How?

[Sqad]

How can the NHS afford to maintain 4 levels of health advice?

1) NHS direct.
2)Walk-in clinics
3) GP surgeries
4)A&E

[Sqad]

Home visits byGP's should be abolished.
The chronic sick do NOT necessarily need to be seen at home by a GP visit....this is a British thing, with little basis to it.

Nurses are now well trained and many having University degrees and quite capable of supervising chronic or indeed acute illnesses and if there is a change in the patient's condition then they can be sent by ambulance if necessary to hospital.

[237SJ]

Buses, taxis and cars are not all available in very rural areas. Taxis are extremely expensive in rural areas and bus services are very limited. My mother`s village (for example before she moved near me) - bus stop down a hill one mile away. Taxi £12 for 4 miles to the GP (each way). No car as my father died and she couldn`t drive.
I think if (particularly elderly) people had a daunting 30 mile each way journey over somewhere like Exmoor they would be less inclined to go to the GP and potentially serious ailments would be ignored.

[Old_Geezer]

Pointing and laughing at trigger.
Were you the one in "only fools & horses" ?

[rowanwitch]

better network of district nurses would solve the elderly with their BP/ diabetes checks Would probably scrap NHS direct in favour of a local phone service operated under the aegis of A and E so you got through to someone who knew about local services
Polyclinics good in practice....coulld also see a role for a return to smaller local units with low dependancy beds ideal for managing the elderly with exacerbations of chronic conditions keeping them away from the overloaded general hospitals

[Sqad]

2376SJ....rural in England means 30 miles to the nearest hospital....rural in other countries..Australia, South Africa, Spain and parts of France mean 100miles away and they cope.

Off to club now, but will be back in 2 hours.

[Sqad]

rowan....exactly.

[samak]

Off to club what? Seals ?

Seriously though, Australia has the Royal Flying Doctor Service for remote locations.

[mccfluff]

i don;t agree with you sqad, i think many people wouldn't go to see doc if they have to travel a long sidtance this could lead to illness not being diagnosed and costing NHS more in the long rung.

my local practice is pretty much over the road they have and early morning surgery and i can get seen before work and get to work on time. if i had to take a day off to travel to sutton i probably wouldn't bother

[rowanwitch]

I think Sqad is trying to get a debate going as it was a bit quiet... and noone was talking about one of his other pet subjects

[Old_Geezer]

Well he managed to get his opinon on home visits in again, so score one point.

[Sqad]

redhelen.....

1) Yes
2)10 years ago
3) Yes
4) Yes

I can't see the significance but I hope those answers help.

[Sqad]

McCluff... Clearly I disagree with you.

Other countries which do not have GP practices either rural or urban have better survival cancer rates than the UK and that is thought to be due to early pick up rates.
Having the doctor across the road or 50 miles away seems to make no difference in survival rates indeed there is an indication that having easy access has no advantage,

[mccfluff]

Other countries which do not have GP practices either rural or urban have better survival cancer rates than the UK and that is thought to be due to early pick up rates.

but if you don;t go to your docs because access/transport is dfficult then how do you get early pick up rates?

[Old_Geezer]

There was a time when the customer was supposed to be always right. Or when whoever paid the piper called the tune. Ah but no more. You get what you're offered and like it.

[237SJ]

Old-geezer - the people who play the tune don`t pay the piper. That`s the problem with the NHS ;-)

[Sqad]

McCluff..........ask the other countries that have better pick up and survival rates, but do not have our system of health care. It is clear that there are other factors in health care and ease of access plays only a small perhaps insignificant part.

Old -Geezer.....don't worry, it will never happen....the Politicians would dare to suggest it and the electorate who have never had another system, wouldn't accept it.
So, the NHS will continue to hemorrhage your hard earned taxes like a ruptured blood vessel and there will always be "Political turmoil"