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GUEST,Fogie BS: UK An NHS Story (21) RE: BS: UK An NHS Story 15 Jun 06

I sympathise with your mothers history. As a part of the front-line NHS I have had a worrying feeling for a decade or so that we are overseeing the run-down of what we understand as the NHS, while being urged to do more and more for patients, with an increased but still inadequate budget. I also think that now even the management costs are now pared to the bone,( but not neccesarily the business advisors the government takes on.)
I can't really report on what is happenning in hospitals,but hospitals and primary care services and ambulances and other services are all fighting for their own costs.
It makes me angry at leaks the government puts out about GPs income, and before anyone kicks the GP contract funding and out-of hours costs it is important to realise what a demoralised bunch they were, and how little money was offered to continue working their previous hours, which led to the acceptance of the new contract and rejection of the OOH funding- (now many times the cost it was)
Much of the direction of the new GP contract is admirable, but has resulted in many extra costs to the system, which are not specifically being funded.
It is interesting that the GP contract, far from being set in stone seems to have become elastic again as treatments for new diseases have been hoisted on them, without negociation and once again reimbursement is dependant upon ticking boxes doing tests prescribing more drugs etc. etc. -all from the same pot!
It really must be a difficult job pleasing all the people all the time within a country that is not making more and more money, and with so many other commitments, such as keeping world class armed services!
Just to give two examples of budget problems, 1 the number of elderly being kept alive for longer has vastly increased,as has what is able to be treated, and so the drug budget has rocketed. 2 The cost of herceptin for breast carcinoma for a single woman year is £22K which is a good percentage of keeping a nurse in her post! Unfortunately the NHS is a bottomless pit of needs which is unlikely ever to be fully met, so its just a matter of politicians jumping in and sorting the most emotive issues as the rest go to the wall.
I'm not sure how to fix the system, it depends as a society what we elect to spend our taxes on, and how our usual party political system copes with everyone wanting different things from that money.
I find it perplexing, and too complex a subject for a "bear with little brain" to try grasp or explain all the facets of the system.

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