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.

Sorry Chandler, but do I understand that you haven't actually tried asking your GP about your family history of coronary disease and 'changes' in your health? You 'know' the NHS won't investigate it properly so you haven't mentioned it to your doctor? Words fail me.

Words can fail you all you like Thymout but where did the NHS gain authority to treat a person without their permission? I am sick up to here with their incompetence and treating everyone as if they are unfit, smoking overweight person, or trying to turn them into one. I have tried to raise the matter of my family's early deaths from heart disease in many previous visits, and I've been told I can be put on statins if I want. No suggestion of testing whatsoever for an actual cause. And now that I am thinking about it a bit more, I want to avoid falling into that NHS trap of unnecessary, ineffective treatment that doesn't really address the problem, but is cheaper and just one of those things that the NHS does.

Hence, I would rather take charge of my own health and if I have to pay for it (as well as the tax I am paying in this country), I will take my business to another country in which I have more confidence.

As for "asking my GP about my family history of heart disease" - words actually fail me. Its all there in my notes, I've mentioned it a number of times; it should be the GP or something flagged up in the health service asking me, not the other way round. But since it seems up to me to assume the medical investigatory role, I might as well make sure its done by a competent health provider.

It may be all there in your notes, Chandler, but it wasn't in your original post. If he has dismissed your symptoms without having them investigated then, obviously, you see another doctor and get a second opinion. Whether here on the NHS or privately or in the Netherlands, if that's possible.

Not sure what you're saying about a patient being treated without their permission? That's never happened to anyone I know.

Woolly - not inherently bad to spend more money on healthcare? No! I agree. And we could do with spending a bit more. Especially on frontline services, training and possibly the more expensive drug treatments. We should not so dependent on agencies and medical staff from abroad. Agency nurses cost the NHS a staggering amount. We should be thinking ahead and training our own nurses and doctors and stop trying to run wards on a skeleton staff.

But obviously it's relevant in terms of cost-effectiveness.

I think the bottom line to all this is that no country is going to switch from one system to another. There are far too many vested interests in the US for any but minor changes in health funding - witness the storm of protest over 'socialised medicine' and Obamacare. And in the UK, despite the views of pp on this thread, popular support for the NHS is so entrenched and heart-felt that attempts to introduce co-payment or deductibles will fail. Only 8% even of Tories want to privatise the NHS or so they say. The danger is it may happen incrementally, bit by bit to a tipping point.

But it's interesting to see how other countries prioritise their resources in terms of preventive medicine and primary care.

Thymeout It may be all there in your notes, Chandler, but it wasn't in your original post. If he has dismissed your symptoms without having them investigated then, obviously, you see another doctor and get a second opinion. Whether here on the NHS or privately or in the Netherlands, if that's possible.

That is of course what I said originally (without the NHS bit).

I haven't specifically seen my GP about it, but have mentioned it as a risk factor. Its something I would expect my GP to be aware of. You get asked often enough about it for various forms.

I would rather not be treated by the NHS.

Just like people who get fed up with waiting lists and pay to go private. I think it (can be) that bad, and I don't want to take that risk. And if I am paying to go private, going abroad to a European country with an excellent private system is certainly an option I will consider.

I don't want a second NHS opinion. I should have a CT angiogram, whether I pay privately or do so through insurance is something I will find out. I don't have enough symptoms, I look too well I suspect, to get one quickly on the NHS, and I don't want to wait months or years on a waiting list for a waiting list.

I suspect at the moment its virtually impossible to get rid of the NHS, because it induces too much hysterical harping on internet sites for one thing (this thread has been refreshingly thoughtful, which is a change) because some people will literally jump down your throat if you suggest it. But one of the benefits of being in Europe is that we can move as consumers from one country to another, and to me, that seems to offer the better options.

Friends in the US have good health insurance.
It costs $120 fur a simple tube of cream. It is the most inefficient healthcare system in the world.

Yes - I'm not totally clear on the detail. He had to keep watering down his original plans to get it through Congress(?) But it mainly relates to Medicare and Medicaid, people who can't afford insurance or have been refused for pre-existing conditions.

I'm on a US medical site, and there's a whole section on financial advice. From what I gather, there are various plans you can go on, but they vary from state to state. Kentucky is still refusing to implement the reforms.

Hopefully, there'll be someone who can enlighten us.

Yes - dentistry is a particular bugbear for me atm. Pensioners get free eyetests and prescription charges, but no help with dentistry, just when your teeth are wearing out. I hardly ever need a prescription, and a free eyetest is often available for all as a promotion at opticians, but I have to stagger my dental work to fit my budget. Am currently trying to decide between a crown and a replacement plate. And I no longer have an NHS dentist, because he now only does private work. The new system didn't reimburse him enough to be able to do further training to update his skills.

I think it goes back to the early days of the NHS. They never really got the dentists on side. Most families relied on the school dental system for treatment, and didn't have their own dentist, as such. They only went themselves when in pain. A lot of my family had all their teeth out in their 40's, to save trouble.

