Notes on the NHS

A curve ball of note, to which one can but reply, “It depends.”

The NHS shrieking is just the usual socialists demanding more of other peoples money, nothing one need really pay attention to.

However, on the medical side it is important to understand that while the NHS is a centralised govt dept, it is administered as a group of Trusts, nationwide, this being a feeble attempt to make it look a bit more ‘private sector’ than the monolith it is.

As a result, you end up with a lottery in terms of how good your local trust is, which in certain areas can be a problem. The probs can be sheer bureaucratic or management incompetence, as being a trustee is a very lucrative job to be handed out to the faithful.

There are also areas where the infrastructure is lacking, or old, or where they have difficulties in attracting staff. North of James is one such area.

There are also areas where the immigrant masses have descended, and the infrastructure and setting in general more closely resemble Mpumulanga that a first world locale.

It also depends on all the other factors – do they have ties to a particular part of the country, are they city dwellers, or do they prefer the more rural setting; will they need full time employment, etc etc etc.

There are some fairly obvious guidelines – avoid most of the larger cities like the plague, except for certain areas, which usually require local knowledge. The cities are usually way more expensive than the smaller places, as well, particularly London.

Ditto tourist traps.

There are also places like Stevenage, Luton, Bedford, and many more that are absolutely avoid at all costs.

Using our place as an example, we’re 10-12 miles outside Cambridge, in a village of 2-3000 people. Small local shop, and a couple of pubs, limited hours post office. One B&B. Nearest large supermarket is 7 miles away, on bus route. There is a bus every hour to/from Cambridge, 7am to 7pm mon to fri. 1 mile away is the high speed Busway bus link to Cambridge – dedicated, bus only route, with buses every couple of minutes. Weekends, not so great on both.

Cambridge NHS trust is backed by the Universities, so the hospital is a huge teaching and research hospital, so it is well stocked with very capable consultants, and very well funded. Unfortunately it suffers from the bureaucratic mania for centralisation, so murderous to get to, and very busy at times. Superb medical care though.

Local doctors are 75 yards away from us, a practice of 4 or 5 or so. Most of the older docs have retired, and one now gets the current NHS output, who are basically trained as bureaucratic box tickers, and on how to use Google. Their sole job is to determinedly implement the current NHS, BBC and media obsession. Any illness is secondary.

One has to get them to refer one to a consultant at one of the hospitals to get any real treatment other than minor ailments.

In many parts of the country, particularly the cities, the frontline GPs are predominately freshly minted Pakistani or Indian or similar ‘doctors’ who are employed in droves to make up the box ticking numbers (all interchangeable, you know?) which is why such are, again, best avoided.

Accommodation wise, in Cambridge, very pricy, you’re competing with zillions of students. Out our way, a lot better price wise, but neither locale has a lot of spare accomm. (Remember that here the local councils are the main landlords).

Lots of work of various levels and desirability, but I’d imagine most of it is pretty close to entry level. e.g. just about anybody could walk into a job as a carer in a care home tomorrow. Not the greatest work, but it pays a reasonable salary, although the hours can be dreadful. For skilled people, one has to determine where the skills are needed.

STOP PRESS – just found some extra notes:

Let me expand a bit on the NHS systems, processes and procedures. (All of this assumes one is in the country legally, and able to use the services in the first place)

When you move into a new house/area/whatever, you track down the local doctors practice or practices, and register with them. In the cities there are usually several practices nearby, although some may not be accepting new patients due to numbers/popularity. In the villages and such it is more common to have 1 or perhaps 2.

Most village practices are also a dispensing pharmacy.

This local practice then becomes ones primary ‘access point’ for medical services, as with such things in most places, they do the everyday consultations, prescribe any required medicines and such and refer any more serious or complicated matters to specialists and consultants.

In chronic cases, such as myself or James, or potentially Christine, one is referred to a specialist consultant in the particular field, end e.g. in my case, for that condition, I become a permanent patient of the specialist and their/his department. All treatment, prescriptions, tests etc etc to do with condition are handled directly by them and directly with me.

