To worry about not being able to see a paediatrician on the NHS?

[RevoltingPeasant]

Okay, so talk some sense into me, please.

I grew up in the US with private health insurance (obv). My sisters and I saw a paediatrician until we were in our late teens - in fact our 'family doctor' (GP) would not take patients under 16. I think this is normal in other countries as well - my German friend says the same.

We also got check ups really regularly, at least once a year but often more, and especially when we were babies. In fact, my younger sister's extremely aggressive abdominal cancer was first spotted when she was still pre-verbal, just during a routine check up. A few more weeks and it probably would have been untreatable - we are super lucky she lived.

DP and I are planning a family now, so I'm looking into these things, and have been told by friends that it's not normal to take DCs to a paed in this country (except in serious cases in hospital) and that check ups aren't regular if there aren't obvious symptoms. I find this worrying in a general sense, and also because with my family history, there is an increased chance that any baby of mine will develop that form of cancer.

Am I just being extremely precious?? Suffering from culture shock? Or this is genuinely a real gap in the NHS? It just seems.... negligent to me, not to give children routine preventative medicine, especially when they are too young to verbalise properly.

sorry missed a word some are less than excellent was what I wanted to say.

thing is most peple are happier in their 'home' system that's probably why she takes them back, either that or they are seeing a friend, or she has some genuine concerns about their health she doesn't wish to share with you or anyone of many other possibilities really

holiday I have already explained that I don't rate the US system. I do not think it promotes good health effectively, like I said. That doesn't mean I think I should put up and shut up and be grateful, is all. I don't think the NHS is fantastic either, and I do think people die preventable deaths on it.

Also, I don't 'come from' the US, I grew up there. I'm English....

I am not saying the NHS does everything right. But I do believe in the drive towards evidence based medicine. i know regular health screenings where there are no symptoms or worrying family history tends to lead to over treatment i.e. people receiving medication/operations for things that would in many cases have got better in their own. The issue with that isn't just wasting resources - all medication and operations have side effects and over treatment kills and injures people. I had thought that over treatment of well off people in America is a huge problem.

of course these kind of checks do occasionally pick up very serious illnesses which is why patients tend to like them.

I don't know with paediatric care, but with adults I actually thought preventative medicine in America was much worse there than here. I regularly holiday with a great American holiday firm - not in America, just has mainly American tourists. Many of these Americans are very well off - often retired or semi retired Dr's, Surgeons and Dentists. I have heard lots of complaints about how insurance companies won't pay for preventative medicine. They are surprised for example at the range of reventative medication and checks routinely given to people here with type 2 diabetes. So it doesn't seem to me that the States is much better than Britain for preventative medicine tbh.

If you have the money, how about getting private health insurance here?

So, a perfectly healthy baby in the US would have blood tests EVERY MONTH?! Thats so over the top and clearly just a money spinning exercise.

I agree with other posters that this must seem like a culture shock to you though. I worked with an American woman once who was freaked out that she did not see an actual Doctor on each hospital clinic visit. It had to be explained to her that she was pregnant, not sick. When she did develop some minor health problems, she was treated by one of the best specialist docs in the UK, the problem was treated and she was back to seeing the clinic nursing staff.

i think the tendency in the US is to over medicalise every little problem - I have laughed out loud at some US tv shows where a kid is rushed to a peadiatrician with a cold ... but perhaps we are the other extreme here?

RevoltingPeasant yes. Turns out ds has a chromosomal disorder. Not hereditary but any problems we can contact his geneticist in hospital. Which is why I'm saying if there is a chance of having hereditary problems to speak to your GP. It most defiantely wouldn't have been picked up if he hadn't of had such good care and so many check-ups.

I never said you rate the US system you have consistantly raved on here about your experience with it and how excellent it is at preventative medicine you raised obseity not me (excluding your very recent comment about your sister)

I never suggested you should put up and shut up if you read my posts I have commented on a lot wrong with the NHS too in fact I have made several suggestions as to how you can get the check ups you have suggested you feel you might need in my reading of your earlier posts

i have no access to your passport your second line in you OP says something like growing up with the US system from that I took that you had a lot of familiarity with that sustem and were discussing that

why are you being so aggressive towards me?