2012 data, USD equivalent, OECD countries, spending per capita on health. If UK aimed for the middle of those countries above UK (not counting OTT USA number), so $4600, or 40% more than we currently spend. Then maybe we could comment whether the NHS system is truly crap or whether it'd be amazing if properly funded.

UK: 3289
Finland 3559
Japan: 3649
Ireland: 3890
Sweden: 4106
France 4288
Belgium 4419
Luxembourg 4578
Canada: 4602
Denmark 4698
Germany 4811
Austria 4896
Switzerland: 6080
Norway: 6140
USA: 8745

lijkk - thanks for that. Couldn't agree more.

From my recent experience, there was no shortage of drugs, towels, sheets etc. I have 2 pairs of NHS slippersocks and 3 pairs of surgical socks. And I was given v expensive bottles of fortisip to take at home pre-op, so my cells would be fighting fit for recovery. I also had 2 CT scans and 2 MRI's. One of my wardmates had had a PET scan - v expensive. I had an epidural for post-op pain, which would surely be more expensive than pills. And I'm being monitored with scans and a consultant for 5 years, tho' my surgeon told me that other hospitals might have discharged me at this point.

If I had had cancer, my chemo would have been the same as in the U.S. (Tho' I gather that some insurance companies there will only pay for Avastin by infusion, not as a tablet for long-term maintenance.)

But what I did notice was agency nurses doing night shifts and weekends on what seemed to be a routine basis.

Fir those advocating insurance.
I don't think we could afford it. On top of a huge mortgage and student loans, three children etc.

So what if my five year old a life threatening illness and I could only afford basic insurance?

Is that the model that people are looking for?

How much do we currently pay from our salaries to fund the NHS? Does anyone know? Because obviously that saving would fund a lot of private health insurance (rather than paying twice as some people do, if the NHS won't treat them).

85 Euros per month seems to be standard for Dutch health insurance. That seems to cover everything the NHS does, to a higher standard and without lengthy waiting lists. Those who can't afford it get it free or subsidised.

I'd rather pay insurance than use the NHS. It has too many problems now, and waiting lists or "diversions" for serious problems just aren't acceptable, in my opinion.

Ubik1 Why do you think that people would not be able to afford insurance if it is based on a social system like the German public one where what you pay is based on income? The more you earn, the more you pay (up to a certain capped figure) and if you are unemployed without any other income, the state pays for you until you can again yourself.

No one starves in Germany because of it and in my experience the average lower income person / family has a better quality of life than the equivalent in the UK.

I think the truth is more likely that a lot of people are simply too tight to spend that little extra on health (especially if it does not benefit themselves directly straight away) wich is very sad. Or simply too proud to accept that there are systems that are better funded and offer superior patient care than their 'national treasure' NHS that needs to be defended, no matter what.

You have news stories in the UK of ambulances queuing outside of hospitals, operations being cancelled routinely and patients drinking water out of vases.

How can people of a civilised, first world country like the UK accept these sort of things?

Maybe they need to see their own old granny die, neglected in an overcrowded and understaffed, dirty hospital ward like an old work colleague of mine unfortunately had to.

As I said before, not everything in Germany is perfect (and sorry to constantly bang on about Germany but it is the only other health system that I have recent direct experience with), but I am sure that if the above things happened over here, people would be up in arms.

And one more thing. If the UK introduced an insurance based system, the money would be ringfenced. The government could no longer decide how much or little tax money is spent on health, depending on when the next election is looming.

Paying more tax is not a vote winner in this country. Many countries in Europe have higher taxation and fewer inequalities - Denmark, Netherlands and Germany I suppose.

Working frontline NHS fir a few years, I found the NHS was actually frontline in dealing with 'shit life syndrome.' There is a huge section of society who are just unable to cope. They have chronic health conditions brought about by poverty: lung conditions, liver conditions, diabetes, mental health problems, prescription meds addiction. These are people unable to order their lives. And to being unwell is normal - everyone they know is unwell. For a company to make a profit out of treating these people is nigh on impossible. There is no cure. They are never 'better.'

The Tory government is in the process of running down services so that privatisation looks like the only option. It is a cynical exercise which is killing people every day.

We are a wealthy country. We are capable of having a good free health service without private companies being involved. You only need look at the lack of service and blatant profiteering going on in other privatised sectors to see how well it would go for our health service.

There is a huge section of society who are just unable to cope. They have chronic health conditions brought about by poverty: lung conditions, liver conditions, diabetes, mental health problems, prescription meds addiction. These are people unable to order their lives. And to being unwell is normal - everyone they know is unwell. For a company to make a profit out of treating these people is nigh on impossible. There is no cure. They are never 'better

But where are they in other countries? I really don't notice them to the same extent.
Are they looked after by families whereas we insist the state takes responsiblity.

you have news stories.... This is what happens when papers like the Daily Mail run a drip, drip, drip campaign against the NHS. Ambulance queues are only news because they are exceptional. Drinking water out of vases? How many patients? What vases? All the hospitals in my area ban flowers as an infection risk.

According to the CF figures, the UK was top in 'shorter waiting times'. And better than Germany (France and Canada) in treating the chronically sick.

In the German system, are private health insurance companies involved? Or is it National Insurance under another name? Surely the private companies have a say in charges, to ensure their profits? Our experience of Public Private Initiatives has not been a happy one.

