A question for NHS staff

[Glowinginthedark]

AIBU to think that no amount of money throw at the NHS in it current state will fix the issues? What is the real problem? Lack of funds or people completely abusing and misusing A&E or both?

More info on financing of Danish healthcare. Only very few of the population are in group 2 which have co-payments.

Group 1: Free consultation with your chosen GP or a specialist upon referral. Treatment from dentists, podiatrists, psychologists and physiotherapists are available at a subsidised rate.

Group 2: You will have to pay a higher rate of contribution. However you are free to choose a different GP each time you need to consult a doctor, rather than keeping the same GP as in group 1. You are also free to consult a specialist without having been referred by a GP. Fees are subsidised at the same rate as group 1. Treatment from dentists, podiatrists, psychologists and physiotherapists are available under the same conditions as in group 1. Roughly 98% of Danish residents are insured in Group 1.

However, the issue of whether the NHS is being slowly privatised is not in my view 'guff'. People need to be aware if this is happening and do they want a profit based healthcare model? There should be more transparency and discussion.

Look at what happened with PFI under Gordon Fuckwit-Brown.

It’s costing an absolute fortune to fund that part of the NHS on an ongoing basis and it will continue for decades to come.

It’s hard to put into words exactly how much it’s estimated to cost over the decades the contracts are in place for, but apparently it’s over £300bn.

Over £300bn!!

A third of a fucking trillion pounds!!

Feodora All of DHs family pay for their medical care through their union memberships. My SIL is no longer working and still has her medical care costs paid for by her union. While working she paid a % of her income to the union for this coverage while working through to retirement should she fall ill. She did fall ill and they are making payments. Calling that money paid to the union part of income tax is not wholly accurate.

Also funny how I work here in America and the vast majority of people get far more than 2 weeks vacation. I get 4 weeks vacation and when I started work 10 years ago I got 3 weeks vacation.

Also maternity pay is excellent. I got $550 a week for 16 weeks. It's called disability but is, for all purposes as it's designed, maternity pay. You get 6 weeks for a regular vaginal birth, 8 weeks for a CS and up to 26 weeks of disability if you have medical issues such as PND.

DHs family are working class people who are lower income. They are certainly not part of any top 1% income or benefit group. They all pay to see the doctor and for prescriptions unless they have the package with their union. Those union dues are not cheap.

The NHS is basically a Ponzi scheme - it’s entirely dependent on the taxpayer (generally a decreasing proportion of the population) to cope with the needs of the entire population which includes an ever increasing proportion of older people (who generate a lower tax revenue by proportion of income). I appreciate this is a generalisation regarding who pays what in tax, but the principle is valid.

This is combined with an increasing expectation of what will be funded - for example when the NHS was formed 70 years ago a cancer diagnosis was generally a death sentence (if they even managed to diagnose it before death), whereas a significant number of those diagnosed today will have reasonably good odds of making it to 5 years post-diagnosis - if not successful treatment.

Money alone is not the solution. We need to accept that certain elements of what we expect from a “free” service will inevitably be subject to additional cost to the individual sooner or later. This might be paying £10 to see your GP (and let’s not forget that GPs are already private contractors) in the same way there are charges to see an NHS dentist.

There is no perfect solution, but the premise of a “free” NHS and modern medical science are simply incompatible.

Sorry Tittygolightly Brexit is not a key factor in an overworked NHS. If we are so unwelcoming why are so many people coming from abroad to use it. Brexit will make this country much stronger rather than kowtowing to an unelected elite in Brussels.

ZUBE you comment that health tourism is NOT a factor as it is "only" 0.3% of the NHS budget. The budget for England and Wales alone is around £133 billion so even 0.3% of that figure is an astonishing amount of money - think of the number of the operations/doctors/nurses that would pay for, so how can it NOT be a factor.

Seems to me it depends on how much will there is to make it happen; where the government wants to put our tax money.Trouble is most members of the government have plenty of money for private health care and seem to gain from 'selling off' sections of the NHS to private companies

Multiple issues:
Successive Governments have reduced mental health beds by 85% since 1975;
This government has cut 15,000 hospital beds;
OAP care dramatically reduced sooo... those people that would have accessed mental health and OAP beds are now in hospital (of prison) ... that, and the drop in staffing caused by people looking to take their brain power to an industry that isn’t attacked every five minutes by MSM...

Linda - if health tourism accounts for 0.3% of the NHS budget and 5.6% of workers in the NHS are from other EU countries which of these two figures do you think is going to have more of an impact on the running of the NHS??? Brexit is very much a key factor.

Would charging people a token sum (eg £10-30 ish) who don't bother to show up for appointments make any dent in the pot?

I think it's quite inefficient, I know quite a few people in NHS "management". There are a lot of "managers" and quite a few earn 6 figure salaries (sorry, pendants, I don't have the statistic and/or empirical evidence to hand to back this statement up). Is it a case of too many chiefs and not enough indians (I probably can't say this anymore..)?

Brexit is having an impact on our ability to recruit qualified staff from the EU. They apply different criteria when deciding whether to come to the UK or not than health tourists do. You can't be that fucking thick linda.

