Bye bye Starmer

[GG.]

Question for you.

If you were to contract cancer personally, without private health insurance, and of any description - would you want treatment in the UK or Japan?

Probably the easiest question you'll ever have to answer.

[ZedLeg]

I haven’t got a clue.


Survival rates for cancer are pretty good here aren’t they?

[GG.]

No

[Explosive Newt]

Our healthcare service is poor compared to a lot of countries you would think we would be better than e.g. Poland. Japan has a universal healthcare insurance policy so is perhaps hard to compare directly.

Part of our issue (as Darzi has highlighted) is that we spend money in the wrong places.
We cut preventative medicine and community services to try and save money.
But this created extra demand in hospital services. The solution has been to expand hospital services to try and address this demand, which is actually more expensive than providing the services in primary care or preventing their need entirely.

[ZedLeg]

Much like Japan and Spain, it seems to depend on the type of cancer.

I wonder if public visibility campaigns help, ball and prostate cancer have had a lot of attention.

IMG_1758.jpeg (137.2 KiB) Viewed 937 times

https://www.nuffieldtrust.org.uk/resour ... 0diagnosed.

[Explosive Newt]

Much like Japan and Spain, it seems to depend on the type of cancer.

I would also caution against comparing us directly to different countries. E.g. Japanese have different genetics, diet and attitudes to health than us in the UK. So their baseline cancer risk is different, which will affect their survival. E.g. classically they eat more smoked food which places them at higher risk of bladder cancer.

[GG.]

@ZedLeg

https://www.macmillan.org.uk/healthcare ... des-behind

We're 25 years behind mate. We have to deal with it - it isn't a good system and we shouldn't defend it as not facing up to the problems is a hindrence in dealing with them. The first step towards solving a problem is acknowledging there is one. Not smacking pans about in the street and writing we love the NHS on zebra crossings.

You have to draw a distinction between the hard work people do in the system and system itself.

[GG.]

Much like Japan and Spain, it seems to depend on the type of cancer.

I would also caution against comparing us directly to different countries. E.g. Japanese have different genetics, diet and attitudes to health than us in the UK. So their baseline cancer risk is different, which will affect their survival. E.g. classically they eat more smoked food which places them at higher risk of bladder cancer.

I think they're nuances, that whilst valid, don't alter the overall picture regarding treatment standards.

Other European countries are also much more comparable re diet and genetics and we still fare worse.

Getting through the door via a GP is a massive problem. The GP service is not fit for purpose and needs really radical overhaul.

[ZedLeg]

Much like Japan and Spain, it seems to depend on the type of cancer.

I would also caution against comparing us directly to different countries. E.g. Japanese have different genetics, diet and attitudes to health than us in the UK. So their baseline cancer risk is different, which will affect their survival. E.g. classically they eat more smoked food which places them at higher risk of bladder cancer.

That was my point earlier. From my (a layman’s) pov, it seems really hard to accurately gauge outcomes in healthcare due to the number of variables involved.

[Explosive Newt]

Much like Japan and Spain, it seems to depend on the type of cancer.

I would also caution against comparing us directly to different countries. E.g. Japanese have different genetics, diet and attitudes to health than us in the UK. So their baseline cancer risk is different, which will affect their survival. E.g. classically they eat more smoked food which places them at higher risk of bladder cancer.

I think they're nuances, that whilst valid, don't alter the overall picture regarding treatment standards.

Other European countries are also much more comparable re diet and genetics and we still fare worse.

Getting through the door via a GP is a massive problem. The GP service is not fit for purpose and needs really radical overhaul.

I would agree with all those points. See above on our error on where we allocate resources currently.

[ZedLeg]

genet

Getting through the door via a GP is a massive problem. The GP service is not fit for purpose and needs really radical overhaul.

I agree with this, it also ties into what Newt was saying about lack of funding for community care etc.

[ZedLeg]

@ZedLeg

https://www.macmillan.org.uk/healthcare ... des-behind

We're 25 years behind mate. We have to deal with it - it isn't a good system and we shouldn't defend it as not facing up to the problems is a hindrence in dealing with them. The first step towards solving a problem is acknowledging there is one. Not smacking pans about in the street and writing we love the NHS on zebra crossings.

You have to draw a distinction between the hard work people do in the system and system itself.

I am, my partner and I both have mental health problems. We’re very aware of how shit services are.

