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.

One of my relatives has just had his life saved by a fabulous ICU department elsewhere in the country. My husband has been seen by a consultant within weeks of referral and I've just come back from an outpatients appt. at the local hospital. I was referred two weeks ago, had a choice of venue, date and time to visit. I was seen promptly and have ended up with a choice of what to do about my condition, and if I change my mind at any time I am free to go back and have surgery.
I cannot fault the service.
The NHS is only as good as the people who manage it with the rescource they have... some get it right, some don't.
It is wrong to blame the whole of the NHS for what's wrong in your part of the country.

yes well people on expat forums very often have an axe to grind and are bored and cynical and homesick.

Those silly foreigners with their silly opinions eh?

NHS is crap.....you wont think that way if they take it away

I haven't had access to the NHS for nearly 10 years and TBH I haven't once missed it.

no, not 'foreigners', people on expat forums....that means expats from UK. Usually.

broken
NHS is crap.....you wont think that way if they take it away.

Why do you assume it would be replaced with a worse system?

No one suggested an American style system.

Several people have described the schemes in European countries which sound much, much better than the NHS.

What seems to come across from this thread is that the NHS is far better at emergency care and dealing with acute, life-threatening conditions than it is at handling chronic conditions and providing long-term, basic medical care. I think it's this base level, workaday stuff that needs looking at most urgently, especially where it crosses over with social care (e.g. care for the elderly).

There seem to be specific issues with geriatric, maternity and mental health services, which historically have been neglected, underfunded areas (possibly because they serve vulnerable groups who are less likely to make a fuss). We seem to be able to fund the bright, shiny, exciting stuff like the latest ICU technology, which is obviously very much needed, but we don't seem to cope with the everyday basics, like providing GP appointments and ensuring elderly and vulnerable patients are properly cared for.

not all European countries though wanttosqueezeyou.
You should have seen the look of incredulous delight when my Polish SIL realised she didnt have to pay for her baby's medicine. IN her country, if you cannot pay, your baby does not get medicines. Why do you think people like the UK so much.? and no I do not mean any offence in saying that. Even in Ireland you have to pay for the day for a hospital stay I beleive.

I'm sure you're right sunny

And to clarify, if we are going to change the system I would like us to pick one of the European countries that do it better than us.

So we could have an improved system, not a hit and miss one.

Totally agree Temps its often the vulnerable groups that get the worst treatment.

The 'glamorous' high profile areas (ICU would be an example) generally offer much higher standards of care.

I think what has happened on the non life threatening issues is that some people DO claim their life is over if they dont have a better shaped nose or have their longed for baby,. So the NHS covers it. If someone is claiming to beso mentally unstable unless they have xxx then surely that's what needs addressing not giving them what they think they want

I always get the impression that the NHS concentrates their resources on lifestyle-related diseases (e.g. adult diabetes, some heart disease) but is poor on people with shorter term problems who want to get better quickly.

Everything seems to be aimed at a very low standard of fitness - NHS physio seems to be based on some standard person who takes no exercise and who will probably therefore deteriorate or fail to heal quickly. I've had it and found that, as a fit and active person, I improved so much by the time that my 6 week wait for physio was over, I felt like a timewaster. They also try to hold you back - I was told I shouldn't be doing sports and jogging, because I "wasn't capable" - utter nonsense. I've a friend who had NHS physio after a badly broken arm and she was told she shouldn't be doing all sorts of things, yet after a few weeks she was better while the patients they presumably prefer were still in a similar state.

I also know someone who was paralysed after a riding accident, who found NHS after-care so depressing and limiting that she discharged herself and now spends her life doing all sorts of athletic and interesting stuff. She was extremely discouraged by the NHS from standing in a frame to keep her muscles strong and told that she had psychological issues as a result of "not accepting" her disability and hoping to walk again one day if advances in medical technology were quick enough. Her name is Claire Lomas and she walked the London Marathon in a specially adapted suit.

