Westminster Politics 2024-2029

You're making a mockery of the system that bows and scrapes at the sausage fingered mate and landlord of a sexual predator, who also fantasies about being his second wife's tampon, for emerging out of more magical genitals than everyone else's, Jeremy!
:lol:


Rachel Reeves launches £7.3bn national wealth fund

Chancellor says government aims to attract billions of pounds of private cash for big infrastructure projects

https://www.theguardian.com/business/article/2024/jul/09/rachel-reeves-national-wealth-fund-labour

Is that it?
Is this just about socializing the losses ?

 
I would definitely support legalising assisted suicide
I’m on the fence, leaning towards legalisation provided the proper safeguards are in place.

That said, I’ve heard plenty of stories about the misapplication of Canada’s assisted dying policy that make me nervous.

In 2022, 4.1% of all Canadian deaths were due to euthanasia.
 
Rachel Reeves launches £7.3bn national wealth fund

Chancellor says government aims to attract billions of pounds of private cash for big infrastructure projects

https://www.theguardian.com/business/article/2024/jul/09/rachel-reeves-national-wealth-fund-labour

Is that it?
"The chancellor insisted there would be a clear distinction between the NWF and GB Energy, another publicly owned company proposed by Labour. While GB Energy will focus on the “production of clean, low carbon energy”, investment made via the NWF will seek to deploy £1.8bn to ports, £1.5bn for gigafactories including for electric vehicles, £2.5bn to clean steel, £1bn for carbon capture and £500m to green hydrogen."

It always makes me wonder why we don't invest in ourselves to do these things rather than paying corporations and billionaires to do them instead and then charge us a premium for the pleasure.
 
As far as the NHS is concerned, it's clear that a growing elderly population, living longer, requiring more support, more medical interventions, and taking up 90 of the 95 spaces in the queue ahead of you when you try to get a GP appointment, is a major issue. They're filling up A&E's, they're lined up in hospital corridors, they're costing the country a fortune.

I work in a care home. The support network for the residents is staggering. There are GPs, district nurses, pharmacists, occupational therapists, dieticians, speech and language therapists, mental health nurses, psychiatrists, social workers, on-call clinicians, equipment services, and so on.

This example is very common: an elderly resident develops a pressure sore because they're old and tired and do a lot of sitting around. Their skin is fragile and they don't drink as much as they should do because their thirst mechanism has dissipated with age and they don't feel thirsty. Besides, if they drink more, they pee more, and they don't want to keep getting up to go to the toilet because they're old and tired.

The care home might need to contact the district nurses to dress the wound. The DNs then arrange for pressure relieving equipment, such as an airflow mattress, profile beds or pressure cushions (which is provided by the local authority). Maybe the wound deteriorates and becomes infected, so the GP becomes involved, prescribing antibiotics. Now that the person has an infection, they go off their food. They were already frail and lean but now their weight plummets, with their MUST score triggering a referral to the dietician. The dietician prescribes them some Ensure drinks to supplement their diet. However, that doesn't seem to do the trick because, although they drink the Ensures, they still won't eat solid food. Which then triggers a referral to the speech and language therapists (SALTs), who figure out if the individual isn't eating because there's an issue with their swallowing.

The SALT recommends that the resident only has soft or blended food and also prescribes thickening powder for their drinks, to help with their fluid intake. The pharmacist reviews their medication, changing as many pills and capsules as possible to liquid versions (which can be waaay more expensive). All of this has taken its toll on the resident, who is now bedbound. Previously only requiring some discreet assistance to go to the bathroom with one carer, now they're on a two hourly turns chart, mandated by the district nurses, requiring two carers to reposition them and attend to their continence needs. At this point, they may require bed rails to stop them falling out of bed. If they lack capacity (eg: have dementia) a DoLS (Deprivation of Liberty Safeguards) referral is sent off to the local authority. This is because bed rails are classed as a restraint and you need to justify their use.

They continue to deteriorate. Having a poor diet and fluid intake, living with chronic pain from lying in bed all day and having regular pain relief, they now require laxatives because the Paracetamol and Codeine makes them constipated. Immobile, they're now prone to chest infections and UTIs. Any fluid sits on their lungs and they're too weak to cough it up. They require antibiotics. The antibiotics don't work. The GP prescribes a second dose. This time, it just about works. They recover slowly from the infection but it brought it home to all concerned how frail they now are. The Enhanced Health Care team are contacted. They draw up, along with the individual and their family, a list of criteria that will determine whether the resident is admitted to hospital (usually only for a broken bone or if IV antibiotics are required to fight an infection). An anticipatory care plan is put in place.

