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BBC's "Hospital" goes behind the scenes at Imperial College Healthcare NHS Trust

The second programme last Wednesday provided nail-biting suspense just like the first. What the surgeons said in their comments and their attitudes was very telling. One said bitterly: "I just wish someone would tell me when I can get on with my job!" And this week another said that it didn't matter that tens of thousands had just been wasted because there was no ICU bed available for their patient and so the surgery had to be postponed: the surgery was the right thing to do for this patient! The team was assembled four weeks later.What this series shows us is how inefficient and wasteful of resources it is to have an underfunded acute service. The bottleneck here is the supply of ICU beds: we need to devise a system to provide more ICU beds in the winter. And more HDU and step-down beds and better discharge arrangements, yes I know.....But the pressure on the A&Es at St Mary's and Charing Cross predates the winter: neither A&E has met the 4 hours treat or discharge target at any time in 2016.With demand going up by 5% per year, but funding by only 1% the outcome is inevitable.

Una-Jane Winfield ● 3542d7 Comments

Have not watched the programme but have read articles about it, and what is very evident is the population of this country is growing but our health service is shrinking.  The demands are greater but the powers that be seem to think it makes sense to close wards/clinics/hospitals or merge them into one massive hospital which surely puts greater pressure on the doctors/nurses and the resources available?  Would it not make more sense to have more smaller hospitals or more walk in clinics?  My GP surgery is open Monday to Friday, 8.30 to 6 and closed for an hour at lunch, so basically keeps office hours.  If these surgeries provided a 24/7 walk in service would it not help alleviate the pressures on the hospitals?

Carol Burge ● 3537d

Every front-line health service needs more funding, GPs as well as acute services. The profession of GP is currently so pressurised, laden with accounting and monitoring tasks for NHS management as well as rising demand from patients of all ages, that GPs rightly complain of burn-out and few medical students want to become GPs, despite the demands of NHS managers to "transfer care to primary services". "Walk-in GP services" are already provided in "Urgent Care Centres" or "Minor Injuries Units".The fact is that the UK spends too little on health services as a proportion of GDP compared to other European countries. We must spend more and catch up!

Una-Jane Winfield ● 3537d

I know there have been recent articles on some people entering the country specifically to use our free health service, and although being told they have to pay, leave the country and that is it.  Surely this has to stop?  I do not know enough about the politics of the health service but what I do know is that it cannot continue to be used at the level it is, particularly in the bigger towns and cities.  Whether it is more money it needs or the money it has needs to be better spent, ie less managers and more trained medical staff, I could not comment on, but it certainly does need something.

Carol Burge ● 3537d

The number of "health tourists" is very small and the amount of money to be recovered from them is estimated at £200M which is 0.2% of the £105 billion spent annually on the NHS. Health and social services are the second largest government budget after benefits and pensions. We can't get away from it: the population is increasing and it is ageing. If we want western-style healthcare for all (European countries) we have to pay more. There is no way around this uncomfortable fact. Even the Financial Times agrees: "Memo to Theresa May: it is vital that the NHS gets more money" 14th Jan 2017 - https://www.ft.com/content/50d3a12e-d8e1-11e6-944b-e7eb37a6aa8e

Una-Jane Winfield ● 3537d

Agree it does need a radical rethink/overhaul and if it is more money then the question is where would it come from?  Do we as individuals pay more, if so how?  Increase our NI contributions?  That then puts the onus on the people who are paying NI contributions.  Or do we do away with the "free" health service for all and only those that somehow qualify would get it.  And those that don't have to pay into a private health insurance plan?  Also assuming the health service does get a massive injection of money, it then needs to be spent in such a way that it does get used to provide health care, not on managers/administration etc.

Carol Burge ● 3537d

The NHS does NOT need a radical overhaul. It has had many, many overhauls which all waste money and cannot change the basic, equitable, free-to-all-at-the-point-of-delivery service!The NHS works on UK Civil Service principles which are efficient compared with other European countries (e.g. Greece!) The US insurance model is wasteful and inequitable.The NHS is already a mix of publicly and privately provided services. The NHS needs managers to "feed" patients efficiently to extremely capable and adaptable teams of clinical specialists. The NHS is always looking for savings from Quality Improvement Plans, but the savings are becoming harder to find: e.g. new employees from local authority social services work in some hospitals to speed up discharge from the moment the patient comes in the front door!I am not and never have been employed by the NHS. I have observed Imperial Trust and Hammersmith CCG board meetings in public for the last 4-5 years. The NHS is already a slick system. It has improved enormously in its lifetime. But the demand is increasing by 5% year on year. It must be funded equitably from an increase in income tax: 1-2% increase is needed now.

Una-Jane Winfield ● 3537d

Having been superbly treated at Hammersmith,St Mary's and CharingX hospitals,I do think the time has come for us to pay minimum payments as we do when we attend NHS dentists. Some treatment is free, but for other we pay a little. I really think we can no longer just go on as if it was still 1945 and Nye Bevan was alive. This is not to be anti NHS.As I say it is superb in our region, apart from the atrocious non nutritious food. But a minimum payment, and non payment for those who cannot would help out. Make people respect it more, and turn up for all appointments! People do abuse the NHS at present. Ask the staff!

Michael Wale ● 3528d