IOM DHSC & MANX CARE

[asitis]

It's also pertinent to look at the qaulity of minister the service has functioned under, Quayle, Shredder Ashford and it wasn't me Hooper !

Edited Friday at 05:17 AM by asitis

[2112]

CM Cannan in the NPM saying it’s completely unsustainable for Manx Care to keep spending. Yes - but CM Cannan is Chief Minister, in charge of the island, and was previously the Treasury Minister, and as such he bears some responsibility for the mess. What’s he going to do, keep increasing taxes, punishing the lower paid? 
 

Enough is Emough!

[hoopsaa]

1 hour ago, asitis said:

It's also pertinent to look at the qaulity of minister the service has functioned under, Quayle, Shredder Ashford and it wasn't me Hooper !

It's amazing any of us are alive, really.

[Banker]

2 hours ago, asitis said:

It's also pertinent to look at the qaulity of minister the service has functioned under, Quayle, Shredder Ashford and it wasn't me Hooper !

To be fair the service we generally receive in Iom is better than the complete shambles in the Uk 

[2112]

CM Cannan say he will present an outline of a turnaround plan next week at the IOMG Conference. WTF!!! This type of back slapping self congratulatory affair is not the place to make grand announcements. How about doing it on the floor of Tynpotwald! Whatever plan he creates, more taxpayers cash will be poured into Manx Care, with zero results, and little accountability by Manx Care management, and Minister Hooper. 

[Happier diner]

2 minutes ago, Banker said:

To be fair the service we generally receive in Iom is better than the complete shambles in the Uk 

The gap is getting smaller. And it's not due to the UK improving.

[Banker]

7 minutes ago, Happier diner said:

The gap is getting smaller. And it's not due to the UK improving.

Probably but my family have always received excellent service and able to contact relevant people, elderly relative this week admitted and could not fault the care.

According to some of Headings cult the issues with healthcare are caused by mass inoculation with poison 😂

[Boo Gay'n]

3 hours ago, asitis said:

It's also pertinent to look at the qaulity of minister the service has functioned under, Quayle, Shredder Ashford and it wasn't me Hooper !

You forgot Saint Kate!

[lfc84]

It might argued that it's under funded.

 

Are there still 80 vacancies in healthcare? If so, no wonder there are problems 

 

[Jarndyce]

1 hour ago, Boo Gay'n said:

4 hours ago, asitis said:

It's also pertinent to look at the qaulity of minister the service has functioned under, Quayle, Shredder Ashford and it wasn't me Hooper !

You forgot Saint Kate!

I suspect you’re being ironic: but, compared to the Three Stooges…

[thommo2010]

It would be interesting to see a breakdown of the spend, I would imagine the most money goes on wages which can't be helped to an extent but where is the rest of the money going?

[wrighty]

6 minutes ago, thommo2010 said:

It would be interesting to see a breakdown of the spend, I would imagine the most money goes on wages which can't be helped to an extent but where is the rest of the money going?

It used to be healthcare dogma that funding was split 60/20/20 into salaries/drugs and other consumables/infrastructure.  In recent years I think the infrastructure spending has been cut and a higher proportion (94% in the UK according to the Kings Fund) spent on the other two.  

So how do you save money? Cut salaries (can't fill posts as it is, and paycuts won't make it easier) or cut drugs spending (and hence stop doing various things)? 

And all this while there is more and more demand for more and more services.  In the UK at least, we're starting to think about what replaces the NHS model as there is wider agreement every day that it is unsustainable in its current form, and it really can't take any more reform and reorganisation (which doesn't work anyway).  If the NHS model is so great why aren't France, Germany, Australia etc copying it? It was designed in the 1940s. It's no longer fit for purpose 80 years later.