It is purely a case of needing more money spent on it though. We shouldn’t be farming primary mental health care to charities.

[GG.]

@ZedLeg

https://www.macmillan.org.uk/healthcare ... des-behind

We're 25 years behind mate. We have to deal with it - it isn't a good system and we shouldn't defend it as not facing up to the problems is a hindrence in dealing with them. The first step towards solving a problem is acknowledging there is one. Not smacking pans about in the street and writing we love the NHS on zebra crossings.

You have to draw a distinction between the hard work people do in the system and system itself.

I am, my partner and I both have mental health problems. We’re very aware of how shit services are.

It is purely a case of needing more money spent on it though. We shouldn’t be farming primary mental health care to charities.

Not spent if by that you mean more money in. Reallocated from what is already there and is being misused.

[Explosive Newt]

I am, my partner and I both have mental health problems. We’re very aware of how shit services are.

I am sorry to hear that. MH is the prime example of how cutting a community service has cost us far more in the long run. Lack of community MH nurses means people wind up in crisis and land up in places where a) they can't be treated effectively and b) cost the taxpayer much more money (A&E and police cells).

[Explosive Newt]

@ZedLeg

https://www.macmillan.org.uk/healthcare ... des-behind

We're 25 years behind mate. We have to deal with it - it isn't a good system and we shouldn't defend it as not facing up to the problems is a hindrence in dealing with them. The first step towards solving a problem is acknowledging there is one. Not smacking pans about in the street and writing we love the NHS on zebra crossings.

You have to draw a distinction between the hard work people do in the system and system itself.

I am, my partner and I both have mental health problems. We’re very aware of how shit services are.

It is purely a case of needing more money spent on it though. We shouldn’t be farming primary mental health care to charities.

Not spent if by that you mean more money in. Reallocated from what is already there and is being misused.

This is going to be hard though. If you expand primary care (and prevention) there is going to be a lag while the demand in secondary care diminishes.

Also it's the NHS so it's bascally impossible to fire people...

I suspect the only way for it to work is to repurpose a lot of people in secondary care to provide services in primary care. With better tech you can probably direct people towards telemedicine consults with secondary care clinicians rather than going via the GP but that is removing the role of GP as gatekeeper which is fundamental to the design of the NHS.

[Mito Man]

Speaking from personal experience I think the GP system we have here is utterly shit and I think that's where most of the problems start in terms of late diagnosis. In between getting a GP appointment, then getting a physical appointment for a GP to actually see you, then usually its a blood test, getting misdiagnosed, then a referral, and so on and so forth it can easily be 6 months.
Also don't know why the quality of care at hospitals varies so much. I was told if I get sepsis in Kent do not go to a particular hospital named after an old physician, just find someone to drive me to London...

[GG.]

Drug enforcement also a big factor if we're talking about mental health. De-criminalise skunk and wow, what a surpise, lots more paranoid schizophrenics to deal with. Funny that.

[Explosive Newt]

Speaking from personal experience I think the GP system we have here is utterly shit and I think that's where most of the problems start in terms of late diagnosis. In between getting a GP appointment, then getting a physical appointment for a GP to actually see you, then usually its a blood test, getting misdiagnosed, then a referral, and so on and so forth it can easily be 6 months.
Also don't know why the quality of care at hospitals varies so much. I was told if I get sepsis in Kent do not go to a particular hospital named after an old physician, just find someone to drive me to London...

Often large teaching hospital vs small district general. The large teaching hospital will have far greater resource.

Also some hospitals / clinical departments are very badly managed and dysfunctional.

[IanF]

We have a digital gp service (with Axa maybe?) and it’s very good.. problem allocated to the right person and funding authorised if you want to get seen quicker (ie privately).

Just back from Boston MA, and there’s a small shop there called Forward, think it’s an automated human MOT centre..

https://goforward.com/carepod

Preventative medicine and treatment is a no brainer, like servicing your car before something actually fails, saving us and gov money plus it’s less messy when you don’t end up dumping a load of fluids below your chassis

[ZedLeg]

Drug enforcement also a big factor if we're talking about mental health. De-criminalise skunk and wow, what a surpise, lots more paranoid schizophrenics to deal with. Funny that.

Even that isn’t cut and dry though, there’s strong evidence that cannabis and some other currently illegal drugs can help with personality disorders when used properly.