to think if a business operated like the NHS...

[hairytriangle]

then it would quickly go out of business

Just in terms of client communication and customer service.

Today I've been

1. kept waiting for one hour past my appointment time

1. had a snooty receptionist tell me I'll 'just have to wait' when I asked (nicely) whether I'd been forgotten about

1. Had to push for investigations that their own NICE guidelines say I 'should' be offered

1. Been given advice contrary to what another department of the same Trust gave, about a potentially life threatening action.

1. Been examined yet again when they could easily have got the results of the exams I had six weeks ago by lifting the phone.

I know if we treated our clients like this, then we'd quickly lose them.

BootyMum - I've worked in the NHS and the private sector. I will never work in the private sector again. Ever. Lower wages, fewer increments, holiday allowances. Training opportunities are virtually non existant.

The consultants are treated like kings and all the over staff treated like serfs and IME the care is no better. In fact I wouldn't let them do much more then cut my toenails.

GothAnneGeddes - thank you for proving my point.

You had poorer working conditions, you say? Bless. That'll be because the company doesn't exist to serve you. Patients come first.

And somehow, these companies don't go out of business because their satisfied customers keep coming back.

No, the service provided was poorer all round. That's despite the big fat premiums people were paying.

I will repeat, I would not have any surgery in a private hospital. They do not have the out of hours or emergency provision that an NHS hospital has. I would also not like a surgeon operating on me after he's already done a list elsewhere that day. There's also the fact that CEPOD is very poorly adhered to in the private sector.

Bless indeed.

mamatomany I only got confused by your comment of how people think that the pennies that they pay into their NI fund the NHS. Well... they do.

i'm now in Germany and whenever i have any dealings with the Health system here i always compare it to the UK (lived in the UK till recently and worked all my adult life for the NHS!)

obviously as a family we pay more for our healthcare than we did with our NI contributions but like our NI its taken off our pay so its money we never see anyway. but i'm happy to pay for it since the service is so much better.

I think the main difference is that the onus here is on the patient to be responsible for their healthcare - for example - my son needed to be seen by a surgeon. we went to the paediatrician who then gave me a referral to the surgeon. we made the appointment with the surgeon and after that consultation he needed a scan. we were given a referral for that and we had to organise it ourself - it was up to us where we went for any of these appointments. Thankfully it was all ok and the diagnosis was explained by the radiologist.
at no point after did the paediatrician or the surgeon chase us to make a follow up appointment - there was no legion of administrators passing referrals back and forward and making and cancelling appointments - it was all up to us to sort out.

I understand this cant work with all of society - for example elderly patients with alzheimers cant be left to organise their own healthcare but for the rest of the population why cant people be responsible for organising their own healthcare needs?

there are downsides to healthcare here - there is a tendency for any doc to refer you on to a different specialist or for the most complicated investigations - this is obviously down to them getting paid for what they do and the referrals they make but its not abused to the level it is in the US.

this would never happen in the NHS since it is not run to make money but there are definite lessons to be learned from other countries and if people really want an improved healthcare then they may need to consider paying more for it.

The NHS should scrap all operations that do not fit the description of what the NHS was intended for. Breast augmentation, 'gender reassignment, IVF, etc etc. The NHS should be there for 'need' not 'want'. I'm also sure money would be saved by shortening the time it takes for nurses to qualify. 3 years??? FFS.

I used to whinge and whine about all of this until my serious health condition was diagnosed. Can't praise the NHS enough. When things are shit, they are amazing. Yabvvvu.

scatteredbraincells No they do not cover in a lifetime what it would cost for one operation, prescriptions, GP's time, a trip to A&E.
People have no comprehension as to what it costs to provide NHS services, your average pregnant women with no complications cost £4k, how much did you pay in NI last year ? Oh and you're expecting a pension from that too I expect ?

I shouldn't bite really, but Hammy, why on earth do you think nurse training should be shorter? Are you one of those people who think nurses are glorified hand holders with ideas above their station?

I would also disagree about private hospitals being poorer from the patients point of view, I had surgery in a Bupa hospital and it was wonderful, hot and cold running nurses, pleasant receptionists, food was lovely and available when you needed it. It was done on a Sat morning so unless my surgeon had been out on the lash the night before no reason to believe he was anything but fresh

Nurses roles have changed dramatically since it was 18 months of college level training, there are very few nurses without degree's now which is required since they are educated to the equivalent of a Dr 20 years ago if that makes sense.

GothAnneGeddes I agree with some of your thoughts about working in the private sector - "consultants are treated like kings* but I have to say I have never felt treated like a serf - although I did in the NHS. In the NHS I felt like an inconsequential cog in a big machine with very little control over how things were run or managed and little interest shown by management in whether my needs were being met in the job I was doing [ie regularly going without breaks due to staff shortages, performance appraisals which were tick box exercises whereby I would say I needed further training in this or that in order to be able to do my job most effectively but the money for this was never ultimately available...]
Now I work for a company which runs 6 private hospitals in London. I am paid nearly £10 an hour more for doing the exact same work. I regularly request training from my manager and as long as I can demonstrate that it will benefit my work and the needs of the department I am quickly approved for this, fully paid for by the company. I work in clean pleasant surroundings with friendly motivated fellow staff. I enjoy my work so much more and I cannot imagine that the NHS will ever tempt me back.

