff here are troopers, especially given everything going on with covid.

 

[Shechemite]

I know three people with sleep apnoea, all diagnosed quite quickly, all with CPAP devices. I'm unsure though, if that is what you mean by sleeping disability.

was a typo. See correction

 

[Spandex]

pay better wages for such skilled and demanding work

Pay staff more. Make the career ladders better.

Absolutely this x1,000,000

Frontline social care work is physically, mentally and emotionally demanding, but usually paid minimum wage on a zero hours contract. Lots of people go into it, but the staff turnover is phenomenal.

If care workers got paid a fair amount for the important work they do, and had some - any - job security, the profession wouldn't be staffed by those with no option but to be shat on (I meant that figuratively, but since it's care work sometimes literally).

 

[Shechemite]

The NHS/social care ‘heroes’ narrative needs to go too. Doesn’t help the staff, and makes it (even) harder to address abuse and neglect

 

[ska invita]

Absolutely this x1,000,000

Frontline social care work is physically, mentally and emotionally demanding, but usually paid minimum wage on a zero hours contract. Lots of people go into it, but the staff turnover is phenomenal.

If care workers got paid a fair amount for the important work they do, and had some - any - job security, the profession wouldn't be staffed by those with no option but to be shat on (I meant that figuratively, but since it's care work sometimes literally).

plus i think im right in saying theres often agencies involved who take out obscene amounts of money from the pot that is put aside for spending on this
it should be nationalised like the rest of the NHS
sometimes its easy to say Spend More Money, though I think here its a case of huge sums not so much being skimmed off the top, as taken right down to the bone

 

[Spandex]

plus i think im right in saying theres often agencies involved who take out obscene amounts of money from the pot that is put aside for spending on this
it should be nationalised like the rest of the NHS
sometimes its easy to say Spend More Money, though I think here its a case of huge sums not so much being skimmed off the top, as taken right down to the bone

Running a private care home/care agency isn't that profitable. A big part of social care is paid for by cash strapped local authorities, who in recent years have used their buying power to drive down the price they pay below agencies' running costs. That means any profits come from overcharging private clients. Sure, the bosses of the really big care agencies might drive a nice car and have a big house, but a lot of the big care chains are in a pile of debt, which is why you see them go bankrupt from time to time.

 

[ska invita]

Running a private care home/care agency isn't that profitable. A big part of social care is paid for by cash strapped local authorities, who in recent years have used their buying power to drive down the price they pay below agencies' running costs. That means any profits come from overcharging private clients. Sure, the bosses of the really big care agencies might drive a nice car and have a big house, but a lot of the big care chains are in a pile of debt, which is why you see them go bankrupt from time to time.

i stand corrected

 

[bellaozzydog]

You know what puts excessive stress on the capacity of a health service

POVERTY

I have no idea what these ultra-cunts have announced today but with their long term objectives with regard to the NHS firmly on record it will not be good news

To think anything else is gross naivety

 

[Puddy_Tat]

yes, well, hmm.

the idea of health (NHS) and social care (local authorities) working more closely together sounds a good thing, as does less privatisation.

i will believe any of it when i see it, and am wary of tories appearing to bear gifts...

as for democratisation, i think part of the problem is the whole thing has been 'reorganised' so often that the average person in the street has little idea of who's responsible for what - i can faintly remember the concept of local health authorities (which i think at least included some local elected councillors) and family practitioner committees (which i think were elected as representatives of local GPs) but now it just seems to be a quangocracy.

running the whole thing from whitehall sounds questionable.

although whether local authorities would be up to it is another question (especially in places like berkshire where the county council got gerrymandered out of existence and everything's now at the level of parocihial minded district councils that are largely too small and underfunded to be of any practical use (and where there are less main hospitals than local authorities)

 

[Shechemite]

To add further to ‘it’s not just extra funding that’s needed’ argument

Why Children's Psychiatric Hospitals are Abuse Breeding Grounds

The children’s psychiatric hospitalisation system, at present, is handing abusers the opportunity to take advantage of children who are in ...

reformtorecover.blogspot.com

 

[teqniq]

User account

We Own It is a voice for everyone who wants UK public services to be run for people, not profit.

weownit.org.uk

 

[steeplejack]

Aggressive privatisation is the plan and has been for a number of years.

COVID has upset the applecart a little for now, but this is the plan, and it will be returned to and sold as marvellous, life-chance enhancing news to the voters in England when the conditions are right.

 

[LDC]

Social care is where the focus needs to be. It’s far worse funded than the NHS, it’s staff are paid a pittance and have limited career trajectory, the sparsity of ‘care in the community’ results in people becoming ill and needing inpatient/medical care.

the NHS does need a lot more funding. But it also needs a change in culture and needs to be democratised.

I somewhat agree, I think both much of the NHS and social care are focused at the acute and chronic end of the spectrum, I think for me the big shift needs to be away from the focus on acute and chronic healthcare and towards public and community health and preventative healthcare, which is a long term complex project.

