Is this a completely bonkers U-turn by the NHS?

[HappySecret]

My faster is well and truly flabbered. Can this be in any way reasonable? Justifiable?

From today's Times:

Yes, of course I know that other countries are using the profit from our rail to further subsidise their own. Does.that seem a good idea to extend to the nhs? Pay more, see the profit go elsewhere. Get more shit services.

Sorry Painting, didn't mean you!

I would happily pay an extra £100 a mo th tax if I knew that it would directly go to the NHS
I also think that they could explore efficiencies and improving morale although how that is done without paying a consultant I don't know !

It's so depressing that as a society we won't pay more tax for such a critical issue

I leave my house and see money being frittered endlessly . I am NOT talking about taxing poor people , people on benefits but the many many people in the 40% bracket

And even people with private healthcare ending using the NHS in an emergency !

My point is that good healthcare costs money. Thinking you can provide services like IVF on a shoestring budget is just not sustainable. Certain procedures should be available for a supplemental payment. Very few people in the UK have an appreciation for what their medical care costs because they don't see the bills.

Our healthcare costs are about $50k a year because we can afford to pay for DS therapy sessions and don't claim from our school district like we are entitled to do. For the healthcare we have received I think an average of $10k a person per year is probably closer to what should be budgeted by the government.

2008: dd broke leg and it had to be reset. She had to go for a second x-ray before we left. Trolley, porter, me and a nurse to carry the notes. And nurses claim they are overworked. She got a 40 minute break, a chat with the porter and gossips with reception in X-ray. Complete waste of time.

2016: dd having been refused CAMHS when cutting and taking small od's and after we appointed a private psychiatrist took a tiny od and 26 hours later went to a&e to check herself physically. They failed to phone me for 4 hours, they persuaded dd to stay overnight with a 1:1 nurse, contravening the MH Code of Conduct and DOLS for 16-17 year olds. When I arrived and dd wanted to come home and I questioned the decision making and there was a MH assessor on premises who could assess over 16s. The ed nurses and consultant pass had not been awarevof this. But there was money for acute admission and 1:1 nurse to facilitate a CAMHS assessment the next day because CAMHS only work 9-5. Guess what when CAMHS assessed the next week they referred to partner. The partner did another assessment 3 weeks later and d's used she was non urgent. They provided six weeks of mediocre counselling three months later and not when they said they would. So money for admission, three assessme rd and a 1:1 nurse but minimal support.

The system is a shambles.

're funding, if I happen to develop a clinical MH disease like Alzheimer's that will result in my death I can pay for MY care down to 100,000. For me that could be more than £1 million, for others it might be nothing. If i develop a physical disease like cancer that will result in my death i would pay nothing.

The system cannot continue.

What’s your solution raindrops?

My solution is a Continental system like in France. I am happy to pay more for a different system not for the BHS because I think the rot and poor practices are too embedded and bit has been viewed as a sacred cow for much too long.

We all have to stop being grateful for sub optimal services because they are "free. They aren't.

Remove it from politics and have an apolitical steering committee of judges, business people, clinical experts, academics. The political pendulum has destroyed it and it can't continue in its current form. I suspect it will have to be done regionally.

The problem is that charging for certain services opens a dialogue on what's considered essential and non essential. Maybe IVF today, maybe smoking cessation and weight loss surgery tomorrow (although not providing these things leads to increased costs down the line)... next month, cancer treatments that don't give at least 8 months survival on average, then 10 months, then 12, then 2 years. Even now they're stopping prescribing certain opiates that are more expensive, even though some patients are massively reliant on them for quality of life and they're far more effective for them than the alternatives. The NHS is no longer prescribing T3 for thyroid patients even though it's the only thing that allows some to function.

@user1489679054 Your example only highlights the failings of your sister's GP, not of the NHS system.
If the GP had correctly flagged it as suspected cancer she would have been fast tracked.

