To think the NHS’s biggest problems aren’t management but an ageing population, unrealistic expectations and over-medicalisation?

I agree with this.
But the issue is, I suppose, how/who makes the decision if a life is worth fighting for?

I was just thinking about this while reading the thread. At the opposite end of the spectrum to the people living longer argument, very, very prem babies and those with multiple morbidities are now able to be kept alive due to huge advances in treatment. To support these children through life is hugely expensive and requires ongoing and permanent resources provided by the NHS and ancillary services. I believe that quality of life is paramount and wonder how this intensive support can be justified if the child has multiple disabilities, many of which are sensory and mean that said child has no awareness. Probably a very unpopular opinion on here but my own belief is that some babies are kept alive because they can be rather than that they should be.

I agree totally with your post 👏

I am 60 and healthwise not great but not bad . At this moment in time I have foot drop, unexplained weight loss (so seeing a Dietician now) and various other (non serious) issues.
I have always thought, from young, that those who are in pain, terminally Ill should be able to choose to be euthanised , as we would not let an animal suffer would we ? I still stick by that.
My own DM is 81 and fit as a fiddle, but she has always looked after herself..

There are so many factors creating problems for the NHS Model: 1) aging population and underfunded social care (creates bed blocking as nowhere for the patients to go who aren't able to return to their homes); 2) Escalating costs of care with new medicines and machines, 3) Understaffing - Lack of places for newly qualified doctors, no longer bursaries for student nurses, Brexit meaning excellent healthcare staff from EU cannot help out; 4) Expectations and 5) difficulty in getting GP appointments mean people either rock up at A and E, or they leave the problem until it gets really bad and they need hospital. I don't believe health tourism is really an issue - it's a scapegoat created by the tabloid press.

Does it say P or POM on the box. If P you can buy if POM you can't.

The vast majority of people could buy ferrous sulphate, ferrous fumarate or ferrous gluconate at the pharmacy counter.

No, it’s basically the NHS wasting money due to inefficiency and poor management. It needs reform.

Oh God, not the parking costs again. As if no one else who works ever has to pay for parking.

Could I add that a lot of admin, hcas and portering staff will be earning under or around £13 an hour. Plus having parking costs deducted.

I think prevention is often overlooked - I include the NHS in that. Infection control in hospitals, GPs etc is woeful, especially for airborne viruses. Patients shouldn’t be made more ill by attending healthcare, especially when there is little that is done for life changing impacts of poor infection control on them. Staff should have a safer workplace too.

I think many things take too long to diagnose or offer help with. How many posts on here do we see about people where it’s taken years to get a diagnosis for something that shouldn’t be that difficult. How many have had to fight for simple things like HRT or to have blood work properly looked at and responded to? One size fits all approach rather than looking at results that are abnormal for that individual. I’ve read posts of people desperate for mental health help too, but are offered little or nothing in between crisis mode and major crisis mode.
Patients with complex needs are often not looked at holistically.

One thing that I find particularly frustrating, is giving evidence based advice and a treatment plan, which the patient then refuses to engage with, resulting in often years of sub-optimal treatment at huge cost to the NHS.

I think you will find that things have changed in Spain in the last twenty years. Even in UK, the NHS was in a far better state than it is now.

My French friends tell me that their access to treatment has declined greatly in quality since Covid in particular.

@greencartbluecart Diabetes costs 10% of the NHS budget.

My neighbour has been diagnosed with type 2 diabetes recently, he is very overweight, late fifties. Well educated, has a decent well paid job. Pops off on cruises. My DH saw him a few roads away when he was popping in to a small corner shop. He was dumping loads of wine bottles in a public bin. I’m friendly with his wife he is obviously drinking behind her back making his condition worse. He isn’t stupid he knows full well what he is doing. I’m staying out of it.

The NHS are as bad at cancelling appts at the last minutes.