 

[LDC]

I'll post this somewhere else soon, but this is going on which is relevant to this discussion....

New healthcare publication // call-out for submissions

We’re a small group of anarchists and libertarian communists who are intending to produce a publication covering the broad topic of healthcare provision in the UK.

We want to take a look at the structure and provision of healthcare now, how it might be run in a communist future, and discuss possibilities for the transition between the two. As well as this we want to take a look at some examples where this has been tried, or places that have something for us to learn from.

Rather than just reports on healthcare struggles we would like analysis, critical reflections, strategic overviews, and thought-provoking writing that comes from a revolutionary anti-capitalist perspective.

Although anyone can submit a piece we would particularly like writing from people that work in healthcare, or have experience of different models of healthcare organisation and provision. Articles can be of any length, and we might also be able to do interviews if that would be easier.

If you have a topic you think fits with what we’ve said we encourage you to get in touch, either for a chat about what you might write, or by submitting a short summary of your idea via email to <commie_health@protonmail.com>

Please feel free to circulate this call-out.

 

[Shechemite]

Hmm, the NHS - certainly re MH - has moved away from focussing on those with acute/chronic needs (hence reduction in beds, big increase in ‘recovery colleges’). From my perspective services are far too oriented towards ‘lower level’ needs and those with long term needs are seen as malingering

the problem with so much of ‘prevention’ is that it’s based on this ‘recovery model’ bollocks - ‘you need to take responsibility’ whilst social care provision and social security is destroyed

 

[Shechemite]

I'll post this somewhere else soon, but this is going on which is relevant to this discussion....

New healthcare publication // call-out for submissions

We’re a small group of anarchist and libertarian communists who are intending to produce a publication covering the broad topic of healthcare provision in the UK.

We want to take a look at the structure and provision of healthcare now, how it might be run in a communist future, and discuss possibilities for the transition between the two. As well as this we want to take a look at some examples where this has been tried, or places that have something for us to learn from.

Rather than just reports on healthcare struggles we would like analysis, critical reflections, strategic overviews, and thought-provoking writing that comes from a revolutionary anti-capitalist perspective.

Although anyone can submit a piece we would particularly like writing from people that work in healthcare, or have experience of different models of healthcare organisation and provision. Articles can be of any length, and we might also be able to do interviews if that would be easier.

If you have a topic you think fits with what we’ve said we encourage you to get in touch, either for a chat about what you might write, or by submitting a short summary of your idea via email to <commie_health@protonmail.com>

Please feel free to circulate this call-out.

love that email address

 

[Shechemite]

You know what puts excessive stress on the capacity of a health service

POVERTY

I have no idea what these ultra-cunts have announced today but with their long term objectives with regard to the NHS firmly on record it will not be good news

To think anything else is gross naivety

the rates of detention under the MHA since 2008 have increased year on year. So much of that has been due to cuts/attacks on the welfare state.

 

[Shechemite]

oh and the complaints system is a joke. Just further traumatises harmed patients and their families

And the inquest system...

 

[Spandex]

It's been quite hard to figure out what the proposed reforms to the NHS will actually mean in practice. There's been a snowstorm of spin around them, and NHS reform is such a politicised issue that lots of people have interpreted the proposals through their existing lenses and biases.

The best explanation I've found so far is from a far from neutral source - the FT's Investors Chronicle magazine:

Health reforms won’t limit private sector opportunities

A leaked government white paper suggests more direct government control in NHS England, but that doesn’t necessarily mean less private provision

It's from the perspective of 'don't worry Mr Capitalist, your private sector NHS investments are safe', but that's what makes it interesting. It notes:

The removal of the tender process is therefore unlikely to stymie post-pandemic opportunities in the private sector. In fact, with NHS England under sole control of a health minister who desperately needs to clear the backlog of overdue operations and prevent criticism of the government’s handling of the pandemic, private sector outsourcing could actually be on the rise.

 

[Shechemite]

Grim

 

[mojo pixy]

A major problem is that people do not want to work in social care

We say wages are poor, but working in care pays as much as or more than working in a shop, or in a bar - that is, minimum wage, or slightly over.

Long and antisocial hours are often mentioned, but again, loads of jobs have that too - bar work, door work, the military, nursing, many performing arts etc. These are not less popular job choices for the hours spent at work.

Poor conditions and workplace stress also come up a lot, and this is one I happen to agree with. But if anything it's a reason more campaigning needs to be done to un-profit-ize social care (because it's largely property owners aka 'care providers' taking profits that most impacts staff wages and care budgets .. creating the 'market conditions' everyone else follows)

What I'm curious about is the non-material reasons that repel potential care workers. Emotional reasons, eg. the stigma attached to caring not for healthy but unlucky to be ill for a time people in hospital, but disabled and elderly people, who are already hidden away like something shameful (under the guise of 'safeguarding' usually) and as low status humans, the job of caring for them seen as less important than hospital work.

This is the real difficulty IMO. Though better wages and conditions would help considerably to begin with.