# NHS A & E problems in UK



## Taurian (Dec 12, 2009)

As an active volunteer for St John Ambulance and the British Red Cross, I have first hand experience of the parlous state of the NHS with patients filling most A & E corridors in the hospitals and paramedic crews waiting up to 5 hours to hand over their patients to the hospitals - certainly the case with those hospitals I've been involved with in the East of England. It's a truly sorry state of affairs.

What is the situation with the Spanish hospitals at the moment ? Are they going through the same problems with A & E patients ? Are their corridors lined with patients waiting to be seen ?


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## 90199 (Mar 21, 2010)

I went to the equivalent of A&E just before Christmas on a Sunday in the evening. Straight inside and treated immediately. Canary Isles, El Hierro.


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## kalohi (May 6, 2012)

I went to "urgencias" at a state hospital in Seville on a Friday morning last July, and I was triaged immediately and taken in to be seen within 20-30 minutes. Considering that I wasn't there with a life threatening condition I thought that was excellent care.


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## Taurian (Dec 12, 2009)

Good to hear that the Spanish healthcare system is not in meltdown like the UK is at the moment!


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## xabiaxica (Jun 23, 2009)

I spent several hours at the A&E with my daughter twice in October. The first time she was through triage in minutes but then a wait of a few hours before she was eventually admitted. 
The wait was mainly because she doesn't give up her blood easily, she didn't have much in the way of symptoms when we arrived, although when her condition deteriorated rapidly & suddenly & was taken immediately into surgery - all around us people were being dealt with efficiently 

the second time was similar - but it was extremely busy & at one point there were people in wheelchairs lining the corridor - the 2 post-triage waiting rooms were full.


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## baldilocks (Mar 7, 2010)

My personal experience was Tuesday at 4 a.m. a couple of years ago when my wife took me to the small 'cottage' hospital in a nearby town because I had a persistent, but not severe, pain in my chest. I was in and given treatment within five minutes leading to quick stabilisation. An enzyme test (I thought that could not be done for about 12 hours, but here they do it straight away) showed that I was having a mild heart attack. I was transferred to the Provincial hospital by ambulance with a Dr. and nurse, two stents were fitted and I was discharged on the Friday. 

Things have changed a little since then and there is now a full team plus ambulance on standby at our health centre in the village (pop <5000) plus we have a helipad for emergency evacuation if required.

Spanish health service in Andalucía is excellent


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## The Skipper (Nov 26, 2014)

I took a neighbour to A&E at Alcoy hospital shortly before Christmas. He had severe back pain, later diagnosed as a slipped disc. A porter came to the car with a wheelchair as soon as we pulled up at the door and took us into the waiting room, which was packed. But within five minutes he was seen by a triage nurse and within 30 minutes he was put on a drip to give pain relief. All in all a far more efficient service than ever experienced in the UK.


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## Isobella (Oct 16, 2014)

Over three hours in Urgencias Costa del Sol last year New Years Day.

According to Spanish news some Malaga wards have been closed and operations cancelled. People sleeping on trollys in corridors in the North, over a year waiting for some operations, sounds like the UK dunnit It's all on Google also the Spanish trade Union accusing hospitals of fiddling the figures and lack of transparency.

It's a good service if you don't read much Spanish and had a good personnel experience


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## Alcalaina (Aug 6, 2010)

Depends where you are, like everything else about Spain. Healthcare is managed at regional level and it is impossible to generalise. Some of the hospitals in Cádiz province where I live are very short-staffed because of the cuts, and waiting times after you've been through triage can be long.


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## Guest (Jan 8, 2015)

I've had two encounters with the hospitals in Spain - one in Caceres and one in Denia, so on opposite sides of the country. Caceres hospital - clearly heavily used and not a flagship hospital, also little English spoken. Couldn't fault them even if I wanted to. I'd had chest pains so I was whisked through the system (and was given the all-clear, thankfully). Total time from arrival to exit, including tests and X-rays, 4 hours. Second encounter at Denia hospital. This hospital is one of the best in Spain and lived up to its reputation. Went to urgencia after an accident with query broken bones - triaged immediately, all tests done and we were out having coffee within a couple of hours (again, thankfully, no great damage found). I am very very glad I live in Spain as regards healthcare.


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## Derek H (Dec 7, 2008)

Good to hear. A health service that is a health service. Not a political football.
Sometimes, no all of the time, these plonkers in Westminster take us for idiots.

Getting hot n bothered,
Derek

Nurse, the screens!


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## baldilocks (Mar 7, 2010)

Derek H said:


> Good to hear. A health service that is a health service. Not a political football.
> Sometimes, no all of the time, these plonkers in Westminster take us for idiots.
> 
> Getting hot n bothered,
> ...


I hope that the nurse will not be behind the screens with you otherwise you'll be getting even more hot and bothered and so will she.


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## Derek H (Dec 7, 2008)

baldilocks said:


> I hope that the nurse will not be behind the screens with you otherwise you'll be getting even more hot and bothered and so will she.


I can dream.
Derek :evil:


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## Pesky Wesky (May 10, 2009)

Derek H said:


> Good to hear. A health service that is a health service. Not a political football.
> Sometimes, no all of the time, these plonkers in Westminster take us for idiots.
> 
> Getting hot n bothered,
> ...


I don't have recent experience of Spanish ER thank goodness, but in the past I've been very satisfied with the medical treatment offered, although I'm not the only one to have commented on the the staff being professional yet very matter of fact, even distant.
However, it would be a mistake to think that the Spanish NHS is without its problems. There have been drastic cuts in personnel and equipment. For example, there have been huge protests in the last few days about the treatment of hepatitis C. 
Asociaciones tachan de 'nefasta' la gesti?n sanitaria de la hepatitis C | Salud | EL MUNDO
It seems that there is a new treatment, but the government has priced the treatment way over its real cost therefore making it available only too those who can pay. (I think that's the story anyway). Even so it seems to come out better than people's experience with the British NHS 

PS Info in English about the Hepatitis thing
http://elpais.com/elpais/2015/01/06/inenglish/1420544396_017257.html


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## IanB (Feb 11, 2013)

Hello All

I haven't been around for a while as our plans had to be on hold and still are to a certain extent due to the incompetence of the NHS ( which almost killed me this year) and other matters. It is heartening to read of of such good healthcare in a country which has economic problems on the scale that Spain has.

