AIBU to ask if you believe that a labour government will go some way to fixing the NHS?

The four hour target was from arrival in A&E to discharge or transfer to a ward. No wonder you’re so wrong about it when you don’t even know what it was. Incidentally public satisfaction with the NHS was 70% in 2010.

I have had decades longer experience of being on the receiving end of NHS practices than your 20 years of working

The 4 hour target was to be seen by someone. It didn’t mean they got treated within 4 hours and waved on their way.

It took me doctors appointments, probably in their 100s and with them prescriptions from birth to eventually ending up in a&e at 60 years old to finally get an allergy test

How much money the NHS has wasted on me by not treating me is definitely over £1million
Most likely in 7 figures all in the name of saving money on an allergy test.

I sometimes wonder what my life would look like if the NHS could actually do their job

Don't spoil it, olivehater ... the narrative on here is that everything in the NHS was rainbows and unicorns under Labour, with some apparently forgetting (or perhaps too young to remember) that the howling about "the cuts" was just as loud back then, and the answers when it was pointed out there hadn't actually been any cuts just the same

Oh yes and lots of pointless overpaid management with stupid job titles.

I trained and spent the early part of my career in the NHs under labour. I mostly saw loads of overpaid locums mostly from Australia and buildings being built under expensive leases we still can’t get out of. Didn’t see much improvement for actual permanent staff pay or conditions. I worked 24 hour shifts under labour.

It’ll take money, even if it’s to ‘reform’ stuff and that depends on growth

It’ll be linked to whether policies bring growth or more debt. Debt has gone up and servicing it is very high currently, so we’ll see

Nobody’s seen ahead of others in A&E because they work in the NHS nor would they want to be. We consistently rated 95-99% against the four hour target. The failure rate was because some extremely sick patients took longer to be stabilised enough to be moved to a ward or ITU. But I’m pleased you know more about my 20 year experience than I do.

I can only assume you weren’t ever a patient or if you were you were seen ahead of others as you worked for the NHS

Yes your waiting rooms might have been empty but the patients were still waiting to be seen by someone who could help them in curtained off cubicles or different rooms

The targets were fudged. Anyone who had lots of dealings with the NHS at that time could see it.

They weren’t. I worked in the NHS for the entirety of the last Labour government and saw the improvements first hand. There were times when our A&E waiting room was empty.

@Yalta

The 4 hours to be seen in A&E was only “achieved” because they had you go to a nurse to take your details, blood pressure etc and other pointless things
Badly sprained/possibly broken ankle, come through so I can take your blood pressure. Patient seen within 4 hours ✅ Need an X Ray or anything to do with the what you were in for. Wait hours more.

Nail on the head. The targets were fudged. Anyone who had lots of dealings with the NHS at that time could see it. I had to regularly take either my father or mother in law to A&E as they both had cancer. You could set your watch by them running around like headless chickens when you'd already been waiting there for 3 and a half hours with no attention at all, and then suddenly they were all over you like a rash during the "last" 30 minutes and you were either fobbed off and discharged or transferred to a "holding ward" which was usually a corridor or cupboard, just so that they could "hit" the 4 hours A&E target.

With my father, they fudged the cancer timelines for diagnose and operations multiple time. It took 18 months before he finally got his cancer operation after being moved from pillar to post between wards, between hospitals, etc., every time the (I think) 18 week target for the operation was approaching - they'd either move him or change treatment plan, so the 18 week re-started. He ended up languishing in various hospital wards for 18 months whilst they dithered about and played with targets. By the time they finally operated, he was so weak and the cancer has spread so much, it was too late. But hey-ho, they managed to meet all the different "fudged" targets, so didn't care!

The NHS problem isn’t about which government is in power, it is about changing the mindset of those that work for the NHS to look at the bigger picture and put into practice things that would save money overall not just push everything out to other departments

The 4 hours to be seen in A&E was only “achieved” because they had you go to a nurse to take your details, blood pressure etc and other pointless things
Badly sprained/possibly broken ankle, come through so I can take your blood pressure. Patient seen within 4 hours ✅
Need an X Ray or anything to do with the what you were in for. Wait hours more.

Just moved to a new area and under Conservative government A&E with most things you can be out in around 1 hour

They don’t operate like every other A &E I have been to.

I was diagnosed with ADHD, it took around 8 weeks from GPs referral to walking out with a prescription for meds. Again the system in place was unlike every other assessment I have read about.

Its the systems that need changing but the NHS staff themselves don’t seem to want to change and can’t or won’t do anything about the issues the NHS has

When I was a child and first married it was normal in the different GP practices I used for a partner in the practice to do private consultations. My boyfriends mother had a room in their house for consultations. When I married different surgery the senior partner did a lot of private work. The same receptionist just booked you in privately.

Today I've no idea which GPs in our practice or locally are taking private patients it's very secretive. Are they afraid of being lynched?

We can give sown explanations why

poor management of many services and them not being linked to other services (that’s not about poor managers more how it’s set up)

money wasted within the nhs (contract agencies being used)

constant changes that staff do not have time to implement before the next set of procedural changes come along

cut back in funds

GP’s being over subscribed

not enough staff

to much reliance on bank staff as not enough permanent staff

^ that is just a few of the issues I deal with week in week out

we deserve better but some have this nonsense idea that the NHS was amazing 15 years ago because of what one report. It wasn’t great but was certainly better than it is now but once you have seen the difference in France/Germany, the outcomes the quickness of people treatments it’s shocking how low our expectations have become

when the NHS was set up it was fantastic, that lasted for some time but those days are long gone. What the NHS provides now is just so far removed form what it was set up to provide

a cross party committee is needed to reform the NHS (we can look to France/Germany and base it on their healthcare services) so the parties stop using healthcare as a political football

Indeed there are but the NHS is a religion in Britain so here we are

As someone who is a leader in the system - a whole lot! Expansion of the ageing population, staff shortages due to poor wage growth and strain/burnout, medical advances in that time have been very expensive too and the pandemic broke the camels back. The NHS and the NIHR (the Research arm of the NHS) actually are doing decently considering.