Now they're categorised as End of Life. Palliative nurses come and check on them monthly, weekly or several times a day, depending on how close they are to the end. The GP has prescribed anticipatory medication, so they can be kept as comfortable as possible when they are in the final days of their life. Towards the end, they require round the clock care. This is how a lot of you will end up, whether you like it or not.

Look at how many healthcare professionals are involved. Some will be involved multiple times for different reasons. The cost is stratospheric. There will be an enormous amount of phone calls, emails, appointments, and time spent on this individual's health and wellbeing.

I haven't even mentioned falls, which can be prevalent, requiring ambulances, taking up space in A&E, then recovery wards. There's the cost of supplying zimmer frames, wheelchairs, etc. All of which are bespoke and require occupational therapists to assess.Every hospital visit for someone in a wheelchair requires an ambulance there and back, eating up more resources. I've only really scratched the surface. I've heard, anecdotally, that we spend more on healthcare in the last year of someone's life than we do for the rest of their life put together. I don't know if that's true but it feels like it is.

I love my job and I'm passionate about helping people, especially some of the most vulnerable in society, but I can't say I'm enamoured with the amount of time and money we spend on keeping people alive, many of whom say that they've lived long enough and just want to die. I don't know what the answer is. I'm just trying to paint a picture for those who are unaware of how much money is spent on caring for the elderly. Maybe that's why Hancock tried to kill so many of them?

So, to sum up, if you can't get through to your GP at 8am and are 95th in the queue, it's probably because people like me are ahead of you.

Great post. I am a GP and look after a nursing home myself with a weekly MDT and it’s insane how much work comes up from there every week. The number of visits, calls and resources used up is so difficult for anyone else to comprehend
 
Great post. I am a GP and look after a nursing home myself with a weekly MDT and it’s insane how much work comes up from there every week. The number of visits, calls and resources used up is so difficult for anyone else to comprehend
Weekly MDTs are a great idea and it looks like our GPs are moving in that direction very soon, divvying up the local care homes between them. Which makes sense, as our residents are currently with 8 different surgeries. Plus, it's a proactive measure, meaning a lot of issues will get noticed before they escalate.

We had a great initiative here, whereby an Integrated Care Team, led by a GP and a geriatric consultant from the hospital, came to review residents holistically. They looked at the residents' medical history, medications, falls history, diet and fluid intake, mobility, pressure areas, layout of their room, even their footwear. All with a view to targeting support directly where it was needed. I thought it was brilliant. But they just pulled the plug on it a month ago, saying that it didn't represent good value for money. :confused:
 
Just because other European countries do it it doesn't mean it is a good thing.

The Common wealth fund did a study to see the percentage of people put of accessing healthcare by charges.

Obviously the US came out on top with 37%, but France and Germany had 18 and 15% respectively, the UK had 4%.

Those percentages are going to represent the poorest and most vulnerable in any society, I'd prefer not to live in a country where the poorest arw afraid to access healthcare, we should be proud of the principle we have.

You've got to take those numbers into context. There absolutely should be some people put off by the cost, that's the entire point. Got a sniffle? Don't go to your GP. Scraped your arm? Stay away from A&E. There is none of that in the UK and any doctor will tell you people do turn up for those things. Being blunt in many areas the UK needs to stop disproportionately pandering to the bottom percent of society if it is going to make any progress for the rest.

And i'd be interested to know how they came to the conclusion that the cost of a completely free system put 4% of people off.
 
You've got to take those numbers into context. There absolutely should be some people put off by the cost, that's the entire point. Got a sniffle? Don't go to your GP. Scraped your arm? Stay away from A&E. There is none of that in the UK and any doctor will tell you people do turn up for those things. Being blunt in many areas the UK needs to stop disproportionately pandering to the bottom percent of society if it is going to make any progress for the rest.

And i'd be interested to know how they came to the conclusion that the cost of a completely free system put 4% of people off.
Crikey.
 