This simply isn't true though is it? We all know that you can eat healthily and cheaply so I don't know how this figure was calculated. An apple costs the same as a chocolate bar. Lentils, frozen veg etc are all very affordable. You don't need that much meat in a healthy diet. Eggs are relatively affordable. I know it isn't true because I was fed and extremely healthy diet as a child and it would be extremely affordable by now.

I'm not saying it had lots of berries, expensive meat and expensive veggies. A pack of carrots is still pennies as are bananas. It is totally achievable to eat well still on a very limited budget.

Here’s some:

Quick Google if my experience isn’t enough….

In Canada, while many healthcare services, including most doctor's appointments, are covered by public health insurance, patients may be charged a fee for missed appointments, especially if they don't provide sufficient notice of cancellation. This fee is not covered by provincial health insurance and is intended to offset the cost to the clinic or physician for the missed time.

France will introduce a €5 penalty for people who fail to turn up to doctors' appointments, Prime Minister Gabriel Attal said Saturday, April 6. The fine was one of several measures
announced by Attal to boost a health service struggling to keep up with increasing demands from an aging and growing population.

Yes, in the Netherlands, you may be charged a no-show fee if you miss a doctor's appointment without canceling it in advance, typically within 24 hours or a full working day. This fee is not covered by your health insurance.

In Germany, doctors can charge patients for missed or cancelled appointments, but usually only in exceptional cases and if they can demonstrate financial loss. A common scenario where a fee might be charged is when an appointment is cancelled with less than 24 hours' notice, or if a patient has a pattern of missed appointments.

In Australia, patients may be charged a cancellation fee or a "no-show" fee for missed doctor's appointments, especially if they don't provide sufficient notice of cancellation. The specific fee amount can vary between clinics, but is typically between $50 and $100. If you repeatedly miss appointments or fail to cancel, the clinic may refuse to schedule future appointments.

No and take a minute. Most other universal healthcare systems in the western world do this. They do charge for legitimate misses. I have feeling - I just don’t have the arrogance that the NHS system is the best having experienced other universal healthcare systems: it’s broken: it needs to be fixed and that means thinking differently.

I’m going to assume that as someone who works with SEN children you know that most people with ADHD and or Autism don’t claim PIP?

And that you also know of the wider economic costs of not identifying and supporting people with neurodiversity, in terms of depression, addiction and other mental illness, along with a higher likelihood of being involved in criminal activities, spending less time in employment and struggling with relationships?

Yeah it’s all from their own healthcare systems but I can’t be asked to go back and source specifically to allay your question.

it can work and it does quite successfully in a lot of places. The negative multiple reasons is why we have a broken system - because there is always a reason why we can’t do something. What I’m saying is there are a lot of good solutions in a lot of the western world in universal healthcare that do work.

What I objected to was your statement that good care is only available if you go private, which is both misleading and incorrect. 🙄

I didn't make that statement though 🙄

@spoonbillstretford you need to re read what I actually replied to and said...

I replied to a post that said they wanted every person to receive excellent palliative care. And I said that it's not possible to do that unless you can afford private because after all until you are ill you don't know what you will get.

I know there are definitely people who don't have someone to advocate for them and don't receive good care.

So you agree then 😆

I object to your lack of comprehension but it's pretty common on MNs these days.

"They were unhappy with the trend in people demanding diagnosis, for ADHD or Autism in later life. Who then go on to want PIP.
I work with SEND children and questioned the leading psychiatrist response was we are all neurodiverse. We all learn in different ways"

Would you say the same to people trying to get a diagnosis for a physical condition where there's no treatment or cure?

No I don't, I know there are definitely people who don't have someone to advocate for them and don't receive good care.

What I objected to was your statement that good care is only available if you go private, which is both misleading and incorrect. 🙄

But yes, it would've been politically problematic to talk about this.

still is

I’ve had pretty rubbish experiences on NHS and that’s wholly down to staff incomprtence - my expectations were 100% mainstream

@spoonbillstretford I'm still confused why you are extrapolating your experience to everyone. You seriously think everybody experiences excellent palliative care on the NHS? 😆