Two instances of superlative care for you. My daughter's neighbour had chest pains at 4 a.m. His wife called 999. The ambulance arrived within 10 mins, 20 mins to specialist care centre and he was operated on within the hour. (Blocked artery.) Another friend had a similar experience. Major by-pass surgery equally swiftly after a 999 call. Different hospital.

I don't think people in the UK have different attitudes to their health. Don't know the figures, but vast numbers say they would be happy to pay more taxes to improve the NHS. I know people who have given up paying for private insurance, 'not worth it' and 'the NHS is better for serious stuff' and one with pre-existing conditions that was turned down.

I needed a CT scan. Two week 'could be cancer' pathway. Got an appointment for two and a half weeks. I wasn't in pain. Just very anxious. Thought I'd speed things up by having a private scan. Could have got one in a week, but then I'd have to pay for expert radiologist and consultant and would have to go back to the NHS for treatment. My doctor talked me out of it. Told me to ring my NHS consultant's secretary. She moved the appointment forward, cancellation, with an MRI thrown in, on the same day.

But I doubt if the Daily Mail would be interested.

In 'other countries' ?

Well in the USA people either fir if the condition, get into huge debt paying fir meds or use a fantastic healthcare package to get the treatment they need.

In Europe - well I suppose people are prepared to pay a greater proportion of their income into the system for the common good. Perhaps pressure is take off their health services with community care that is not run by private companies staffed by people on zero hours contracts with barely enough time to say hello to client.

I would gladly pay more into the pot for the NHS and other services. How lovely to be confident that when I am old there will be a system set up to care for me after all my years of paying National Insurance.

Community care - another example of privatisation leading to lower wages and inferior service.

It is a very, very difficult question. Of course we're massively lucky to have the NHS. I work with international students and they have nothing but praise for the NHS, coming from places like Iraq and Libya. I have the utmost respect for healthcare professionals, lots of my friends and family have worked in the NHS and I wouldn't want any of their jobs.

The NHS should not be above questioning, though. Healthcare which is free at the point of service should be a basic right and we should never feel that gratefulness should trump our right to question and complain if necessary.

I've never paid for healthcare and felt doing so was completely outwith my principles. But I went through MH services for Generalised Anxiety Disorder with the NHS and the waiting times and often identikit treatment (IME) can be utterly disastrous for people who don't need the crisis team right now but are in a slow, frightening process of suffering. I am only just starting to get better after many, many years of treatment which was never forthcoming when i needed it most. My DH has also experienced MH issues (was sectioned when he was young) and things are getting a bit tough again. He is eligible for free private care through his work and I am urging him to take it, rather than wait 3 months for CBT out of a one size fits all handbook.

This is purely personal. Ultimately i think the NHS is precious and that practitioners need more and better resources to keep going.

Thymeout Please google Stafford hospital and vases. This was reality and not something dreamt up by the DM.

The public insurance companies here in Germany are non-profit making companies that have to adhere to strict government implemented guidelines. The healthcare is provided by doctors and hospitals that have contracts with these insurance companies and these are (nationally) negotiated on a regular basis.

Patients can choose the doctors / hospitals treating them (within reason and certain guidelines). There is more competition and therefore more of an incentive to treat patients well. People vote with their feet and it is not in the interest of a healthcare provider to treat their patients badly as they would lose all their funds.

Little - I did. I also read the Squawkbox item further down pointing out the inconsistency regarding flowers being banned and vases of water on the ward. And the account of another family's experience on the same ward.

Something obviously went badly wrong at Stafford. There are also horrific cases of privately run care homes mistreating their residents. It's not representative of the NHS as a whole or in itself a reason for changing to a private system.

Competition exists in the community care system, of which I had 5 years' experience with my mother. The contracts come up for renewal. Another company puts in a lower bid. They get the new contract. A fresh set of carers for my demented mother. Chaos during the changeover. Lower wages, higher turnover of staff. The only competent manager I spoke to during this time was the LA manager who remembered the old days.

I think health (and education) are too important to be subject to the free market economy.

Thymeout Contracts here in Germany are nationally negotiated, i.e. any doctor / hospital working with the public insurance scheme is paid the same level for a certain service provided.

The competition between healthcare providers results from them trying to get patients to choose their service above that of others as doctors / hospitals with a bad reputation are likely to attract less patients which leads to less funds and possible closure.

For every "Stafford" tbough there is a hell of a lot more good, or even outstanding stuff going on. Of course that doesn't fit any media agenda though.

Things go wrong in any health care system. There is no such thing as a perfect system.

Last night DS woke up with a severe case of croup. Home treatment didn't work so we went to a and e. We were in, out and treated within 2 hours and that included just over an hours observation time after he had been treated to check he didn't need admitting.

Sirzy For every 'Stafford' though there is hell of a lot more good ...

Sorry, Sirzy but there should not be a Stafford, EVER. Not in a civilised first world country like the UK. It should not and cannot be cancelled out by the good things the NHS does.

Doctors are paid a lot less on Germany. We had German doctors working in the Uk because the pay is so much higher.