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?

I still think that things will come in by stealth. Pay to see your GP ( as we do for nhs dentists) , then paying to go to A and E ( maybe if its self inflicted problem, too much to drink, drug induced etc) a gruadual change. Just my opinion but Ican see one of our future governments doing this.

someone up thread said postnatal care was dreadful: not mine nor anyone I know and I had a hideous medical problem after my 2nd child.

The NHS can be brilliant and awful: they misdiagnosed my son's stroke - but then, after a tantrum (mine), they got someone else and he was sent off to the best children's hospital in the world IMHO where the care was exceptional. However, back at the local, the care was dire and we ended up leaving and getting my mum to give him the heparin injections he needed. My recent care for an infected cyst was a bit shite. But when it was eventually removed it was ace.

My GP surgery is excellent. My local hospital is crap in every area I've been in. So it's up and down, good and bad. But it is certainly better than the substandard expensive care I had in the middle east, where I had brilliant health insurance that didn't turn out to be that brilliant when it was really needed.

Yes it needs improvement but insurance isn't the answer and surely any sane person realises that. Customer service, health for profit? Or maybe they are sane, just immune to the needs of others less fortunate than themselves. "Most of us can afford £45 to see a GP" Really? Who actually thinks that? What bubble do you live in to not realise there are people who couldn't afford £20, £10, £5....

Many of my family members have worked in the NHS all their lives. Some went to work in private. All say the same: when the shit hits the fan you want to be in the NHS. And yes, almost all of those private specialists and surgeons work in the NHS too, its usually how they gained their experience and specialism and became so damn good at their jobs.

It isn't the holy grail, but thank fuck we have it. And thank fuck we have enough people rooting for it, for now.

How do you know this? Can you prove this statement

Google is your friend. Type in "NHS box ticking" and you will get a lot of results. In fact Google's predictive text suggests the above term. It's a target-heavy organisation that no longer really looks at patients, but at stats

Google may be my friend, but that doesn't mean that it produces reliable results. Anyone can post anything which might get picked up by Google.

Where is your genuine evidence that this is a problem? And, just as a clue, the Daily Mail or The Daily Telegraph editorials don't count.

More effective in what way? And how 'free'?
Please read the post of someonestolemynick. It's obviously free elsewhere.

Actually, I'd like you to answer this question.

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.
In Germany, for example (and other EU countries, too), health insurance is compulsory. There are two types of insurances: Statutory health insurance and Private health insurance. The former is non-profit and designed for employees earning below €50k, as well as those on benefits. Rates are low. For employees, rates are paid with joint employer-employee contributions. For those on benefits, municipalities pay the fees. Nearly 90% of the population are covered under this scheme. The rest have private health insurance - which may give you nicer rooms in hospital, access to select few private hospitals (e.g. my mum gave birth in a private hospital that did not accept those with a statutory health insurance, but neither does the Portland accept NHS, right?). From experience, what you got outside of hospital was fairly similar. I was covered private, friends had the statutory one, and we went to the same doctors, specialists, etc.

You are (wilfully?) missing my point. If insurance companies are involved, there is a profit motive.

Where is your proof that 'client service' is elusive?
Experience. Am I not able to draw conclusion from experience?

As is often said on Mumsnet, the plural of anecdote is not data. Please supply me with the data to prove this.

Because healthcare should be about the best course of treatment for every person, not the quality of their insurance.

Mismanagement is not unique to public bodies!

Fannydabbydozey

someone up thread said postnatal care was dreadful: not mine nor anyone I know and I had a hideous medical problem after my 2nd child.

That would be me!

Count yourself lucky. I almost died and several of my friends can't even talk about their experiences they were so horrific. I'm waiting for my debrief as I've only just been able to muster the courage to find out why things went so wrong at the time they did. Disclaimer: I wept when my midwife went on annual leave a few days postpartum. She was quite literally angel pretending to be human. I'm never this woo btw, talking about angels and such

I've several post natal experiences and will compare maternity wards to some sort of inner circle of hell. Even when I've been in private rooms. Maybe it's me?!

The NHS saved my life last year that makes them pretty special in my eyes.

There's been comparisons to Ireland frequently enough on this thread. So it's not just the US being used as a comparison. There's a large proportion of the Irish population where health insurance isn't an option, but there is no free at source treatment (GP, A&E and perscription drugs) so they aren't seeking medical help when needed. You pay through taxes and at source. There's people dying on trollys and the hospitals (non private that is) are overstretched.

