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?

Does anyone else live in the EU ? or knows how much it costs per month for healthcare in these insurance based systems

Whatever it is it is certainly going to be cheaper.

Ultimately we have time to reflect that if we had lived in another country with private health insurance DP would not be terminally ill.

They would have listened and taken all his systems into consideration before things had gone too far. Instead dp listed his systems and was treated for a tummy ache by one doctor, constipation by another, a hernia by a third. In the meantime the cancer was growing. Only when he became so ill and ended up in A&E did anyone listen.

I was treated for years for anorexia in my teens. I knew I didn't have anorexia I had a stomach ulcer. I saw a psychologist every week for at least 3 years who tried to convince me to eat and the pain I was in was all in my head.
Only when I had a screaming match with my gp aged 15 did he send me for a Barium Meal test to proove I didn't have an ulcer and it was all in my mind.
I was told I had 6 weeks to live as I had several ulcers in my stomach.

What I was trying to point out with Alexa regardless of whether she should be using the NHS or not. It took 3 attempts by so called doctors to actually find out what was wrong and treat accordingly. That is a waste of 2 appointments because someone could not do their job in the first place.

The money wasted in mid diagnosis I think is the main problem.

I don't believe myself and dp are the only ones to have suffered at the hands of the NHS. Me alone over the years the NHS must have wasted a million on. Dp another million of NI contributions , operations and several rounds of chemo etc
From what I understand from one EU country is if you see the doctor they listen to you and test you for everything in one go. Not fanny around trying to treat a symptom at a time till the problem has grown and costs more to fix if it ever can.

FruitCider why did you choose to go into prison nursing? You sound very aggrieved. You’re not the only one facing difficult and often dangerous/violent situations in the “everyday course” of performing your job. As a student nurse, years ago, myself and a physio spent a very long morning trapped in a room with a violent (mentally ill) patient. The police were called eventually and the chap was manhandled away. No, not an everyday occurrence but working on the district in an area of Manchester where we had to go out in 2’s for our own wellbeing was concerning. We didn’t have a go at other team members who werent in our vulnerable position, though.

Perhaps....just perhaps, you are in the wrong job?

In France they pay 8% of salary plus insurance

www.expatica.com/fr/healthcare/french-healthcare-france-health-care-system_101166.html

In Spain they pay 4.7%, with employers contributing 23% plus insurance

www.expatica.com/es/healthcare/Guide-to-health-insurance-in-Spain_439814.html

In Germany they pay 15.8%

www.howtogermany.com/pages/healthinsurance.html

Poland 8.5%

www.expatarrivals.com/poland/healthcare-in-poland

I’m not aggrieved, I just feel a bit insulted when it’s insinuated that radiographer face the same risks, clearly this is not true. I went into prison nursing as I enjoy working with addicts, enjoy working with those experiencing homelessness, and enjoy working with people with personality disorders. 40% of all crime is linked to addiction and around 65% of Prisoners experience traits of personality disorders so it makes sense. I enjoy my job, I just find it unreasonable to have sole responsibility of 100+ detox patients and be paid circa £27k a year for it!

FruitCider, admittedly, that’s crap. Like most nurses, I went in, like you, for love of the job. Pay and conditions have always been atrocious. There’s still this misguided “vocation” factor. Only yesterday, Jeremy Hunt was banging on about the dedication of nhs staff. As if pay weren’t really important.

Pay and conditions have always been atrocious.

Nurses make a good income in the US:

nursesalaryguide.net/nurse-salary-by-state/

The states in that list where the pay is on the low end of the range also have much lower cost of living. Multiply the dollar amounts by 0.74 to get the equivalent in pounds at the current exchange rate.

Oliversmumsarmy sadly that is not the case in any country I have lived in.

Ds1 was born in France. He had extremely bad reflux, so much that he would not eat.

I was seen by half a dozen hcps. Each diagnosed a different thing (without actually doing any tests), but most agreed that it was somehow my fault. Our belief that it was reflux combined with a cmp intolerance was dismissed out of hand.

I only eventually managed to get treatment after 4 months when ds1 was borderline malnourished and I took him to a specialist in another country who actually did tests, diagnosed the reflux and gave us the meds he needed.

Within 6 months he went from off the bottom of the charts to the 90th percentile.

If we hadn't figured out what was wrong ourselves and gone to find the specialist, who knows what would have happened to ds1?

Those figures are interesting Fruit , I presume they would be taken from gross pay like pensions ? the plus insurance bit is interesting too , I wonder how much that insurance is and if it is effected by previous health etc.

Rough estimates seem to about 1/5th of the tax you pay goes to the NHS , so about £90 a month of your tax goes to the NHS a month if you earn £25,000. I do wonder if they do away with the NHS whether people would be paying less tax ? Germans seem to pay very similar levels of income tax and pay 15.8% of their pay for health care , so about £300 a month for healthcare at £25,000 .