It is an unfortunate fact that NHS Wales (which we come under) has in general a high proportion of "lions" at the front end trying to do a good job and are led by braying donkeys from the political elite through the whole administration. In the current circumstances, likening NHS managers to braying donkeys is an insult to the donkeys. We are informal complaint at the moment and they are even are in defiance of the court to provide the relevant data.

So the crisis in the NHS in the UK is fomented by rank bad leadership, bad and corrupt management having no probity which in turn has led to the whole matter degenerating into what it has become.

It is a fact that NHS Wales hospitals alone are killing citizens of Wales with avoidable deaths three times faster than the Nazi killing machines killed German citizens in their 12 year reign. That is based on published official statistics from the ONS for the last twelve years.

So please, be aware that from what I read of the Spanish system that it is far superior to the substandard treatment handed out to many of us in the UK. If you complain your card is marked an even a High Court order will be defied.

regards
Ian


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## Derek H (Dec 7, 2008)

While both Spain and the UK are experiencing financial difficulties, Spain, AFAIK, do not get themselves involved in trying to inflict world peace on every county, region or political regime that takes their fancy. I heard somewhere, on the BEEB, radio 4 probably, that the UK defence budget exceeded that of the NHS.
Perhaps, if the Defence Budget was used to Defend the UK, instead of sending troops into harms way, the world would now be a safer place. And we would have a Health Service worthy of the name. We are not the world's policeman.
Here endeth the rant.
Derek


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## thrax (Nov 13, 2008)

This is a recent diary from a senior registrar at a teaching hospital in UK. It's long but worth the read for those of us who don't know what it is like to work in A&E. This is part 1, part 2 immediately after that.

I am a senior registrar A&E doctor in a major teaching hospital. I qualified over 10 years ago and have been an A&E doctor for three quarters of my career. On most daytime shifts, I am in charge of a section of our department, such as the resuscitation room, majors, minor injuries, children’s A&E or clinical decision unit; when I work night shifts, I am in charge of the entire department, covering all those areas.
The difficulties we are facing this winter arise from patient and population factors, issues around senior staffing of A&E departments, and problems with the broader health and social care system. Most of the difficulties are not new, but the chronic strain they have been putting on the system for years has, for many reasons, been felt particularly acutely in 2014. It’s being called a winter crisis, but the summer of 2014 was the most difficult I have seen in my career; winter is only making matters that little bit worse – and so far, we are lucky that there has not been a big spike in influenza cases.
I’ll try to explain the problems using the format of a diary of a typical night shift in my A&E department.
10pm
I start work and take a handover of all areas of the department.
There are 72 patients in A&E. Half of them haven’t seen a doctor yet. Ten of them haven’t even seen a triage nurse who will decide how serious their case is. We don’t have enough space for them all.
All the beds in the resuscitation room (“resus”) are full.
Patients with chest pain are sitting on chairs, waiting for up to an hour for an electrocardiogram (ECG) to make sure they’re not having a heart attack.
Patients with minor injuries have been waiting for more than three hours to see a doctor. The day shift is finishing; more doctors are going home than are starting for the night shift. That waiting time is going to get longer. I cannot divert more doctors to see those patients because I need them with me in majors and resus to see the more unwell cases.
Three of the six doctors working under me tonight are locum doctors. They are not employed full time; they pick up the shifts they want, when they want, at different hospitals, for two or three times the pay I’m getting for tonight. Some of them are great doctors; others not so good. Two of them have never worked in this department before, so I’m going to have to show them round, explain our local policies, and teach them how to use the computer system before they can even see one patient. The reason? Nobody wants to take up full-time jobs in A&E any more – especially the more senior posts like registrar and consultant.
And why would they? For the same amount of training and experience, I could be a dermatologist or a kidney doctor. I’d work the same number of hours for the same pay, but much less (or no) evening and nighttime work, with regular, predictable, scheduled activities in my day, time for lunch, and no drunk people to deal with. Most of my patients wouldn’t be acutely unwell; I wouldn’t be making life-and-death decisions every shift. So why choose A&E, with constant pressure from dealing with really sick patients, drunks causing havoc all night, often no time for a lunch or dinner break, and frequent evening and night shifts? So – we’re really short of senior doctors, every day.
11pm
The ambulance service calls to say they’re bringing in a very unwell 80-year-old with difficulty in breathing. He’s going to need the resuscitation room, but it’s still full. I have to decide which of the sick patients in there can come out to a less high priority area.
The population is getting older and carrying a higher burden of serious illness. Patients with longstanding heart, lung, or kidney disease can become extremely unwell very quickly, especially if they catch flu or a vomiting bug. We are getting better at treating them. There is more we can do, but it takes a huge amount of resources. It’s expensive. The result is people do get better; they live longer with their chronic illnesses; and they keep coming back when new complications arise.
Minutes later, another call from the ambulance service. They’re bringing in a drunk man with a head injury who is being aggressive and difficult to manage. Maybe he’s being difficult because he’s drunk; maybe he’s always like that; but maybe he has a brain injury that’s causing this behaviour. He’s going to need to be in resus as well, and he will take four or five members of staff to sort him out.
1am
I’ve stabilised the two new resus cases. But my junior doctors are waiting to discuss their cases with me. Because I’m the only senior doctor on duty tonight, and I’ve been busy in resus, the juniors haven’t been able to make any real decisions about the patients they’ve seen. The queue, and the waiting time, is getting longer by the minute.
One of the patients they need to discuss is a 96-year-old whose relatives called an ambulance early in the evening because they couldn’t get her GP to visit her and treat what is probably a minor chest infection. But now it’s nearly 2am, so although she is not very unwell, she’s going to have to stay in hospital overnight: it’s not fair to send her home alone at this time. In hospital, she will occupy a bed unnecessarily.
Outside her familiar home environment, she is at increased risk of getting confused or falling over. And she may be at risk of contracting a hospital-acquired infection. If her GP could have visited her, she would have avoided all those risks, and we’d have another bed free. It’s not her GP’s fault: the GPs are terribly overstretched and under-resourced, too.
2am
The last four patients to arrive by ambulance were drunk. Very, very drunk. They’re taking up A&E cubicles and nursing staff, meaning that the old man who got a taxi here with chest pain (he “didn’t want to bother” the ambulance service) doesn’t have a cubicle or a nurse. One of the drunk patients is shouting and swearing. He urinates all over the floor. It’s upsetting for the family of the dying cancer patient next door. They should be spending these last days together in a hospice, not in A&E – but all the local hospices are full.
We’re seeing more and more drink-related problems. Drunk patients take up a lot of resources and they’re often frightening for other patients and relatives in the department.
3am
A woman arrives with her three-year old son in an ambulance. The boy has had a runny nose for three days and vomited once tonight. There’s no way they should be here, at this time, when he just has a cold – and they certainly shouldn’t have called an ambulance – but we have to see him anyway. She’s never heard of*NHS 111.
4am
Phil has arrived in an ambulance. It’s the third time in the last 24 hours, the tenth time this week, and the 20th time this month he’s come to A&E, every time by ambulance. He has heart disease, it’s true, but every time he’s come to see us this month, we’ve found nothing acutely wrong with him. Maybe he’s lonely. Maybe he thinks it’s funny. Maybe he actually thinks there is something wrong. I’m not sure. But I do know we’ll have to do an ECG again, and a doctor is going to have to spend time carefully examining him to be sure that this isn’t the time when he actually is unwell.
Phil isn’t the only patient like this is our area. There are maybe eight or 10 of them. They take up a lot of time and resources unnecessarily, but there doesn’t seem to be much we can do about it.
5am
I still haven’t had a break. I’m tired and hungry. We still have 35 patients in A&E. It never stops. A few years ago, you could sometimes hope to get A&E empty by 4am and have an hour or so for the team to eat and freshen up, maybe do some teaching for the juniors. Not any more.
Patients want a 24/7 health service. Only A&E provides that. So they come, and they come, and they keep coming, all times of day and night.
The hospital is full. There are no more beds. If we decide to admit anyone else, they will have to stay in A&E for hours until mid-morning, when patients get discharged from upstairs. The hospital simply isn’t big enough. Part of the reason is that it’s so hard to put in place social care packages for patients who are medically well but need help looking after themselves at home. So they have to stay in a hospital bed until social services which are grossly underfunded – can organise a carer.
7am


