AIBU to think it is not the NHS which reduces quality of life in the UK compared with other European countries(37 Posts)
In my experience smoking is far more widespread (and accepted) in countries like Italy and the Netherlands compared with the UK. Drinking, including binge drinking, is a big a problem in the Netherlands as it is in the UK.
So what causes the differences in outcome?
My thoughts are:
- people in the UK work longer hours
- have to commute far longer than in most other countries (people in the UK are much more mobile, in the Netherlands and Italy most people don't consider a job which involves a significant commute)
- much higher proportion of women is working in the UK, this makes life a lot more hectic for the whole family as all household work has to be fitted into just a few hours
- many people in the UK have a lot less time and less opportunity to go to markets to shop around for fresh produce (of course you can get fresh produce in supermarkets, and in some the quality is second to none, but not always)
Due to the above, in the UK people have less time for themselves, their kids, their family, and are possibly more socially isolated, are possibly more likely to resort to quick and easy meals including ready made meals.
So, to just blame the NHS seems a cheap shot to me. It has to do with the UK's infrastructure (or lack thereof), London focus (better paid jobs are most likely to be in London but very expensive to live in London if you have a family, hence need for commuting) and either the need to work long hours for financial reasons or wish to do so for career reasons or combination of the two (hence long hours for working parents and need for kids to spend a lot of time at school/before/after school care) combined with the high cost of housing and commuting. The Netherlands was always known for its protestant work ethic, but I have the impression that the work ethic is a lot stronger in the UK then in the Netherlands.
meant to say, cycle paths are a lot safer in the Netherlands compared with the UK
Dolomites - I am not bashing the Dutch. I am Dutch. But I also try to look at things objectively. From what I can see around me, my friends, my family, the work ethic is a lot less here than in the UK. I have worked a large part of my career in the UK, now I work here. It is a big difference. The Dutch may think they work hard .... sure, but they have not worked in London.
The Netherlands are as flat as a pancake. The UK is far far more hilly than the UK. At best the Netherlands has a few humps. However, hills should not prevent anyone cycling, I think. The key is that cycle paths are a lot better and safer in the UK and of course distances are much much more manageable by bike. If you live in the commuter belt and have to travel to London each day it is sheer impossible to cycle.
In the Netherlands most people live very close to where they work. My neighbour complains about his commute - it is less than 1 hour door to door. My father used to commute about 1.5 hours door to door and as a result he could even all those years ago, work from home three days a week as it was not considered reasonable to have a man (married with kids) having to commute for three hours a day - in the UK I have commuted for four to five hours a day, no home working allowed, having a small child.
The Dutch healthcare system is one of the most expensive in the world. Basically fully privatised. There is now more and more evidence that doctors carry out totally unnecessary procedures, including operations, just to earn money. Hygiene in Dutch hospitals is poor, they look very clean, very new, but many doctors point blank refuse to wash their hands as they think it is for sissies, many still wear ties, rings etc. The Dutch probably overtreat a lot of people compared with the UK.
I am not saying the Netherlands is terrible BTW, I think the quality of life for families is much better in the Netherlands, but I think that many Dutch people are very pretentious and seem to think they work so so hard and deserve so so much. The Brits just get on and do it, the Dutch moan a lot more.
I do think some GPs could help a lot. My son is asthmatic, because he was diagnosed so young (12 months) my GP basically said he doesn't have asthma and everytime the consultant has changed his meds we have had to fight with the GP to get them on repeat. The latest time took calls from me and the consultant to get finally get it sorted. Thankfully his consultant is fantastic!
After 2 years of asthma attacks I am pretty up on the symptoms that things are going wrong yet the GP refuses to give pred to him insisting it's a chest infection - every time this has happened we have been in a and e within 12 hours, no infection but needing pred (and by then often nebulisers/oxygen/admission)
The issue with GPs seems to be (through no fault of their own a lot of the time) they need to know about so many conditions they don't know enough about most to cope with anything outside the normal. Too often they dont take the time to read the notes before a patient comes in and they don't listen to what they/the family say.
Thankfully our local peads a and e and the whole peads service are outstanding and have saved his life on more than one occasion but the lack of support from GPs means that we end up being bad enough for A and E when really there was no need for it to get to that stage.
