Manx Care Has Failed

[Gladys]

1 minute ago, wrighty said:

Agree with all that. The very mention of charging, even if to dismiss it as an option, is always going to get the comments section on Facebook buzzing - perhaps that was the point?

Anyway, charging is such an anathema because there’s nobody alive that remembers anything but healthcare free at the point of delivery. But in my view, that model is now broken. The UK NHS, rather than being the envy of the world, is failing. I don’t know what the endgame will be, but surely, waiting outside A&E in an ambulance for 10 hours, in July, is telling. The system is crumbling - can’t get a GP, can’t get an ambulance, EDs full, hospitals unable to discharge people as there’s no social care available.

If the NHS model of care is so great, why aren’t countries everywhere copying it? I’ve experienced better systems elsewhere, where charging and co-payments are part of it. What’s better? A ‘free’ service that can’t deliver, or a part-paid one that can? Charging should not be off the table simply because of the quasi-religious affinity that the population have with the NHS. It’s broken, and something needs doing to fix it. 

Quite.  That is why we should be reassured that all options are being considered by MC.  A more fundamental shift in the ideology has to come from the politicians, obviously with data and input from MC.

[wrighty]

Just now, Gladys said:

 A more fundamental shift in the ideology has to come from the politicians

Which is why it won’t happen and we’ll continue bumbling along from crisis to crisis for evermore. Any politician, of whichever colour, would not get elected on a mandate of changing the NHS model. And if attempted by stealth, like the Tories are meant to be doing, it gets called out by the opposition (both official and within) and little changes. 

[2112]

If they want to charge, fine, as much as I disagree, but I would pay it. What I want is proper service, proper diagnosis not passed from pillar to post, test after test, consultants and consultants referring my case to their colleagues. When having bloods done I want a doctor or consultant to read said results and take appropriate action, not do nothing, and leave it to an off island consultant to notice something not right when arranging bloods to be taken, who in turn arranged for me to get appropriate treatment back on the island. I don’t mind paying, but not for poor service and treatment. 

[wrighty]

Change can happen - university fees for example? In the 30 years since the time I was there we’ve moved from student loans to top up the maintenance grant, to paying fees and having no grant. It wiped the Lib Dems out in the 2015 election after they backed the tories in the coalition government.

Something similar needs to happen in health, but it would have to be over a timescale way beyond a parliamentary term which is why it’s difficult. 

[Andy Onchan]

15 hours ago, Gladys said:

Like I said, you need to listen to the whole programme.  She is in favour of free at point of delivery health services and did not support the proposal. 

They are also trying to make inroads into the various long waiting lists. 

TBH, she has inherited a shit show, as shown by the Michael's Report, and sounds committed to delivering a good service.  She also has a huge job in changing the culture as shown by both that report and the Ranson shenanigans.  These things aren't achieved overnight and certainly not easily in a sector which has recruitment issues.

Also remember those at the helm during the most impactful health crisis to hit since the NHS was created. 

She had some reassuring comments about geriatric care amongst other things.

At the end of the day, I don't think a charge will be applied for A&E, but would hope that the GP services, and perhaps MEDS, are improved to help people go elsewhere for help rather than take up the A&E resource.   It is an A&E, the clue is in the name.

I haven't listened to the program but it did occur to me that if the idea was rejected why mention it at all.

I can't help thinking that this is the first in the buttering up process, a warning if you like, that it will eventually be brought in.

Having said that, it will be a costly exercise to employ folk to chase up unpaid bills for emergency medical treatment. That alone would be a good enough reason not to proceed with it.

As I've said before, open up a tender for private operators to run it and pay an agreed rate per patient, as insurance companies do now.

[Gladys]

2 minutes ago, Andy Onchan said:

I haven't listened to the program but it did occur to me that if the idea was rejected why mention it at all.

I can't help thinking that this is the first in the buttering up process, a warning if you like, that it will eventually be brought in.

Having said that, it will be a costly exercise to employ folk to chase up unpaid bills for emergency medical treatment. That alone would be a good enough reason not to proceed with it.

As I've said before, open up a tender for private operators to run it and pay an agreed rate per patient, as insurance companies do now.

I can't remember what caused it to be mentioned and it may have been mentioned to demonstrate that all options are being considered, and some rejected, but kept on the 'long list'.

As Wrighty says the system does need an overhaul.  This has to cover culture, methods of working, staff recruitment and retention, and perhaps in the longer term, some kind of payment system.  But these small steps are part of that, you would hope. 

More fundamentally, perhaps the scope of the NHS needs a review to ensure its resources are delivered to those in medical need.  Perhaps that is already being done by doctors deciding which cases to treat, I don't know, but the system is creaking. 

