Why do people think the NHS is so special?

[SnowBells]

There are always people around who proclaim the NHS is some sort of holy grail. It can't be touched, and don't even think about reforming it. The government may be offering free healthcare through the NHS, but nothing is really free, is it?!

My gripe with the NHS is that just like most institutions funded by the government, it becomes a big bureaucratic mess, where people are more concerned about ticking boxes than the actual patients. Most other developed countries have some sort of free healthcare that can actually be more effective than the NHS. I have lived in countries where, for example, health care insurances are mandatory, so that everyone has one (and a lot of times, employers contribute the bulk or the government subsidises it). Hospitals may be subsidised by the government, but GPs run their practice like a business, and rely on clients to earn their living (this means, they actually have to provide a bit of "client service" that's almost elusive here in Britain). You can make appointments with specialists directly - no need to waste time at the GP's practice when really, you needed to see, say, a gynaecologist.

Why is it that some hail is as the holy grail?

Am starting to think all these NHS critique threads are trolls or Tory interns ??

xiaozhu

I have clearly stated DEVELOPED COUNTRIES in my OP. The term used was not a coincidence. I am very much aware there are other countries that have no free health service.

By your example, we should not improve the trains/railway network in this country either, because - hey ho - the trains of developing countries are worse. And yet, there are other countries where even a 10-minute delay is seen not acceptable.

Taking your point of view, the UK will never be able to compete on top... it will always be middle of the range. Not too bad, but not great either... which is obviously fine if you are comparing it to a developing nation, but it is incredibly uninspiring that people think it can't be better.

And by the way... yes, I have lived in a developing country, too. Doesn't stop me from wanting improvements.

But the NHS is always getting criticised!! Waiting lists for operations, waiting times in a&e, services closing down, its in the news everyday. The point is people do want it to be improved on.

Insurance based healthcare isnt just 'better' because its private, its probably because it has more money. I wouldnt object to the government increasing National Insurance to help fund the improvements that are required. This never seems to be talked about just the same old about insurance.

I have insurance for every fucking thing and i must say that i dont trust them with a barge pole. They would do anything to get out of paying for something because their objective is to make money, not customer care like you bizarrely think.

NHS is wonderful and a main reason so many people try to come to the UK. There is huge migration from where I live of people who cannot afford health insurance to the UK.

I wish it was a viable option for every country in the world. I hope one day it will be.

Op - who has said it can't be better? That has certainly never been the ethos in any bit of the nhs I have worked in.

Acute care in the NHS is great. Long term conditions and mental health are utterly appalling and subject to a postcode lottery. For mental health in particular the UK is a disgrace. Not the fault of practitioners but the continual messing around and interference by successive governments and bogged down by bureaucracy. And I've experience of health care in a fair few countries. For mental health the Netherlands is outstanding.

It is heartening to read on this thread how much people value the nhs despite its shortcomings, and how the fantastic work is recognised

applecatchers36

I have not seen other NHS critique threads.

And why should the NHS be beyond criticism? Is there some sort of NHS infallibility written somewhere in dogma like that of the pope that I don't know of? The pope still gets criticised, by the way, regardless of that dogma.

You want to see a nasty bureaucratic mess, come here to the US and deal with our byzantine health insurance system. I expect to get attacked by historians who study the Byzantine empire for giving the Byzantines a bad name by comparing them to our train wreck of a health insurance system, but there really isn't a word in English for "byzantine, but way worse".

A story: My DM, who lives in Maryland, came to visit me when I lived in California. One night, she had severe stomach cramps. She and DF looked for a hospital that would take their insurance near where I lived (not the hospital nearest to where I lived), and we took her to the hospital. She was in the hospital for a week, basically getting tests- they never found out what was wrong. Her insurance decided they didn't want to pay for this, because she hadn't gotten prior authorization from her doctor (when she was 3000 miles away from her doctor, at 1 in the morning). The hospital sent me a bill for $40,000 (about 25,900 pounds at current exchange rates). Fortunately, she and DF did somehow convince the insurance company to pay. I don't know how. I hope there was violence involved.

