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.

Looks like our GPs are over-payed (they're privately self-employed, remember), but our specialists are not. I would be the first to argue doctors get too much money under the current system, but I'd bet my mortgage that any break-up of the NHS or privatisation (and the subsequent competition for skilled labour) would drive wages up further. This is more to do with the fact that we've trained too few doctors, and relied on imported labour to fill some of the shortfall (which is the same problem as with nurses, predictably);

www.motherjones.com/kevin-drum/2013/02/charts-day-doctor-pay-america-and-other-countries

Babycham1979, you may be able to help me. My DH needed relatively surgery on his knee. Available on the NHS with a 4 month wait. Our (very good) GP consulted some paperwork and said that the cost of the procedure to the NHS was £3,400.

Our local (private) Knee Clinic was able to perform the surgery (plus consultation, scan and physio) for £1800.

Am I comparing apples with apples?

Ooops, overpaid*

Relatively minor

Looks like our GPs are over-payed

A practice is funded around £80 per year per registered patient as basic funding. That has to pay for the doctors, nurses, cleaners, admin staff, consumables, heat/light/insure the building etc etc etc.

Do let me know where else you can insure even a hamster for that sort of money.

I've worked in it and would say the best thing that could happen to it is to contract out to more private services.

I have never worked in the public sector before and was shocked at the top heavy organisation, the bureaucracy and the sheer incompetence and laziness of the staff.

We had on one occasion something happen due to a staff members incompetence which meant a young patient had to have surgery and when I questioned why the staff member responsible wasn't immediately suspended and heavily disciplined (in the private sector they would have been sacked) the HR manager said that he would just go off sick with stress for 6 months on full pay and after that it would be almost impossible to sack him.

Grovel, private clinics do provide some services cheaper and quicker (hip and knee factories pile them high and sell them cheap). The price your GP will be referring to is the tariff they receive from the commissioners (the retail price, if you like), not the cost of providing the service.

The private provider will, understandably, undercut this, usually by ensuring a much earlier discharge, lower wages and worse pensions for staff (excluding the surgeons) and little or no follow-up care (such as physio, wound-dressing etc etc).

However, and this is the important bit - the tariff that providers are paid sometimes cover the cost of provision and sometimes don't. Hospitals make 'profit' on surgery, but usually lose money on medicine (ie every A&E patient). Obviously, private providers don't have to take emergencies or frail, vulnerable elderly patients, and so cherry-pick the profitable procedures.

It's tempting for commissioners to refer to private providers for short-term savings, but it ultimately destabilises your local district general hospital by driving them into the red. This isn't a small quirk of the system; it's a huge, endemic problem.

Circle Health Ltd failed to make a success of Hitchinbrook hospital because they overestimated their ability to cherry-pick, and under-estimated the loss they'd make on medicine and non-elective patients.

madame not surprised in the least. A friend of mine lost a son to meningitis and the GP who let him down gave an entirely false account of an examination that did not take place. She is still in practice.

It's terrifying.

Has anyone mentioned the Swiss Healthcare System?

en.wikipedia.org/wiki/Health_care_in_Switzerland

As the NHS effectively killed my grandmother last week I can categorically say that I believe the system is flawed, twisted and impossible to fix.

Can anyone explain to me why our NHS, which isn't bloody free - I pay a healthy amount of NI just the same as most people - is an improvement on the Swiss system detailed above?

Letsplayscrabble, GPs typicall earn £102,000 to £142,000. That puts them in the 90th percentile of earnings in the UK.

They may get £80 per patient, but when you've got 20,000 patients on the roll, that's not a bad screw.

As someone who has in the past experienced the US system with limited insurance provided by my employer, and a UK citizen who grew up with the NHS I wouldn't wish the private insurance US system on my worst enemy.
See this article, which rings very true of my own experience.
uk.businessinsider.com/an-american-uses-britain-nhs-2015-1

For those shouting about going private, some of us actually have.

I have private healthcare as part of my benefits through work. Pay a not inconsiderable amount of tax for it too. But I struggle to use it as it only kicks in when your GP refers you which 9 times out of 10 my surgery won't regardless of the fact it won't cost them anything from their budget beyond writing a letter.

I did manage to talk them into it for my ganglion last year but I had to be bloody pushy to make it happen. Fast growing ganglion that was causing significant pain and limiting movement in my hand. NHS option - leave it until you can't use your hand at all. Private option - needle aspiration within 2 weeks with one the country's top consultants.

I'm now seriously looking for a properly private GP in my area to come out of the NHS system completely.

The NHS is a marvelous thing but its fucked and the sooner we realise it the better.

YANBU.

The people who think that the NHS is amazing (or even just acceptable) have never experienced a system that actually works. Where I am in Germany it is normal to have same day appointments, quick referrals and clean hospitals (and I have heard similar from friends/family in France, Belgium and Luxembourg).

