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This is the NHS: Guardian event – live coverage This is the NHS: Guardian event – live coverage
(35 minutes later)
8.13pm GMT
20:13
Another member of the audience - a police officer whose partner is a junior doctor - asks whether the NHS of the future should have all publicly funded social care under the one umbrella.
A hospital doctor asks why the media hasn’t picked up more on the fact that a seven-day NHS will cost much more because of the need for all other medical professionals, and not just doctors - who already work nights and weekends.
8.09pm GMT
20:09
A junior doctor says that morale is very low because of how the public views the NHS and media coverage of the service. She says targets are being met, but the way patients are handled in hospital may not be what they want.
8.07pm GMT
20:07
Another tweet:
All round we have better care today. We have better trained doctors, says Dame Donna Kinnair #ThisIsTheNHS #GuardianLive
8.04pm GMT
20:04
Salyeha Ahsan misses the old-school consultant and matron who knows exactly who their patients are. She trained in Scotland, where things were closer to that model: “It was a different culture. It was very patient-driven and the word of the consultant was everything.”
8.01pm GMT
20:01
Sometimes it is necessary to close services in order to improve the quality of care, Faye Kirland says, which is never popular with people. Sometimes “we can do a lot better”, she explains.
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at 8.09pm GMT
7.57pm GMT
19:57
Guardian news editor Mark Rice-Oxley tweets:
"The NHS is very different to the one we created and we have to have a proper debate about the service we want" Rob Freeman #ThisIsTheNHS
7.55pm GMT
19:55
Polly Toynbee says that many NHS managers are very good indeed, but a balance is needed.
Managers are just doing what they are told to do by the government, Robert Freeman says, while people’s expectations of the NHS keep rising.
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at 8.08pm GMT
7.51pm GMT
19:51
Questions and comments from the audience now.
Dr Wendy Savage says that the first bad reorganisation of the NHS didn’t make much difference to patients, but the 1984 changes brought in managers with little experience of running a big hospital.
The average tenure for a hospital chief executive now is 36 months, she says, because of all the top-down pressure and the burden of regulation.
“So much is wasted on all this bureaucracy,” Dr Savage says. “We have got to fight the politicians and get our professional standards back,” she adds, to applause from the audience.
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at 8.07pm GMT
7.44pm GMT
19:44
Salyeha Ahsan says the last thing the NHS needs is “competition”.
7.42pm GMT
19:42
Can competition quietly be removed from the NHS, Polly Toynbee asks, given the remote chance of getting a new NHS bill through parliament? She thinks Simon Stevens, head of the NHS in England, is trying to achieve that goal.
Donna Kinnair says that despite the internal market, clinicians do come to sensible conclusions and achieve the best possible care for patients.
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at 8.07pm GMT
7.39pm GMT7.39pm GMT
19:3919:39
Faye Kirkland says the differences between CCGs in terms of what they will pay for can often be quite big, which creates problems on the frontline for doctors.Faye Kirkland says the differences between CCGs in terms of what they will pay for can often be quite big, which creates problems on the frontline for doctors.
7.37pm GMT7.37pm GMT
19:3719:37
CCGs are doing more public consultations in a bid to craft services to meet local needs, Robert Freeman says. He used to talk to colleagues more often in the past, but everyone is now so busy that there is often no time to do so.CCGs are doing more public consultations in a bid to craft services to meet local needs, Robert Freeman says. He used to talk to colleagues more often in the past, but everyone is now so busy that there is often no time to do so.
7.34pm GMT7.34pm GMT
19:3419:34
Robert Freeman says the 2012 reforms have created more paperwork and he now needs permission for funding for each patient.Robert Freeman says the 2012 reforms have created more paperwork and he now needs permission for funding for each patient.
He also does some work for a clinical commissioning group (CCG) and says that people are only just getting used to the way the system now works.He also does some work for a clinical commissioning group (CCG) and says that people are only just getting used to the way the system now works.
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at 7.39pm GMTat 7.39pm GMT
7.32pm GMT7.32pm GMT
19:3219:32
General practice really started getting very complex in 2012, Fay Kirkland says. “It was the perfect storm.”General practice really started getting very complex in 2012, Fay Kirkland says. “It was the perfect storm.”