You've got to take those numbers into context. There absolutely should be some people put off by the cost, that's the entire point. Got a sniffle? Don't go to your GP. Scraped your arm? Stay away from A&E. There is none of that in the UK and any doctor will tell you people do turn up for those things. Being blunt in many areas the UK needs to stop disproportionately pandering to the bottom percent of society if it is going to make any progress for the rest.

And i'd be interested to know how they came to the conclusion that the cost of a completely free system put 4% of people off.

Yea man, feck the poor, amirite
 
You've got to take those numbers into context. There absolutely should be some people put off by the cost, that's the entire point. Got a sniffle? Don't go to your GP. Scraped your arm? Stay away from A&E. There is none of that in the UK and any doctor will tell you people do turn up for those things. Being blunt in many areas the UK needs to stop disproportionately pandering to the bottom percent of society if it is going to make any progress for the rest.

And i'd be interested to know how they came to the conclusion that the cost of a completely free system put 4% of people off.

I don't think you understand the relationship between healthcare and economic productivity.

https://www.mckinsey.com/industries...oritizing-health-could-help-rebuild-economies
 
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Am extra sentence or several to explain what you do mean, would be handy.
Not sure I understand the confusion. A big part of charging a nominal fee is to put off hypochondriacs or at least make people think twice about going to see their GP about a bruise or scratch.

If the fee puts off 4% from ever seeking medical attention maybe that's the price we pay. Obviously you have to ensure there are safety nets so the poorest don't neglect help because of cost fears. You also try to educate those that don't go and see their GPs for anything now anyway -it's a problem already- about serious symptoms to look out for.
 
I’m on the fence, leaning towards legalisation provided the proper safeguards are in place.

That said, I’ve heard plenty of stories about the misapplication of Canada’s assisted dying policy that make me nervous.

In 2022, 4.1% of all Canadian deaths were due to euthanasia.

And the vast majority were old people very close to the end of life so merely had their life shortened slightly to avoid unnecesary pain and suffering. Also in the vast majority of cases where palliative care was available it was used first and of the 23% who didn't 20% declined it (3% unavailable), before assisted euthanasia, presumably right at the end. So it sounds like Canada is using it exactly as it should be. A normal way for people to die a dignified death.
 


For the love of God, what’s wrong with this now?

It’s simple maths - a healthier nation, able to resolve medical issues quicker, is a more productive nation. Fewer sick days, fewer health-related absences, fewer long-term absences due to chronic issues.

This is the short-sightedness of the right, thinking that crippling our only access to healthcare will somehow help people, or that they ‘just need to work through’ the pain/issues they’re dealing with.

A top notch NHS pays for itself in the subsequent financial savings made in the workplaces up and down the country.
 
I'm not sure what's that's got to do with what i wrote?

Because poor people and hypochondriacs are also workers and consumers and needs access to healthcare. There must be other ways to stop them allegedly clogging up the system than charging a fee.
 
And the vast majority were old people very close to the end of life so merely had their life shortened slightly to avoid unnecesary pain and suffering. Also in the vast majority of cases where palliative care was available it was used first and of the 23% who didn't 20% declined it (3% unavailable), before assisted euthanasia, presumably right at the end. So it sounds like Canada is using it exactly as it should be. A normal way for people to die a dignified death.
While the majority of assisted dying cases are merely allowing people to die with dignity a little earlier than they would have anyway, there are clearly some unsettling examples from Canada. Maybe that’s to be expected with any new law?

This (long) article — from someone who is generally pro-euthanasia — is what gave me pause:

https://www.noahpinion.blog/p/the-perverse-incentives-of-euthanasia

In theory, I’m in favour of legalised assisted dying. If/when I get old and seriously ill, I’d like to have the option to choose when to die rather than be forced to suffer. But I don’t want to be pressured into it.
 
Because poor people and hypochondriacs are also workers and consumers and needs access to healthcare. There must be other ways to stop them allegedly clogging up the system than charging a fee.

Surely you can see how diverting the disproportionate amount of money and attention going towards those who abuse or overuse the system will improve overall outcomes.

Is there another health system that is totally free? Even the Scandi countries have co pay.
 
What do you mean then by the "bottom percent of society"?

Those who take the piss one way or another. Might be poor, might not. Goes beyond healthcare and the UK is far too easy on those people to the detriment of everybody else.
 
