to think the NHS is a bit crap

[eyebags63]

And because it is treated almost as a kind of religion nobody is allowed to say anything negative about it at all. And actually just because it is "free" (a mere 110bn a year) doesn't mean we should be eternally grateful for bad treatment.

My experiences are of elderly relatives being mistreated in hospital, non-existent services in some areas, screw-ups, buck passing, treatment delays, being treated as a number with no dignity or privacy, a significant number of staff that appear not to care one little bit. I could go on.

In other health systems people can get referred and treated within days or weeks. Here we accept that waiting for months on end in pain is normal. We accept exhausted staff, lack of access, dirty hospitals, ambulances queuing outside hospitals and restricted treatment resources.

Yes it is "free at the point of use", but isn't that half of the problem? Walk into any GP surgery or A&E and you can witness so many abuses of the system. On the other hand genuine patients are often seem to be treated as a nuisance.

I'm not saying the NHS should be scrapped but surely it is about time we at least looked at different ways of doing things.

If an elderly person won't go to the GP then they won't go, again you are assuming that ALL old people have little money and that £5 will put them off. Well, they weren't going in the first place....

I work in an area of the NHS that is very unpopular at times, especially on here.

There are massive problems in the NHS and they are possibly too far gone to tackle. The main issues I see within the NHS are wasting of resources, still too much middle management and too many people who have forgotten how to provide a caring service. Some because they are jaded and some because they are burnt out.

However, the problems from external factors are as bad. Constant cuts in funding, lack of Doctors and Nurses and endless bureaucratic nonsense - tick boxing is almost an Olympic sport!

Last issue is people who have completely lost or were never taught any kind of self care or taking responsibility for their own health. I am not making that as a sweeping statement, a massive percentage of people we see need to be there or were right to get something checked even when it turned out to be nothing serious. What I get fed up with is people repeatedly placing unreasonable demands and kicking up a stink when we can't meet them.

I'd love to give examples, you may or may not be astounded at some of the crap my staff have to deal with day in day out, all the while people with genuine needs are being kept waiting.

Of course the GP surgery is full of older people, they are the ones with the chronic illnesses. They are the major users of the NHS, they often need multiple appointments to keep their heart failure/COPD/Diabetes under control. If it doesn't stay under control, they would end up in hospital. Treating people in primary care is much cheaper than dealing with them once they require hospital treatment. They don't have to pay at the point of delivery, so that's why they are there at the GP. If you charge them for GP visits, they will miss appointments. That doesn't mean their illnesses will just magically go away.
Let's humour you and pretend that this idea is a goer.
Who would collect and administer this fee anyway? Who would pay? How much would the bureaucracy cost, how many more civil servants would we need?

a lot of truth in your post but I don't see that anyone has the appetite to do what should be done.

Someone once said to me that the crazy thing about the middle class is they worship the NHS without realising that it is killing them in their 1000's and they would be so much better (health wise) under another system.

(I too do not think a US type private system is the answer)

Moan is correct. Once you get to a certain level you are expected to do the extra hours, there is no overtime for middle managers. If you don't like it then they will get someone else.

Whilst I work in the private sector I have worked almost exclusively with local government and central gov. The waste and inability to make decisions in a sensible timescale resulting in extra costs for them is truly shocking.

moan She wasn't moaning about hard done she was. But consider my half day was from 08:30 until 1:30 and I often don't leave until 4, am I not allowed to be a bit frustrated? She's not paid a whacking great sum for half days. She's paid an appropriate wage for her weekly sessions and one of her days in work happens to be a half day as she is full time. It's really odd why you are annoyed by that. No GP who works part time will ask for a full time wage, I have no idea why you think that either. That poster will earn a part time wage based on a sessional amount (we don't earn an hourly rate we earn by session. A session is classed as 4 hrs 15 mins ie: a full morning or afternoon clinic with time after to mop up/see extra patients and the time is never used to mop up but to see extra patients or spend longer with an ill patient than the ridiculous 10 min allocation time we have ).

Part time is different in GP anyway. Most part time GPs work 'officially' around 30 hours a week (but Unofficially more) and are paid part time wages as a result. I really do not see the problem.