In Germany you do need to pay a compulsory percentage of your income towards a public healthcare insurance and so does your employer. However, unlike in the U.S. you are not kicked out of if you can no longer contribute in the case of unemployment, illness etc. And as it has been mentioned several times before; the NHS is not free ... you pay with your taxes.

The big difference I can see is that the UK system is much more open to abuse by people from abroad who have never contributed. When we moved to Germany we were only allowed to access their system after meeting certain eligibility criteria such as a German work contract and proof from HMRC that we had previously paid UK national insurance contributions.

Yes I agree it's not perfect but my goodness when you really need it the NHS is amazing!! My son and I would no doubt be dead without the amazing care we received just before and in the weeks after he was born. The antenatal care I received with my daughter to ensure the same didn't happen again was also fantastic. I am extremely grateful for the NHS allowing me to safely have a family.

The general population is helping to bring it to its knees, not just the politicians.

If people learned to take some responsibility for their health and wellbeing and stopped treating their local GP as some sort of parent/guru/miracle worker, then things would be a lot easier on the system.

Trotting along to the GP or A&E with things that are easily dealt with at home - as they were years ago - would certainly help. Missing appointments and un-needed medication also represents a huge waste of resources.

People are too demanding and expect too much now.

Babycham, thanks for that.

I think they should start charging people now too. People value things if they have to stick their hand in their pocket. Even a fiver would be something.

The NHS is a marvelous thing but its fucked and the sooner we realise it the better

I don't disagree with this. The sad thing is that you can replace 'NHS' with pensions, universities, schools, the UKBA, British railway network, parliamentary democracy, the Royal Family etc etc etc.

The uncomfortable truth is that the post-war settlement is over. The Thatcher Government ushered in a revolution; decades of under-investment, social fragmentation and privatisation (in every sense of the word) have undermined that model for society and now it's all fucked.

There are lots of great things about this country, but there's plenty that's obsolescent and not fit-for-purpose. It all needs a massive overhaul, and the sad reality is, that if/when this finally happens, it will leave nothing but a residual safety-net for the poorest and most vulnerable.

Agree 100% babycham

I'm in Sweden. Here we get charged £10 to see a doctor (with a yearly cap) but everything that follows on from that first appointment is free. If my dr orders tests I go to the lab down the corridor to have then done, then wait for 10 minutes or so to see the gp again once the results are in. When DH was having problems which the gp thought might be cancer he was referred to the hospital for tests and told he'd get a phone call with an appointment. We were surprised to get a phone call just an hour later with an appointment for the next day, and an apology because they were short staffed so couldn't fit him in that day.

uk.businessinsider.com/an-american-uses-britain-nhs-2015-1
This Rolls Royce isn't moving fast enough

drjengunter.wordpress.com/2014/08/12/an-american-doctor-experiences-an-nhs-emergency-room/
Do you have a spare £1000 to pay for dust in your eye?

www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror

Crap compared with What?

Patrician are you sure the GP knows you have private healthcare? I can't think of any reason why they would not refer you if you have insurance cover as it costs them nothing.

The BMI specialists I see for cancer follow up have never insisted on a GP referral, but I think technically they could/should have. DH receives PP referrals from surgeons and other consultant colleagues so it may not even need to be a GP.

My ultra left wing mother was bullied (by me and DSis!) into using her insurance for a suspect mole that her GP thought was "nothing to worry about". Of course, when she saw a dermatologist privately for a biopsy, it was a BCC. I gather they are very unlikely to spread but still probably a good idea to get cancerous cells removed asap.

I don't envy the GP's job of deciding who has a serious problem and who doesn't based on a 10 minute chat, but the present system of guessing/winging it doesn't seem to work too well.

Babycham1979
"You're really not very bright, are you?"

"that completely refute your anecdotal experience and Daily Mail propaganda yet you still don't want to hear it."

So personal insult followed by telling me my "anecdotal" experience isn't valid because it doesn't show things in a positive light and conform to your experience/opinion/views. You raise the issue of NHS vs US system when I have not mentioned the US system. I'm not sure anybody would want to model the US system.

You slag off the daily mail (rightly so) but then claim the guardian is impartial...

Your posts highlight part of what I was trying to get at in my OP. Any criticism of the NHS leads to a borderline hysterical response from a significant portion of the population. I feel this is an attempt to shut down any debate really.

babycham
GPs typicall earn £102,000 to £142,000. That puts them in the 90th percentile of earnings in the UK.

Out of genuine interest, where at the figures for this? I find it hard to believe my GP earns anything like this judging by objective criteria of the areas they live in and the cars in the carpark!

I don't think GPs are overpaid. We have a big shortage of GPs and one of the main reasons for that is the insane workload and poor working conditions.

eyebags

Don't worry, it's me who is not terribly bright! Nice.