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## thrax (Nov 13, 2008)

Another priority call from the ambulance service. An 86-year-old man was found on the floor of his home by his son, who was going to pick him up for a hospital appointment. He’s been on the floor for 36 hours, lying in his own urine and faeces, shouting for help, because no one visited him yesterday. He has a broken hip and he’s gone into kidney failure. He might not survive. Maybe if people looked out for their elderly neighbours a little more, he could have been found sooner and he would have been much less unwell when he got to us.
Meanwhile, a man in his forties with a three-year complaint of back pain wants to know why he’s been waiting for over two hours to see a doctor. And why are there doctors sitting at the desk “not doing anything” when he is waiting to be seen? He came here instead of going to his GP because he couldn’t get an appointment until next week.
I want to ask him why it’s so urgent now, after three years and nothing’s changed, but hold my tongue. (The doctors at the desk aren’t “not doing anything”. They’re writing up notes on the patients they have seen – detailed, accurate notes are essential for delivering safe ongoing care – checking blood test results and scans, and discussing their patients with me and with specialist teams to decide on the best course of action for each case. And besides, none of them have had a break tonight.)
8am
Time to hand over to the day team. I’m past being hungry now; I just want to crawl home and into bed.
As I’m leaving, I see a man arriving with a blocked urinary catheter. The district nurse is meant to change it, which would solve the problem, but there weren’t any district nurses available this morning. So, like everyone else, his fallback plan is to come to A&E. It’s unfair on him – much better for him that he be treated at home – and it places even more pressure on our department, with too few senior staff, not enough space to see patients, and no beds for people if they need a hospital stay.
The day shift is short of nurses. Maybe that’s because half the senior charge nurses in our department have resigned in the last year or so. They’ve gone to find less stressful work in other specialities – or even other countries.
As well as too few nurses, there are two unfilled consultant shifts and three unfilled junior doctor shifts. Nobody wants to do A&E. I’m starting to see why.


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## Pesky Wesky (May 10, 2009)

thrax said:


> Another priority call from the ambulance service. An 86-year-old man was found on the floor of his home by his son, who was going to pick him up for a hospital appointment. He’s been on the floor for 36 hours, lying in his own urine and faeces, shouting for help, because no one visited him yesterday. He has a broken hip and he’s gone into kidney failure. He might not survive. Maybe if people looked out for their elderly neighbours a little more, he could have been found sooner and he would have been much less unwell when he got to us.
> Meanwhile, a man in his forties with a three-year complaint of back pain wants to know why he’s been waiting for over two hours to see a doctor. And why are there doctors sitting at the desk “not doing anything” when he is waiting to be seen? He came here instead of going to his GP because he couldn’t get an appointment until next week.
> I want to ask him why it’s so urgent now, after three years and nothing’s changed, but hold my tongue. (The doctors at the desk aren’t “not doing anything”. They’re writing up notes on the patients they have seen – detailed, accurate notes are essential for delivering safe ongoing care – checking blood test results and scans, and discussing their patients with me and with specialist teams to decide on the best course of action for each case. And besides, none of them have had a break tonight.)
> 8am
> ...


