To think the time has come to abolish the NHS healthcare model

Have you really not stopped to think why the NHS wasn't there when you needed it?

Might it be something to do with the government of the last 14 years deliberately deciding to underfund the NHS in order to be able to boast that they'd kept taxes low? Or that the longest-serving health minister was keen to promote private medical services and two-tier healthcare in the UK?

What happens when you can't afford to pay into your private healthcare plan? What happens when they say "sorry, but treating you is no longer profitable for us, so we're cancelling your plan" or you turn up with a condition that they refuse to treat?

https://northyorkshireccg.nhs.uk/wp-content/uploads/2021/10/NY-Paracetamol.pdf

Those posters are often put up on clinic room walls so it's quite possible they'd have seen it!!!

In 2021 the cost to NHS of prescribing paracetamol was put at £80million, and the cost of a GP issuing 32 tablets was £3.40. I doubt it includes the cost of the GPs time otherwise I suspect it would cost quite a bit more, especially if it was the only medication being issued.

There's been an increasing push to stop prescribing OTC medications.
I work in a GP surgery and every single day without fail there's at least one slot taken up by someone who knows their diagnosis, knows the treatment, know's it's available over the counter but they come in because they want it to be prescribed instead. That's a whole appointment taken up because someone doesn't want to pay for antisickness tablets for their cruise they're going on, or the thrush cream, the bazuka/salicylic acid for their verruca... By saying no more often the hope is that we reduce the number of lost appointments to this practice.

Poor people die and middle inc people are bankrupted presumably .
Aka I'm all right Jack.

This! 👏👏
The one and only time I've really needed the NHS, it wasn't there for me, despite the ££££s I've paid in taxes for the past 30+ years.

Was forced to go private and the care I recieved was first class. I would frankly rather pay more into my private insurance plan than into an NHS that isn't there for me when I need it.

Ah I see, yes she might. However I think that includes the costs associated with the prescription (prescribing time, dispensing fee etc.) as well as the medicine itself.

It’s true that it can be cheaper overall for patients (those who don’t pay the prescription charge) to pay for a general sale list medicine themselves, but this does not in itself mean that the NHS is poor at getting the best possible prices for generic medicines. There are tenders, and in general the lowest price offered gets the contract. The NHS can’t force suppliers to supply, and it can’t make its own medicines (apart from a few niche ones).

Also I would not be at all surprised if some of the really cheap 40p for 16 packs you see in Aldi are supplied as loss leaders.

@SnakesAndArrows I just googled & the following link came up

https://northyorkshireccg.nhs.uk/wp-content/uploads/2021/10/NY-Paracetamol.pdf

I’m not in North Yorks but is it outlandish to think a midwife may have seen similar narratives?

Maybe that’s because (from what I’ve read) there is an admin charge of £7 (?) for every NHS prescription, regardless of the cost of the item.

Why so rude?

I don’t know any more, and when I did it was commercially confidential. But medicines on contract generally cost a small fraction of the list price.

I’m not suggesting you were making it up! I’m suggesting she was. She has absolutely no way of knowing the prices.

My stepson needs surgery for a slipped disc. When he was told that the wait would be 10-12 months, his mother offered to pay for him to have it done privately. He saw a private consultant, had an x-ray or scan (possibly both), and got a date for his operation.

A few days before, he had to go to the private hospital for pre-op checks/tests and one of the questions was about diabetes. Then he was told that they wouldn't be able to carry out his surgery at that hospital because he's T1 diabetic which makes it riskier, and they weren't equipped to deal with it if anything went wrong (this is second hand info, so I can't guarantee that the details are 100% correct).

He's a few hundred quid out of pocket and no nearer getting it done.

@SnakesAndArrows what is the cost to the NHS for a pack of paracetamol?

@SnakesAndArrows a midwife, why would I make it up?

I agree with this, the NHS loves their “watchful waiting” approach and leave people with long term chronic conditions in extreme pain and discomfort until it ends becoming so far gone it’s almost untreatable or requires major intervention/surgery/amputation/transplant when if they had just treated the symptoms when they first happened it could have all been avoided.
This goes for both physical and mental health problems.

Where I'm from we don't have free health care at the point of use. It is affordable and if you're low income it is possible to be excused from paying. Medication is also not free but there is a max per year you have to pay in attempt to make it fair for those who has chronic conditions. Also private insurance is affordable so those who can pay is able to use private health care. Also employers are required to pay for health care. The minimum is to cover work.place accidents but most employers who want to be competitive they provide specialist health care. The system is far from perfect but another example that there is something in between of totally free and bankruptcy.

If “more taxes are unfair” where will the money come from to fund the healthcare you want?

Who asked you? I doubt very much whether anyone on the ward had any idea what a packet of paracetamol costs the NHS. (The price in the BNF is list price, not what is actually paid).

It is of course cheaper for the NHS if you buy your own, because they aren’t paying at all…

I am saying NHS staff IN GENERAL are striving to deliver an excellence service - in typically difficult circumstances. And on average, succeed. That will mean there are instances where that is not the case.

There are over 100 million appointments occurring per year in the NHS. Some will fall below the levels of excellence expected. Your experience is one of those

And I also believe that reorganisation of the service - including some elements paid for at the point of service will improve the service delivered. Because that often changes behaviour on both the supply and delivery side.

@taxguru I'm sorry younare going through all that and hope your DH's treatment helps him recover and reach remission.