I fear the private sector will cherry pick what turns them a profit. For example elective orthopaedics, cataract surgery.
The private sector is unlikely to recruit any psychiatrists, paediatricians or GPs because there aren’t any out there.

I have worked for 5 NHS trusts and have never seen it in such a desperate state. The majority of its staff are brilliant and work tirelessly to provide the best service they can despite rising demand and no further funds. However treating the NHS like a sacred cow will ironically be its undoing. Most patients imo have no idea how much treatment costs and as a result some will misuse it. Politicians promise the public the NHS will be all things to all people because it's a vote winner while at the same time refusing to fund it properly so patients get fed up when the reality doesn't match the promises. The management and organisation is chaotic and short term due to constant reorganisations. We have been told to accept there is no more money for extra staff but patients numbers will keep rising, partly because we can save a lot more people with chronic conditions, so we have to just do our best to meet the demand so increased waiting times, short tempered staff, services cut.

What's the solution? I think unless you have a recognised chronic condition a fee for adults to see a GP, more people paying for prescriptions, clamp down on health tourism, not funding treatments such as IVF and an discussion about how far down the line the NHS should treat patients with very poor quality of life as often people imo are over treated because staff are scared of litigation

One thing that constantly shocks me is the cost of missed hospital and GP appointments—apparently this is costing the NHS in the region of £750m a year in outpatient appointments and £162m in GP appointments. People who miss appointments should have to pay a fine!

Champagne what about hard to diagnose conditions? Those with conditions like endometriosis, that take an average of 9 years to diagnose, what then? Or MS, which can take an extremely long time? They have tons of appointments because they're in constant pain and nothing works.

One thing that constantly shocks me is the cost of missed hospital and GP appointments—apparently this is costing the NHS in the region of £750m a year in outpatient appointments and £162m in GP appointments. People who miss appointments should have to pay a fine!

It might help if appointment systems were more standardised and better organised. I've had many appointments sent to me which have been wrong, not requested or that I can't attend and then have been a nightmare to cancel. That is entirely about bad business processes which are endemic in the NHS and make the life of both staff and patients more difficult.

raindrops I'm so sorry your DD has had such poorly coordinated care. It is awful that your experience is brushed under the carpet and people dealing with complaints at the top think everyone who complains is a Tory voting, foaming at the mouth moron.

My father was fobbed off for 3 years about his prostate cancer. It started with 'oh it's only prostate cancer and best approach is wait and see' to 'oh let's see if there is a second life limiting disease' to 'oh you are stage four and as you are over 70 we don't recommend treatment'. We are fortunate that I happen to live near an excellent hospital with the urology department headed by a British trained doctor here in America. He shook his head when I told him what had happened. He gave me a suggested treatment plan. I had to hire a lawyer and advocate via an MP to get the NHS to follow the plan. Today my father is in remission but dealing with all sorts of other health problems. I have to strong arm the NHS into doing anything beyond the bare minimum (i.e. Giving him an annual flu shot).

It's not perfect here in America but they have a couple of really good processes in place here in our state. The schools pay for mental healthcare of children so issues like drug taking, self harm and eating disorders are dealt with quickly and at not cost to parents. I've noticed an awful lot less issues with self harm and eating disorders, even in affluent high performing school districts, compared to the U.K.

@Chrys2017 I agree that was one issue. However, I believe the truth behind that is that GPs are in a difficult situation budget wise- they are worried about budgets so only willing to fast track what they see as the worst cases, most likely to be cancer. Most English GPs don't see a huge number of melanomas too, so aren't so likely to spot them quickly. (that's not a failing of the nhs, but just the result of the English climate!)

However, there were also several other issues:

• it took two weeks to get a GP appointment in the first place. That's too long.
• it took four weeks to get the biopsy results - that's ridiculous with aggressive cancer.
• the cancer diagnosis was delivered by letter and she had to google it to work out that it WAS cancer and what the staging meant. She then had to call to get an appointment to speak to the consultant to ask questions. No one should be told in a four line letter they have a serious and aggressive cancer.
• the follow up post cancer (one she had completed the treatment)was one appt six months later. No more. My own dermatologist in Oz was astounded by all of these things - in Australia you'd be checked every three to six months- for at least five years, possibly forever.

