NHS is absolutely appalling and I’m paying for this

[Dumbleyellowdore]

I know it’s been done to death but I need a rant.

My DS is 12 and every time he gets even a slight cold or cough he gets a hacking cough which lasts weeks and keeps him awake all night. It is so bad he coughs in his sleep. He literally coughs 24/7 and is exhausted.

This has been going on for 18 months. He caught a cold off his sister at the beginning of the month and has been coughing ever since. He’s had to take time off school and I’m worried about his attendance.

Over the last 18 months I have done econsult after econsult and only get telephone appointments for him and the doctors say he needs a full asthma assessment. The problem is there are no appointments. We have to books months ahead (only 1 nurse does it) and typically when the appointment comes round he doesn’t have a cough. Last time the nurse said there’s no point coming unless he has the cough. Come back when he has one.

I did an econsult last week saying he has the cough please can we see the asthma nurse so she can do the tests. I had a text back with an appointment. We turned up but it was with a paramedic who said he doesn’t do asthma tests and to book with the asthma nurse! What a waste of time.

I rang the doctors and explained what had happened. Said DS has the cough and can he please see the asthma nurse. Was told next appointment in February.

What sort of broken system is this? I am so sick of being forced to pay into this system every month from my pay and I can’t even get my son the appointment he needs. It’s disgusting.

I just don’t know what to do any more. I work with doctors and they have said it sounds like DS needs an inhaler which needs to be prescribed. They have told me a GP can prescribe this and it doesn’t have to be an asthma nurse. Unfortunately the doctors I work with are not GPS so they can’t help.

After another night of none of us getting any sleep due to the constant coughing I just don’t know what to do.

Go to PALs? I sympathise it's broken and I work in it too. You need to email the GP practice manager about the conflicting messages, impact on your sons wellbeing, impact on your wellbeing etc. No practice wants a complaint and investigation so they will try to appease you.

I think the problem with the ‘I pay for this’ attitude is that, realistically, you (your parents, grand parents, children) will have all taken a lot more out of the system than you ever put in by the end of your life. I’m not saying it’s not frustrating, and the system is definitely broken, but don’t focus on your NI contributions.
eg.
The normal NHS tariff for the cost to the taxpayer of antenatal care is £1,590 to £4,233. A straightforward birth with the shortest possible stay in hospital will cost around £3,282. Postnatal care can cost up to £1,207.50

Write to the practice manager if you want to make a complaint, maybe they can manage to arrange something to be sorted out for you.

OP, the UK spends less on health than the G7 average, the US, Germany, Japan and France. Public spending on healthcare in 2019 worked out about £2647 per person in the population per year. Tax revenue works out at 33% of GDP which again, is lower than most European countries.
How much tax do you pay in a year? That will give you a rough idea of how much of your tax goes towards the NHS. Some analysts say this is around 20%, whereas up to 33% goes towards funding welfare benefits for a typical tax payer. Do you begrudge paying towards people's benefits?
I just looked at my last P60 and see that I paid a bit over 4K in tax for the year. So I would have contributed £800 of that to the NHS.
I work in the NHS and share your frustration but the NHS problems are very much more complicated. There are few GP appointments because there is a shortage of GP's. There is possibly only 1 asthma nurse because there are 50,000 nurse vacancies nationally.
That said, organisation at your particular GP surgery sounds poor - and I can appreciate your frustration at not getting the right support for your son. Speak with the practice manager, explain your need for a face to face appointment.

Ask them to prescribe a peak flow meter. It comes with a paper chart which you fill in. Do this for a few days and then take child and chart to GP . A e consult will be better than nothing.

tell the GP he is so ill he is missing school and ask for a prescription of a preventer and a reliever. If they say see the nurse, explain there is nothing until February and he can’t stay off school until then.

If that doesn’t work, change to another surgery. You don’t have to give any reasons to anyone. Obv ask around locally first and find out which is teh best of a bad bunch.

I hate the “I pay into it attitude”

Id just ring up and get a GP appointment or go into the doctors and book one there and then and explain (calmly) that you’re at breaking point now.

They do have face to face appointments available daily - I know this as I’m pregnant so I seem to jump the list and get face to face ones straight away.

I think going in and explaining rather than over the phone they’ll take it more seriously and you can properly explain the issue etc.

My mum also managed to get same day appointment face to face because she went into the doctors first thing in the morning. This is a different doctors to mine so they do have appointments. I just think it’s more effective if you go in to book in person because they want you to leave!