Those who take the piss one way or another. Might be poor, might not. Goes beyond healthcare and the UK is far too easy on those people to the detriment of everybody else.

You should probably edit your post so that's more clear, because it certainly does not read as people who take the piss and absolutely reads as if you're talking about poor people.
 
You should probably edit your post so that's more clear, because it certainly does not read as people who take the piss and absolutely reads as if you're talking about poor people.
He is. He's just sort of backpedalling a bit now.
 
Not sure I understand the confusion. A big part of charging a nominal fee is to put off hypochondriacs or at least make people think twice about going to see their GP about a bruise or scratch.

If the fee puts off 4% from ever seeking medical attention maybe that's the price we pay. Obviously you have to ensure there are safety nets so the poorest don't neglect help because of cost fears. You also try to educate those that don't go and see their GPs for anything now anyway -it's a problem already- about serious symptoms to look out for.

I’m genuinely confused about why so many people can’t wrap their heads round this. Classic example of ideology trumping common sense. As it stands, the NHS is so fecking busy that people are put off by how hard it is to see someone. So let’s not pretend that the current system means everyone gets the access they need to begin with.

Reading this thread I get the impression people have basically given up on the concept of getting an appointment to see their GP. Which is fecking nuts. But hey, let’s all shout down proposals which might free up GP’s time.
 
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You should probably edit your post so that's more clear, because it certainly does not read as people who take the piss and absolutely reads as if you're talking about poor people.

@Jippy got it. It's clarified now anyway, and still some don't believe me.
 
Not sure I understand the confusion. A big part of charging a nominal fee is to put off hypochondriacs or at least make people think twice about going to see their GP about a bruise or scratch.

If the fee puts off 4% from ever seeking medical attention maybe that's the price we pay. Obviously you have to ensure there are safety nets so the poorest don't neglect help because of cost fears. You also try to educate those that don't go and see their GPs for anything now anyway -it's a problem already- about serious symptoms to look out for.

And what's the safety net and how much would that cost to administer? Often the answer is that it costs more. Would it just shift people to A&E?

It just feels very typical Telegraph type politics, escalating an exception issue to punish the proles when the focus and fix is elsewhere.
 
And what's the safety net and how much would that cost to administer? Often the answer is that it costs more. Would it just shift people to A&E?

It just feels very typical Telegraph type politics, escalating an exception issue to punish the proles when the focus and fix is elsewhere.

You'd need to figure out the answer to all these questions before changing anything. Just like any other change, you need to consider costs and consequences. But something has to change. And you need to open minded about all the possible solutions. Because sticking your heads in the sand and/or coming up with ideologically motivated red lines is going to hinder, rather than help, fix a system that is currently broken.
 
A fee obviously won't put off hypochondriacs more than other people, because the whole point is that they think they're sick. Hypochondriacs will be put off if they're poor, just like the rest of the population.

The point of paying is to discourage people from using the service. The people discouraged will be the ones who value a visit at equal to or greater than zero pounds, but below whatever the fee is. Generalized, people value goods based on two things: 1) their preferences, i.e. how much they'd like to use health services relative to all other available goods. 2) their budget.

Getting people to pay turns away two groups, those who are just on the fence about going to the doctor, and poor people. You can try things to make poor people to show up anyway, but that's rarely politically flashy and it'll at best just sort of work.
 
A fee obviously won't put off hypochondriacs more than other people, because the whole point is that they think they're sick. Hypochondriacs will be put off if they're poor, just like the rest of the population.

The point of paying is to discourage people from using the service. The people discouraged will be the ones who value a visit at equal to or greater than zero pounds, but below whatever the fee is. Generalized, people value goods based on two things: 1) their preferences, i.e. how much they'd like to use health services relative to all other available goods. 2) their budget.

Getting people to pay turns away two groups, those who are just on the fence about going to the doctor, and poor people. You can try things to make poor people to show up anyway, but that's rarely politically flashy and it'll at best just sort of work.

Hmmm...
 
Not sure I understand the confusion. A big part of charging a nominal fee is to put off hypochondriacs or at least make people think twice about going to see their GP about a bruise or scratch.