Hillingdon, you're tying yourself in logical knots.

By charging you will also allow people to take personal responsibility for their health. To say it must be free otherwise they won't go is not sustainable.

How is charging going to make people accountable for their health? It makes no sense. GP surgeries will end up being full of the middle class worried well. People who are very unwell often don't work for one reason or another? How much will they pay?

illingdon

By charging you will also allow people to take personal responsibility for their health. To say it must be free otherwise they won't go is not sustainable.

Totally agree, people expect to do whatever to their body and then the NHS to fix it for them. People don't appreticate stuff that is free. Stop giving away 90% of perwcriptions for free and charge a small amount to people that can afford it for appointments.

Actually moan I think I've misread you.

Basically all public sector works should shut up and put up because they have better job situations than private sector? Right. I don't think so.

NHS workers are stretched to the fucking brink. I don't give a stuff if they have better on paper circumstances than private sector, the conditions are untenable and people have a right and a public duty to highlight where things are unacceptable.

The NHS is not fucking free! How many times? It's paid for through taxation.

Don't work for one reason or another - that is a sweeping generalisation.

No, it isn't free, but for some it is.

Hillingdon
If you think that charging will make things better, read the link about the administrative nightmare that is the American system - even for people who have full insurance.

The accounts and invoicing swallows up HUGE amounts of resources
middle managers, box tickers
money which SHOULD be spend on health care not management accountants

The NHS might be a bit crap in some parts but it is amazing in many other parts.

The principle of care free at the point of access for all is worth defending and it is that principle that I am proud of. That we treat everyone on the basis of need not ability to pay. I do not want to ever see that eroded.

The NHS should not be beyond criticism but I can see precious little discussion of solutions. Not the US system. Ooh something like err some other European country which no-one knows much detail about. How do these systems ensure fair access to care for the poor, the unemployed and the chronically sick? What if you can't pay for insurance do you get a worse service? How is compulsory insurance really much different to tax?

No-one is keen on fees for consultations or presumably on Scandinavian levels of taxation. Circle have just epically failed to run Hinchingbrooke hospital so it seems the private sector don't have all the answers either.

In fact the NHS is very efficient as health care systems go. Some of its efficiency eg NICE restrictions on cost effective treatments and rationing of some services like IVF are not very popular so it's a bit damned if it does, damned if it doesn't.

All of us have experience of the NHS so it's not surprising there will be tales of great deeds and awful screw ups. All the basic unmemorable stuff eg vaccinations, antibiotics for an ear infection, sick notes pass unrecalled but mostly gets done competently.

Often people die despite the best care, sometimes diagnoses are hard to make and take some time and due to being human errors will always happen. This stuff would happen and does happen in any system, public or private in any country. The important point is whether this happens more or less often than in other places and official comparisons would suggest that for the % GDP we pay out the UK results are good.

Sure some things can be improved but please not another huge reorganisation. We just had one which if anything made things worse.

Op is right, more and more things seem to be covered, as an example ivf and something topical a three parent baby. Bearing in mind the state of the NHS should that be offered? Something has got to change, whether that be charging a token amount or something else.

What cannot happen is that as soon as someone comes up with an idea it is shouted down. The other thing is if something is implemented it doesn't mean it's here forever. A few things could be trialled

There have been quite a few sad stories about bad experiences with the NHS. We have family and friends all over the world and I can tell you an equal amount of upsetting stories of poor treatment in other health systems. There are bad doctors and nurses everywhere and bad things will happen regardless of what type of system it is. Mistakes don't happen because we have a nationalised health service. Moreover private hospitals are no more accountable or transparent than the NHS when things go wrong.

Hillingdon
three parent baby
Do you understand how much money the NHS will save by getting rid of Mitochondrial diseases.

And actually the VAST BULK of NHS beds and resources, particularly, staff time, go on geriatric care and chronic diseases
like obesity
and heart disease
and lung cancer
and dementia

How old are you? How well are you? How fit are you?

I think we could have a season ticket rather like prescriptions. For people who use the NHS a lot.

You ask why you should pay twice? Well I barely use the NHS, should I get a discount?

Yes, I do, one of my clients last year was a hospital trust.