All of these are failings of the NHS. With a really aggressive cancer like melanoma every week you wait really counts. The chance of recurrence at her stage is high- there should be way more follow up but her consultant says there's no budget for it. The failings go far beyond the GP not putting her on fast track.

@TammySwansonTwo the question about things like endometriois is interesting.

In a private/partly private system GPs can get personally sued. Trust me that this results in them being a LOT more careful about missing things and makes an early diagnosis much more likely.

In the Oz system you only pay a % of a gp appt cost (about 25% from memory) but there's an annual limit, so you don't pay above a certain amount each year. There is also always the option of a bulk billing GP (Gps who don't charge above the fee the govt pays, so are effectively free).

From what I've heard, the diagnosis rates aren't any faster there or in the US, but I'd have to look up the stats.

There's a large number of people with debilitating symptoms pre-diagnosis, of a variety of conditions. Sometimes so debilitating they can no longer work but qualify for practically nothing. I'd be very concerned about those people in a two tier system.

After the experience my father has been through and the countless people we have met along the way I struggle to believe the diagnosis rate are faster in the UK compared to Australia or America just based on the number I have met who have remained undiagnosed until stage 4 and gone straight to a terminal status. Yes they were diagnosed quickly because it was blindingly obvious they had cancer by the time they got to the specialist who could give the diagnosis.

Sadest case I've seen was a young lady, 19 years old in the final stages of cervical cancer. The only reason she had been diagnosed was because her mother paid her for to have a smear test privately after the GP refused. They had to then pay for her to see a specialist privately because the GP wanted to wait and monitor with smear tests every 6 months. She died 9 months after her private smear, 7 months after diagnosis. She was in the wait room with my father a couple of times. It was obvious to me that she was sick. How a GP could not take her seriously is beyond me.

Supermum

Are they still not giving smear tests to those under 25?

Why did the GP want to wait and monitor every six months FFS!

@RaindropsAndSparklesyoure happy to pay for a better system, presumably because you can afford it? I couldn't. We are not on benefits and would not fall under any means tested system. But we have no spare money and struggle as it is.

@user1489679054 the issue is a lack of GPs in some areas. Because like teachers and other professions they are leaving in droves and going part time in order to get some sort of work life balance. I've lived all over and never not been able to get a same day appointment. And I've had moles always taken seriously.

Is it really as simple as Labour v Tory? I don't think so. I waited 6 months for a scan under the last government and had my surgery cancelled on the day as I was about to set off due to a lack of beds. Post op I waited in the clinic for 2 1/2 hours to be seen. Desperately sick people didn't even have a chair to sit on. I've just waited 3 weeks for the same scan, and I was seen 15 minutes before my appointment time. My scan was in a mobile (state of the art) scanner as the hospital is having its scanners replaced with the new state of the art scanners. My results will be available to me next week.

Both parties have flogged off the cheap and easy procedures to the private sector, leaving the poor old NHS with the complex stuff.

If we want better, we'll have too pay more, that's the crux of it.

How can you say you can't afford it when there are no proposals about which to consult?

If we hadn't had insurance and 4.5k to pay for dd's care 're MH she'd have dropped out and her chances would be shot. That's under our modern NHS. Acceptable? I think not.

Nope they are not giving smears to under 25s in all areas. There is also an awful lack of education around cervical cancer. Rates are much higher in those who have multiple sexual partners and those who smoke. Smears should start when a female becomes sexually active and it's what they do here in the US. I know from when I was a teen there were so many girls who were sexually active with many partners from the age of 13/14 and a few as young as 12. I was one of the last, if not the last, at 20. Waiting a decade to start testing seems silly to me.