(Once again, for clarity, this is my personal view - I'm not the official spokesman for Manx Care, the medical profession, or the government)

[Alanbellend]

12 minutes ago, wrighty said:

It used to be healthcare dogma that funding was split 60/20/20 into salaries/drugs and other consumables/infrastructure.  In recent years I think the infrastructure spending has been cut and a higher proportion (94% in the UK according to the Kings Fund) spent on the other two.  

Same with any other IOM government service. 90% of the cost is employing people on ever escalating packages even if they do absolutely jack shit. And the rest is spent on delivering services.

It seems our health service can’t even employ admin staff who can successfully put 12 letters in the post to advise people of appointments despite paying them £35k a year. 

[Derek Flint]

3 hours ago, Banker said:

To be fair the service we generally receive in Iom is better than the complete shambles in the Uk 

It's a lottery. Getting a GP appointment is the toughest bit. Once in the system it's pretty slick. Still a wait but you are booked in for consultations within a week or so.

I really miss the personal relationships with the GPs in Ramsey as it used to be. That was great. Nobles did 3 ops on me and were faultless. 

29 minutes ago, wrighty said:

It used to be healthcare dogma that funding was split 60/20/20 into salaries/drugs and other consumables/infrastructure.  In recent years I think the infrastructure spending has been cut and a higher proportion (94% in the UK according to the Kings Fund) spent on the other two.  

So how do you save money? Cut salaries (can't fill posts as it is, and paycuts won't make it easier) or cut drugs spending (and hence stop doing various things)? 

And all this while there is more and more demand for more and more services.  In the UK at least, we're starting to think about what replaces the NHS model as there is wider agreement every day that it is unsustainable in its current form, and it really can't take any more reform and reorganisation (which doesn't work anyway).  If the NHS model is so great why aren't France, Germany, Australia etc copying it? It was designed in the 1940s. It's no longer fit for purpose 80 years later.

(Once again, for clarity, this is my personal view - I'm not the official spokesman for Manx Care, the medical profession, or the government)

The best designers are usually those that 'do'. 

What do you think it should look like if it was to be remained from the ground up?

[wrighty]

3 minutes ago, Derek Flint said:

 

The best designers are usually those that 'do'. 

What do you think it should look like if it was to be remained from the ground up?

Bloody hell Derek, bit much to do that in a forum post, but I'll give it a go with some basic principles I think are needed.

• Keep the primary care/secondary care split.  Charge patients for GP appointments (with checks and balances in place such that the most impoverished can still access care they need).  Limit what GPs can refer to secondary care, with criteria.  
• Secondary NHS care is largely for emergencies/serious problems such as heart attacks/strokes/cancer.  Charge patients for A&E visits.
• Proper integrated digital records.  I see a medical record as much like your Amazon home page.  From any computer in the world I, and those with access to it, can see exactly what I've bought, I can order more stuff, I can send messages to customer services etc.  If a medical record were similarly set up it could be used for storage of information, referrals, communication between professionals, ordering tests, prescribing medication etc.  If I were king I'd be in touch with Amazon or Google and ask them to design something from scratch along those lines.
• Rationing - some treatments would not be available on the NHS.  Have an NHS formulary consisting of only generic medication rather than branded high cost drugs.  Same for implants such as joint replacements.  If a patient wants a different brand they pay.
• Somehow, stop getting tied up in red tape over GDPR and confidentiality.  Vladimir Putin is absolutely not interested in Mrs Miggins' forthcoming gall bladder operation, so it doesn't have to have the same level of security as the nuclear codes.  Similarly, society needs to accept risk.  Not everything that goes wrong should mean a payout.
• Private practice.  I'd hate to see a US system, which is widely recognised as the worst of all worlds, but we need to embrace private practice and facilitate it as taking pressure off the NHS, rather that objecct to it on ideological grounds.

That's not, obviously, a coherent plan for change, more a brainstorm really listing a few things I think might help stem the inexorable rise in NHS expenditure.  We need to raise money and cut costs and be more efficient, so that means charging, rationing, and better tech.  All three are required otherwise we fail.