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Mr Hawkes,"Topic: This is unforgivable! Posted by: Ivonne HollidayDate/Time: 17/02/23 10:12:00NHS battles sewage leaks as repair backlog growsSewage leaks are causing hospitals a host of problems as the backlog in repairs and maintenance grows.Hospitals in England reported patients slipping on sewage, staff becoming ill, and leaks in A&E departments, cancer wards and maternity units.It comes after the repairs backlog grew by 11% in the past year to a total of £10.2bn.https://www.bbc.co.uk/news/health-64653482"Please also see:  htpps://www.standard.co.uk/news/uk/nhs-sewage-leaks-england-hospitals-london-ed-davey-lib-dems-b1061037.html#:~:text=The%20leaks%2C%20totalling%20456%2C%20saw,reported%20over%20the%20past%20year.So yes, the infrastructure in hospitals is not being maintained.  I find this disgusting and unforgivable. I have never doubted the quality of medical treatment at NHS hospitals.  From personal experience, there are not enough superlatives to describe how truly brilliant they are.As for the striking junior doctors and consultants, do you remember how we all clapped during COVID to show our enourmous appreciation for their dedication?  Clap for our heroes happened every Thursday evening for some 10 weeks?  As some of the placards during their strikes said, clapping does not pay bills.  I do not blame them for asking for salary increases taking into consideration that their salaries were virtually frozen for 10 years.You say: "They are obviously in it for the money as much as altruistic public service, and even the most junior are not on the same wage as a barista."  No, that is not true.  Being a doctor is a vocation not a money making machine.  As for junior doctors, I did post some time ago a link to the BMA's table containing the rate of pay.  And, yes, junior doctors were being paid, for the first two years I believe, some £14 per hour.  And that is after some 5 or 6 years of studies......As for GPs, they are independent contractors with the NHS.  This has been the case, I understand, since the creation of the NHS in 1948.  Most GPs treat only NHS patients, work to NHS guidelines and uphold the principles of the NHS. They are not seeking a business advantage or profiteering. https://lowdownnhs.info/explainers/are-gps-already-privatised-or-still-part-of-the-nhs/That changed when outsourcing was brought in.I hope this helps.

Ivonne Holliday ● 47d

Mr Ixer'Perhaps the NHS would collapse without immigrants? And the ones not speaking English in the waiting room might be British and bilingual ... they may not be but do you have evidence of that?'I am sure it is true that the NHS would collapse without migrants.However their presence represents a financial arrangement the country has with them.We allow residency in a place and under terms that are much better than they obviously would expect in their countries of origin.They provide us with a service that we need and do not have indigenous resources to provide.Fair dos.But my point is how many immigrants are there that have contributed little or nothing to the service the NHS offers them ?Are we providing and paying for an International Health Service ?Of course I have no proof that those I mention not speaking English are not actually fluent in our national tongue.If so why not speak it ?Nor do I know that they are not as British as me in terms of residency and citizenship qualifications. I just don't get that impression and wonder how much more the NHS can accommodate when inward migration levels are as reported by the BBC on 23/11/23 using Government data.'The net migration figure to the UK for 2022 has been revised upwards to 745,000.In May, figure for 2022 was given as 606,000 - a record at the time - and that was today revised up by 139,000.At the same time, new figures for the 12 months until June 2023 show net migration to the UK of 672,000.The figures show the number people arriving in the UK, versus the number leaving.Immigration in the 12 months to June 2023 was 1.2m - emigration was 508,000.The vast majority of immigration was from non-EU countries - 968,000'.And of course such immigration levels must be having an affect on our schools and particularly housing as is indicated by reports of the shortage of such and the rising costs of rental accommodation. It is not racism to highlight these facts if for no other reason it concentrates the minds of politicians of all persuasions on the fact that all of this represents a major set of practical problems that must be addressed and not glossed over.But I doubt the topic will be given major prominence in any Party manifesto.

John Hawkes ● 47d

Ms HollidayI have nothing but praise for the treatment I am receiving from the NHS at St George's for a potentially life threatening condition.I also think that a health service free at the point of delivery is a prerequisite of a civilised society.Hence I am more than happy to have paid higher rate income tax for some 50 years to fund it.Though when I sometimes share a hospital waiting room with many that do not speak English and hence probably have not chipped in that much to fund the system, my feelings of a willing generosity to my fellow men sometimes waver.Unfortunately there is no cure I know of for mild forms of misanthropy !Is the NHS collapsing ?I don't recognise this phenomena.Is tax the best way to fund the service ?I am not an expert here.I believe the French health service is insurance based and those there who are quick to take umbrage on so many matters seem quite content with this.And perhaps it would result in a system where those that could pay more do so in order to help out those that can't.Extended waiting times in themselves indicate little other than we (or some of us !) are all getting older and medical science seems to have the means to keep us going on and on.How much more and by what means are we willing to fund this?Which Party at the next election will say it will put up income tax to increase health cares spending?As for striking hospital doctors and particularly consultants, this at least gives the lie to the claim the service is delivered by saints making huge financial sacrifices on our behalf.They are obviously in it for the money as much as altruistic public service, and even the most junior are not on the same wage as a barista.Google what they do earn and don't forget to factor in gold plated pension provisions.Is it money or lack of it that is causing NHS staff to quit ?As for health care in Australia according to Wikipedia -"Health care in Australia operates under a shared public-private model underpinned by the Medicare system, the national single-payer funding model. State and territory governments operate public health facilities where eligible patients receive care free of charge. Primary health services, such as GP clinics, are privately owned in most situations, but attract Medicare rebates. Australian citizens, permanent residents, and some visitors and visa holders are eligible for health services under the Medicare system. Individuals are encouraged through tax surcharges to purchase health insurance to cover services offered in the private sector, and further fund health care".This is the system that apparently is now full of expatriate British medics working from their surf boards on Bondi beach.Doesn't seem that wonderful or different to me.You are obviously well aware that all GP practices are private businesses.Mine gives me a good level of service, though I doubt if this would decline if it were American owned.In fact American entrepreneurship could perhaps lead to improvements.Finally my views on most matters are a result of a synthesis formed from a triangulation of comment gained from the BBC, the Guardian and the Mail.Yours ?

John Hawkes ● 48d