GP's in the UK almost all spend some time working in Paediatrics as part of their training, wheras a general internal physician in the States will have spent their training doing adult medicine. If you tell your GP about your family history and your concnerns they will refer you to a paediatrician who will then be able to follow you up in an outpatient clinic for as long as they feel is necessary. The trouble with routine health checks when looking for paediatric cancers in particular is that generally paediatric cancers are pretty rapid to develop so even with checks every month or couple of months, the child could be fine in their health check and ill before the next one - so it is not an effective way of picking things up before they become apparent (unlike smear tests for example where pre-cancerous cells can be picked up)

But if there is a family history you should get regular checks. So discuss this with your GP. I do think in Britain with families more spread apart and peopel more mobile, there is lack of emphasis in Britain on the family medical history. Also GP's in past often knew the whole family, so knew the family medical history - usually better than the parents.

My in laws are cousins. When they planned to get married they visited the Gp to check this was okay in terms of future childrens health. The GP said that foot problems ran in the family so the children would be at a much higher risk from them, but with the rest of the history, should be fine.

I think that you are being a little unreasonable. I understand where you are coming from, but the healthcare you receive in England is unique and in my opinion generally brilliant. And free. What you received in America was paid for and all you need to do to receive the same in the UK is to pay for it. Unfortunately the NHS doesn't have an endless amount of funding so isn't able to provide the kind of service you're talking about. If you have a family history of an illness, the NHS will monitor it, so you may still get a yearly check up from a paediatrician because of it, but there just aren't the resources for routine check ups, sorry. I'm currently in a country where you have to pay for EVERYTHING, I miss being able to go to the doctor without thinking about whether I can afford it.

Just to say as well that the same job titles here can mean different levels of training between here and the US. So gynaecologists in US would as I understand routinely do smear tests. Here you would normally have a nurse do this who has been trained in it and does lots.

It doesn't mean that she doesn't have the training to do it.

From what I have heard of the German health system it is excellent. But they spend much more of their GDP on health than the UK.

Maybe consider taking out private health insurance?

holiday really don't think I'm being aggressive Just stating facts. I also don't think I have raved about the US system, just explained what I thought was good about it, and tbh I found your whole 'how can you come on here and expect us not to laugh at you' thing pretty unpleasant, and actually, if I had been American, kind of xenophobic.

I'm not on here for a fight with you though, so let's leave it.

Yes I agree the US system is over-medicalised, but it is hard to think that maybe my sister would have died had she been brought up in this country. I think I probably will get private health ins for any DCs I have. Thanks to all who suggested that :)

I am also in the middle of a not-so-fantastic experience with the NHS myself, which is why all this is coming to the fore now, too (kidney problem diagnosed in 2009, still not properly treated).

You can take under fives to a see a Health Visitor. Most GP practices offer this service.

White- it isn't a case of being brainwashed into believing the UK system is good, the statistics show that it works well, For All Incomes.

Most of us posting do actually mix with other families, who's children have or have had serious illnesses (including cancer) and lived through them.

Now I may be talking out of my backside here - but it seems to that in the UK patients are expected to be responsible for their own healthcare (or parents for their children's healthcare). So it is down to the patient to initiate contact via the GP or HV. So they go to the GP about an ear infection and come away with treatment for an ear infection.
In the US it seems as though HCPs are expected to be responsible for the healthcare of their patients, perhaps because patients are more likely to sue if they feel that their HCP should have spotted something but didn't. So patients go to the doctor about an ear infection, and then "while you are here" have a series of tests, just in case there is anything else happening.

But the american medical system doesn't work. There is a much lower life expectancy there than here - surely a type of proof. Also complications and death by over treatment is recognised as a huge medical problem there.

If you were raving about the french or german system against the uk system tbh I could understand more.

Also it is only worth taking blood tests if they are then quality controlled, to argue the point about which system is better, you would have to know the ins and outs of it, including infection control, complaints procedure, etc.

I know that the baby snatching incidents that have happened across the US and the murdering of pregnant women, without detection, could not have happened in the UK.

