Re: ot Matt

[Broadback]

I always thought that the NHS was there to protect us. It seems not we are here to protect the NHS. Cart before the horse?

[JoeJoe]

I can tell you with 100% certainty that at least in Scotland this is not the case. The hospitals there are full of such people who cannot be sent back since they must first have 2 negative tests, and this can take weeks.

[John Rumm]

Sometimes the relationship is symbiotic.

[Roger Hayter]

It is not the job of the *health* service to accommodate or quarantine people who are fit to go home. Getting people out of hospital (largely the elderly infirm) is even in normal times the biggest single problem running a hospital. If the NHS stopped sending convalescent old people home even for a week then *all* other health acitvity, including emergency surgery and Covid-19 treatment would stop completely as convalescent and frail patients would rapidly fill every bed in the hospital. The blame lies entirely with the government who gave the local authorites no advice, money or PPE supplies to deal with the problem of infected discharged patients. This prolblem was entirely predictable and, I repeat, quite outside the power of the hospitals to do anything about.

[Roger Hayter]

PS. Someone mentioned Scotland. Scotland didn't cut beds like England, and still has enough space to carry out a lot of functions regarded as social in England.

[Brian Gaff (Sofa]

A little unfair, but the problem has always been in the nhs, one of timely communications. Have you noticed the ethnicity of many care home workers? Have you noticed the biggest percentage of people affected ethnicity? Have you noticed that social care is the most under part of the care establishment? Brian

[Ophelia]

PS. Someone mentioned Scotland. Scotland didn't cut beds like England, and still has enough space to carry out a lot of functions regarded as social in England.

Roger Hayter

===

Roger, what is it we are doing compared to England?

[spuorgelgoog]

Well, we have a brand new £510 million children's hospital empty and going spare (just needing a few extra drains and smoke detectors to finish off the snagging) :-)

Public expenditure in Scotland is about 20% higher than in England. In Scotland, just under £11,000 was spent per person in 2016/17 and in England it was just under £9,000.

To pay for it, we do have some of the highest tax rates in the UK.

Scotland?s higher-rate tax of 41% (applied to salaries of £43,431 to £150,000). However, in the rest of the UK, the higher rate applies at £50,001 at only 40%. This regime change has meant that top- and higher-rate earners in Scotland now pay more than elsewhere in the UK.

All those earning more than £27,000 pay more income tax in Scotland. At £50k salary people in Scotland pay £1,550 more income tax than England. About 45% of people in Scotland pay more income tax than they would in England.

(which shows that the claim that is 'mostly false' isn't actually mostly false, it's 55% false and 45% true)

However that doesn't mention stamp duty or equivalent, which for subsequent properties at the marginal rate over £750,000 is 8% in England and 16% in Scotland, and we have no first time buyer relief at any property value.

In 2014/15, health spending per head across the four UK countries was:

Scotland: £2,208 Northern Ireland: £2,177 Wales: £2,129 England: £2,112

Public spending on adult social care varies for each country in the UK, from £295 per head in England, to £435 in Scotland, both in real terms. This is partly explained by a difference in relative need for the populations, and decisions made by the respective devolved governments.

In Scotland, where total spend per head is highest, funding has risen by an average of 0.5% a year in real terms between 2008/09 and 2014/15, During the same period, funding per head has fallen in England and Wales, by an average of 1.6% and 0.4% a year respectively.

Since 2016, work has been underway across Scotland to integrate health and social care services between the NHS, Councils, and other bodies. So we shouldn't have people leaving hospital, or not being able to leave hospital, without social care.

Owain

[Roger Hayter]

According to someone in this thread (and I have no personal knowledge) not sending patients back to care homes until they have had two negative Covid-19 tests.

[Roger Hayter]

snip

Without wishing to sound cynical about health management, this has been planned for at least the last 35 years in England to my personal knowledge and hasn't happened yet. Pilot attempts usually employ vast numbers of well paid nurse case managers (they don't nurse anyone, just manage) and social workers who proceed to look after a new group of clients who haven't had any social or health intervention before, while having no money or accommodation to to help the existing patients languishing in hospital or inadequate care homes. It is expensive and pointless. Just hope Scotland does it better!

[Robin]

To pay for /part/ of it... As the fullfact page you linked to notes there is also the block grant from the UK Treasury.

The block grant involves the renowned Barnett formula. A good primer on that is IMHO

Don't ask me for details though as what little more I once knew has gone the way of so many things.