Drugs are expensive, more expensive than you realise if you don't have to pay for them. The NHS means you don't hesitated when you child is sick wondering about the cost. I've already mentioned about treating eczema, it's not cheap, so what happens when money's an issue.

if it's not brilliant when you pay for it I can't understand why it's expected to be unwaveringly faultless when it's free (at source). The expectations of the NHS are certainly high. But no health service is faultless free or paid for.

I just got back from America where a very quick trip to the Doctor for my 12 year old son cost us 400 Dollars. I for one am very grateful for the NHS.

The NHS saved my life. But then so did the US system.

Based on that, do we think the US system is 'pretty special'?

lertgush I guess the difference being that you are less likely to be bankrupted by using the NHS...

Ahem. I live in France and there is nothing free about the healthcare here. The government pays for some (what it says treatment should cost), the practitioner charges what they believe it should cost ( usually significantly more than the gov will fund) and the punter either makes up the shortfall via extortionately expensive 'top up' insurance or just sucks it up. Only certain approved treatments / medications are on the 100% reimbursement list. And most now have to be accessed via a GP, because the system of allowing people to go straight to specialists for every twinge was bankrupting the country!

Long live thé NHS. Like the BBC, you don't half miss it once you can't use it.

Why do I think the NHS is so special?
Because I've lived in America, and seen what happens to people who are neither insured, nor picked up by the (limited) state coverage.

The only healthcare system in the world that would have brought my family member back to working health is the NHS
I've looked into it in great detail over many years
NO OTHER system would allow that person to return to taxpaying work

and as it is she'll die before me despite being much younger than me
US healthcare my arse

The system is massively flawed. I need to see a neurologist and yet my GP has been barred from referring me so I'm passed onto specialist GP run clinics run by drs who freely admit I need to see a neurologist! For chronic life affecting but not life limiting conditions the nhs is crap.

Saying that. I recently had a serious health issue, called 111 who made me an ooh GP appointment on a Saturday night within 20mins. I was seen by a GP who decided I needed admitting so rang the admissions team where I was seen by a surgeon within an hour and kept in for monitoring. From there I'm being followed up by the surgeon as an outpatient in 2-4 weeks. All this in a trust that is being battered in the press for being crisis hit:

In an emergency its second to none

Having lived in Ireland, worked in the public health system and given birth there, folk really don't know how good out NHS is.

Imagine needing to bring your child to the Dr & you can't afford it or not being able to collect all your prescription as it was too expensive.

BIWI

Google may be my friend, but that doesn't mean that it produces reliable results. Anyone can post anything which might get picked up by Google.

What would you accept as reliable results? You know all research can be tweaked to support a political agenda.

More effective in what way? And how 'free'?
I said: Please read the post of someonestolemynick.*
Actually, I'd like you to answer this question.

And I would like you to read the post of someonestolemynick. What's the point of me repeating what another poster has already said?!? What is wrong with you? She says how it works in other countries which is more effective and free.

You are (wilfully?) missing my point. If insurance companies are involved, there is a profit motive.

You are also (very wilfully, I must say!!!) missing my point. As I said:
There are two types of insurances: Statutory health insurance and Private health insurance. The former is non-profit and designed for employees earning below €50k, as well as those on benefits. Rates are low. For employees, rates are paid with joint employer-employee contributions. For those on benefits, municipalities pay the fees. Nearly 90% of the population are covered under this scheme.

If you choose to have nicer rooms, etc. that comes along with the second option (private health care) why should you NOT be expected to pay more? And yes, the insurance profits, but people still go for it because of what they get in return - like people paying £600 for shoes just because they are Christian Louboutin.

snowbells
Your whole statutory insurance thing is a pile of arse
Somebody with kidney failure cannot get a job, cannot seek a job but is not "disabled"
so remains uninsured
so gets shat on
and dies young

compulsory insurance : tax in other words - ie the NHS with less effective collection

and don't give me that "through wages" pap when 15 - 20% of the workforce are self employed ..... how do you enforce THEIR insurance
or do they HAVE to sign on?
Or are they allowed to deduct £200 from a £200 a year hobby business profit

FannyFifer the comparison with Ireland (a very close country and not the US) has been pointed out a good few times.