From that point of view, I'm always a bit wary of NHS standard opinions, in that they can be harmful to health and recovery when they are not specific to the patient. I think a private insurance based system would be less likely to do that.

I better add of course that if you really feel a boob job, IVF or hair transplant will help you change your life and you are not complete without it then save up and fund it yourself. The screams of horror and excuses as to why it shouldnt be YOU that has to pay for it is perhaps why the NHS is in the position it is.

It cannot cover every single medical issue regardless. Its rather like NICE having to regulate drugs. Paying say 10k to prolong someone's life for say 6 months. Is that something that should be offered. Again the screams of people saying that regardless of the cost of something life needs to be prolonged and what if it was your mother who needed them.

There was a situation a few months ago where I was asked this question as it was looking likely that my DM had cancer. Mum was adamant that she was willing to go when God decided and 100% didnt want to be kept alive just because there was some drug that would.

Luckily all was Ok and the cancer scare is over but we need to have a big debate here. People who retired at 60 are now living to 80 90 plus... The money is running out.

The problem is, when there's a non-life threatening issue requiring cosmetic surgery to deal with an issue that causes physical pain or discomfort, why should the NHS refuse to deal with that, when they'll do surgery to remove gallbladders etc? How do you decide that gallbladder removal is more worthy than a breast reduction to allow someone to work without being crippled by pain, or (from first hand experience), a badly-done scar that causes severe physical pain - does the NHS refuse to treat because it's cosmetic surgery?

When Mum was in hospital last year I became an observer of her care and the hospital The nurses were 80% agency and almost all from abroad, a couple would talk to each other in their native language whilst doing a procedure on Mum. They were amost without fail surly, disinterested and rude. The best two were the two student nurses who were training. I never saw the matron for the ward and I was there alot over the three weeks.

Lets make nursing a career, not necessarily with a degree but lets get young people into the profession. A PP said they applied for a nursing degree and apparently the tutor said she could have filled the course three times over. You dont need a degree to be a nurse. You do need to be the right sort of person though and from what I saw at this hospital recruiting in from abroad doesnt cut it.

And before anyone thinks 'racist' My DM was an immigrant and so was my DF

Moom - I honestly think if you have something that is very important to you - you need to make a decision and decide how you are going to fund it or even go without it. Some will bleat they couldnt possibly be expected to pay for anything. Its their right to have anything they want because they are feeling depressed or even suicidal. There are plenty of high profile cases around this sense of entitlement.

And in IMHO that is why the NHS is crumbling.

People have been so used to assuming its all free that its going to be very difficult to take it away and ask people to pay something more towards it. For people who use it alot then perhaps a pre payment type system might work.

Its your health we are talking about!

It cannot do everything. I speak from personal experience regarding IVF, I havent had it but a few friends have. They saved up for it. One went for a promotion at work, the other took a second job. The issue I feel is that everyone has a reason or excuse as to why THEY shouldnt have to pay for it

Anything from the rich pensioner claiming they have paid in all their life and want to get something back to the silly bint on this morning saying that the benefits cap means she has to go to find a job despite the fact she is a single Mum with 8 children. To be fair to her she did say that it wasnt fair that others were paying for her choices in life but she still chose to have 8 kids. She also looked about 15 but I am rubbish at guessing people's ages

Chandler - my experience was exactly the same. I was treated with contempt by the aftercare management team as my riding accident was self inflicted and the snobbery was unreal. My riding accident was caused by a driver who spooked my horse and threw me off. I was thrown off and hit a tree falling into a ditch. My horse had to be put down. It was through youtube that I did exercises myself as I couldn't afford physio.

After being airlifted to hospital and an 8 hour operation to set broken bones you would think the physio would have started right away. Instead I was on a three year wait list. When I arrived in the US my GP happend to see me walk down the stairs and asked why I couldn't do it. He wrote a script and told me to walk up the road to the physio for an appointment. Was shocked I could get an appointment same day. It was covered by insurance but to pay by yourself is $65. Not bad IMO considering I am a stone throw away from Manhattan.

