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.

Woolly - I think I read somewhere that the reason the US has better cancer survival figures than we do is because the money tends to go to the diseases suffered by older rich people and their wives. Not that the poor don't get cancer, but that it's a disease that the rich can't avoid. (Does anyone remember Tom Lehrer and the doctor who 'specialised in the diseases of the rich'?) A lot of ovarian cancer seems to be picked up in 'routine annual gyne' checks. I don't know anyone who does that here. Good for the few with early oc va but hugely expensive and a waste of time to run out nationally. There would be a lot of unnecessary surgery, since atm that is the only sure diagnosis.

On the other hand, their record for stillbirth and neo-natal deaths is surprisingly high for an advanced country. I assume because many of the poor slip through the net.

It's a complex subject. I don't think any country without an NHS is in a position to switch to full provision now. The trend, as in NZ, is in the other direction. We were incredibly fortunate in the years after the war to be able to introduce it. (People were used to austerity, and govt control, due to the War, among other reasons.) All the more reason to resist the erosion of the basic principle now.

Sorry - ov-ca.

There's a blood test called CA125, Woolly, but it's unreliable, especially for younger women. Can be raised for other reasons, and some forms of ov-ca have normal readings. And ov-ca, tho the biggest gyne killer, is relatively rare compared with other cancers.

Smoking, drinking and obesity are red herrings. What do you think costs more? Someone who dies of cirrohis, cancer or a heart attack in their 50s or someone who lingers until their late 90s?

*Moniker - I think you seriously underestimate the difficulty of caring for a demented relative.

There is also the (justifiable?) suspicion that taking on the care of said relative, even for a few days, is likely to mean that social services will put him/her to the back of the queue*

Well, this lady was bedridden so if she isn't on the move and at risk of falling, going out etc the difficulties are less. And yes, definitely in the UK if you suggest being able to care for a relative they will be dumped on you, hence people try to offload the problem as soon as possible. But many people, myself included would have cared at home for an elderly rellie if adequate support was there, but it wasn't and the risk of being left with it all was too high. Also other relatives are discounted eg male relatives, in future their should be a compulsion on all relatives to do something even if just contributing funding.
But that is much of the problem, it is seen that only the care services can care for ill elderly, did I hear it was 70,000 pa to care for someone with dementia in a care home. Imagine that person lives for 10 years that's approaching a million pounds for one person. There are 3 million people over 80, so if a third get dementia that is 70,000 million pounds pa. The number of aged are set to double? at least over the next decade or so.

My point is that something has to change/ give and all this bollocks about whether the Cons are privatizing or whether Labour have brought in x thousand more nurses is irrelevant in the long run because as things are we are heading for an unpayable health bill in the not too distant future. And all the bickering here and in parliament is skirting a dire problem which no one will face.
Rant over.

I'm one of those who thinks a charge at the first point of contact (GP, ambulance and A&E) might be a good idea to manage demand. Mainly because of my crap experiences with GP's. However, as far as GPs are concerned, to the extent unavailability is due to time-wasters, maybe it could be dealt with without charging. Maybe patient records could be surreptitiously marked with a "time-waster" flag after any such appointment, that automatically expires after a year, and thereafter any appointments they tried to make would be from a segregated allocation of appointments which would have a longer waiting time than the main pool. Their longer waiting times would ensure no waiting time for the majority of patients.

Someone will be along to give reasons why these people should not have to wait, but please remember that other people are waiting at the moment. This proposal doesn't increase overall waiting times, just shifts it from one set of patients to another. Also note it doesn't affect people who need to see a GP regularly for chronic conditions, only those a GP judges not to have special needs.

Virtually every doctor that I have visited here in Germany has worked in the UK for a few years and is therefore very happy to talk about the country and the things they experienced there, including working for the NHS.

I was told about the great doctors' pay which is considerable higher than here in Germany as well as the great practical work experience as 'junior doctors are simply not let loose on patients without close supervision in Germany' (these were the exact words used).

All said that they generally found the English people to be less demanding of their health care system than the Germans and less likely to waste a doctor's time on trivial matters such as colds.

Every single one praised the NHS for the reasons outlined, but also emphasised that they would not want to be treated in the UK themselves!!!

Much of the reason for the high US infant mortality rate actually relates to the lack of a standardised definition of a live birth. In the US every infant born who shows any sign of life is recorded as a live birth. i.e. a 22 week old baby who takes one breath. This simply is not the case in most countries where typically babies born prior to 24 weeks gestation, or below a certain weight are not recorded as a live birth (rather stillbirth or miscarriage) hence they do not 'die' so are not recorded in infant mortality rates. This skews the figures quite drastically.

Related to this the viability cut off point in the US is much lower than other nations i.e. they will try to save a baby at 20 weeks even though I don't think a baby has survived earlier than 22 weeks gestation. If the baby shows any sign of life, a breath, a heartbeat, a movement its recorded as a live birth even though in effect there is no chance of survival.