Horrifying.
And scary


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## Lynn R (Feb 21, 2014)

Pesky Wesky said:


> Horrifying.
> And scary


No other way to describe it

And this is how the Department of Health proposes to treat the staff working in these conditions:-

NHS staff ‘unsocial hours’ payments under threat | Society | The Guardian


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## Derek H (Dec 7, 2008)

Things will remain like this, until our wonderful government work out how they can show a profit. Health Insurance is a real possibility under the Tories.

Derek


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## thrax (Nov 13, 2008)

But of course it isn't just A&E which is failing, it is the entire health service, both primary and secondary healthcare are in a terrible state. As I think JoJo mentioned somewhere, there is far too much money spent on top management and not enough on the real deal, health care. When my first daughter was born she was quite ill and we often had to call a doctor who would turn up at any time of day or night. Now we would have to take her to A&E which is entirely unnecessary but without primary health care in place what else can people do. I have no idea which government destroyed primary healthcare, and no doubt Mary can tell us, but I suspect it was probably several of different political persuasions.


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## Derek H (Dec 7, 2008)

I reckon I'll get myself into trouble with the Moderators, if I continue on this subject. So I'll leave it to Mary.
I remain of the opinion that, their is a party in the UK, who know the cost of everything. And the value of nothing.
Derek


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## Roy C (Sep 29, 2012)

I really don't understand why people attack the staff that are trying to make them better, a common occurrence in UK hospitals, these people ( for want of a better word) should be treated as severely in the courts as ones who get drunk and fight on planes.

It certainly looks like the Spanish HS is better although I do love our NHS.


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## Isobella (Oct 16, 2014)

I am not sure how people come to the conclusion one is better than the other:confused2: my experience of a cottage style hospital in Hampshire has been fantastic but I realise it is not good everywhere.

News stories about salud in Spain are about the same as the UK. 2 patients died in Toledo last year whilst waiting in corridors for beds and there are lots of photos on the web of patients on corridors. Over 72,000 patients were on the waiting list for operations in Madrid last year (an increase of 12%). Average time for a heart operation 4 months. Health Service workers say it is worse and accuse the Government of massaging the figures.

Sound familiar! Perhaps all countries in Europe are the same


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## baldilocks (Mar 7, 2010)

Isobella said:


> I am not sure how people come to the conclusion one is better than the other:confused2: my experience of a cottage style hospital in Hampshire has been fantastic but I realise it is not good everywhere.
> 
> News stories about salud in Spain are about the same as the UK. 2 patients died in Toledo last year whilst waiting in corridors for beds and there are lots of photos on the web of patients on corridors. Over 72,000 patients were on the waiting list for operations in Madrid last year (an increase of 12%). Average time for a heart operation 4 months. Health Service workers say it is worse and accuse the Government of massaging the figures.
> 
> Sound familiar! Perhaps all countries in Europe are the same


I think that much depends on region and the AC that is running the health service. Here it is Andalucia and is in PSOE hands which might make a difference since they feel less obligated to follow the PP run Cortes and Rajoy's line.


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## Pesky Wesky (May 10, 2009)

Isobella said:


> I am not sure how people come to the conclusion one is better than the other:confused2: my experience of a cottage style hospital in Hampshire has been fantastic but I realise it is not good everywhere.
> 
> News stories about salud in Spain are about the same as the UK. 2 patients died in Toledo last year whilst waiting in corridors for beds and there are lots of photos on the web of patients on corridors. Over 72,000 patients were on the waiting list for operations in Madrid last year (an increase of 12%). Average time for a heart operation 4 months. Health Service workers say it is worse and accuse the Government of massaging the figures.
> 
> Sound familiar! Perhaps all countries in Europe are the same


It's not very "useful" to talk about Spain or the UK. 
Situations depend not only on the region patients are in, but also the conditions they suffer from, their age (some regions provide better geriatric/ pediatric care than others), the local government, the ambulance company that's contracted and probably in some regions in Spain at least, if it's the summer or the winter. People can only talk about their own experiences - mine are in Madrid. However, in the time I've been on the forum I've read a lot of very positive posts about the health service here in many different areas, few negative comments (Yes, that's right for those who gauge the forum to be a den of negativity!!) and many unfavourable comments about the NHS UK


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## Maureen47 (Mar 27, 2014)

Having spent my working life in the NHS in the UK both as a registered nurse and a manager I understand some of the frustrations people have. I have to say though I have worked in some fabulous hospitals around the country and in the main many people work in healthcare for the right reasons. There have been many many changes in the NHS in the 30 yrs I have been worked there. The biggest issue many of us have is trying to hit unrealistic targets set by folks in government who have never worked on the frontline. I don't think the 4 hr wait in A/E reflects the quality of care nor does trying to hit the target improve things.If Primary and Secondary Care work in harmony the results are incredible. A couple of examples.

Many patients having planned surgery for example a joint replacement require planned support on discharge from hospital but can be stuck in hospital as this has not been arranged prior to admission , if you set up a system where all the support is in place prior to surgery then discharge is carefully planned and successful on the planned day. If a GP is referring a patient for Day Surgery but has not checked that the patient is a suitable candidate then they will arrive for their appointment and be sent home as the risk is too great to carry out the surgery prior to some investigations. If you have a system where there is a series of checks required prior to having the appointment the planned surgery goes ahead in a safe manner with the patient having confidence all will be ok. I have strived for years wherever I have worked to ensure this is the standard way of working but have came across a lot of pushback from folks involved at all stages of the patient journey. Much as I have loved my career in the NHS I am glad it is coming to an end soon as the frustrations are starting to outweigh the pleasures of doing the job. I wouldn't change my career decisions as I have so many wonderful memories , sad , happy ,funny, frustrating but its been a fabulous 30 years. I do hope the NHS is never privatised in the UK , having worked in countiRIs with no NHS , folks sometimes really don't appreciate what they have until its too late.


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## Lynn R (Feb 21, 2014)

baldilocks said:


> I think that much depends on region and the AC that is running the health service. Here it is Andalucia and is in PSOE hands which might make a difference since they feel less obligated to follow the PP run Cortes and Rajoy's line.


