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.

Dogmatic views on the NHS just shut down debate on something that people are 'allowed' to question in a democratic society - it's called 'freedom of speech'. What 'help' is is to tell people to fuck off and go private just simply because people are offended by the contentious issue of the NHS being questioned.

walking around*

'A mere 110bn per year' would be a fair point if it weren't for the fact that it's taken completely out of context. As a proportion of GDP, we spend less on healthcare than every comparable advanced economy. The NHS is consistently rated the most efficient healthcare system in the developed world (yes, counter to Tory tabloid propaganda), and was ranked the overall best in the world by the Washington-based Commonwealth Institute in 2014.

You are right to suggest that the complete absence of payment/co-payment does allow/encourage abuse, especially of A&E (one of the most expensive entry points to the system).

The simple answer is that we don't pay enough. We get the best system possible for what we're willing to contribute. The arch irony is that the right-wingers who want to privatise the system will actually end up paying considerably more with a private insurance system than they currently do, while those at the bottom of the pile will be screwed, frankly.

I say this as a Director of an NHS hospital, who was worked across sectors and industries, and has a background in management consultancy. I am stating these facts from a purely fact-based, non-ideological point of view.

RabidFairy
I don't mean to sound like a conspiracy theory nutjob but have you read some of the replies? They literally do read like they are from people who have been brainwashed and are unable to see any flaws and unable to acknowledge that many people have had horrific experiences.

I don't deny the NHS has provided excellent care to many people. However those same people seem blind to the fact that many others have been badly let down - and IMO it is too many people to be 'exceptional' cases.

Unfortunately anyone expecting a Labour government to do anything differently or better is going to be disappointed. Look at the mess in (Labour-controlled) NHS Wales.

It's not a Human Right to not be offended and it really detracts from 'debate' as people get caught up with debating what they are not 'comfortable' with- get over yourself!

Evidence here:

Efficiency: www.ncbi.nlm.nih.gov/pmc/articles/PMC3147241/

Overall effectiveness: www.theguardian.com/society/2014/jun/17/nhs-health

The Commonwealth Institute is about as unbiased as the Daily Heil!

Babycham I would be interested in your theory as to why there were no productivity improvements under Labour when they (rightly imo) increased the funding towards more European levels? The only change I noticed was an increase in the number of Jags in the consultants' car park when I collected DH from work.

OP, you seem to be the brainwashed one. I'm providing links to impartial, evidence-based international studies that completely refute your anecdotal experience and Daily Mail propaganda yet you still don't want to hear it. Now who's the brainwashed cult member?

Interesting commentary here:

www.iea.org.uk/blog/the-envy-of-the-world-a-closer-look-at-the-commonwealth-fund-healthcare-study

Since when was the Grauniad "impartial and evidence-based?!"

As someone who had a child that takes several hundred pounds worth of medication before breakfast everyday and then another couple of hundred during the day, I don't see how there is anyway we'd manage without the nhs.
Both my elder children and I would be dead by now.
I've also been in the position of paying for emergency health care and medication in another country and it crippled us to the point that we had to return home to the uk.

Youngirl, apologies, I meant Commonwealth Fund. Can you explain why a privately funded, US-based, non-partisan academic institute is as biased as the formerly Nazi-supporting Daily Mail?

Many of the 'improvements' made under New Labour's investment years were qualitative changes that won't directly affect productivity, such as new hospital buildings and equipment. British hospitals in the 1980s were like something from the GDR.

It's true that some of this investment was also 'lost' on higher wages, but this was needed in order to recruit and retain and fill the massive workforce shortfalls that couldn't be plugged with foreign labour, in order to improve care quality.

The consultants point is moot. More than half the typical consultant's pay will come from private practice anyway, so they can comfortably afford a Jag or two without their basic NHS sessions.

Finally, the effect of investment in healthcare will not be instantaneous (especially during a period of sustained mass immigration from developing countries and the subsequent statistical negative effect on health-outcomes that brings). Our health outcomes are actually remarkably good in the context of our lifestyles. The UK has worse inequality, a worse diet, dreadful weather, poor working conditions and high social fragmentation. Yet we still live as long as most of our peer nations. Why? Because of our socialised health system.

My personal experience of the NHS is limited but both MIL and FIL have had underwhelming experiences. MIL was fobbed off with 'lose some weight' when she repeatedly reported uncomfortable stomach symptoms. She turned out to have a cyst the size of a football

FIL, on the other hand, was repeatedly told by the same fucking useless GP that his headaches were just ageing and to stop malingering. Then he collapsed, and died five months later of a brain cancer that by the time it was detected was untreatable

The whole NHS 'religion' is just a frenzy whipped up by the Labour Party in an attempt to divert attention from the economy which no-one trusts them to run. Personally I don't understand the issue with having healthcare provided by a range of suppliers, as long as it's delivered where needed and available whether the patient is rich or poor. All the frothing about privatisation smells to me just a teeny bit like a cartel protecting its own interests.