The OP is ignoring it, most likely because it's not supporting her "Most other developed countries have some sort of free healthcare that can actually be more effective than the NHS" and it's the closest one to the UK

For all it's faults, i have never been turned away from treatment for either myself or my child.

It has happened in the USA, when we were medically insured and resident there - my son badly hurt his ankle and it could have been broken. I had our medical insurance cards, but not my passport on me and they wanted me to go home and get it, with my son in that condition. He was 3 years old. I had to beg them and a nurse took pity / persuaded the admin staff to take my driving licence as ID.

Obviously lesson learn't to keep passports with us - but FFS, no duty of care for a 3 yr old.

The NHS pediatrics have been brilliant dealing with multiple issues with my son and also A&E. I think the cost management needs seriously sorting, along with the whistle blowing procedures. But I value and respect the work the NHS overall.

TalkinPiece
In your example, the government pays for their insurance. I don't understand why people find this so difficult to understand - that even in a place without NHS, everyone gets health care. It would be against the law not to be insured.

People should realise that "Health care for all" is not exclusive to the NHS. It's not really a unique idea...

Thanks OP - just what I needed to read after a tough working week and then some working in management at the sharp end of NHS acute care.

First thing to say is I work bloody hard and so do my colleagues to keep patients safe and get them home happy and healthy as quickly as possible. We are constantly evaluating our services. Looking for better value for money and better patient experience. We balance having a no blame culture (because blaming people is about the most destructive thing you can do) with seeking after the truth about things that have gone wrong and then we innovate and improve to ensure services are sustainable AND SAFE. And yes sometimes despite everything we do it all goes to shit and you are left with broken lives. I've seen that and it's awful. AWFUL. So I don't need you or anybody else bitching about the management of the NHS because the vast majority of NHS managers deal with stuff you couldn't even begin to contemplate. You'd run screaming from my job and my responsibility and I know I do it better than you could ever imagine.

The NHS leaves nobody behind. NOBODY. Even if you aren't entitled to NHS treatment you will still be treated and we'll talk about the bill afterwards.

Care for chronic conditions has been mentioned and care for the elderly. How many people on this thread actually understand what's involved in managing aservice to support a chronic life-changing condition. I do. i'm passionate about it and it's more complex than you could possibly imagine and it's more expensive than you can possibly contemplate. And with a very few expensive drug related exceptions that cost is NEVER mentioned to the patients.
Care of the elderly - how many people on this thread have actually engaged with the issues that bring elderly people in to hospital and the barriers to keeping them at home? It is hugely complex as well and it involves treating some of our most vulnerable patients. Each one an individual, each one a complicated balancing act between what is medically possible and what is right for the person.

The NHS is remarkable. It probably cared for most of those reading this thread as they came in to the world and it will see us out. It's not beyond challenge, nothing is, but don't attack those working within it out of ignorance and don't ever, ever think you can do better. You can't.

Sorry, SnowBells, I don't have the mental or physical energy to debate with you further this evening, as I'm really not well, and it's been a long day.

However, one thing I am seriously moved to argue with you about is the whole insurance thing. Do you seriously, seriously think that insurance companies would be getting involved if there was no money involved? If so, you are totally deluded.

Snowbells
In your example, the government pays for their insurance. I don't understand why people find this so difficult to understand - that even in a place without NHS, everyone gets health care. It would be against the law not to be insured.
Read upthread what has happened.
Government insurance has condemned the person to a slow and painful death.

Because insurance has paid the minimum rather than the right

and if they had paid the right, the person might now be in work and paying taxes

separating healthcare from work is ESSENTIAL

I think people probably like it because you don't have To pay up front for care.

I know that doesn't mean it's free, but it is easier To Get heart surgey when it's needed if you don't have to raise £100,000 To pay for it in advance and then claim it back if the OP is a success. This is what happened To a friend of ours here in Chile.

I would probably have seen a GP about my chest infección 3 days ago instead of seeing if I improved before spending £70 that we can't really spare. Obviously if the DDs Go down with I will spend the money.

And other friend, the family couldn't afford a "good" Dr. for their diabétic mother because between ten adult DCs all working full time they didn't have the cash To Get her To the capitol where the Drs are better trained and educated. This is because the good medical schools are in the capitol, so a student who can't afford To study there gets a poorer standard of universidad.

Also, when a child is admited, be it for scheduled surgery or an emergency because they think it's apendicitis, it feels wrong To have To make sure you take your crédito card for the admisión process.