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.

By the way, I bow to no one in my admiration for the NHS. Just over a year ago DS came down with a 38.8C fever in the space of an hour. We rushed him to our A&E (10 minute drive) - I dropped him and MrsLH off and went to park. When I got back 5 minutes later he had been admitted, already had some paracetamol and was seen by a doctor within another 5 minutes.

From our house to hospital bed in less than 30 minutes.

(Obviously the concern was meningitis, which thankfully it wasn't. But they kept him in for 5 days, as he kept on spiking a fever).

Insurance-based healthcare, as in the USA, is one third less cost-efficient than the NHS. Try reading an American health forum for what happens when you've lost your job and you - and your family - are no longer covered. Even those with insurance find themselves in debt when the costs of cancer treatment start mounting, or they can't afford the deductibles. 69% of bankruptcies are caused by medical bills which families can't pay.

I think your perception of how things are here is skewed by papers such as the Daily Mail which seems to have an agenda on privatisation. Drip, drip, drip about NHS 'failures' to soften us up for a change in free provision.

I've just had life-saving surgery, estimated at £35,000. I've paid for it in taxes over the years and would be happy to may more in tax now rather than go down the private route. (Could give you some horror stories about that, too.) The principle of free health care is too important to tinker with. We are so lucky in this country.

YABU. I live in a country (NZ) where you have to pay $50 to go A&E if you are over the age of 13 (which is v v recent) and $20 to go see your GP per appointment and last time I was at A&E I had a two hour wait.

I or take DD to the doctor/A&E if it is really important, because simply I cannot afford it, for example I cannot take DD (15) to the doctor get better hay fever medicine for her because I cannot afford it. Count yourself very lucky.

YANBU. I would much prefer to be poor and ill in France or Germany than in the UK.

*I cannot

From my experiences, YABU.
I've had cancer treatments that worked, my grandparents have new hips, and at no point have I witnessed anyone be mistreated.
People expect the world from the NHS with no realistic idea of where its limitations are. I remember a guy on the news the other week bleating because his mother had to wait 4 hours in A&E over xmas. She was in a bed and looked after the entire time, but her condition was not life threatening so others were treated before her. That's perfectly reasonable, but the way he was going on you'd think they stuck her in the bin and forgot about her.

eyebags, I've risen to your bait. I'm a huge supporter of the NHS and from the school of you don't know how lucky we are. Let me tell you why; my son was resuscitated at birth and whisked to NICU where he stayed for a week, gradually moving beds til he was just in high dependency. He was diagnosed with Down's Syndrome and posterior urethral valves and needed an op, at another hospital, as a two week old. We had another hospital stay there. These NHS staff saved my son's life and made a great start on sorting out his other medical issues. Every member of staff who worked with us gave their absolute all, despite working within the constraints of the modern NHS. My DH is a hefty taxpayer so obviously we have contributed like many others but I shudder to think, for example if we lived in America, what our final hospital bill would have been!!

I have sat in innumerable hospital clinics since and I know they overrun, sometimes by hours, I know the staff are hard pressed, I know the hospitals have targets and lists which must be jiggled to ensure they are meeting government targets but every single nurse and consultant we have ever seen have been more than professional. They have been friendly and interested and wanted their best outcome for our son. Recently, one of our longstanding consultants retired and we attended one last clinic with him. We wished him well and I said we are always profoundly grateful for the action he and his team took when our son was a tiny baby and he replied, and he really meant it, it's just brilliant to see such a positive outcome from surgery on a tiny infant and how delighted he was for us and our son. He is one among many, doing a brilliant job in very trying circumstances.

I can not let you call the NHS "crap"...

Personally I think there should be a nominal charge for seeing the GP -£5. That would discourage a lot of the turning up demanding antibiotics for a sniffle, not turning up at all behaviour yet is affordable to most (certain exemptions would obviously be needed - extreme poverty, chronic illnesses sufferers who require frequent GP visits).

Sure it won't solve all the issues, but it would ease the pressure.

