AIBU to think it is not the NHS which reduces quality of life in the UK compared with other European countries

[dikkertjedap]

Here.

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.

AIBU?

[dikkertjedap]

I should have labelled my link - it is to the BBC news website.

[ItsAllGoingToBeFine]

YANBU, but I think the NHS has to play a part too. What with it being systematically dismantled in England, that is going to become more of a contributory factor.

But all the points you make arrangements very valid.

[malinois]

Long commutes, long working hours, job insecurity leading to long commutes (why move when you have no job security?), poor/non-existent food culture, car dependency, poor educational attainment, low expectations.

The NHS does all it can, but if people eat crap, drink too much, smoke and do no exercise there's a limit to what they can achieve.

I suspect there's a big class divide particularly among women - in my sport (triathlon) you see builders vans and Mercedes at a meet and the male athletes are (judging on accents at least), from across the societal board. The women athletes seem to be almost exclusively middle class and university educated. I think a very large proportion of working class women drop out of sport and physical activity at an early age.

[trice]

I think the deskilling of pharmacists has been a bad move in the UK. In other parts of the world you can go and get instant primary health care at the pharmacy for minor ailments, and they can sell you real drugs. Here a pharmacist only has the role of deciphering bad doctor handwriting and counting pills. It is a shame and a waste.

[ChairmanWow]

The BBC has adopted a very hostile agenda towards the NHS in the last couple of years (now why would that be...?). This is typical reporting from them. Some areas have nonetheless suffered since privatisation began in earnest but not enough to massively impact on health outcomes - yet.

I agree that long hours, higher consumption of fast and processed food than most other European countries and higher consumption of alcohol absolutely play a part.

Don't agree that working women can be blamed. Why not working men? Why not say 'households in which both parents are working'?

But do agree that blaming the NHS is lazy and inaccurate. There is a debate raging about CCGs being compelled to privatise services and GPs are threatening to pull out of running them. The BBC tends to do a bit of NHS-bashing when stuff like this is happening. There was loads of negative reporting when the Health and Social Care Act was going through.

[Beveridge]

We eat lard, don't exercise, lack Vitamin D, drink our own body weight weekly and there are regions of the country afflicted by such poverty and deprivation that they pull the averages right down. Not exactly rocket science.

Imagine how much worse our figures would be WITHOUT the NHS.

[Beveridge]

And the USA is below us, so that blows the NHS argument out of the water.

[mummymeister]

its what we do to ourselves that causes the problem. the nhs only picks up the pieces once we have got ourselves into a state. its the entitlement issue that really needs to be addressed not the NHS. people make all sorts of crap lifestyle choices and then wait for someone else to sort it out for them and there is no magic pill for obesity, smoking, lack of exercise etc. how can the NHS be to blame if i have a mcdonalds breakfast with my morning fag because i got wasted in the pub last night and cant be bothered to make breakfast.

[dikkertjedap]

I agree that it is what we do to ourselves. But in part people have far fewer choices than on the Continent. In the Netherlands many people cycle to work and kids cycle to school, in part because the distances are so small and in part because cycle paths are excellent and very safe for kids. So people get exercise without having to make too much of an effort. Also, primary school kids have every Wednesday afternoon off and most schools have either a very long lunch break (almost two hours) or finish early, so there is lots of opportunity for kids to take part in sports, play outside with friends etc. which you would expect to help contribute to a healthier lifestyle/old age.

I have now moved back to the Netherlands and I really do think that life is far less stressful and much easier than in the UK. Also, fresh fruit and veg is much cheaper here and very good quality compared with for example Tesco. That coupled with more available time, makes it much easier to cook more healthily, I think.

I agree that it is not working women, but the fact is that in the UK there are many more families where both parents work (and many probably commute on top of that), when my dh and I did that we found that we were exhausted by the time we came home and still had to cook etc.

I just think that life in the UK is much tougher for most people (but for the few lucky ones the potential financial rewards are bigger as well though).

There is a lot of poverty in the UK, but the same applies to many other European countries. In the Netherlands there are waiting lists for food banks in big cities ... here there is a lot of hidden poverty as well. But here there is a lot of recycling going on, so low income people can go to special shops where everything is free or very very cheap (second hand clothes, TVs, books, toys, furniture), still not nice if you end up in that situation obviously.

[CogitoErgoSometimes]

YABU.... Public health in the UK is a very complex issue with some very polarised behavioural traditions and outcomes. We have a big chunk of the nation that go the convenience route of very poor dietary choices and another big chunk of 'farm shop' and home-cooking devotees.... unlike the continent where food skills are still strong (working women included) and good food is valued by all sectors of society. They don't eat double the kilos of fruit and veg per capita in Germany or Holland because the stuff is half the price (it isn't) ... the eat it because very simply they have a stronger tradition of eating fruit and veg.

We also have more polarised behaviour with drinking and smoking. Both of which are far cheaper pastimes on the continent of course. Some carrying on as heavily and recklessly as ever, ignoring fifty years of health messages and eye-wateringly high prices in the process..... others completely abstaining. Life expectancy is on the rise but there is 20 year difference between some parts of the country and others. That's our problem

So if heart-disease etc is higher than elsewhere in Europe I'd say it's because the worst examples are dragging down our average. But the NHS cannot just shrug its shoulders and say 'nothing to do with us' either. The NHS is great at 'cure' but crap at 'prevention'.

[crashdoll]

The NHS is great at 'cure' but crap at 'prevention'.

Genuine question, not a snipe - what can the NHS really do to prevent? I see that as a personal choice and freedom to make good decisions. I don't see it as the NHS to prevent conditions such as; obesity related illnesses. We need to see schools involved, parents involved etc.

[stargirl1701]

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.

[MmeThenardier]

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.

[HollyBerryBush]

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.

www.nhs.uk/chq/Pages/1629.aspx?CategoryID=68&SubCategoryID=161

?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)

[Sirzy]

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

[GravityDefier]

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.

[Nancy66]

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.

[LadyPessaryPam]

It's easy to cycle in the Netherlands though, it's bloody flat!! Where I live it's not that easy.

[CogitoErgoSometimes]

"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.

[crashdoll]

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.

[CogitoErgoSometimes]

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?

[EmmelineGoulden]

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.

[CloudsAndTrees]

YANBU.

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.

[malinois]

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.

[WafflyVersatile]

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.