There are conditions which have a better rate of survival in the UK and vise versa, so sgain that is down to luck.

well I'm not going to drop it actually I never said 'how can you come on here and expect us not to laugh at you' and i'd appreciate it if you didn't try to put words into my mouth I said I really don't think you can talk about the American health system and obseity and preventative medicine and expect us not to laugh, why would we laugh at you? I'm sure you don't make policy decisions.

If you don't think you've raved maybe you should re read your post especially your OP and think about how you come across

Fact is America is amongst the most obese nations, we are all failing to deal with the obesity problem, since the problem is particularly severe in the States etc etc

I really don't take kindly to being called racist, bit of a leap from one to the other! You are not supposed to make personal attacks and i don't think anything I've said justifies you trying to call me racist (even if you choose to try and dress it up)

Lesley yes, point taken, I have also lived in France & Switzerland and am basing my expectations partially on that, too. I don't think the American system is wonderful, as I've said a few times now, but that it is better at certain things (for example, I would never have waited 2 and a half years to get a recognised problem treated as I have on the NHS).

I am grateful for the NHS but I also get concerned about gaps and things not being followed up and I feel that here, you have to be much more assertive about asking for stuff and checking that info has been passed on than in other medical systems.

holiday I don't think I called you racist. I don't think you will find that word in any of my posts. I have re read my OP, don't think it is raving: I simply stated exactly what my experience was. The only 'positive' thing I said was, we are super lucky my sister lived. That's true, we are.

I think we just have different posting styles. I'm going to leave this now, because I don't think it's the point of the thread. Thanks anyhow, though.

I understand your anxiety about cancer. It's true that one of the failings of our current system in the UK is that it's not great at picking up rare cancers in children and treating them swiftly. Or in adults sometimes, which is why our death rates from cancers are poorer than many other countries.

However, I suspect that in an over all assessment of healthcare systems, the NHS provides a very good bang for your buck - you get a lot for your money.

The key thing to getting the best out of the NHS is finding a really outstanding GP - they do exist.

On a slightly different tack - I'm amazed that having to pay for healthcare at the point of use doesn't stop so many Americans from adopting horribly unhealthy lifestyles. You'd think it would be a powerful incentive wouldn't you?

RevoltingPeasant my advice would be to really not worry.

DD1 was born in Kentucky and nearly died after the birth, DD2 was born in California and I nearly died, so we had quite a bit to do with the doctors.

My other six have been born in Oxford, Munster and Dorset and the care they've received in the UK is just as good as the care elsewhere and a great deal less stressful. There are dodgy doctors everywhere and brilliant ones too; sack the dodgy ones if need be, you'd be entirely free to move on, even within the NHS.

Between Kentucky and California DD1 was put in plaster for a month after coming out of intensive care, misdiagnosed with a dislocated hip. She was then diagnosed with a hole in the heart which was found to be a misdiagnosis after weeks of worry and waiting to see a cardiac specialist. She was then diagnosed with spina bifida which was found to be a misdiagnosis after weeks of worry and waiting to see the spina bifida specialist.

All this treatment was paid for by the US Army, so there was no financial motive to rack up costs, just a very, very different and cautious approach, fuelled then as much as anything by the notion of defensive medicine.

Oh come on by using the word xenophobia you insinuated racist what exactly were you trying to say?

I'm not going to quote bits of pervious posts where you are enthusiastic about the US system back to you I don't need to

I would like to be able to self refer to a gynaecologist. I dont want a random gp rummaging around my bits when a gynaecologist will need to do it anyway.

For the same reason I would like to take my children to a paediatrician rather than a GP who won't order tests til you've visited 4 times with the same complaint.

I feel that because we have a health service which is free at point of use GP's are mainly there to shield specialists from the general public.

holiday against my better judgement, then...... I said I found your tone unpleasant and if I had been American (which I am not!!!!) I would have found it xenophobic. That is true, I think if I were a foreigner and read something like that, I would've felt like I was being told to shut up because of my nationality.

found - felt like - I did not say, you are racist. I am enthusiastic about parts of the American system, like the parts that saved my sister's life, less so about others.

Okay, I am really going to leave this now, as it is distracting the thread.