I think it's more about the care you receive when you are sick. With the amount of cutbacks. Closing of A&Es across cities, shrinkage of staff, increasing dependency on overseas recruitment for front line medical staff..it does seem to be going down quite spectacularly.
I think the biggest problem is not just the unhealthy life choices we make but the the fact that the very number of people who rely on the system and burden it. If you compare the ratios of budget to population you shall see how stretched the NHS is as compared to other parts of Europe. And that I think it key.
This article sounds like a propaganda article for the lovely minister
Well I am, to my neurologist! Not so much to my rather disinterested GP (really must look into moving practice, (I can't be my dh's patient but I can't find one I like as much as him/his colleagues where we used to live!).
I know though that my dh gives lots of attention to whoever he sees. He's talked about it - not giving details, of course, he's too professional - and he says no matter how trivial, if the patient has worried enough to come to see him, then he takes it seriously! The other day he came home and said "I saved someone's life today!". Cue "wow!" from me and our dc. Yes, he put him on low-dose aspirin!
We don't appreciate it, but the UK GP system, free at the point of use, is pretty much only available here. Other places have better secondary care, but the uk does primary/preventative care much better. The places where you get an annual smear etc ... pay for it.
weegiemum you sound like a much more interesting patient than a bog standard broken limb / fell of a bike being a tool, kind of patient.
My dh is a GP (and not here at 5am because he's working!) and reckons over half his work is now preventative, and managing conditions to decrease morbidity and mortality.
Personally, I love the NHS (and not because it pays our mortgage!). I have a very rare (1 in 2 million diagnoses a year) neurological syndrome. Because I'm in the uk, I was admitted to hospital on the day I fell, had 2xCT scans, an ultrasound, 4 x-rays and an MRI of my whole body, followed by a PET scan. 22 blood tubes, including 2 that had to be couriered to London (from Glasgow). Consultations with a neuro-physiologist for nerve testing (emg) and then seen by 4 consultants, including a professor who is the top doc in the uk for my condition. Then treatment once a month at a monthly cost of over £8000. For the rest of my life (hopefully).
My syndrome is so rare that I'm in touch with people worldwide who have it. Only in the uk have I come across anyone diagnosed and treated as swiftly and effectively as me. In the US they're working on a cure but I'm not sure I'm up for stem cell transplant as several people who volunteered have died.
I love the NHS!
My brother is a doctor. He says "try to avoid having to go into hospital unless absolutely necessary and if you have to go in, get out again as fast as you can"
That and my own experience on the NHS as a patient in a UK hospital - despite the best will in the world, does lead me to disagree with the OP
Ps anyone who thinks NL is flat clearly missed the world bike championships this year. I know people who cycle 25km on that at 4am to get to work.
Different attitude towards "stranger danger" too. My kids will cycle to school, the "bad man" will need to pedal fast to catch them. None of this cars 3 deep at the school gates nonsense.
Yabu and are really trying to get the boot in to NL.
Not sure where in nl you're from, but where I am people WORK longer hours, less presenteism, but actual work. Women work. Nobody, but nobody here bangs on about "wine o'clock" and smoking is now as socially unacceptable here as it is in the UK.
I reckon the uk's health problems have a log to do with the absolute shite being shovelled into gobs combined with the giggling "oooh I really shouldn't, what the hell I deserve it" attitude towards booze.
I agree that the type of health system is only one, relatively minor, determinant of good health. additionally, we pay less per capita for health than in many other countries. The nhs as a system isn't too bad but we really don't spend much on healthcare for a developed country.
More screening can also lead to more false positives.
Also comparisons between the NHS performance and the performance of health services on the continent can be biased because we gather more comprehensive data so you end up comparing all NHS hospitals with only the best of the continental hospitals, ie teaching hospitals in affluent areas.
It's easy to cycle in the Netherlands though, it's bloody flat!! Where I live it's not that easy.
The weather/terrain arguments don't really wash I'm afraid: Copenhagen and Stockholm have worse weather than most places in the UK, and Stuttgart and many other German cities are hillier than most British cities yet still utility cycling is far more popular.
It boils down to infrastructure and culture. Cycling infrastructure is poor in many parts of the UK, and a lot Brits are frankly a bit soft about being outdoors and working up a bit of a sweat.
