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NHS reality. An NHS soapbox. Speakers' corner for the NHS.

Trying to get reality into the 4 UK Health Services - rationing overtly rather than covertly.

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In most respects, especially fiscally, devolution has failed its children, especially in Wales where more parochial behaviour is encouraged and choices and opportunities are limited. We are in a “national multi-issue denial…

I have lived in Wales for 46 years now, and bought up 3 children in Pembrokeshire. The little England beyond Wales had no problem with its identity and although the Welsh Nationalists were committing arson in Cardigan, it rarely came south. The signposting was deliberately destroyed, but intelligent visitors used maps. The Pembrokeshire Yeomanry and [ ]

Politicians are sighting on GP pay in their desire to cut costs.. And the spectre of a 10 year course to be a consultant GP

Is making a profit a vice ? ( It is time for Labour to grow up. Profit is not a vice This reflects a distorted market. The high profits of a few practices are probably because they can employ cheap labour in city centres and suburbia. In these locations good transport means that part time doctors can [ ]

My local rationing . An example and a challenge for local politicians to admit that Enoch Powell was right…

Hywel Dda had correspondence with a citizen under the FOI rules. This is the response to their reply posted on Facebook in the Save Withybush Campaign. My response is below and relates to how we are going to ration overtly. Every local person wants the greatest number and choice of services local to them. Enoch [ ]

Running out of food? Not impossible in a warming world where nations are not prepared to act together…. A strategic food supply plan is needed… for the UK

The Global Food Security Index ( see below ) web page was last complete 2022. The 11th Global Food Security Index shows a deterioration in the global food environment for the third year, threatening food security. But in 2025 the insights at economist enterprise published In 2025, Finland ranks first in the Global Food Security [ ]

Still using paper notes – after all this time!

NHSreality has suggested integrated IT systems in every trust, and recommended that any of the GP systems available should be chosen in each Trust. Since this has not happened, probably because GPs were never allowed to influence trusts ( we are self employed businessmen who make a profit and this is a vice ) no [ ]

A possible template for a plan for the future of General Practice – who wants to be the fall guy?

Is the Descriptor below inevitable? I can see that Prof Hay be predicting correctly. I personally would probably not have chosen GP as a career under such a plan but who knows? Medical school training courses to be extended to add an MBA for all aspiring GP Team leaders? Think of the increased cost, and personal [ ]

The management of the crumbling NHS Estate… Mistakes compounded on mistakes

NHSreality has opined on the RAAC ( Reinforced Autoclaved Aeriated Concrete ) scandal and it being swept under the radar .. The lack of an Honest Debate means that structures are failing, and service failures will have to follow. In my own part of the country, and an example that follows through in many other [ ]

Equitable funding of social care – and the choices we all have to make. “Denying nursing home residents equitable access to NHS community services increases pressure on care providers and contributes to avoidable hospital admissions”.

The big question is whether equitable funding of social care should be pre-planned and covered by insurance or not? If not I see no way to make it fair, because those who have saved and were thrifty are punished more than those who spent everything. If we take the risk that we will never need [ ]

Is the unfair funding of GP practices ( And NHS Dentists ) a scandal yet to be exposed? Is the word profit unethical/ banned / a “vice”?

NHSreality has tried to explain the funding of the self employed businesses which have subcontracted to the 4 Health Services since inception. General Practice and Dentistry. The two groups have had their contracts imposed on them, and in Dentistry this has resulted in a complete breakdown, numerous citizens who do without a dentist, and a [ ]

As access gets worse, and waits lengthen, referrals increase, and complaints rise, the waiting list could be solved especially in the rural areas where there will be the most excess deaths

A retired Medical Director, who I suspect never had an exit interview, has spoken out in Pembrokeshire. The reality of poor survival and outcomes due to distance from basic facilities is real. The golden hour is the time between presentation and treatment for a cardiovascular event (Heart or brain) and in left behind parts of [ ]