And if you work for a company where the high mucky-mucks decide they're against birth control, your insurance can decide not to pay for birth control (you could fill the universe with 's, and there still wouldn't be enough 's to express how I feel about this)

Of course, the people who decide that the insurance company shouldn't have to pay for an unauthorized hospital stay don't work for free (even if they clearly have no souls). And there are lots of them, because there are lots of different insurance companies. A lot more of the money we spend on health care goes to insurance company overhead like this than does in the UK or Canada. We spend more per capita on health care than literally any other country in the world. 62% of people who file for bankruptcy cite high health care costs as a reason. It's ugly.

applecatcher, I think so, as the OP seems unable to perceive or respond to any of the posts I've made on this thread and keeps saying no one will compare to other developed countries.

Truthiness vs data. I know which I prefer.

They saved my dh' s life. They will be performing life saving surgery on my db next week.
They were responsible for the safe delivery of both my dc.

you must live in a bubble if you think the NHS isnt criticised. If it werent then surely your OP would be profound and insightful as we wpuld be unaware of its shortcomings. We are aware but a lot of people just dont agree with it being resolved by paying private insurance companies.

"German doctors get paid by the patient's insurance for every service performed."

is this private insurance or govt. insurance?

In a system where the doctor regards the patient as a customer, there must be lots of problems.

Dr: You have a cold. I'm afraid I can do nothing to cure that. Go home and rest. Take plenty of fluids.

Patient: I want antibiotics.

Dr: You don't have a bacterial infection. Antibiotics will do you no good.

Patient: Look, who's the customer here? Write me a prescription for antibiotics. I come here feeling like death, I'm paying £xxx for this consultation and you want to send me away with nothing in return!

Geekymommy the wry style of your post made me smile, though very glad of course that your dm was ok and you managed to get the money sorted. Thank goodness we don't have to think about that when ringing for an ambulance at 1am.

Can I say this one last time - the nhs welcomes criticism and actively takes on feedback to help improve services.

Snowbells: I obviously didn't read your post properly. I agree that things could be better, especially in comparison with other developed countries.

No need for the shouty capitals...

I don't think you can generalise about such a huge organisation. There are parts of the NHS that are absolutely wonderful-as good as anything anywhere in the world, in fact, and parts that are awful, with all shades inbetween represented as well.

A relative goes to a specialist hospital in London who are world leaders in his disease. The care he gets there is wonderful. We've had DC referred to another London hospital and were very impressed with the treatment on offer (as was my American relative when his child was there).

And then there are the bits that don't work. My mother's GP surgery, for example, which currently features a 3 week wait for a routine appointment, only one really caring and thorough doctor and a distinct lack of administrative competence.

The geriatric ward at Hull Royal Informary, where someone I know was admitted. We went to visit. A large puddle of urine left on the floor. A corpse in another bed (seriously!) not even screened off. Weak old ladies who had not been fed, given drinks, or washed. Everywhere dirt and a distinct lack of interest in patients. I was frightened by that.

Having said you can't really generalise, I'm going to, a bit: I think the NHS is very good at public health stuff like vaccines. It is also very good at emergency things, from major incidents and epidemics to individual emergency needs. It often seems to be very poor at managing chronic conditions or diagnostics, with too much 'wait and see' or outright fobbing off. That's probably partly cultural, partly budgetary.

My maternity care was mixed: excellent consultants and other doctors, midwives good and bad, overall too stretched and the whole culture not considerate enough of mothers' needs.

NHS mental health provision is a national scandal.

And the basic conditions on wards seem to be deteriorating (from my experience of 5 hospitals over the last 3 years).

Oh, and my experience of private insurance companies is that they are money-grubbing pirates who will leave you in the lurch with cover refused or withdrawn without a backward glance, and provide you with distinctly mediocre medical care, albeit in premises with decent decor and flowers in reception.

in other countries you have to pay or die in pain

There are always people around who proclaim the NHS is some sort of holy grail. It can't be touched, and don't even think about reforming it. The government may be offering free healthcare through the NHS, but nothing is really free, is it?!

Well it isn't free at all, because we all pay for it through our taxes. But we all pay for it, so that we can all access it - so it's 'free' when you need it. We don't need to worry about whether or not we can afford to go to the doctor.

My gripe with the NHS is that just like most institutions funded by the government, it becomes a big bureaucratic mess, where people are more concerned about ticking boxes than the actual patients.

How do you know this? Can you prove this statement?

Most other developed countries have some sort of free healthcare that can actually be more effective than the NHS.

More effective in what way? And how 'free'?

I have lived in countries where, for example, health care insurances are mandatory, so that everyone has one (and a lot of times, employers contribute the bulk or the government subsidises it).