Even in Andalucia, we do seem to be increasingly reading of problems due to cuts. Now emergency care nursing staff at Carlos Haya Hospital in Malaga are to strike as staff shortages are affecting patient care -

Profesionales de enfermería de las urgencias de Carlos Haya anuncian una huelga . SUR.es

I read of similar problems in Urgencias at Motril Hospital in Granada province in a local free paper I picked up in Nerja last week.


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## extranjero (Nov 16, 2012)

Maureen -don't expect discharge planning after hip, knee replacements in the same manner as the UK, where patients are really spoiled for aftercare with support teams etc.
Firstly, getting the patient mobile in hospital will depend on the relatives.aids such as crutches, frames, raised toilet seats/ rails will have to be supplied by the family.
No one will come to your home to check if it is suitable for the patient to be discharged.
Physiotherapy may be arranged, and the nurse at the local practice may come to the house for dressings injections etc. 
It can be daunting for a relative with with no support to cope with all this, particularly if frail themselves, staying with the patient, helping with personal care as well, particularly if the hospital is a long way from their home.
Yes the health system is efficient here in most cases, with excellent hospital treatment, but many find out the hard way that their experience or that of relatives may be very different in Spain.
I agree that many people do not give the wonderful NHS the appreciation it deserves.
I'm speaking as a former nurse.


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## Maureen47 (Mar 27, 2014)

extranjero said:


> Maureen -don't expect discharge planning after hip, knee replacements in the same manner as the UK, where patients are really spoiled for aftercare with support teams etc.
> Firstly, getting the patient mobile in hospital will depend on the relatives.aids such as crutches, frames, raised toilet seats/ rails will have to be supplied by the family.
> No one will come to your home to check if it is suitable for the patient to be discharged.
> Physiotherapy may be arranged, and the nurse at the local practice may come to the house for dressings injections etc.
> ...



Yes , I understand it is different in Spain , have a couple of friends who have had some major health interventions in Spain and although the care and medical treatment was great , they needed family support for many basic things that happen as a matter of course in the UK. I don't think this is a bad thing unless of course you have no family to support you then it must be a dreadful time for folks. In fact, thinking about it, sounds like a thing ex pat ex nurses could volunteer to help with , maybe a group of folks like this exists already ? Supporting families in times like this and I mean on a voluntary basis not as a business. Anyone know of anything like this ?


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## Pesky Wesky (May 10, 2009)

I've just come off the phone with my sister. My mother is in hospital after a fall. She was in hospital last Feb too after she fell and broke her hip. The reason she fell this time is partly due to the fact that she wasn't given the correct amount of physio when she was recovering from the hip replacement, nor was she given thorough follow up treatment. 
This time round she was mistakenly discharged and fell again within hours of being at home. Finally we think she seems to be on the real road to recovery and she seems to be in a ward where they are giving her the right treatment, the motivation and the general care that she needs and deserves. We suspect this could be because we haven't made a formal complaint about the mistaken discharge.

I do think that the follow up care after being in hospital can be completely lacking here. However my father was operated on for cancer at the age of 89 last year. My mum went to a care home and he was sent home on his own within days and nobody checked up on him at home.
Where they do seem to shine here is on pysiotherapy. You have a daily session normally after a broken bone for example.


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## mrypg9 (Apr 26, 2008)

Derek H said:


> I reckon I'll get myself into trouble with the Moderators, if I continue on this subject. So I'll leave it to Mary.
> I remain of the opinion that, their is a party in the UK, who know the cost of everything. And the value of nothing.
> Derek


I've given my opinion on the merits of Andalucian v UK healthcare elsewhere.
As to the current state of the NHS ...for all her sins, Thatcher didn't dare touch it. Blair introduced the private sector to cut waiting lists but this government has opened up the whole field of health care to the private sector with disastrous results.
Imo the private sector has no place in health care. But in view of the new problems posed by an ageing population and expensive new drug treatments and innovative technologies a fresh,radical look at how health care and system management are required.
Maybe an insurance - based system run by not for profit agencies is an option?


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## Isobella (Oct 16, 2014)

If it is one versus the other I would say they are both in a mess. I read the Spanish news most days as it helps my Spanish. Although Spain doesn't go in for a health scare a day there are still lots and there are photos on the web of corridors full of beds, even beds in a storeroom. Not long ago a man at Carlos Haya Malaga had to wait 8 hours for thirty stitches when his ear was almost torn off. 

There are also many people in both countries who speak highly of the wonderful service they received.

I agree about the Aging population, nearly every pensioner you talk to seems to have had a new hip or knee. Even just on this forum many say they have had a relative who has been taken to hospital with a fall so statistically there must be thousands each week.

What is the solution though:confused2: I am not sure just throwing Money at it would improve it.


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## Alcalaina (Aug 6, 2010)

maureen47 said:


> Yes , I understand it is different in Spain , have a couple of friends who have had some major health interventions in Spain and although the care and medical treatment was great , they needed family support for many basic things that happen as a matter of course in the UK. I don't think this is a bad thing unless of course you have no family to support you then it must be a dreadful time for folks. In fact, thinking about it, sounds like a thing ex pat ex nurses could volunteer to help with , maybe a group of folks like this exists already ? Supporting families in times like this and I mean on a voluntary basis not as a business. Anyone know of anything like this ?


Yes there are opportunities for voluntary assistance, coordinated by groups like Age Concern España. 

It is not just families who help. In my village there was a case of an old man who had no relatives, and the whole street organised a rota to care for him, taking him cooked meals etc. And the hospital is 30 km away!


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## mrypg9 (Apr 26, 2008)

Alcalaina said:


> Yes there are opportunities for voluntary assistance, coordinated by groups like Age Concern España.
> 
> It is not just families who help. In my village there was a case of an old man who had no relatives, and the whole street organised a rota to care for him, taking him cooked meals etc. And the hospital is 30 km away!