Polly Toynbee has been writing about the NHS since 1977, when she had a book on the subject published. Every health secretary since then has tried to change the structures.Polly Toynbee has been writing about the NHS since 1977, when she had a book on the subject published. Every health secretary since then has tried to change the structures.
Dr Salya Ahsan says the 2012 NHS reforms had the biggest impact and were the most fractious: “It pitched doctor against doctor.” Dr Salyeha Ahsan says the 2012 NHS reforms had the biggest impact and were the most fractious: “It pitched doctor against doctor.”
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at 7.35pm GMT at 7.59pm GMT
7.25pm GMT7.25pm GMT
19:2519:25
Dr Faye Kirkland qualified as a GP in 2010 in Eastbourne but admits she found the pressure too much: 18 patients in the morning and 18 in the afternoon every day. Many of those she trained with have not gone into general practice. She is now working part time as a GP after going back to university to complete a broadcast journalism degree.Dr Faye Kirkland qualified as a GP in 2010 in Eastbourne but admits she found the pressure too much: 18 patients in the morning and 18 in the afternoon every day. Many of those she trained with have not gone into general practice. She is now working part time as a GP after going back to university to complete a broadcast journalism degree.
Fay says 10 minutes is not nearly enough time to see patients and deal with the resulting administration. “It’s just become impossible.” Fifteen to 20 minutes would be a more realistic time frame, she says, particularly as patients save up complaints because appointments are so difficult to obtain.Fay says 10 minutes is not nearly enough time to see patients and deal with the resulting administration. “It’s just become impossible.” Fifteen to 20 minutes would be a more realistic time frame, she says, particularly as patients save up complaints because appointments are so difficult to obtain.
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at 7.34pm GMTat 7.34pm GMT
7.22pm GMT7.22pm GMT
19:2219:22
Robert Freeman is asked if the NHS is under more pressure. He says that people seem to enjoy their work, but they are asked to see more patients and keep productivity high, “whizzing them through the system”.Robert Freeman is asked if the NHS is under more pressure. He says that people seem to enjoy their work, but they are asked to see more patients and keep productivity high, “whizzing them through the system”.
His paediatric orthopaedic work involves treating children with cerebral palsy and says that survival rates have risen, so that child patients now become adult patients more.His paediatric orthopaedic work involves treating children with cerebral palsy and says that survival rates have risen, so that child patients now become adult patients more.
7.15pm GMT7.15pm GMT
19:1519:15
Donna Kinnair is looking at nursing education in her new role at the RCN. She says money is not the primary motivator for entering the profession. Iif you provide the right culture, nurses will want to work there, she says.Donna Kinnair is looking at nursing education in her new role at the RCN. She says money is not the primary motivator for entering the profession. Iif you provide the right culture, nurses will want to work there, she says.
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at 7.33pm GMTat 7.33pm GMT
7.11pm GMT7.11pm GMT
19:1119:11
The panellists tonight are Dr Salyeha Ahsan, A&E doctor and broadcaster; Robert Freeman, consultant paediatric orthopaedic surgeon at the Robert Jones & Agnes Hunt NHS Foundation Trust; Dr Faye Kirkland, broadcast journalist and GP; and Dame Donna Kinnair, director of nursing, policy and practice at RCN.The panellists tonight are Dr Salyeha Ahsan, A&E doctor and broadcaster; Robert Freeman, consultant paediatric orthopaedic surgeon at the Robert Jones & Agnes Hunt NHS Foundation Trust; Dr Faye Kirkland, broadcast journalist and GP; and Dame Donna Kinnair, director of nursing, policy and practice at RCN.
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at 7.33pm GMTat 7.33pm GMT
7.08pm GMT7.08pm GMT
19:0819:08
Hello and welcome to the first Guardian live event to coincide with our month-long coverage of the NHS. It is being held in the Scott Room at Kings Place in central London.Hello and welcome to the first Guardian live event to coincide with our month-long coverage of the NHS. It is being held in the Scott Room at Kings Place in central London.
7.08pm GMT7.08pm GMT
19:0819:08
Guardian columnist Polly Toynbee is moderating tonight’s event, which features four people who work on the frontline of the NHS.Guardian columnist Polly Toynbee is moderating tonight’s event, which features four people who work on the frontline of the NHS.