If he can then get a GP appointment he can then hopefully get an inhaler.

Not shortage of funds it's bad management. They need to recruit more clinical staff and less diversity and inclusion managers on huge salaries

There are no same day appointments. I have tried all this. I was on the phone at 8 am sharp this morning and got through at 9.12 to be told no appointments and to do an econsult. They won’t let you book even a coupling days ahead, it is ring on the day only.

I have taken him to urgent treatment centres who say he needs to see his GP. I even emailed my MP who said it is well known there are problems with this GP surgery.

notmyfirstchoice thank you so much for your advice I will ask about these inhalers, never heard of a preventer inhaler before.

In every single econsult I have done I have mentioned how unwell he is, not sleeping due to 24/7 coughing, time off school etc and just get told to book in with asthma nurse.

I don’t think I have an entitled attitude. Every month DH and I like most people are taxed with large NI deductions taken to help fund a service we cannot access. After having an NHS birth with DS the appalling care I received at my hospital led to me paying thousands in private care to get myself repaired, the NHS couldn’t have cared less. The attitude in this country seems to be the NHS is “free” when it is t for most people, and that we should be grateful to get an appointment with a paramedic!!

Buy a peak flow metre. They cost around £10.
Keep records.

Some kids get 'viral wheeze' which can cause a cough. I'd push for a salbutamol inhaler and spacer for him.

You could pay for 1 private doctor appointment and you'd probably get the prescription you need for the blue inhaler which might just solve the issue for now.

Honestly, make a formal complaint (information will be on the practice website). They have a legal duty to investigate and respond to these within a particular timeframe and it’s your best chance of getting a decent response .

My surgery has been on "emergency only" for a month.

the doors are locked. You buzz and enter only if you have an appointment.

not all surgeries are the same, shock horror.

OP, some places you can buy an inhaler but I appreciate you might not want to.

You need to change GP surgery if you're getting nowhere, they are not all created equally.

Mine is next level fantastic. I called yesterday afternoon at 2.30pm, they had no appointments until Thursday but could tell I was really struggling and called me back later saying I could come in at the end of the day and see the GP. I've never struggled getting timely care even throughout the pandemic (and I have had a lot of health issues).

Can you change surgeries?

Can you refer yourself to asthma clinic? Many trusts have self referral.

Can you go through the health element at school as it's impacting his education?

Can family wear masks when they are unwell so he doesn't catch it? Increase anti baccing around the house like handles, banisters etc.

Can you get an air purifier in the house?

What heating do you have? This can impact asthma.

What brings an attack on outside of a cold? Breathing hard due to exercise in cold air can. Going between different temperatures can. What is it that triggers an asthma attack?

Your child needs an asthma assessment.Write to the practice manager explaining where the system has let you down and asking them to reply to you with a solution. I agree that a peak flow meter will be useful and that if you have some cash it will be worth buying. Your surgery seems to be undee huge pressure if it is not finding time to assess chronic diseases, particularly in a child. Most GP surgeries have been swamped since COVID and there are insufficient staff to cover the extra footfall.

The lack of "joined up" thinking in the NHS is scandalously and is wasting huge amounts of money and surgery time. It's one huge shambles.

OH is on long term chemotherapy and every sodding month it's a run-around trying to get blood tests done for his chemo drug prescription. Just constantly passed from pillar to post. Told different things by different people.

He turned up for a pre-arranged blood test appointment on Monday at the oncology ward, only to be told they don't do blood tests anymore and that he had to go to his GP for it (this was a pre-arranged appointment, same place, same reason as for the last two years!). Nurse just glibly said it was a "new rule". Couldn't get an appointment at GP surgery - blood nurses all booked up for several weeks. So he phoned the oncology dept back to ask what they hell he should do, as they won't issue the drugs without a blood test, and they couldn't understand why he'd been turned away and told him to come straight in for it as there are no "rule changes" and they're still doing the blood tests there for chemotherapy!

I think there are two many staff rather than not enough. Too many staff tripping up over each other, too many who don't know what they're doing (or are lazy), etc. It takes OH at least a dozen, maybe more, phone calls every sodding month just to get his chemo drugs, even when the oncology dept authorise them, he has to battle with the hospital pharmacy to actually issue them as they're constantly claiming it's not been authorised properly, etc.