People used to do that in the UK. In our little area of a few cottages, anyone who had to spend time in hospital received flowers and visits. Our nearest neighbour used to organise it, collecting money and seeing to anything that needed doing.
I bet they don't do that now. We lived in a cluster of eight old cottages. At least two of them were sold before we left, to Buy to Rent, and are now occupied by Eastern Europeans.


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## Maureen47 (Mar 27, 2014)

Alcalaina said:


> Yes there are opportunities for voluntary assistance, coordinated by groups like Age Concern España.
> 
> It is not just families who help. In my village there was a case of an old man who had no relatives, and the whole street organised a rota to care for him, taking him cooked meals etc. And the hospital is 30 km away!


Thanks for letting me know about that , I will make enquiries when we are permanently in Spain later this year


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## Alcalaina (Aug 6, 2010)

mrypg9 said:


> People used to do that in the UK. In our little area of a few cottages, anyone who had to spend time in hospital received flowers and visits. Our nearest neighbour used to organise it, collecting money and seeing to anything that needed doing.
> I bet they don't do that now. We lived in a cluster of eight old cottages. At least two of them were sold before we left, to Buy to Rent, and are now occupied by Eastern Europeans.


What a strange comment! Of course it still goes on.


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## Derek H (Dec 7, 2008)

mrypg9 said:


> I've given my opinion on the merits of Andalucian v UK healthcare elsewhere.
> As to the current state of the NHS ...for all her sins, Thatcher didn't dare touch it. Blair introduced the private sector to cut waiting lists but this government has opened up the whole field of health care to the private sector with disastrous results.
> Imo the private sector has no place in health care. But in view of the new problems posed by an ageing population and expensive new drug treatments and innovative technologies a fresh,radical look at how health care and system management are required.
> Maybe an insurance - based system run by not for profit agencies is an option?


I knew I could depend on you.

To add to the thread, please look up the fiasco concerning, Hinchingbrook Hospital. Huntingdon.


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## Isobella (Oct 16, 2014)

mrypg9 said:


> People used to do that in the UK. In our little area of a few cottages, anyone who had to spend time in hospital received flowers and visits. Our nearest neighbour used to organise it, collecting money and seeing to anything that needed doing.
> I bet they don't do that now. We lived in a cluster of eight old cottages. At least two of them were sold before we left, to Buy to Rent, and are now occupied by Eastern Europeans.


I think it still happens in many places. Has in all the places I have lived and still happens here. The problem is if you find that someone in your family needs assistance. You can't be all things to everyone.

I did notice in our local paper a woman complaining that the care home her Mother was in had not cut her nails. Surely she could have done that whilst visiting. We truly are a Nanny state.


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## extranjero (Nov 16, 2012)

Isobella said:


> I think it still happens in many places. Has in all the places I have lived and still happens here. The problem is if you find that someone in your family needs assistance. You can't be all things to everyone.
> 
> I did notice in our local paper a woman complaining that the care home her Mother was in had not cut her nails. Surely she could have done that whilst visiting. We truly are a Nanny state.


Considering the high charges of care homes, I expect the daughter thought that personal care was part of the service!


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## angil (Sep 24, 2012)

I lived in a 'real' expat community prior to coming to Spain and we all rallied around to help each other regardless of nationality, religion, ethnicity. From young women having babies and no one at home to care for the little ones / needing help while in hospital (Spain is not alone in its limited nursing care) to helping a single older man who had a horrific motorbike accident. Made you feel all warm and fuzzy inside seeing everyone chipping in. I have yet to get that same fuzzy feeling, although I am sure it goes on. I do have a lovely Bulgarian neighbour who I am sure I could call upon & the Spanish around me are salt of the earth types. I dearly hope I am well off the mark but there are a couple of instances I have witnessed with regards very old infirm Brits being cared for by 'kindly' slightly younger members of the community that have raised my eyebrows. Especially when I suggested I could pop in any time as I wasn't working to the 'kindly' gent assisting the very old lady in my building. "Oh no, don't do that, she doesn't like to accept help!" As far as I am aware neither this gent nor his associates who do 'help' this lady are qualified nurses and surely if they had this ladies best interest at heart then a female neighbour at hand should be thanked not discouraged! Not the only case I have had a funny feeling about the one closest to me!


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## extranjero (Nov 16, 2012)

I think many people who have had to spend a long time caring for their spouse in hospital due to an incapacitating condition, find that they feel unsupported, and alone
Help tends to wane after the first few days, neighbours are busy getting on with their own lives and problems.
It's worse when the hospital is a long way away, the spouse doesn't drive and local transport is infrequent.friends may help out a few times, at first, but then it becomes an expensive inconvenience.
Family can't drop everything at the drop of a hat, and fly over, they have work and family 
commitments, 
It all sounds very nice and cosy having neighbours in a rota, caring round the clock, offering services of transport, patient sitting, help with the home etc, but I fear iit isn't the norm. There probably is a need for an official organisation which can help in return for affordable fees.
We have helped our friend recently, with transport etc , whose wife had an orthopaedic operation, 
But he really needed ongoing daily help, and trying to organise everything for discharge, medication, dressings, aids , maintaining the home etc has worn him to a frazzle, and that's after only a few days!
So I can see why some people prefer to go back to the UK as their spouse becomes more frail and is at risk of regular hospitalisation.often it's the carer who dies first, worn out and stressed with it all!


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## mrypg9 (Apr 26, 2008)

Alcalaina said:


> What a strange comment! Of course it still goes on.


Not strange at all. I find it strange that you find it strange. After all, you have no first-hand knowledge of the area I lived in, or in this specific instance, a group of cottages on the edge of a small rural town. The fact that a large number of foreigners moved into what was a small tightly-knit community of mainly elderly residents has caused many changes. 
It may well still go on in many parts of the UK but I can tell you it does not where I used to live. Over the years I lived there I saw huge changes....old cottages tarted up, gentrified and sold to young middle-class professionals, some properties bought to rent and let to Poles, Portuguese, Latvians and other nationalities....all this in an area where little had changed for yonks.