[Robin]

On 16/05/2020 23:29, Roger Hayter wrote: <snip>

Be nice to know the figures you are comparing and what period they cover. Last figure I saw showed acut beds per 1,000 around 2.3 in Enhland and 2.4 in Sctland.

And as you surely know, many of the NHS beds cut in England over the past 30 years were for mental health and disabilities as a resul of the move to care in the comunity. The cut in acute beds was 34%. Many of thoise were indeed beds for the long-term care of older people which have fallen under successive administrations of all flavours. See eg

. And the same seems to be true for NHS Scotland. Eg last year when they reported 6,000 fewer beds over 10 years:

"The Scottish Government said: 'Bed numbers in a hospital setting have been reducing to reflect the changing nature of our modern health service where, over the last 10 years, advances in treatment have meant the length of time patients spend in acute hospitals has reduced markedly and there are now more than 35,000 day cases per year.

'In addition, the number of beds ­necessary has reduced since 2009 due to provision of geriatric and mental health services in the community.' "

[Ophelia]

Scotland is cool .... I'm getting TWO calls from TWO hospitals next week

==

Calls for what?

[Ophelia]

Well, we have a brand new £510 million children's hospital empty and going spare (just needing a few extra drains and smoke detectors to finish off the snagging) :-)

Public expenditure in Scotland is about 20% higher than in England. In Scotland, just under £11,000 was spent per person in 2016/17 and in England it was just under £9,000.

To pay for it, we do have some of the highest tax rates in the UK.

Scotland?s higher-rate tax of 41% (applied to salaries of £43,431 to £150,000). However, in the rest of the UK, the higher rate applies at £50,001 at only 40%. This regime change has meant that top- and higher-rate earners in Scotland now pay more than elsewhere in the UK.

All those earning more than £27,000 pay more income tax in Scotland. At £50k salary people in Scotland pay £1,550 more income tax than England. About 45% of people in Scotland pay more income tax than they would in England.

(which shows that the claim that is 'mostly false' isn't actually mostly false, it's 55% false and 45% true)

However that doesn't mention stamp duty or equivalent, which for subsequent properties at the marginal rate over £750,000 is 8% in England and 16% in Scotland, and we have no first time buyer relief at any property value.

In 2014/15, health spending per head across the four UK countries was:

Scotland: £2,208 Northern Ireland: £2,177 Wales: £2,129 England: £2,112

Public spending on adult social care varies for each country in the UK, from £295 per head in England, to £435 in Scotland, both in real terms. This is partly explained by a difference in relative need for the populations, and decisions made by the respective devolved governments.

In Scotland, where total spend per head is highest, funding has risen by an average of 0.5% a year in real terms between 2008/09 and 2014/15, During the same period, funding per head has fallen in England and Wales, by an average of 1.6% and 0.4% a year respectively.

Since 2016, work has been underway across Scotland to integrate health and social care services between the NHS, Councils, and other bodies. So we shouldn't have people leaving hospital, or not being able to leave hospital, without social care.

Owain

====

Thanks very much!! I didn't know:))))

[Ophelia]

snip

Without wishing to sound cynical about health management, this has been planned for at least the last 35 years in England to my personal knowledge and hasn't happened yet. Pilot attempts usually employ vast numbers of well paid nurse case managers (they don't nurse anyone, just manage) and social workers who proceed to look after a new group of clients who haven't had any social or health intervention before, while having no money or accommodation to to help the existing patients languishing in hospital or inadequate care homes. It is expensive and pointless. Just hope Scotland does it better!

Roger Hayter

===

So do I !!!

[Ophelia]

According to someone in this thread (and I have no personal knowledge) not sending patients back to care homes until they have had two negative Covid-19 tests.

Roger Hayter

====

Thanks, Roger! If this is right then it is a very good thing.

[ARW]

Drinking more would be my guess;-)

[Ophelia]

usual liver check up both hospitals appointments should be spaced 6 months apart but what do I know...told them,,,...be fun how they are going to do two sets of bloods over the phone....

===

Not sure about fun, but interesting .... Everything medical here now is done over the phone.

I feel very sorry for that poor woman who had to have her op for cancer postponed and now it is too late. Bless her, she was so nice this morning on the radio.

[Ophelia]

Drinking more would be my guess;-)

Adam

===

Funny you should say that ........ ;-)

[Andrew]

If Neil Fergusons worst case was correct and hospitals were unable to admit patients because many NHS beds were occupied by 'bed blockers', then the BBC and all the usual 'commentators' would be screaming for an explanation as to why these people had NOT been moved to care homes. Damned if you do, damned if you don't.