YABU and YANBU. I worked in the NHS for a long time. There are services which are absolutely amazing, dedicated staff, hard workers, really committed to patient care. I was lucky enough to work in some of these departments and the good they did really can't be underestimated and I'm still in awe of the work they did and the service they provided.

Unfortunately it is also true that some parts of the NHS are not so good. Under the last government there were an awful lot of highly paid managers who sat around in shiny offices shuffling papers and doing the sum total of fuck all in terms of adding to patient care yet drawing massive salaries. There were also services like Mid-Staffs where patients were treated as an inconvenience and the priority was not patient care but box ticking and the staff felt hard done by just for being expected to come in and do the job they were being paid to do and showed little more than contempt for the patients they were looking after.

In one of my jobs part of the work I did was going in to departments where things had gone badly wrong and revamping them to improve things. This meant I saw the best and the worst of the NHS because I went into the places where things had gone really, really badly wrong (I'm talking about patients dying horrible painful deaths due to neglect and poor care). But I also saw the best because managers with proven track records of brilliant care would be parachuted in to sort it out, and it would be sorted out.

But the problem was, things weren't being sorted out until things had gone very, very badly wrong and people were killed. There was, particularly under the last Labour government, an attitude that the NHS was a sacred cow and it and it's staff should not be criticized which led to very poor care being hushed up. Long term widespread poor attitudes towards patients, where they were literally viewed as little more than cattle and an inconvenience.

Yes, in a lot of places the NHS is brilliant, but there are other places where it isn't and people should feel a lot more comfortable about speaking out about it and politicians should be less scared of tackling it. Saying that some services are failing does not mean that you are attacking the fundamental ideas which underpin the NHS. Covering up poor care to protect the ideology behind the NHS should not happen and we would have a better NHS if this was recognized.

I think there are two NHSs.
The service for things that can't be avoided - life&death dashes, babies arriving when they feel like it - is quite good.
The service for the day-to-day (like feeding the elderly in hospital, treating chronic problems) is not so good, it's all a bit mañana.

The NHS loves the drama of an emergency but cannot cope with the routine.

You don't fine for non attendance. You pay a deposit held until you do attend.

Or you accept 20% wastage in appointments, and paying for them ?

There are of course other areas of wastage. Doctors don't help by ignoring patients and prescribing the wrong medicines which then get thrown away (happens to us a lot). Can't even give them to charity .

And don't get me started about the "self service" check in system which is so easy to use there are 5 volunteers needed to assist people in using them.

You can always opt out by taking out private health insurance if you feel the NHS is crap. Then you would't have anything to complain about and it would free up resources for those who don't want/can't afford a private system.

In the meantime, I lived in a country for a number of years that had a poor compromise between an NHS system and a private system. It cost 120 euros per month for my (basic) health insurance and my employer had to contribute an equal amount, I had a 500 euro excess on the insurance, which still meant if I called the GP for a repeat prescription, I paid 40 euros, plus another 40 euros for the prescription to be filled out at the pharmacy. If I wanted a smear test, it cost me 120 euros because it was under the excess of my health insurance, but I didn't get a choice in the policy I used. I also had an accident once and had to get to hospital quickly, but before I could be seen, I needed to provide my insurance details. On top of those fees, I paid 60% tax, but people without jobs had a lot of problems getting health insurance, because it had to be arranged via your employer. So, yes, I think the fact that we still have an NHS and what they manage on limited resources is brilliant.

The nhs has its problems which are partly due to understaffed departments and overworked staff, not to mention immigration which has added significantly to the amount of people using the nhs.

Every new government wastes so much money 'restructuring' which could be better spent on patient care and more staff.

I agree with pp about fines for missed appointments unless it's unavoidable such as coming down with d&v. Even a £5 fine would make people think again about not turning up.

It's easy to forget about appointments for routine things, a text system like our dentist has where they text the day before an appointment to remind you would surely be cost effective very quickly. Missed appointments cost thousands and the text system would.likely pay for itself very quickly if it reduced the number of missed appointments.