It's only to be expected that people who speak no English and are often transitory rarely fit in to such settled communities.
Like it or not, it's a fact. Nothing to do with racism or xenophobia either. It takes time and stability to build real communities.


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## mrypg9 (Apr 26, 2008)

Derek H said:


> I knew I could depend on you.
> 
> To add to the thread, please look up the fiasco concerning, Hinchingbrook Hospital. Huntingdon.


I did. One of many. As for that Circle Trust...I remember reading a piece in The Guardian, of all rags, full of enthusiasm for this 'exciting new venture'. A friend told me that it's normal to wait two weeks to get a GP appointment....
Seems unbelievable.


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## Haggis4092 (Jan 14, 2015)

Found the medical care second to none! Had a brilliant service on the 3 occasions we have needed to visit the hospital.


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## baldilocks (Mar 7, 2010)

mrypg9 said:


> Not strange at all. I find it strange that you find it strange. After all, you have no first-hand knowledge of the area I lived in, or in this specific instance, a group of cottages on the edge of a small rural town. The fact that a large number of foreigners moved into what was a small tightly-knit community of mainly elderly residents has caused many changes.
> It may well still go on in many parts of the UK but I can tell you it does not where I used to live. Over the years I lived there I saw huge changes....old cottages tarted up, gentrified and sold to young middle-class professionals, some properties bought to rent and let to Poles, Portuguese, Latvians and other nationalities....all this in an area where little had changed for yonks.
> 
> It's only to be expected that people who speak no English and are often transitory rarely fit in to such settled communities.
> Like it or not, it's a fact. Nothing to do with racism or xenophobia either. It takes time and stability to build real communities.


I am in accord with you on incomers in large quantities changing the entire make-up of a small area. Likewise it has all changed where i was born with 'townies' 
moving in.



> It's only to be expected that people who speak no English and are often transitory rarely fit in to such settled communities.


re-word that to read Spanish instead of English and you get many parts of Spain until the quantity of them creates an area is no longer Spanish.


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## mrypg9 (Apr 26, 2008)

baldilocks said:


> I am in accord with you on incomers in large quantities changing the entire make-up of a small area. Likewise it has all changed where i was born with 'townies'
> moving in.
> 
> 
> ...


The changes started about a year before we left when one cottage was rented to some Poles, young people. They weren't interested in getting to know their neighbours, not surprising really as we were most of us getting on a bit and apart from me no-one spoke Polish...it's not a skill often found amongst elderly rural folk.

A lot of Eastern Europeans moved into small villages, working for gang masters who often exploited them . Of course their arrival changed communities. Most didn't stay long.

Yes, a lot of immigrants can change an area wherever, not just in Spain. Most liberal-minded folk would say 'So what?'
It is also surely hypocritical to accept and praise multi-culturalism when practised by Muslims in Bradford yet deplore it when practised by Brits in Benidorm.


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## Alcalaina (Aug 6, 2010)

mrypg9 said:


> Not strange at all. I find it strange that you find it strange. After all, you have no first-hand knowledge of the area I lived in, or in this specific instance, a group of cottages on the edge of a small rural town. The fact that a large number of foreigners moved into what was a small tightly-knit community of mainly elderly residents has caused many changes.
> It may well still go on in many parts of the UK but I can tell you it does not where I used to live. Over the years I lived there I saw huge changes....old cottages tarted up, gentrified and sold to young middle-class professionals, some properties bought to rent and let to Poles, Portuguese, Latvians and other nationalities....all this in an area where little had changed for yonks.
> 
> It's only to be expected that people who speak no English and are often transitory rarely fit in to such settled communities.
> Like it or not, it's a fact. Nothing to do with racism or xenophobia either. It takes time and stability to build real communities.


Oh, sorry. I misunderstood, I thought you were referring to the UK as a whole, not your street.

But don't these foreign incomers support each other in times of need, much as we British immigrants do in our respective communities in Spain?


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## mrypg9 (Apr 26, 2008)

Alcalaina said:


> Oh, sorry. I misunderstood, I thought you were referring to the UK as a whole, not your street.
> 
> But don't these foreign incomers support each other in times of need, much as we British immigrants do in our respective communities in Spain?


Well, I didn't make myself very clear either, looking back.
As for immigrants helping each other....there's no general rule and I think a lot depends on culture. The majority of Eastern Europeans in our area where young, single males with a few single females and rarely any couples with children. We didn't exactly help cement community relations as we rented our house for six months to a Polish woman who sub-let and filled every room with several people. I 'm told there was a lot of drinking and riotous goings-on.
But before the Poles arrived we had a large number of Portuguese. They came as families and from what I gathered were very community-minded. They left when the Poles arrived, who were happy to work for lower wages and live in cramped conditions to save money.
There really is a lot of hostility towards the newcomers, more so the Poles, Latvians etc. Much more crimes of violence, often involving knives and alcohol-fuelled and an increase in motoring offences. From first-hand experience I can say that a lot of pressure was put on schools and medical services, mainly by the arrival of Portuguese children but also the few Polish children who came with their parents.

Too many people came too soon and the local community's views were not solicited in any shape or form. Villages that had been dozy backwaters since the Battle of Waterloo suddenly had to adapt to large numbers of non-English-speaking people. Easy for middle-class liberals living in leafy suburbs to prattle on about the duty to welcome people with open arms.


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## Isobella (Oct 16, 2014)

I so agree with you. It is the poorest communities which have been devastated. The chattering classes living in expensive houses don't see the devastation a large influx of people has caused.


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## baldilocks (Mar 7, 2010)

mrypg9 said:


> Well, I didn't make myself very clear either, looking back.
> As for immigrants helping each other....there's no general rule and I think a lot depends on culture. The majority of Eastern Europeans in our area where young, single males with a few single females and rarely any couples with children. We didn't exactly help cement community relations as we rented our house for six months to a Polish woman who sub-let and filled every room with several people. I 'm told there was a lot of drinking and riotous goings-on.
> But before the Poles arrived we had a large number of Portuguese. They came as families and from what I gathered were very community-minded. They left when the Poles arrived, who were happy to work for lower wages and live in cramped conditions to save money.
> There really is a lot of hostility towards the newcomers, more so the Poles, Latvians etc. Much more crimes of violence, often involving knives and alcohol-fuelled and an increase in motoring offences. From first-hand experience I can say that a lot of pressure was put on schools and medical services, mainly by the arrival of Portuguese children but also the few Polish children who came with their parents.
> ...