I also seem to remember if the figures are further broken down into age groups neonatal (infants up to a month old) and post neonatal (between one month and one year) that US rates are good (actually better than most countries) in the neonatal range.
i.e. while babies are in hospital/those first few days at home infant mortality rates are low but after that period the death rate increases - SID's accidents, sudden death etc There is a correlation to socioeconomic status in this category but not to race (from memory) i.e. Mexican-Americans have similar rates of poverty to African-Americans, yet have half the infant mortality rate

Separate to the above I think it needs to be said that US leads the world in medical research. Which is not to say that there are not research facilities outside of the US performing world class, ground breaking work just that the US is the main force in most medical research and the rest of the world 'piggybacks' off this to a certain extent.

Moniker - I think your figures are probably unnecessarily alarmist. Most of the third who develop dementia will be elderly and unlikely to live for 10 years. Most residents of care homes are only there for 2 years before dying. But, yes, it will be an increasing expense but not one that should be part of the health-care budget.

I'm one of those who disagree that the NHS is a bit crap. I've just had recent experience of serious illness and excellent treatment. I think it's doing a pretty good job given it's been expected to produce 'efficiency savings' while coping with an expanding population and covering for the gaps in social care on no extra income. And no pay increases for its overworked employees.

Whispered - yes, re medical research, tho' I'd say the UK is punching above its weight on this. But the USA is a much larger country and this research is not funded by its health system but by drug companies for commercial reasons.

albert some good points/ideas although I am not too sure about the details, I am not sure any hospital consistently adheres to excellent standards although I do agree that some are better than others.

The question of older social care and what constitutes nursing vs social is a difficult question, there are so many ways a family can avoid using a parents house to pay for the care, again it is a debate we as a society really need to have and then ensure whatever decision is reached is applied consistently.

Has anyone mentioned the Swiss Healthcare System?

It's very good, yes - my son has just had surgery for a collapsed lung here - but it does cost us well over a thousand pounds a month for the most basic coverage. He was sharing a room for his entire stay (usually with noisy or difficult patients), and we had to pay for some of the medicines. It ain't such a bargain.

Health Tourism

How many Brits are treated in Spanish hospitals while on holiday?
And Greece, and France and Turkey and Italy

shall we get the Spaniards chasing Brits up for their drunken antics?

A lot of ovarian cancer seems to be picked up in 'routine annual gyne' checks. I don't know anyone who does that here. Good for the few with early oc va but hugely expensive and a waste of time to run out nationally. There would be a lot of unnecessary surgery, since atm that is the only sure diagnosis.

What would one of those be? I'm a 46 year old woman living in the US and I've no idea what you're referring to. I have a smear every 3 years.

I get cross whenever 'health tourism' comes up because the finger is always pointed at the foreigners using the system. But it's not their fault. It's the system which doesn't work and doesn't recoup the costs of treatment. The last time I was in the UK I was taken very poorly. I saw a gp several times and ended up in hospital. I told them repeatedly that I didn't live in the UK and tried to give them my health insurance card so they could claim the costs back but nobody was interested in doing so.

Hedgehog

The same happened to me when I was on holiday in the UK, yet no German doctor will treat you unless you can provide a EHIC (E111).

I am quitting working for the NHS next month because I am sick of the whole thing. I am sick of nursing people with 'abdo pain' who appear when the weather is bad and they have nothing else to do (the ward was free of 'abdo pain' patients over Christmas, of course). I am sick of patients not turning up for outpatients appointments. I am sick of consultants having an extended lunch break while patients wait to see them. I am sick of patients' notes being lost. I am. Sick.

I'm grateful for the NHS to a point.

We have had some appalling treatment - 4month old baby seizing for 4 days and then Dr's wanted to discharge us and were practically pushing us out the door. (Not the last time sad to say)

To the great - a nurse knowing DD has severe LD having a nurse sit with me and DD in sensory room as only 1 room in hospital were DD could relax and fall asleep as she has tons of sensory problems and needs to sleep due to seizures.

We are often told DD cant have something or will have to wait ridiculous lengths of time as the drugs or equipment cost too much. They don't tell u this until u push them though!

There is just not enough money in the NHS to fund everything, a complicated problem that needs to be sorted or the most vulnerable people are the ones who will always suffer the most :(

windchime when i lost a lot of weight quite speedily (a stone a month for 7 months initially then over a year to lose the final 3) i got gallstones and i was in and out in EXCRUTIATING pain. I spent Christmas Day 2002 in hospital after being slightly overdosed with morphine on Christmas Eve. Some ppl are in and out with abdo pain after embarking on a healthy lifestyle to try and improve their health.

There is currently a 24 hour GP service actually. Your local GP 8-6.30 5 days a week and the out of hours GP the rest of the time.

Wobbly - I go on the Inspire, ov-ca site, and it often comes up as how their cyst/tumour was discovered. Routine ultrasound/PAP smear. A lot of the members seem to be from Cal or NYC. Perhaps have more extensive insurance plans? A friend of mine, early 50's, has an annual general check-up.

Yes, Letsplay - OOH. I rang at 6 a.m. on a Sunday and was rung back in 30 mins by a doctor. He told me there was no need to be rushing anywhere that day but, if I was worried, he could make me an appointment at the minor injuries unit, next door to A&E at my local hospital, for that day. Or I could see my GP on Monday.

I chose the latter, got an appointment the same day, and it was all sorted.

We do tend to hear more about the occasions when the NHS doesn't work than when it does.