It's not entitled to expect treatment for an illness. We've lowered our expectation of the NHS so low they're looking up at the toilet.

I already have workplace medical cover but it's the infrastructure that's broken. I hate those bloody lists of 'this is what it'd cost you if you had to pay', no it bloody wouldn't because my work health insurance would pay and those who don't work would have other vehicles to pay - not everywhere is like the US. There are plenty of countries that manage a hybrid health system that isn't actively dangerous to its own population.

You may not realise but tax is not hypothecated (sp?) In the UK so the tax you pay just goes into a massive fund which the government then pay out to the various services and things it spends on.

A GP gets on average around £165 per patient. That covers all the primary care needs of à person. Whether they need 1 appointment or need loads of appointments plus bloods plus physio etc.
I don't know if you've looked into the cost of a private consultation recently but you'd pay around £100 for one of those and blood tests etc on top. That's for 1 appointment. The NHS is not doing well because people are living longer, needing more expensive care and pays all the staff pretty much under market rates.

So YANBU to want to have your son well and seen by a GP. But please understand that you have not really "paid" for this ... and that everyone in the NHS is trying their best most of the time with the limited resources they have.

I have type 2 diabetes. Despite going in yearly for HBA1C blood tests, they've "supervised" a deteriorating situation and havn't picked up on rising levels over the past 4 years. In Summer, after the blood test done by a random HCA, I got a text saying "all OK" from a nurse. So, I thought everything was fine.

When I went to see the GP for an unrelated matter a month ago, he started talking about uncontrolled diabetes etc., and I had to ask him what he was talking about. Apparently, the HBA1C levels went too high 4 years ago and have been rising each year since. He thought I'd be "under" the diabetic nurse to get it back under control! I'm not sure he believed me when I said I had no idea and had been getting "all ok" texts each year!

Of course, pre covid, I had actual "in person" appointments with the diabetic nurse for blood tests, foot checks, general advice, etc., but since covid, it seems they're just doing the blood tests to get the extra funding, but not actually doing the work, such as advice, monitoring, etc.

This is awful, I think it's so area dependent too which shouldn't be the case. My DD had the same awful cough (actually tonsillitis as it turns out) and I phoned doc first thing yesterday and got an in person appt at 11.15. I can't imagine feeling so helpless that you can't get seen. No wonder A&E's are in such dire straits.

I might be missing something but surly not everybody will have taken out more than what they paid into the system? Some people never pay in so this must be balanced by others paying for more than they will use.

I would go even further and say that the ones who are paying the most are also often the ones who can’t attend appointments in the middle of the day / without any choice of dates and therefore are more susceptible to go private.

The “I pay for this “ attitude absolutely stinks. Honestly unless you are an incredibly high earner you pay absolute peanuts for the nhs and over your life time from giving birth, anything else you need you’ll get way more out than you ever put in.

If your GP surgery is awful, I’d honestly look at changing to another. Why have you not done this already? Seems daft to moan and write to your MP but not make a change. Failing that you just keep trying to get an appointment, hell even write in with a request if you feel the need.

No harm in treating your dc as if they have asthma, plenty of thing you can do around the home that may help symptoms if it’s asthma but won’t be any harm if it’s not.

In our nearby city, there's been a huge waste fire in an old burning (stuffed with years of trade waste) that's been alight nearly two weeks. The local area is affected by smoke, smells, ash in the air, etc. The constant message is "if you're worried, phone your gp", but all over local social media, people are saying they can't get appointments, GP receptionists are pushing back telling people to go to A&E if they're worried or having breathing problems. Mixed messaging as usual - people don't know what to do. Local GP surgeries are washing their hands of the problem, yet there's no where else to go, and it's GPs who people affected are being told to contact. Just passing the buck!

I think there are two separate issues here.

1. The NHS is not in a good place overall
2. Even by current standards your GP surgery sounds terrible

I’d focus on issue 2 and how you can get round the lack of systems and logic. Could you get a private GP appointment and get a prescription that way? Go to A&E and request an assessment there? Not ideal I know!

National Insurance pays for all sorts of things including the NHS. But people don't consent to paying it, like other taxes, it's taken out of your pay packet before it reaches your bank account, the joys of PAYE. But anyway, the NHS is a money sink. It can be argued that it's underfunded on the basis that the money is badly spent and goes into things that don't need it. Though, generally, the NHS as a whole is massively overfunded and poorly managed. I hope your son gets better soon, OP.