My husband is a mental health nurse and he cites the following issues as the biggest problems:

• New laws on immigrant earnings meaning many HCOs and nurses have had to leave the country (many are from abroad) - making a huge dent in the level of care available

• Abuse of junior doctors working unreasonable hours for less money - too much is being asked of too little. Junior doctors' overtime rules being changed, for example

• The cutting of bursaries for nursing students leading to an increased crisis in the future as trainee nurses cannot work alongside their studies (placements are full-time) meaning that they have to find the money to live on as they train. Many can't

• Huge funding cuts across the NHS leading to squeezed departments forced to cut corners

• The use of NHS 'trusts' who all operate differently and have differing levels of private services within them, meaning notes aren't always recorded properly and many things are missed

• The huge under-funding of mental health units resulting in an (understandable) abuse of A&E facilities by the mentally ill

• Lack of education regarding when a hospital or doctor should be used - too many claiming paracetamol as a free prescription, for example

• Brexit - as much as nobody wants to talk about it, many EU nurses have returned to their home countries following the vote.

He and all of his colleagues are in agreement that this government are determined to kill the NHS and let us blame everyone else (mainly immigrants) for it. It is a widely-held view by NHS workers that this government is poison and want a privatised system. Very, very few nurses and junior doctors support it, which I think is very telling.

In my experience of working in outpatients, no shows are often the only reason a morning clinic finishes in time for the afternoon one to start or an afternoon one in time for the department to close.

The main issues are 1. Funding too many non-essential treatments that should not be funded, and 2. Not training enough medical professionals.

If we're that short of doctors and nurses then it should be free to train as long as you spend, say, a minimum of 10 years working for the NHS afterwards. I know a few people who would make excellent doctors and nurses but can't afford to pay for the training!

Also not enough GPs to deal with demand.
GP practices see over 90% of patient contacts in the NHS, are trained to manage and assess risk and, crucially, protect secondary care (hospitals) from the deluge of patients.
Without enough GPs, the flood gates are open.

Thank you @Wantobesupermum for your further information. My brief googling says that Danish healthcare is not governed by central government but deducted from pay. What is most certainly isn't is a US for profit healthcare model.

*Also funny how I work here in America and the vast majority of people get far more than 2 weeks vacation. I get 4 weeks vacation and when I started work 10 years ago I got 3 weeks vacation.

Also maternity pay is excellent. I got $550 a week for 16 weeks. It's called disability but is, for all purposes as it's designed, maternity pay. You get 6 weeks for a regular vaginal birth, 8 weeks for a CS and up to 26 weeks of disability if you have medical issues such as PND*

Very interesting. American relatives have told me they get much less annual leave and maternity help than you get and I have read elsewhere annual leave is much lower generally. I will have to do some more googling!!

And the brake down in social care provision - a lot of extra funding will significantly help these issues.

'break' down even!

@wantobeasupermim, briefly reading your posts it sounds you are a very high earner too so I am wondering whether your leave benefits and maternity provision is far from typical. Is your maternity leave through insurance?

This article from 2010 shows annual leave in US is very low www.bbc.co.uk/news/world-11139960

I heard yesterday that there is a move to have a 'consultant' in A and E to see arrivals and send away those that don't need to be there. I can really understand how, if you have to wait for two weeks to see your GP that you might feel that A and E is your answer, but there seems to be a lot of people with ailments that don't need the emergency services taking up too much of the money and resources. I read in the paper this afternoon that one family in north London have called the ambulance service about ten times a day for the last year. This has cost staggering amounts - clearly there is a serious problem in that home but is anyone sorting that out, or are they just resigned to sending an ambulance each time for a pointless and expensive visit, just in case? There are so many reasons why the wonderful NHS is falling apart, but there just seem to be recriminations, political point scoring, boggling amounts of money being thrown about and we still have people lying on a trolley for days.

It is the public's perception of what they are entitled to that has dragged the NHS down.
Slightest cough, runny nose,rash and it's to be fixed by medical staff. No responsibility taken for self. Latest proposal about the provision of safe places for those who are drunk to sober up and be dehydrated in is to be the latest in someone else having to deal with lack of responsibility for self.

I agree manicmij that an attitude of passive entitlement has somehow developed over the decades - but how the hell it is put right I have no idea

I like the system in Italy for Emergencies (and I don't say that often!). Patients are triaged and then get given a category:
Red - life or death situation
Yellow - serious problem, patient needs to see a doctor but can wait a little while
Green - patient needs medical assistance (e.g. minor fracture) - will wait longer
White - not urgent, patient can see their own GP. If they want to wait then they will be at the back of the queue and it will cost 25 euros.

I think a system like that wouldn't put people off going to Casualty if they thought they needed it but a lot of people would probably give up if they were told they could only wait and pay.

Feodora I live in NJ. I always had state level coverage of disability.

My leave benefits offered by my employer were below average and the state provision was more than adequate at about $1850 a month after taxes.

Annual leave is zero if you are a contractor and many more people are contractors and self employed compared to the U.K. This skews numbers down. Also, most lower paid jobs allow time off in lieu. If working 50 hours a week you can accrue 15 hours of vacation or get paid for this time (10 hours at 1.5x pay). So you might start the year off with two weeks but if you are banking your overtime you can very easily accrue an additional week or more if you want to.

Anyway I am sharing what my lower income inlaws have in Denmark. I highly doubt they are top 1% of anything. DHs cousin with breast cancer paid a copayment with each chemo visit. It was about £10. She is not high income at all.

The NHS being free at the point of delivery is both one of its most noble & admirable qualities AND one of its biggest problems, because when something is free (or perceived to be) there is a tendency to abuse it or use it wastefully. When there is a complete disconnect between what we pay (through our taxes) and the service we receive, there is no encouragement to use it judiciously. I have actually heard people say about calling an ambulance in circumstances where it really wasn't necessary, "Why not? After all we've paid for it".