Returning to caving

[Paul Marvin]

Could you give us a couple of examples of the "lots of things"?

Go and have a tattoo done here it goes septic, you will get your free NHS treatment to put it right even if it goes terribly wrong . The " Krankenkasse " won't pay for the treatment you can get  treatment but you will have to pay . Oh hears another, fertility treatment I know here there are hoops to go through but after that its free or at least is it two or three attempts . One thing the French and Germans are considerably better at is football  but thats another story

 

[Paul Marvin]

I think you'd be slightly foolish to claim the NHS is better than the French or German systems. Most analyses suggest the French system is the best in the world. The German system can be outstanding (if you go to a Hochshule - ie university hospital) but some of the small Krankenhausen are less impressive. Both are far better resourced than the NHS (so have more beds and shorter/negligible waiting times) and both, particularly the Germans, offer really good rehabilitation which is something the NHS falls down on.

In favour of the NHS, it's one of the most cost-effective systems in the developed world (though this depends on running close to 100% occupancy which makes pandemics difficult) and care is probably more consistent between hospitals than in other hospitals. Since we've started to centralise some specialist services that were previously offered everywhere (trauma, vascular surgery etc) standards have risen significantly. However, resources were constrained even before Covid, made worse by the shortage of nursing and residential home care and the lack of facilities to deal with elderly patients with complex needs (so they ended up stuck in hospitals, which are fundamentally unsuited to care for them). 

In reality, increasing the NHS and social care budgets to overcome their many shortfalls would probably be less expensive overall than moving to a mixed private/public, insurance based system. The big problem with any private system of medicine is that the more procedures you undertake, the greater the income. This influences both doctors and management, can lead to inappropriate or excessive treatment and is very hard to police.

A university hospital in Germany is called Universit?tsklinik not Hochschule, Die Hochschule  in more higher education as a broad spectrum 

 

[Speleofish]

Fair point.

 

[Speleofish]

I confess, I'd always thought hochschule and university clinics to be synonymous in medicine (eg the Hochschule in Hanover) and we always referred to them as such in the hospitals where I worked. I'm happy to be corrected.

However, semantics aside, the underlying point remains. The best hospitals in Germany are very, very good. The worst are much less so. The difference in the UK is less marked.

 

[pwhole]

I got the feeling, from watching my ward for a couple of days, that they were understaffed, though it's difficult to generalise from one experience - but later confirmed to me by a nurse when she asked me to help her out with another patient (by now I was on my feet and becoming useful, especially picking up litter). She said it was mostly illness, though what I don't know - most of these conversations are snatched fragments rather than proper chats. Also they need to maintain a certain amount of staff/patient separation and confidentiality, so I was trying not to sound too much like Colombo, but I suspect exhaustion might be a good start. Their stamina and cheerfulness was amazing to see, no matter what was happening.

 

[Paul Marvin]

I confess, I'd always thought hochschule and university clinics to be synonymous in medicine (eg the Hochschule in Hanover) and we always referred to them as such in the hospitals where I worked. I'm happy to be corrected.

However, semantics aside, the underlying point remains. The best hospitals in Germany are very, very good. The worst are much less so. The difference in the UK is less marked.

 

 

[Paul Marvin]

I got the feeling, from watching my ward for a couple of days, that they were understaffed, though it's difficult to generalise from one experience - but later confirmed to me by a nurse when she asked me to help her out with another patient (by now I was on my feet and becoming useful, especially picking up litter). She said it was mostly illness, though what I don't know - most of these conversations are snatched fragments rather than proper chats. Also they need to maintain a certain amount of staff/patient separation and confidentiality, so I was trying not to sound too much like Colombo, but I suspect exhaustion might be a good start. Their stamina and cheerfulness was amazing to see, no matter what was happening.

You have it all summed up there buddy  . People are to easy to forget that the staff are human beings as well they get incredibly tired and have emotions to , my wife comes home some mornings in tears after wat she has witnessed on a shift.