But Labour's solution of paying staff to work weekends and evenings and buying more scanners is a plaster. Doesn't get to the heart of the issue. They know there needs to be staff expansion (conservatives already introduced the longterm workforce plan which Labour have said they will continue) but those staff have to be employed and paid properly. Unless they grow the economy, the expansion required is simply not affordable and no one is promising to fund that

You're not being unreasonable. You are being deluded. The NHS doesn't need more money. It needs a major overhaul and rethink. It is not workable in its present form. No government will tackle it as they are only concerned about re-election so never plan more than 5 years ahead

So if you want a better NHS then who do you propose should pay these extra taxes or insurances? we ve already vast numbers in work who have to claim benefits in order to be able to live.

I'd happily part-pay for a decent service and there's potential efficiencies. I think paying even a notional charge of £5 for a GP appointment would cut missed appointments significantly and reduce waiting times.

I pay for private healthcare as the level of service is incomparable to the NHS. I choose my consultant and I get 30-45 minutes for each appointment. I have a private room with an en-suite, nice food, good nursing care and a visit from my consultant every day I'm an inpatient. Yes, urgent care centres are limited (although my hospital has an HDU) but that could change.

I don't understand why people are so vehemently against looking at other countries. It's not just a question of more money, it's a different model altogether. My cousin raves about the (part-pay) healthcare he gets in Switzerland so there must be viable alternatives.

Regardless of your politics, there are stupidities in public sector spending. My Dh's SME does work for five or six Health trusts, from Cornwall to London. Every single Trust has it's own qualification procedures. If only it were possible to standardise those rules to ensure that an NHS standard was applied nationally, so any accredited NHS contractor was eligible to bid on any contract nationwide, pricing jobs would be much more competitive. And, for the taxpayer, please stop the nonsense that money not spent this year is lost and taken off next year.

The UK has a far lower overall tax take than our Euro counterparts.

We therefore have less healthcare staff, hospitals scanners etc as we spend less per head on health than these countries.

So if you want a better NHS then who do you propose should pay these extra taxes or insurances? we ve already vast numbers in work who have to claim benefits in order to be able to live.

Its a total lie the NHS has had more money, in real terms over the last 14 years, they have not, the Tories have used Covid spend (which has now finished) to make it look like they have spent enough to meet demand and inflation.

(Medical inflation runs higher than CPI/RPI)

”It's telling that France and Germany don't have an NHS model, which simply can't cope with the demography of much higher numbers and an ageing population."
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'It's the model that's unsustainable'. 'I blame immigrants for the state of the NHS'.
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This is right wing propaganda and ignores the failures of government policy on public health and on the NHS.

Erm, saying that the NHS model can't cope with the growth in population is not right wing propaganda nor did I blame immigrants for the state of the NHS. Not sure where you got that from but it certainly wasn't me.

The population was around 43 million when the NHS was founded. It's now nearer 70 (and that's likely to be an underestimate). Add in the ageing population and we're talking about demand that is fundamentally different from 70 years ago. People are also living longer so you have increased demand for treatment for complex diseases. Yes, immigration has added to the numbers but they are not to blame.

The NHS can't cope in this current form, I see it as a patient and my consultant friends tell me the same from their side. Do you not think it's telling that our European neighbours don't have an NHS? It's not just a case of chucking more money at it (it's had more money), it's about changing the model. It's only going to get worse as our population continues to age. Why are we so resistant to looking at France, Germany and Switzerland to see if there’s a better model?

Fraud. Waste. Staff shortages. Demographic change - people living much longer with chronic disease, obesity crisis and diabetes, technical advances that increase demand and workload, Brexit, Covid. Cronies lining their pockets with taxpayers' money that was ostensibly intended for public health. (60 million for PPE that somehow got used to buy a yacht, for example, or nightingale hospitals that were never going to be used). That's just off the top of my head. There are probably more examples.

What's changed about the NHS model in the 14 years since it was judged by independent healthcare research to be a well functioning healthcare system by international standards, and good value for money?

I'm utterly sick of reading comments about the model being untenable by people who can never explain why.

I agree completely, but good luck hoping for this; the whole issue is such a hot potato and offers so much opportunity for mudslinging and virtue signalling that I honestly don't see it happening

That's already happening with the "business funding" model within the NHS whereby doctors/surgeons have to put a business case for funding various treatments. My OH has had to go through that twice for his very expensive cancer treatment. His initial course of treatment was "approved" and included stem cell transplant after chemotherapy. In the end, he decided he didn't want the stem cell transplant and just wanted to continue with low dose chemotherapy (which he had moved onto after the initial chemo and would have continued on after the stem cell treatment). There was one hell of a lot of faffing around, meetings between the consultants and "business managers" etc., as apparently that course of action wasn't what had been approved and they had to cancel the treatment plan and create a new one, which took a few months to go through some kind of committee. He has been told that he now has to stay on his current treatment regime as "the committee" won't approve another change! One hell of a lot goes on behind the scenes already in terms of financing/approval of treatments!

The French system is broadly a state system in that roughly 70% is state funded from taxes. If you have no income your health care is funded. If you are employed, your employer must provide top up insurance. If you are self employed you pay an affordable top up insurance.
There is usually a co-pay on top for some procedures, but generally the amount is small. Certainly less than many people spend on hair and nails for example.
Appointments are readily available as are investigations and treatment.
It seems to be a fair and efficient system.