I do think the NHS has a part to play in better screening, but I also think that a lot of people in this country make unhealthy choices and have a generally unhealthy attitude.
People eat cake and biscuits as a normal part of their day, chips seem to be a staple. I think our climate has a lot to do with it.
I don't think the article blames the NHS really. Hunt does, but the article contains counters. It points out that we didn't spend as much on health for decades until recently and say the impact of the lower spending is being seen now. And they mention that we are ahead of most countries on some things like diabetes. I didn't read it as a dig at the NHS at all.
I'm not sure about the regular checks - they're expensive and frequently fail to improve health outcomes for the population in general. There will, of course be some people who benefit, but many more will be denied other treatment because of resources spent on tests and routine testing can lead to false positives, which have a negative impact on health. I think routine health checks should be very carefully implimented.
I don't see why we can't do both... be responsible and also turn up for regular checks. Maybe - and this is going to be controversial I warn you now - if we had to pay for check-ups we'd actually value them more?
Cognito In an ideal world, yes they should but with limited funds, people need to take more responsibility. Even if there was more screening, would people go? I've read countless threads on here about women terrified of smears. I am in no way picking on this particular group (as that would make me hypocritical as I have yet to have a smear) but it's just evidence that more screening would not mean more uptake. At risk groups of certain diseases are monitored. With regards to more check ups, all that will do is encourage the worried well. It's those who don't want to 'bother' the doctor that worry me more. I work with at risk adults and no amount of letters saying "come to X screening" would make them go.
For me, the bottom line is that people really need to take responsibility for their own health and be pro-active.
"what can the NHS really do to prevent? "
Screening of people earlier, identifying at risk groups earlier, encouraging people to get check-ups before they're actually ill, providing advice and monitoring services. All things that could (ironically) be farmed out to private companies on a contract rather than requiring GPs to be involved at the outset.
It's easy to cycle in the Netherlands though, it's bloody flat!! Where I live it's not that easy.
it's true that you see more people smoking in countries like: Spain, Italy, France, Portugal...
But in the Uk the people who smoke also tend to be the people who drink too much and have poor diets. I wouldn't say that was necessarily true in the other countries I mentioned.
But the difference in life expectancy between the top and bottom countries is only about 18 months - so it all seems like a bit of a fuss about nothing.
Interesting thread! I don't know the answer but wanted to answer CrashDoll's question.
The NHS is not good with prevention of certain diseases. In certain European countries smear tests are done yearly. In addition to that you get your organs scanned (uterus etc) and your breasts investigated properly. By doing that once a year you have a sort of surround check that uncovers signs of diseases early, rather than relying on the woman finding something feeling different in her breasts.
When living in Germany I had to go to the dentist once a year for a check up to keep up my best possible insurance cover. That way they found problems early, and we all know that bad teeth can lead to other physical symptoms.
Just two examples, but I hope it makes sense.
But I do agree that a lot of it is life-style related.
I agree crash doll.
We almost need to go right back to basics on a large scale, so many people can't/won't cook and that is being passed onto new generations and the issues seem to be getting worse. Having readily available fast food and ready meals does nothing to help that either.
Children in school need to be taught how to cook decent simple meals, parents should be given the chance to join in if they so wish but at least if we can give the children the skills and understanding about a healthy balanced lifestyle then it may help future generations make better choices.
There again so much is learnt behaviours and what families see as normal it won't be that simple to solve. I am 29 and my generation know full well the dangers of smoking yet so many made the choice to smoke anyway. So knowing what's good for you and actually doing it are two different things really
Here a pharmacist only has the role of deciphering bad doctor handwriting and counting pills.
Thats not true - my pharmacist is an independent dispensing parmacist and can write prescriptions and do consultations.
pharmacist independent prescribers, who can prescribe any medicine for any medical condition within their competence, including some controlled medicines (except diamorphine, cocaine and dipipanone for the treatment of addiction)
Well the evidence from stafford would suggest the nhs has a lot to answer for so yabu.
Although i think u raise some good points esp vit d.
We seriously lack Vit D because of our latitude (I'm in northern Scotland). More and more, research is indicating that it could be a significant factor. Other countries at our latitude fortify food with Vit D.
We have pockets of very significant deprivation. The health gap between rich and poor is huge.
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