It was much the same after WWII when the DP camps took over from PoW facilities and hundreds and thousands of displaced persons who could not speak English were deposited in communities that were not suitable to accommodate them.


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## Alcalaina (Aug 6, 2010)

Back to topic: all this week there have been items on the news about a sudden surge of demand at A&E units in Andalucia. There is an increase of 30% over last year and they have just announced they will hire an extra 255 staff. 

They say the cause is low temperatures and an outbreak of some respiratory virus, but I can't help wondering if the cuts in services at local health centres have contributed as well. We used to have two full-time doctors on duty, now there is just one and he/she also does emergency cover so isn't always there when you go for your appointment.


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## Lynn R (Feb 21, 2014)

Alcalaina said:


> Back to topic: all this week there have been items on the news about a sudden surge of demand at A&E units in Andalucia. There is an increase of 30% over last year and they have just announced they will hire an extra 255 staff.
> 
> They say the cause is low temperatures and an outbreak of some respiratory virus, but I can't help wondering if the cuts in services at local health centres have contributed as well. We used to have two full-time doctors on duty, now there is just one and he/she also does emergency cover so isn't always there when you go for your appointment.


Yes, I have just seen this story today about problems in A&E in Malaga's largest hospital:-

Las urgencias del Clínico se colapsan por virus respiratorios y de la gripe . SUR.es

Staff complaining that they haven't been able to see some patients for 3 hours who should have been seen within 30 minutes (would that be just for triage, do you think, because otherwise that doesn't sound too catastrophic to me) and patients waiting more than 24 hours for a bed to become free on the wards so they can be moved from A&E. 

A fair proportion of the problems in both countries, I think, have been caused not only by cuts in staffing but also by over zealous attempts to remove any "slack" from the system. In a public health service dealing with whatever comes through the door on any given day, surely there NEEDS to be some slack, in the form of extra wards that are normally mothballed but can be opened up in times of peak demand, and staffing at a level above merely the bare minimum so less has to be spent on calling in expensive agency workers. It really can't be run just like a supermarket as it's a bit more important than just making sure the tins of beans on the shelf don't run out by having a "just in time" stock replacement system. Nobody dies if they can't buy their tin of beans.


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## Pesky Wesky (May 10, 2009)

Alcalaina said:


> Back to topic: all this week there have been items on the news about a sudden surge of demand at A&E units in Andalucia. There is an increase of 30% over last year and they have just announced they will hire an extra 255 staff.
> 
> They say the cause is low temperatures and an outbreak of some respiratory virus, but I can't help wondering if the cuts in services at local health centres have contributed as well. We used to have two full-time doctors on duty, now there is just one and he/she also does emergency cover so isn't always there when you go for your appointment.


Same story in Madrid
Colapso en los hospitales | Madrid | EL PAÍS
And of course the Health Authorities say one thing and the unions and workers another
But isn't always the same, or almost, both in the UK and Spain?


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## Isobella (Oct 16, 2014)

Lynn R said:


> Yes, I have just seen this story today about problems in A&E in Malaga's largest hospital:-
> 
> Las urgencias del ClÃ*nico se colapsan por virus respiratorios y de la gripe . SUR.es
> 
> ...


More of the same yesterday it would be difficult to guess which country it is.

A&E collapsed. People who cannot get a Doctors appointment for four or five days are turning up with minor symptoms.
12 patients waiting in corridor for beds
2 floors of Hospital Civil closed for cost savings
Wrangling between Unions and Administration

Un pico de gripe y de virus respiratorios agravan el colapso en las urgencias de Carlos Haya . SUR.es


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## Pesky Wesky (May 10, 2009)

Pesky Wesky said:


> Same story in Madrid
> Colapso en los hospitales | Madrid | EL PAÍS
> And of course the Health Authorities say one thing and the unions and workers another
> But isn't always the same, or almost, both in the UK and Spain?


I meant to add _*at this time of year*
_


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## Pesky Wesky (May 10, 2009)

News of latest cuts in Spain
One million Spanish public workers see their medical coverage reduced | In English | EL PAÍS


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## Alcalaina (Aug 6, 2010)

Pesky Wesky said:


> News of latest cuts in Spain
> One million Spanish public workers see their medical coverage reduced | In English | EL PAÍS


But isn't this because the private insurance scheme that public sector workers can opt for have reduced the number of doctors and hospitals they work with? It's not a direct result of government spending cuts. And they can still opt for the public health system (they get to choose each year). Most of the teachers I know stick with the service offered by the Junta de Andalucia because they think it's better.


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## Pesky Wesky (May 10, 2009)

Alcalaina said:


> But isn't this because the private insurance scheme that public sector workers can opt for have reduced the number of doctors and hospitals they work with? It's not a direct result of government spending cuts. And they can still opt for the public health system (they get to choose each year). Most of the teachers I know stick with the service offered by the Junta de Andalucia because they think it's better.


This is what it says in the article


> Cuts in the number of hospitals and doctors paid through* the Finance Ministry’s health insurance system Muface* could affect about 1.5 million people – one million civil servants plus around half-a-million benefiting family members – who stand to lose medical coverage this year.


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## Lynn R (Feb 21, 2014)

I'm pleased to see that the strike by nursing staff in Urgencias at Malaga's Carlos Haya hospital has been called off after their union reached an agreement with the hospital management that additional staff will be taken on (although only on one year contracts - hopefully that doesn't mean just until the elections are over).

Trabajadores de las urgencias de Carlos Haya se concentran para que haya contratos al cien por cien . SUR.es


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