What happens if you can't afford this insurance - which will be on top of whatever tax you're paying. Who is organising the insurance - oh, yes, that will be insurance companies. Who are making a profit out of it.

Hospitals may be subsidised by the government, but GPs run their practice like a business, and rely on clients to earn their living (this means, they actually have to provide a bit of "client service" that's almost elusive here in Britain).

I don't want the people who are responsible for my medical care to be entrepreneurs, working in the field to make a profit out of me.

Where is your proof that 'client service' is elusive?

You can make appointments with specialists directly - no need to waste time at the GP's practice when really, you needed to see, say, a gynaecologist.

That's all well and good, but sometimes you don't know who you're going to need to see. Which could be a very big waste of time (yours and the various specialists) as you trail from one to another, rather than being diagnosed by the GP first and then sent to the appropriate specialist.

Why is it that some hail is as the holy grail?

Because I think you'll find that

a) we like not having to pay for it
b) in the main, people have pretty good experiences of it
c) we like the security of knowing it's there to look after us/deal with our medical problems rather than how much money they are going to make from us

My experiences with the NHS can charitably be described as "mixed".

I, personally, have had one lovely experience in a hospital. I have also had one which was awful. I had to wait months for one op, the other was done very quickly.

My grandmother had the most appalling treatment when she was in last year after having a heart attack.

The NHS buggered about with my father for 7 years with this severe chronic pain in his side. They put him through all kinds of horrible treatment (spinal injections, exploratory operations etc), but it baffled them. So eventually my dad went to see a private consultant. The kidney stone, missed and completely undiagnosed by the NHS team for the previous 7 years, which was causing all the problems, was removed inside of two weeks.

When I have had to use the American system, it's been a dream to be honest. I've been in to the docs for one thing whilst over there, as has my mum and my grandfather once had to be hospitalised whilst we were in Florida. Everything has been quick, efficient and professional. We were insured up to the hilt, naturally.

I would not like to see a move to a carbon copy of the American system in the UK. There are huge failings in the USA's healthcare, just as there are in the NHS. However I do believe there must be something we can learn from it. This is where I believe privatisation may be the answer. Please note I said may.

Oh - and I didn't pay a thing. The health care insurance did. Every citizen had to have insurance - by law

but....you paid for the insurance?

I'm a mental health nurse and I've worked both within the NHS and privately. iMO the NHS works much better for both the patient and the staff.

Private healthcare, to me, is all about profit and this is my gripe with it. I worked in a secure units which took ECR referrals from the NHS. So although it was private, the fund holders were the NHS....they paid us to take very difficult patients. They were often kept there long after they were able (imo) to return to an open ward. We also had patients on close obs for long periods of time, and the extra costs of this staffing was paid for by the NHS. It was all profit, profit, profit. Although the pay was better in the private sector I went back to the NHS cos I didn't like the way it worked.

For the staff, I felt that the pension scheme was better in the NHS and also there is more recognition of unions.

I'm not knocking private care if you can afford it, though I'm happy to remain with the NHS for my care. However I acknowledge that those who go privately to lessen waiting lists.

I don't agree with referring ourselves to specialist care. GPs are at the very centre of healthcare and should remain so. GPs ain't stupid, they can manage a lot of medical problems in primary care. If people referred themselves it would increase waiting lists for out patient appointments. Also it would mean people turning to Dr Google and then deciding to refer themselves going on that. I'm in community mental health, and while we take self referrals, we prefer it if it came through GPs as they are central to the patient's care. Also there are a number of measures the GP can do in primary care eg medication, counselling, CBT etc. once a client is known to us, if they do self refer, we know more about how they present, past treatment, and can therefore be better placed to advise and support them.

I live in Ireland and I have to pay 50 euro each time to see the GP for myself and son (12). I then have to pay full price for medicines prescribed.
My insurance for the year is 3000 euro which gives me back 40% of this - but you still have to pay it first.
A&E is 100 euro per visit. They do bill you after the visit for this.
I am fortunate that I can manage these infrequent additional charges but there are many who cannot. There are many who may be choosing whether to do a food shop or take their child to a doctor. This is not the case in the UK.

Not being able to refer yourself to specialist care isn't unique to the NHS. My insurance here in the US requires a referral to see any specialist other than a gynecologist.

Having to wait to see a doctor (or especially a specialist) isn't unheard of here, either. I had an infected sebaceous cyst on my back, which was painful, and I had to wait several weeks to get it removed.