The nhs isn't perfect but when you really need it its a life saver. My mum wouldn't have lived as long as she did without chemo and transfusions. We can't afford private health insurance and neither can 99% of the people I know, how can those in minimum wage jobs afford yet another bill? Not everyone can be a high earner, someone has to do the manual jobs and stack shelves, how can they afford health insurance?

The nhs isn't perfect and is at breaking point but I hope that it carries on or there will be a two tier system like in the US, those who can afford decent insurance will be fine while those in low paid jobs have to suffer through not being able to afford treatment.

"The NHS loves the drama of an emergency but cannot cope with the routine."
you might have a point there....the NHS has always been great for eg head injury, broken leg, childbirth.....

I must also stress, you are allowed "to say something" if you find things amiss, you can use PALS to raise your concerns.

I have not encountered a dirty hospital and I have lived in two during our son's hospital stays. Please use the existing system to feedback your experiences and help everyone. The system may not be perfect but I'm profoundly grateful we have it.

YABU

I'm another that thinks we are lucky to have the NHS. I work as an auxiliary nurse in a cottage hospital and sometimes i can't believe how stretched to bursting we are, so bad that with a recent noro virus outbreak at the infirmary they are just discharging them to us regardless of if they have been clear or not. But the infirmary where I live is fantastic hardly no waiting times in a & e and doesn't appear to have problems with beds etc, I think a lot of it is how each individual trust is managed and how funds are spent, I get exasperated at my work by the wastage for example, bowls for washing the patients started out as normal plastic bowls which it was then decided that, as an infection control policy, when that patient was discharged plastic bowl was to then be binned! We use disposable paper bowls now which cost a fortune when the plastic bowls could easily be industrially cleaned or cleaned down with the sporicidal wipes we keep on the ward which kill everything, fair enough dispose if patient had something really life threatening that could be passed but there are ways money could be saved that just isn't happening.

BankWadger, I'm really against that. £5 is a lot of money for some people and in reality it would probably end up costing us more money than it saved. The poorest people suffer the worst health and they are the ones who woud be put off by a £5 charge. It would mean health conditions they had wouldn't be picked up until much further down the line where they would be more expensive to treat.

It would create a two tier health service where the wealthy had much better access than the poor, yet the poor would still be paying a bigger proportion of their income towards the service, so massively unfair.

I had a minor operation at the end of October but had a very good experience. The whole process from my first GP referral to the actual operation was swift and efficient. I only had a short time to wait between hospital appointments and on 2 occasions I only had to wait about 15 mins to be seen by the doctor and when I went for my pre-op they saw me early. All the staff when I had my op were kind, caring and attentive.

HearTheThunderRoar

I'm from NZ and am flabbergasted to hear you now have to pay to go to A&E!!! Actually I'm outraged. Another reason I don't wish to go back to add to the list. Last time I lived there I paid $30 for the GP and DH paid well over $40 for an OOHs one. I used to wait till I need several things sorting and get my monies worth

The NHS is stretched beyond breaking point, and there are particularly big problems with GPs. I have no doubt that people, right now, are dying unnecessarily because the system isn't working.

However, I absolutely support the principle of free healthcare at the point of delivery, and so should you. Not just because it's the right system in moral terms, but because it's the cheapest.

Think about it: if you have private healthcare, the company is going to want to make a profit. So you will pay the cost of the care, plus the profit. Also, private companies will be far smaller than the NHS and unable to negotiate the same bulk discounts from suppliers - so the system will be more expensive. Just look at the US system: it is hugely costly without being more effective.

The simple fact is that we need to pump a LOT more money into the system via taxation. And those on higher than average incomes should fund that. While that might sound harsh, it's worthwhile bearing in mind that funding the system upfront through tax will cost LESS than we would pay if we had to buy private health insurance.

Not only that, but we will remove the anxiety associated with private health cover (don't think for a second that you have 'peace of mind' if you have excellent cover - you don't. Just ask any middle class American family with a sick child and they'll tell you that they spend a lot of time worrying about having to argue with the insurers to get things that they thought they'd be entitled to. And that's those who can afford excellent packages).