Sorry are you saying the staff I dealt with were striving to provide a better service? How is messing the patient about and actually lying to finish early striving to provide a better service? If it were a one off, one could giggle, but it isn't.

They had time to phone me up to try and get me to rearrange and then had time to ring me up and get me in early - to an empty clinic.

And these are members of a highly qualified post graduate workforce. Read Taxguru's post for more examples of not joining the dots.

When my DH travels back from the Yorkshire on the train (former Nationalised industry) nowadays if the train is 40 minutes late he gets a 50% refund. It never happened when the railways were still Nationalised. People complain about services now, but on the whole the communication is better, the trains are clean and the staff are polite.

@RosesAndHellebores

But it works in reverse too. My last apppointment, scheduled for an infusion that had to be given within ten days of a two year course of injectables, was arranged two months in advance. I took the day off work and scheduled in some other personal care stuff. The apt was on a Friday.

Yes, OH has had similar with his chemo infusions. The oncologist is very particular about the days they have to be done and it involves meticulous scheduling of a blood test x days beforehand and then each infusion has to be a specific number of days after the previous one and each course within y days of the blood test.

The amount of times they phone up to try to change an appointment by a day or two is ridiculous, usually trying to bring them forward from afternoon to morning, and completely disregarding the effect on other infusions before and after, I.e. if his infusions are scheduled Monday and Thursday (to allow time between for "recovery", they try to reschedule the Thursday one for Tuesday and he has to patiently explain to them every sodding time that it has to be a certain number of days before/after and he can't have two chemo infusions on successive days and then leave it almost a week before the next. They always act surprised as if they've never heard of it before and didn't think about the effects of a change - these are oncology dept staff. The mind boggles!

Same with his blood test appointment. He has to remind them that he can't have the blood test in the morning of the afternoon appointment as there isn't time for it to be processed, results sent to the oncologist, oncologist to approve the drug issue and then the drug to be issued, all within the same day. Again the staff on the oncology dept don't seem to understand that each step takes a little time to do. They must be doing blood tests, infusions, etc, many times each day, so it beggars belief they can't work it out for himself that things have to be done in a specific order, on specific days, etc.

He often jokes he'd be dead by now if he was elderly/confused who wasn't on top of it himself as he'd be constantly missing appointments, attending on days when the treatments couldn't happen, etc. Every sodding month they mess up something. None of this is the actual treatment itself, it's the piss poor attempt at administration/management of the treatment.

He DNA'd last month because they made an appointment for him to pick up his drugs on the wrong week and didn't even tell him - no phone call, no ping on the app, no appointment letter. Even if he'd turned up (maybe using a Ouija board to get the message), they couldn't have issued the drugs as he'd not had the required blood test that week so the oncologist wouldn't have issued the prescription. So he's a "statistic" for last month, but 100% the fault of the muppets making the appointments.

Agreed - the service provided can be better. As with any service in any sector but in general - staff are overworked and still strive to deliver an excellent service

Most NHS Trusts audit their DNA rates and break it down by demographics to determine causes. I have seen these Service evaluations and they have been used to devise actions to combat DNA rates - which accounted for over 7 million missed appointments in 21/22.

As agreed earlier - there are system and patient factors involved. Published data suggests patient factors are responsible for 8%-45% of DNAs, depending on the study. So not negligible

This isn't patient blaming though - some of the factors causing this intersect with social determinants of health and health inequalities.

https://www.ncbi.nlm.nih.gov/books/NBK260108/

www.england.nhs.uk/long-read/reducing-did-not-attends-dnas-in-outpatient-services/

But it works in reverse too. My last apppointment, scheduled for an infusion that had to be given within ten days of a two year course of injectables, was arranged two months in advance. I took the day off work and scheduled in some other personal care stuff. The apt was on a Friday.

On the Wednesday someone not with clarity of speech called to say, "is it OK if we move your appointment to Tuesday next week as the clinic has has been double booked? I had to say no because of the 10 days and because I had already arranged a professional diary round it.

I was not confident about how things had been left so telephoned the department the next day. It took an hour to get through but I was assured all in order for 3.30pm Friday.

At about 11.15 on Friday I received another call asking if I could get there earlier to help them.manage their workload. I was sitting with a full head of foils but agreed to get there by 1.30 which was the earliest I could do and cancelled lunch with a friend.

When I arrived at 1.30 the department was almost empty. Three staff, two patients. Evidently they were really pleased I could make it early because it meant they could finish the clinic early and end their shifts.

And we are supposed to swallow the guff about our over worked nurses and hospitals who are messed about by rude patients.

I think not. That experience is not unusual and it's a level of poor service that needs to cease.

How clueless are you?

Critical illness and chronic illness/disability are not the same thing at all ffs. And even if there was a way to insure against the latter, it would be out of many people's reach because, funnily enough, chronic illness/disability have a tendency to affect a person's earning capacity. Who'd have thought it?!

And I call BS on your claim that you have 'a lot of empathy with anybody who is struggling with their health' given your airy, and inaccurate, assertions elsewhere on this thread that the 'vast majority of ill health' is preventable and merely a matter of adopting a 'healthy lifestyle'.

Your posts on this thread, besides being ill informed, are incredibly offensive towards the chronically ill/disabled, or 'these people' as you so charmingly call them. I just hope you never have to count yourself among them.