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

Which valve? If aortic then they may be offered TAVI if necessary

Quite. My sister is a nurse and the health advice they give to people re diabetes/obesity etc is largely ignored as "it's too much like hard work" and instead everyone wants dome drugs to do the hard work for them.
Thus taking endless NHS appointments/time/drugs/costs meaning less care for people that actually nee dit.

Legal euthanasia will solve many of the problems the OP outlined, especially once the so-called 'safeguards' have been reduced and diminished over time. Perhaps once folk reach the age of, say 50, we could start the process of slow brainwashing to persuade them to undergo the procedure by their 60th?

Yeah it does it works very well in other countries. And in some you have to pay a deposit if you miss a number and you get back the deposit if you attend.

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.

Over the counter iron is very low power and usually if there is a genuine clinical need for iron tablets, then a prescription is the only way of getting the strength needed.

It's a reasonable point. If this ridiculous idea were implemented, it wouldn't take very long until people started attempting to invoice the NHS for the losses they've incurred attending a missed appointment.

Which isn't to say they'd succeed, but it's another reason why a charging policy would cause more problems than it would solve. It would become a political laughing stock very quickly.

And................once more with feeling!!!!!!!!!!!!!!
Do.you.also.think.it.should.work.the.other.way. Should the NHS pay patients for an appointment cock up caused by them

It isn't plausible that this would work the way you clearly think it would.

For one, there would need to be an assessment process for what's a 'legitimate' miss. How many reminder letters or emails, what happens when the hospital transport hasn't turned up, that kind of thing. This would take staff and resources, at a time when the NHS struggle to recruit. Such decisions would also be subject to legal challenge, if only judicial review, and the usual involvement of elected representatives to try and influence the process. Dealing with this would cost money.

People who miss multiple appointments are also going to be those who lead the most chaotic and unsupported lives. We already know this. Which means they're the ones least likely to actually pay. Chasing that up costs money, and if you eventually have recourse to the court system, the amounts owed will spiral without any corresponding ability to pay it off.

It also means people in that position will avoid presenting to the NHS until their conditions worsen further and they become more expensive to treat.

This is one of those things that sounds nice in theory but doesn't stand up to even cursory examination.

It's the unnecessary tests I'm referring to, not small ailments, why scan someone's heart annually if they are unable to undergo surgery? Why scan to see how much worse their osteoporosis has progressed when they can't undergo surgery? The consultant has said they've exhausted the drugs available to them so why keep testing and scanning ? To what end?

At the sharp end, in hospitals, the main issue is older folk. If someone, somewhere, had the balls to sort out community based health care, most elderly could be managed at home, or in assisted living.

At the moment even care homes are incredibly trigger happy in getting in paramedics for poorly old folk. Treat them at home, or in their care settings, nothing good ever comes out of taking old folk into acute hospitals.

DH went in for Sepsis a few weeks ago, he was the youngest by some 30 years. Everyone on a trolley in that corridor was extremely elderly and on their own. Very sad actually.

If they want my OM who has type 2 to excersise they need to pull their finger out and do the knee replacement hes been waiting six years for. A lifetime of manual work involving heavy lifting caused this. Now he just gets a big Fuck You and a load of gaslighting

But why shouldn’t patients pay for missed appointments? I’m not saying legitimate misses. Or even a couple. I’m saying perpetually missing appointments. This is so offensive to Brits because any thought of any payment for anything is so offensive. And this is what can cause abuse of the system.

I don’t disagree. I think the NHS is almost inaccessible now for working people. I end up using private, even for GP appointments now and it’s frustrating. Must be much worse for people who actually need to access the service to manage a health condition like you. Sorry for your experience.

Yeah no it really isn’t. Many many many other countries have universal healthcare which works a lot better. I speak to close family in three other counties and doctor appointments are faster, consultants are easier to come by, treatment is leading, etc. It’s such a narrow view that the UK has about their healthcare.

I should add my parents live two hours outside a major Canadian city and there are two new hospitals being built within an hour of them (in different directions). When my father needed specialist treatment he was given a choice of three hospitals and given dates at each and what would suit him.

in other countries GPs aren’t gateways to hospitals and you can book directly with consultants (even in China where most GP work is now automated) as GPs don’t get paid for referrals. They are a seperate service and GP salaries (and working hours) are usually lower as a result. It is absolutely mind boggling how some UK GPs can earn many multiples more than that a specialist consultant. It would save so much money.

I don’t think we can actually blame people for living longer, just recognise it’s a factor in the NHS’ decline.

Well im sure the posters on here who think that patients should pay for missed appointments also think it should work the other way.

I disagree with you. Many investigations can help to diagnose quite simple ailments.
Being older myself I am speaking from personal experience plus with friends who are even older. They are happy to have tests.
My own father had a double hip operation in his 80s & went on to live pain free until his late 90s.
Please don’t generalise.

Yeah that isn’t right either. Unfortunately people who work I. The NHS are also users so it perpetuates. It does suggest when it’s free all the time for everything that people dont always value it in the same way.

My sincere best wishes to you and your husband for successful treatment and outcome.

No - the message should be focus on outcomes. By all means aid people to live long and healthy lives. But dont scan, test and prescribe when patients are too frail to undergo treatment. We are living longer - but not healthier.

I understand that and personally I would agree for myself but I dislike intensely people who believe they have the right to say what others should do when they are not in that situation. People over 80 should have the same rights and ability to choose for themselves as anyone else.

Depends where you live. You could vote Tory for ever & a day where I live & they would still get in. Also it’s not always the same political party that has made stupid decisions. Don’t blame the voters.

I agree healthcare is far better in France and Germany.

Sadly the main parties are all too aware that many people feel we are lucky to have free healthcare (which it isn't) and now free at the point of service is being sold to the public (constantly mentioned by Wes Streeting) as to why the NHS is worth keeping it absolutely isn't we deserve better

The NHS has to change culture from within, dealing with poor staff, money wasted and too many senior management wasting money and time on projects that then need another project to fix previous project is standard. The money and time I see wasted while other areas its understaffed, lacking in investment is visible everyday at work

We once received a letter asking we hadn't attended a paediatric appointment in Devon ( with a consultant from Bristol Children's Hospital, because Plymouth didn't have paediatrics at the time) we'd received no appointment letter. On phoning the consultant's secretary, it transpired that nobody had received appointments for the clinic. Plymouth blamed Bristol and Bristol blamed Plymouth, and we had to drive to Bristol from Cornwall for a 10 minute consultation.

The State.................keep your weight down dont smoke dont drink. get plenty of excercise work full time.
Also The State..............run yourself ragged caring for your elderly parents. What do you mean you dont have time. Your parent is blocking a bed. How selfish of you!

MAKE YOUR FUCKING MINDS UP