More importantly still, we'll remove any conflict of interest between the profit motive and treatment. Imagine being a cancer patient who is told that you can't have the gold standard treatment because you're not covered or the company won't pay out, and going through a second rate therapy just because of some administrative decision.

Finally, we avoid the abhorrent situation where, in a rich country, poorer people who simply cannot afford decent health insurance go bankrupt or simply suffer and die from treatable illnesses, while other people buy enormous mansions and flash cars that they don't really need. We don't want to live in a society that looks like that, do we?

Moan did you not read where I said exemption to low income people?

Op I have a chronic illness , sometimes I have to visit my GP weekly I couldn't afford to pay for every visit.

It's a bit inconsistent.

DD2 is seen regularly by a consultant for a long-term issue. Our "regular" department are very good, and most departments she gets referred to for other tests etc. are also good quick turnaround for stuff that's time-sensitive, still a reasonable turnaround for other things but one department are just terrible. DD2 was referred "urgently" for one procedure in November (and our consultant actually went and fetched one of the other department's doctors into the room to look at DD2 on the spot so that they could bypass the "having one of their doctors look at her" stage and go straight to the actual procedure, all of which went into the referral letter) we have just (after I know our consultant has personally chased them twice) had an appointment through for May, which will be more than six months after she was urgently referred and based on the location of the appointment, it's a "having one of our doctors look at her" appointment and there will be another wait after that for the procedure she was actually referred for to happen.

And the treatment my elderly father with Parkinson's gets is woefully inconsistent -- one hospital in particular he generally leaves sicker than when he went in (because he goes in with a simple injury and leaves recovering from that injury but having lost huge amounts of weight, with his medication schedule all screwed up and generally having picked up a urine infection). But at another hospital the Parkinson's consultant has made sure that the nursing staff on the wards are well-briefed and trained on the needs of Parkinson's patients and the difference is like night and day.

We ARE still lucky, though; our system is far less broken than the way things are in the US. That doesn't mean there's no room for improvement.

I've had great experiences with the NHS and a couple not so good. We have private insurance through my dh's job and am quite happy (but not bowled over) with his experience in the Spire group hospitals. However I took my ds to a Bupa hospital last year and I thought it was shit frim beginning to end. One nurse took over 20 minutes to set up an ECG machine because she 'wasnt used' to it. Wtf?
Tbh using private medicine suits my dh because he needs to schedule appointments when it's convenient for him because he travels a lot. It's not very easy to do this in the NHS. However you don't pick and choose your appointment in private medicine either. You have to work round the consultants schedule or the fact there are a limited amount of CT machines. (Dh was diagnosed with stage 1 colon cancer 18 months ago so is a frequent visitor.) Basically you will always have to wait a bit for an appointment and treatment no matter whether it's private or NHS.
Having had a lot of experience in private hospitals in the last couple of years I wouldn't say there is anything intrinsically better about private medicine. You get well run private hospitals and some not so well run.
My experience in the BUPA hospital with ds2 has made me decide private insurance is absolutely not worth it for the rest of the family. We've had much better experiences with the NHS. Dh will stick with private because of his work and ongoing treatment with his consultant.

Oh and I would also be happy to pay more tax towards mine and my families health care. I fear that if, God forbid, the nhs goes completely private the massive divide between rich and poor will become so much more apparent with people who cannot afford health insurance or something happening that their insurance doesn't cover not being able to be seen, these are just my opinions and fears though.

As for patients being ignored etc I don't believe it is as cut and dried as that, of course sometimes that will be the case but where I work quite often there just isn't enough staff and If a patient needs 2 people to help them to the loo etc that's two workers off the floor and nurses now are expected to keep on top of so much paperwork instead of focussing on patient care. Also a lot of new nurses that I come across now believe that they are only there to sit on a computer and refuse to get hands on and help. I believe that more healthcare assistants and auxiliary nurses should be better trained and monitored and have more access to training that would allow them to do some of the work nurses do to alleviate some of the pressure and an easier pathway for healthcares to train as nurses if they so wish