That said, I was referred to the dept and the hospital by the local practice, I did NOT choose it myself, although I guess one could present oneself at accident and emergency and get admitted there that way?

Note also, that many companies provide private medical services for their staff, either automatically, or as an option, and these folk can choose whether they use the NHS or their private cover for operations, treatment etc.

I believe however that there may be a ‘if you start private,you can’t revert to the NHS rule’, James may know more.

I’d note also that specialist referrals are usually as local as possible, so Christine should simply ensure that wherever they are considering there is a well regarded Orthopaedic section attached to the local NHS Trust.

Public transport will usually service the hospital, and the NHS also has NHS transport for less mobile folk or for people with poor public transport to get people to their appointments. If one is well heeled, there may be a charge, but for pensioners and such it is usually free.

They are also VERY strong on the physio and remedial follow up, if required.

So, for example, I have a post op and annual checkup at Addenbrookes on thursday. Full lung function and other tests, x-rays, scans if required, etc etc about 1 1/2 hours worth, and a session with my specialist. If I wanted, I could call NHS transport, and they would collect me and drop me home afterwards…

Likewise, on monday, I start a 16 week post-op rehab course in Cambridge. Since that’s held in an out of the way location, NHS transport will collect me at home, drop me there, and ditto on completion, for the entire 16 weeks.

9 comments for “Notes on the NHS

  1. February 7, 2018 at 10:01 am

    I’ll write a reply on my experiences of it asap.

  2. Ljh
    February 7, 2018 at 10:27 am

    Before you slander Mpumalanga please note it has excellent private medical facilities for those with medical insurance or self paying(discounts for immediate payment). Clean, uncrowded, instant access, immediate diagnostics, pleasant competent medical staff dependent for their livelihoods on patients and consultants continuing to chose that facility. Free state care not so great but a good training ground for staff the NHS pinches.

  3. Penseivat
    February 7, 2018 at 11:01 am

    NHS needs more money? “Simples” as Alexander would say. Work out how much the NHS lost last year in treating visiting or foreign people who were not entitled to free medical care. Add 20% for VAT and another 10% for inflation , and then take that from this year’s foreign aid budget. Unfortunately, those who could do this realise it is only taxpayers money which is being lost and so will do nothing. Tossers!

    • February 8, 2018 at 4:34 pm

      Sadly, I suspect that’d amount to a comparative drop in the ocean.

  4. Errol
    February 7, 2018 at 4:36 pm

    Surely easier just to stop giving the NHS money and shift it to the patient who rocks up with a card with their NHS number on it.

    When the patient is treated, they have their card swiped, just as with a credit card and then – and only then – is the NHS paid from government funds, from taxation.

    That’s how every other system works.

    • Ted Treen
      February 9, 2018 at 1:47 pm

      Nice thought, Errol: simple, relatively easy to implement and administer, biometrics could be added to card as a fraud preventative, and it just oozes common sense. Obviously for the foregoing reasons, our elected halfwits would never countenance it.

    • Stonyground
      February 9, 2018 at 6:42 pm

      That system would probably work well for schools as well.

  5. Pcar
    February 7, 2018 at 10:29 pm

    Public transport will usually service the hospital, and the NHS also has NHS transport for less mobile folk or for people with poor public transport to get people to their appointments. If one is well heeled, there may be a charge, but for pensioners and such it is usually free.

    Not in Scotland, if you can’t get to hospital for appointment by public transport, car, walk etc and can’t afford a taxi you are discharged for non-attendance.

  6. nininina
    February 14, 2018 at 8:09 pm

    They warned that very ill patients could die as a result and questioned whether the NHS can still offer timely acute care all year round. Hospitals say that the NHS’s limited supply of intensive care beds has forced them to prioritise flu patients at risk of dying before surgery over other very sick people, including those with cancer and heart problems. BBC NewsA new ring-fenced tax to fund the NHS and social care has been proposed by a panel of health experts. The panel, set up by the Liberal Democrats, says the NHS in England should be given an extra £4bn on top of inflation in the next financial year.

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