I have a couple of friends that have been nurses for over 20 years and they have said they can't believe it now takes 3 years to train. I think this is just indicative of a government wanting to change everything into degrees of a standard 3 years, regardless. Same applies to teaching, my father was a teacher for 35 years and only took a year to train. Half way through his career, he had to do a degree to progress through the ranks-despite all of his experience!

Yes Hammy but the training was very different 20 years ago... I believe it was then more like an apprenticeship in that a lot of the training took place on the ward under the direct supervision of senior staff. So although your friends may not have done a three year degree I am sure it did take them about the same amount of time to become fully trained, autononous, competent practitioners. Also nursing is a very different job to what it was 20 years ago. Nurses are now required to work more independently with specialised equipment and treatments which were not in use back then. I think some of the public perceive the nursing roles being purely about bed pans and bed making which may take about a week to learn -taking into account understanding about mobilising an ill patient, infection control, etc. But in my experience, when you are managing the care of a critically ill patient in intensive care you are very thankful for your academic background in anatomy and physiology, pharmaceuticals, etc. Because I did not have a Dr working alongside me, I had to know when I required the input of the Intensivist [Intensive Care Dr] and would then bleep them to come assess my patient. I don't think a basic training in practical skills would have helped me with that.

mamatomany, I know exactly how much private costs as I had to use it uninsured when the NHS let me and DD down.

However you're talking like there must be another way of funding the NHS. Someone must be getting less than what they put it, or how would it work? In fact a lot of people must be getting out less than what they put in, or it would have collapsed.

I happen to be lucky enough to be able to put a lot into the system I do demand that myself, as well as the people who never paid a penny in, get treated, first of all with respect, and secondly that they're actually medically cared for the way they need.

I'm not saying "give me my money back so I'll go privately", I wouldn't want to live in a world like that. But you can't simply assume that EVERYONE on here gets out more than they put in. It's simple maths and it wouldn't add up

plus, we shouldn't have to beg to be cared for. When you're suffering and feeling vulnerable and have people fobbing you off it's easy to forget that it's YOUR NHS

"However you're talking like there must be another way of funding the NHS. Someone must be getting less than what they put it, or how would it work? In fact a lot of people must be getting out less than what they put in, or it would have collapsed."

Its funded by borrowing money from future generations, it never was and never will be a sustainable model in terms of what the current population pays into the pot.

Income from National Insurance was predicted to be £104.6 billion for 2008. The NHS budget is about £100 Billion. That notionally leaves 4.6 Billion for all the other things national insurance pays for. Or about £14 per person per week.

National Insurance is just tax.

en.wikipedia.org/wiki/File:UK_taxes.svg

en.wikipedia.org/wiki/File:UKExpenditure.svg

Income from National Insurance - £104.6 Billion.

Cost of things National Insurance nominally pays for - £310 Billion.

Two words for you - GET BUPA.

But, remember that whilst the NHS is crap from a customer service perspective, whilst private is fab from that perspective, if you need the best treatment for a serious medical problem you are almost always better on the NHS - It won't be like a nice hotel or a posh shop on the service front, but its where the best medicine practised in this country is taking place every day.

PS - I have BUPA and almost never use NHS, and also pay massive tax bill each year so am paying for it.

The problem is people who pay no tax, and draw disproportionately on the NHS resources, often with problems which they are causing themselves, or at least making worse themselves -

e.g. -

they have lower back pain and so they don't work but they won't lose any weight even though this would help

the have diabetes but don't manage it properly so end up in hospital for that

they are fat and won't lose weight so have heart/respiratory/circulatory/other problems

they smoke and won't stop

they take drugs/abuse alcohol and don't stop

I kind of agree with IloveDonaldDraper but smokers and drinkers pay a lot of tax!

I am coming quite late to this discussion and I think it is clear to all that have anything to do with the NHS that it is massively underfunded.

DS2 has a lifelong genetic condition, he is under six different consultants plus speech therapists and physio therapists etc. I am very, very grateful to the doctors/ nurses that have saved his life on more than one occassion.

I have also had cause to complain to the cheif exec of our trust and our local MP about a monumental cockup that will also affect him for the rest of his life. It is quite okay (imo) to complain about the NHS if it has let you down. In fact the matron at our hospital practically encouraged the complaint. They want change too.

When DH was ill at the end of last year I was so shocked at the difference in care from childrens to adults. It was like being in a Panaroma programme, it was so appalling.

On one day two patients were waiting for discharge letters before being allowed home. They waited 48 hours!! This was during a well publicised bed crisis, blocking two beds costing several hundred pounds a day. DH himself had to wait 48 hours for a blood transfusion before discharge, because nobody had time to action the doctors request.

I think it is possible to sit right on the fence when it comes to the NHS. As I said I am more grateful than words can say that I still have DS2 because of it, but I can also see its failings and think it's okay to complain (to the right people) about them.

Marjee - Smokers and drinkers pay about £10 Billion in tax. Assuming that's spread out over all spending equally that meant they contribute £1.8 Billion to the NHS budget. Or in other words less than 2%. So the question is if they stopped drinking and smoking would that save the NHS 2% ot it's costs? I think it might well do.