Youngirl, the Guardian was the secondary reference; I didn't link to the Commonwealth Fund study as it's a huge PDF. It's easily searchable via the Grauniad article though.

You're really not very bright, are you?

Yabvvvvu, the alternative is not better at all. I read of an article whereas somebody who lived in the US for 20 years and UK 20 years, compared the health care systems, he said that the UK NHS was far better. My treatment in the NHS has been very positive.

Yabu. I don't live in the UK at the moment and am in a medical insurance based living situation, luckily my husbands company is now paying for this (it wasn't for two years as we had to pay extra for maternity cover). I have given birth to two children under this system, 1 c-section 1 vbac. The total for these births came close to £18k, a nights stay at our hospital was £750. Our insurance now does not cover check ups or vaccinations and this can cost us (out of pocket) up to £400-500 a visit depending on what jabs the kids need. £90-100 of this is for the appointment alone.

I know the NHS isn't perfect and it needs some form of change to insure its survival, but we are lucky in the UK to have access to first rate medical care. A friend of mine has just had to fly back to the UK to get an appointment for her baby son (covered by her insurance, before people start shouting NHS tourist) for a doctor to check out a cyst/tumour as the doctors here just aren't able/equipped to deal with it here. She was told that the doctor she would be seeing is one of the top doctors of his field in the world. His services and knowledge are free to UK residents.

This is why we are lucky to have the NHS

I agree with the general theme of the discussion here. We are so very lucky BUT that doesn't mean the whole thing is run properly - it isn't.

When my DS was ill, and very nearly died, the service was amazing. They saved his life. They did everything they could. They were on the phone at his bedside to specialists in other hospitals, they got him well again. It cost me nothing.

However, I cannot get a GP appointment for two weeks. I went to A and E recently and it was full of time-wasters, (someone who wanted a rash checked out before she went on holiday - it was hives!). I went for a follow-up appointment recently at hospital and waited two hours. When I saw the consultant he said "I have no idea why you are here and I don't have any notes and haven't seen your scans".

In the meantime my elderly mother is treated like a nuisance and when I took her to A&E recently with two broken wrists it was five hours before she was seen and she was in so much pain.

I am interested to read some of these suggestions and experiences and it will be good to get a full and reasoned debate about it.

If you read the article I posted, it explains why the CF report is skewed towards statist systems. The last paragraph is particularly interesting.

DH is a consultant so yes this is anecdotal, but he earns six figures from the NHS and manages to be home by 6pm despite seeing over twice as many patients as the NHS recommends. Lovely for us (!) but sustainable from tax revenue long-term? Doubtful. The recruitment and retention point is impossible to prove or disprove since the NHS is the only show in town.

I would actually be in favour of allowing people to opt in or out once and for all. If the NHS is as good as you claim for the majority, there is no reason why everyone would not sign up. If it's as bad as some people on this thread have experienced, we may get a European system with higher quality care that is not supplied by a monopoly government provider. Having lived abroad under a social insurance system, I would choose the latter.

You're really not very bright are you?

No dear, I only have a Masters in comparative health law. Apart from that I haven't got a fucking clue.

But well done for so ably demonstrating the OP's original point about suppressing debate.

I hate to say it, but I do think some system of co-payment would be a powerful disincentive to time-wasters both at A&E and in GP practices. Far too many people feel able to abuse the system and indulge their hypochondria/attention seeking behaviour because it's free.

However, currently 90% of prescriptions (yes, 90 bloody percent!) are issued for free. Any system of co-payment would likely subsidise those same frequent-flyers, pretty much defeating the whole point of it! The 10% who would be charged are the ones least likely to abuse the system anyway!

Younggirl, the Institute of Economic Affairs describe themselves as a free market think-tank (and offer links and references to the Adam Smith Institute). Now, they really are as unbiased as the Daily Heil!

I'm still waiting for you to explain how the Commonwealth Fund or the US National Institute of Health are partisan in favour of socialised healthcare? Surely, they're anything but?

Life expectancy, infant mortality, administration costs etc etc etc in the US all demonstrate just how effective a free market is in healthcare provision.

I don't think YABU OP. I used to be a believer too, how lucky we were, best in world etc. Then I emmigrated and the difference in service was eye opening.

Where do I suggest I favour the US system? For the record, it's probably the only system worse than the one we have now, in my opinion. Therefore US infant mortality etc is totally irrelevant.

If you want to know why the CF is partisan in favour of socialised healthcare, then I suggest you ask Google, and stop hijacking the thread in order to post abusive comments towards people who happen to disagree with you.

Yes!