Again, the doctors and nurses who treated me were ace. The management were awful and I hope they are subject to the low standards of care they expect others to accept.

hill - totally agree with you on staffing. I have no idea why there are so many foreign doctors and nurses. Often they come from developing countries and I find it abhorrent that we take vital resources from these countries in this way. It's not being racist at all. We should have plenty more home trained doctors and nurses. This has been a known problem for decades. The issue of female doctors going pt has been a known issue also since the early 90s yet nothing has been done about planning around this. Instead they hire a doctor from a country such as Nigeria when that region needs doctors much more than we do.

Having been in hospital a couple of times here in the US the doctors are 95% American with most recent immigrant doctors being expert specialists. They have come here for research opportunities.

Is the UK bad at dealing with chronic diseases? Coz reports don't bear that allegation up.

Mortality rates for heart disease and stroke makes UK about avg for HD among OECD countries, and about avg for stroke among European countries.

T2 Diabetes? UK is 4th best out of 30 European countries.

Living with Multiple Sclerosis? UK is about avg for Europe, again, better place to live than France, Switzerland or Netherlands.

This thread is very British. British compulsion to knock selves down.

DS had chronic uncontrollable asthma. The NHS had been fantastic and his treatment at 2 different hopsitals (and OOH and an a and e away from home) has been fantastic!

I am in a FB group for asthmatic parents and see parents all over the world panic about insurance And paying for things and I am so pleased not to have that added worry

Those are serious chronic diseases and I do think the NHS does a good job in that area.

However where are problems is with people who have a minor problem such as plantar fasciitis or problems controlling their weight. DS is on the heavy side and we are signed up already with a dietitian. It's done online and its part of our health insurance. DS is much healthier and DD has less behavior problems.

The dietician doesn't cost much at all and we submit everything online which is better for everyone. They are preventing huge costs down the road. Also because we know our kids will have to pay for their own healthcare DH is much more vested in putting the effort in now. DH being Danish does suffer from thinking he doesn't have to make a huge effort with his health. I think this is why there doctor pushed us towards a dietician!

once you access the care for chronic conditions it might be ok/adequate but to get there can be a struggle with gp's waiting to refer/not taking symptoms seriously/trying to treat themselves when specialists should be involved.

Many many years ago I thought long and hard abut becoming a nurse. I wish I had. I have a senior (ish) mangement role now in a big FTSE company.

I would have made a great Matron! I love the nurse practioners as well. I have one for asthma and she knows more than the Doctors.

Give the senior nurses more responsibility. At the hospital Mum was in I saw a senior nurse have to get a signature from a doctor who looked about 12. Bet she had far more experience than he did.

Think you should read article in today's guardian by Owen jones on why the nhs is under such pressure ie the recent reforms to 'reorganise' have caused chaos.

Yes, you are being VERY unreasonable.

Well yes because the change isn't being driven by the doctors and nurses. I have not read the article but can tell from my dads care that if management listened to those on the front line and implemented their ideas you would see progress. Instead change that politicans want is implemented.

I've worked on projects for process change and all of my 'ideas' were from front line people often in low wage jobs telling me where the gaps in the process are. 99% of the time their solution is implemented by me and brings about huge improvements. If management took their heads out their arses and listened to those under them while managing those above them I don't think the NHS would be in the shape it is in.

As someone who is an auditor, there is no way that PFi was ever going to work. It was a short term fix to a long term problem. Akin to pissing in your pants to stay warm.

I owe my life to the NHS several times over. I belong to Facebook pages where members from the USA with same the illness spend most of their time completely stressed out because, as a long tern chronic condition their insurance companies will no longer pay for treatment. Without treatment their quality of life will be very poor and they may well die. All systems have faults. In my many hospital stays I have met uncaring nurses, and doctors too busy to be friendly and even polite.I have waited hours sometimes for appointments. However there was never any fear I would not be treated. Whatever its faults we are very lucky to have it