“This is not a new thing caused by lack of funds.” You’re right of course, my own issues go back to the early 80’s.
But underfunding makes the problems worse/More likely.
“Insurers are bastards generally so I would be afraid of having to rely on them for healthcare. They do anything to avoid paying out.” Definitely!
“it’s not nhs or USA system...” posters - WE are not saying it is but we ARE seeing that this current govt:
1 Are regularly meeting officially to talk with USA health insurers, health providers and pharmaceutical companies and NOT meeting/talking with their equivalents in europe or elsewhere outside the USA
2 are ideologically underfunding and under resourcing the nhs.
3 are talking the nhs down - very subtly they’re not completely stupid and know being overtly anti nhs would be an election loser
4 are regularly misleading voters as to how the nhs is organised, funded and managed
Even IF you consider eg one of the other European country’s models, I’ve yet to get on any of these threads (I do understand why but the point is the lack of info we have) a clear and based on experience answer as to how well those countries serve the health needs of the least well off in those countries.
I’ve been given links as to the official regulations in such cases but no information on the reality of access and implementation which deeply concerns me.
Even here, strictly speaking ALL should have access to healthcare, the reality is if you’re homeless, have certain conditions (I’m particularly thinking of mental illness and learning disabilities) or are otherwise more vulnerable it can be incredibly difficult to access healthcare.
Health tourism while a minor issue in the grand scheme of things, ALL unnecessary additional costs eventually add up and mean there’s less funding and resources for everyone.
Personally I think having a policy of expecting the vast majority of people to be able to provide proof of residency and if not proof of insurance is the way to go. There can and should be a clause to show more compassion to those who obviously have reasons for having difficulty in providing this.
I have at times wondered if we should be running things in such a way that the vast majority of people know their national insurance number, ironically similar to how USA citizens seem to know their social security number.
Anyone who like me has spend a lot of time dealing with the benefits system will be used to this I certainly know mine off by heart and many people who don’t have good memories could note it somewhere that they always have to hand.
Again I know this could be problematic for a minority who’d struggle with this but measures could be put in place to mitigate this as much as possible.
Jux I very much sympathise with your socialist opinion but honestly having worked in the nhs and had a LOT of dealings with the nhs as a patient and mother of a patient it’s really not just underfunding. There’s a huge amount of wastage and mismanagement (partly from corrupt practice it must be said, partly outdated practices like sending appointments by snail mail! Also major issues with poor IT infrastructure and poor administration, even as a low level nurse i noticed supposedly full time administrators at management level regularly having Fridays/Mondays off, leaving early etc) but also because of the attitude to health we have in this country.
An awful lot of savings could be made by practicing more preventive and proactive healthcare.
Advance screening for conditions, regular I would say annual health checks for all, this would likely identify many issues BEFORE they require expensive secondary level treatment eg high blood pressure BEFORE someone has a stroke, high cholesterol BEFORE someone has a heart attack.
My particular bug bear on this is SO MANY patients are, at primary care stage, when they present with minor but chronic symptoms they’re fobbed off even completely dismissed, MAYBE prescribed medication for the symptoms which merely mask the problem and told to “come back if it gets worse” NO properly dx & treat the problem NOW.
This would save money and resources in terms of fewer gp appointments, not paying out for years even decades of the masking meds and the time for gp appointments or time reviewing for these, patient much less likely to BECOME more sick requiring secondary level or even a&e care (which is VERY expensive). It even saves the country money in costs not related to the nhs directly in terms of days off, even in patients becoming too sick to work and then needing benefits.
It is SO short sighted and long term more costly to merely “fire fight”
“I hate that a lot of the nhs is based on blocking people from seeing the right person, it’s all about triage and gatekeepers because the system assumes we are mostly time wasters.” Totally agree except I’d add it’s due in part to faulty financial regulations - it’s financially detrimental to gp surgeries to refer patients to specialists
“The NHS needs to do more to encourage people to look after themselves, no drugs and stop eating before you get to 20 stone”
On a surface level I agree but the issues around self care particularly addiction and obesity are MASSIVELY complex and go way beyond healthcare into education, environment, law and order etc.
I am overweight myself (managed to lose some weight a few years ago and not regain that but despite only having one meal a day at present I am still overweight - partly due to medication, partly as I’m housebound due to mental health issues so not very active and partly as I’m limited what exercise I can do due to physical disability, but I’ll admit also partly as food is the one pleasure I currently have that gives me ANY kind of mental boost through the day)
I’m also from a family stuffed full of addicts (not just substance but also gambling, spending, exercising) it’s behaviour that is very much taught/ingrained from an early age, there’s strong evidence of a genetic link (it’s one reason why I have NEVER smoked, taken any street drug and I very rarely drink alcohol I’ve been drunk less than 5 times in my life as I limit even what I drink per occasion, I have never even been in a betting shop or casino, I’ve never had enough money coming in to go down spending route and I won’t borrow money, at one point the exercise thing was starting to be problematic - was younger and much fitter then and was ‘a runner’ which then dh pointed out and so I reined that in), there’s also socio-economic, peer pressure and environmental factors. It’s extremely complex.
I have ocd and quite honestly I really believe part of why I’ve developed it is due to the addictive side of my personality. There’s some evidence to support this too.
Also many addicts particularly those with substance addictions are “self medicating” undx mental health issues.
2 of my relatives I firmly believe also had/have undx ocd with attendant depression and more general anxiety and they had problems with addiction, using drink to “calm” them. I’d say all of the substance addicts suffer and have for many years a level of depression and/or anxiety, including problems with insomnia, lack of appetite etc.
But yes, there are also elements with certain aspects of healthcare of personal responsibility. Personally as a long term asthmatic myself I don’t understand other asthmatics who took up smoking quite honestly at this point I don’t understand ANYONE under say 50 having taken up smoking, I’m 47 and certainly when I was of an age when most do take it up the risks were very well known, I also don’t understand wasting money like that! It’s SO expensive!
“The NHS isn't a free service, we all pay through our NI contributions.” I think I’m right in saying not JUST through NI contributions.
“You could get a gp appointment when you need it here if we had enough GPS.” If patients weren’t having to see gps multiple times for the SAME issue because it’s going undx and untreated there’d be more gp appointments available and possibly fewer gps needed.