If the fee puts off 4% from ever seeking medical attention maybe that's the price we pay. Obviously you have to ensure there are safety nets so the poorest don't neglect help because of cost fears. You also try to educate those that don't go and see their GPs for anything now anyway -it's a problem already- about serious symptoms to look out for.
That 4% figure is the amount of people put off from seeking healthcare in the UK without charging at the point of access, I imagine it is prescription charges that worry them, so people who are living hand to mouth.

Once you start charging like say France does, that figure rises to 18%, that's almost a fifth of the population. Look at what has happened with dentistry in the UK, when people can not get an NHS dentist and have to pay https://www.bbc.co.uk/news/health-68228322

I'm all for paying more for our health service but it needs to be through NI and taxes, not having to find the money to pay up when you need it the most.
 
@NotThatSoph is right though, I think. Hypochondria is an anxiety condition, it's not someone faking for the hell of it or someone using A&E for minor bumps and scratches.

The UK introduced the 111 phone line to try and take pressure off A&E and GPs and it has certainly stopped me making a couple of visits in the past. But using a financial penalty to stop people accessing healthcare seems very wrong and potentially dangerous for the very poorest who due to their circumstances often have the worst health outcomes already.
 
That 4% figure is the amount of people put off from seeking healthcare in the UK without charging at the point of access, I imagine it is prescription charges that worry them, so people who are living hand to mouth.

Once you start charging like say France does, that figure rises to 18%, that's almost a fifth of the population. Look at what has happened with dentistry in the UK, when people can not get an NHS dentist and have to pay https://www.bbc.co.uk/news/health-68228322

I'm all for paying more for our health service but it needs to be through NI and taxes, not having to find the money to pay up when you need it the most.

Don't know where that 18% comes from (never met anyone who won't go to a GP let alone 1 person in 5). You talk about prescription charges putting off Uk people but prescriptions are free as I said in France. Very dubious figures. Whereas a GP appointment would cost you a maximum of €8 (usually nothing) which is less than one item on a UK prescription.
 
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A fee obviously won't put off hypochondriacs more than other people, because the whole point is that they think they're sick. Hypochondriacs will be put off if they're poor, just like the rest of the population.

The point of paying is to discourage people from using the service. The people discouraged will be the ones who value a visit at equal to or greater than zero pounds, but below whatever the fee is. Generalized, people value goods based on two things: 1) their preferences, i.e. how much they'd like to use health services relative to all other available goods. 2) their budget.

Getting people to pay turns away two groups, those who are just on the fence about going to the doctor, and poor people. You can try things to make poor people to show up anyway, but that's rarely politically flashy and it'll at best just sort of work.

Except that doesn't happen in any of the countries that have a co pay system. Their healthcare systems and health outcomes are overall better, not worse, and poor people are not disproportionately impacted because it's all means tested. All that happens in practice is people consider whether they really need to see a doctor or wait a day or two to see if their ailment gets better. These ideological entrenched viewpoints need to go away or the NHS will eventually collapse under its own weight.
 
Don't know where that 18% comes from (never met anyone who won't go to a GP let 1 person in 5). You talk about prescription charges putting off Uk people but prescriptions are free as I said in France. Very dubious figures. Whereas a GP appointment would cost you a maximum of €8 (usually nothing) which is less than one item on a UK prescription.
It's from a study carried out in the US, New Zealand, France, Germany, Netherlands, Australia, UK, Switzerland, Canada, Norway and Sweden by the Commonwealth Fund. https://www.bbc.co.uk/news/health-31797770

EDIT: it's a survey from 2015, so a bit out of date, but a more recent one shows that number has gone upto 25.4% and is mainly, people who live alone, are unemployed or women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10105192/
 
Except that doesn't happen in any of the countries that have a co pay system. Their healthcare systems and health outcomes are overall better, not worse, and poor people are not disproportionately impacted because it's all means tested. All that happens in practice is people consider whether they really need to see a doctor or wait a day or two to see if their ailment gets better. These ideological entrenched viewpoints need to go away or the NHS will eventually collapse under its own weight.

Of course it happens. And no, it's not all means tested. In Norway, for instance, it's capped but not means tested (some local areas have means tested policies on top of this, but they're not well-known and typically not used).

I live in one of the richest countries in the world, with extremely cheap healthcare, and I personally know several people who go without needed healthcare because of costs. It's extremely dumb to say that it doesn't happen. What you mean to say is that it does of course happen, but that it's worth it.