As for the payment at A&E, as you say I can see that being administratively unwieldy, they are just not set up to deal with payments and it would create yet more bureaucracy.  What if someone doesn't have the means to pay?  Is it a fee for everyone, or just non-emergencies?  Will there be exemptions based on age, being receipt of benefits etc?

[code99]

27 minutes ago, wrighty said:

Change can happen - university fees for example? In the 30 years since the time I was there we’ve moved from student loans to top up the maintenance grant, to paying fees and having no grant.

As of 2020/21, delinquent 'Student Loan Debt' is through the roof. IMHO, one of the worst right-wing 'contrivances' ever (sadly, first introduced in the UK under the Labour government of Tony Blair).

[0bserver]

52 minutes ago, wrighty said:

Agree with all that. The very mention of charging, even if to dismiss it as an option, is always going to get the comments section on Facebook buzzing - perhaps that was the point?

Anyway, charging is such an anathema because there’s nobody alive that remembers anything but healthcare free at the point of delivery. But in my view, that model is now broken. The UK NHS, rather than being the envy of the world, is failing. I don’t know what the endgame will be, but surely, waiting outside A&E in an ambulance for 10 hours, in July, is telling. The system is crumbling - can’t get a GP, can’t get an ambulance, EDs full, hospitals unable to discharge people as there’s no social care available.

If the NHS model of care is so great, why aren’t countries everywhere copying it? I’ve experienced better systems elsewhere, where charging and co-payments are part of it. What’s better? A ‘free’ service that can’t deliver, or a part-paid one that can? Charging should not be off the table simply because of the quasi-religious affinity that the population have with the NHS. It’s broken, and something needs doing to fix it. 

I totally agree with you that the current model and funding is unsustainable. 

I don't think a user pays model would be the way to go. But we do need to have a long and honest debate about thr future of health and social care. 

I suspect moving towards a Nordic type model may be the way to go. Of course that would mean increased funding through higher taxes.

[finlo]

Too many at the top are creaming all the money off leaving the coalface on its arse!

[Dirty Buggane]

We can all agree that the MNHS is underfunded always has been, as shown by going cap in hand year on year for funding. What we did not need is another buricratic layer costing many millions. I personally think management should of been tasked with proving their need and usefulness. Manx care are trying there best at to reduce waiting times, but do not seem to be doing anything to reduce bloat in management levels. Which would reduce costs,  wages being the lions share.

I know being to simplistic, which I know will be wrong

[Mistercee]

I was interested to hear on the Manx Radio programme,  Ms Cope's response to a question about the time it takes to consultants to issue letters to patients and GP's. It was claimed that in one case it took 6 weeks from the date of the appointment to the letter being received and she clearly stated that this was not acceptable. This is the first time I have heard anyone in Manx Care make such a clear admission of the existence of a problem. I sincerely hope she will crack on and get something done. I know of an individual who tried to complain about this to their MHK two years ago. The MHK claimed to have spoken to Magson about it and it was being "fixed". The correspondence between the individual and the MHK terminated after the MHK claimed it to be normal business practice to take 10 days to reply to a letter. He does of course have extensive business experience!!!       

[SleepyJoe]

1 hour ago, code99 said:

As of 2020/21, delinquent 'Student Loan Debt' is through the roof. IMHO, one of the worst right-wing 'contrivances' ever (sadly, first introduced in the UK under the Labour government of Tony Blair).

Are a large number of Manx graduates defaulting on their loan agreements?

[0bserver]

25 minutes ago, Mistercee said:

I was interested to hear on the Manx Radio programme,  Ms Cope's response to a question about the time it takes to consultants to issue letters to patients and GP's. It was claimed that in one case it took 6 weeks from the date of the appointment to the letter being received and she clearly stated that this was not acceptable. This is the first time I have heard anyone in Manx Care make such a clear admission of the existence of a problem. I sincerely hope she will crack on and get something done. I know of an individual who tried to complain about this to their MHK two years ago. The MHK claimed to have spoken to Magson about it and it was being "fixed". The correspondence between the individual and the MHK terminated after the MHK claimed it to be normal business practice to take 10 days to reply to a letter. He does of course have extensive business experience!!!       

Why are they even issuing physical paper letters? It should all be by email and text  

[Gladys]

There was also someone travelled to the MIU in Ramsey from Douglas.  Its opening hours are 8am till 8pm. They arrived at 7.45pm and the doors were locked.

She said she would look into what happened so it wouldn't happen again. 

I have to say I listened to the programme expecting to hear a load of hog wash and management/CS jargon, but she was straightforward and came across as wanting to improve things. 

[0bserver]

1 minute ago, Gladys said:

but she was straightforward and came across as wanting to improve things. 

I want to win the lottery. Let's see which one happens first.