It is also interesting that DH has private medical insurance , a benefit he pays tax on . He has used it twice in 20 odd years I have known him , once for a small day surgery hernia repair and for physio for whiplash . Not for the two times he has required surgery due to accidents following bad breaks to limbs , nor for the time he had a peforated bowel , or the time he had a massive heart attack , the NHS picked up the tab for those .which of course he also contributes to

Probably already been said but as a society we need a very serious conversation about personal responsibility for health. By 20/20 3 quarters of death will be from preventable disease and the cost to the NHS currently of lifestyle controlled disease is 18billion and rising. A complete reversal of the medical model we currently have with a focus on prevention, nudging people towards personal responsibility so long term less nudging is required as the social construct has changed.

Why has this turned into a debate about pay and conditions? I think that's a real shame. I speak as a nurse, and I understand that we all (for clarity, I mean nurses, ACP, doctors, admin, cleaners and porters) do a hard and rewarding, but often unappreciated job, which is underpaid. But the current NHS crisis is not about pay and conditions.

Long-term, of course it has an impact. Long-term, we have an aged population of nurses, and there is a large proportion of nursing staff due to retire over the next 5-10 years, with a shortfall of staff to replace them. Let alone agree those staff will have expertise. Closing the door to foreign nurses went down like a lead balloon, also - our Trust had recruited around 50 talented nurses from abroad who then couldn't get visas, and the govt had to rescind their policy when they realised that there were no UK staff to fill the void.

The current crisis is the worst we've seen in years. There are no beds, literally. People are in the news, complaining that their operation has been cancelled. Hospitals are not only above their 85% occupancy rate that is deemed safe, but many are above 91% or higher, with some hospitals 100% full. That means that when the patient with sepsis arrives, or appendicitis, or a heart attack, there is no bed at all for them. They will have to stay in A&E and be treated there.

But in some cases, patients aren't even able to be offloaded from the ambulances. Ambulance staff can't leave until a nurse has accepted the patient, and there has to be an A&E trolley to transfer them on to. No trolley means that they can't leave with their ambulance trolley. So the ambulance crew are stuck at A&E. For hours. That means they can't answer further calls. So 999 call times get longer and longer.

It really is a crisis. Not an inconvenience.

Wishes my vocabulary was more interesting

Well said Lougle

Did I mention the 150,000 NHS beds lost since 1987 ?

Nurses don't get paid enough for what they do given the amount of training they have to undertake

Pays been mentioned because it’s a huge factor in recruitment and retention. People are leaving the nhs because they can’t afford to stay.

@Frumpety, from googling 70% is deducted from pay and 30% is from insurance. The sick and unemployed get 100% cover, no need for insurance. However, most of the insurance companies are mutual societies, not for profit companies and I don't think insurance becomes more expensive if you develop conditions. Online reading says you pay more if you want a premium service such as private room, better food, cover to look after your children if you have to go in for surgery. Also if you develop certain long term conditions such as diabetes, some kinds of cancer etc you then don't have to supplement your healthcare with additional insurance and health costs are 100% covered.

It sounnds like Germany pay more from their salary on healthcare.

Ps apologies, the first paragraph is talking about France.

Just realised that the figures that I got the £90 for the NHS from do not mention social care at all , so is that funded from council tax ? Or when they say NHS , do they also include social care funding ? Or the money included in the Better care fund ? Need to go to work , so will try and have a look for more figures later

Rough estimates seem to about 1/5th of the tax you pay goes to the NHS , so about £90 a month of your tax goes to the NHS a month if you earn £25,000.

It’s more like £50 a month, not £90, so nowhere near enough.

I am pondering how much of the Better care fund will be spent on shiny new badges ?

I get 1 pregnant mum who flies in from Nigeria

Racial.

Does anyone else live in the EU ? or knows how much it costs per month for healthcare in these insurance based systems ?

EU countries each have different health systems! You can't generalize (and the UK is still in the EU!)

I actually don't know how much I pay in taxes (am in Italy) but I do pay a lot more than I would pay in the UK at the point of access. For example, I don't pay for a GP but I do pay for specialist appointments (about 50 euros) and for blood tests. I also pay for medicine even for children which can mount up. I also pay for some private specialists as the public system can have long waiting lists e.g. next month I have a gynae appointment - I booked it in 2015!!

Can I come and be your student Gingerbreadma. I go back to my placement for 5 weeks in Feb and I just get left (not a bad way to learn certain aspects of the ward) and I have to constantly ask and pester to do more 'nursey' things. I just keep getting told you don't learn to be a nurse until you qualify!!! I've heard good things about my management placement tho so fingers crossed. I really do love it and am very keen. I'm nearly 40 tho with another career behind me and can push myself forward, but I do worry for the younger students.

The nhs budget is £2,200 per person per year in England and a bit more in Wales and even more in Scotland, and Northern Ireland.
However as many do not pay tax the average taxpayer in England pays more like £5000 per year.
Sources https://fullfact.org/health/what-is-the-nhs-budget/
https://business-reporter.co.uk/2015/06/10/taxpayers-to-face-5000-in-nhs-costs/