AIBU to not understand the english attitude towards the NHS?

[EggplantsForever]

Every time someone criticises the NHS, every time someone asks for better health service, or to have some not absolutely vital procedure (like IVF) covered, or to be referred to a specialist there is a barrage of voices here calling them "ungrateful", proclaiming that "the NHS is on it's knees", etc.

I just find it so peculiarly English and I have very hard time understanding it! Perhaps you can explain?

I mean, it is almost as if people feel that someone very nice and kind has given the English people the free health service, and they should be eternally grateful and not mention its shortcomings or it will be taken away. But the NHS is in fact paid by your own taxes! It belongs to you. And you have full right to criticise it and expect it to work just as well as other free healthcare systems in the world. Which it doesn't. It actually compares pretty badly even to the countries that spend less money per capita on health. I have a feeling it is actually badly mismanaged.

For example, look at this table en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare
UK is at the bottom at most of them, below Portugal/Spain, Israel, and Slovenia who spend significantly less money on healthcare.

From my personal experience, having lived in a country with free healthcare, you could go to a gynaecologist without referral (and women were advised to see one for a yearly check up). Skin specialist did not require referral either. Referral to any other specialist took me on average two weeks. IVF was available to everyone for free. The list of cancer drugs included drugs that are not funded in the UK. etc And people still routinely complained about their healthcare. Which they had full right to do, because it was funded by their own taxes.

So I am just not sure why is everyone so afraid to criticise the NHS? It is actually one of UK's biggest problems. And why does everyone eternally fear that it will be "taken away"?

It's not free though... I pay high taxes and it's taken from May for me to see a specialist and they can't put me on my long term until January when my next appt is...I love the nhs and the people are wonderful, but it's a dinosaur

Work and patients should be the priority for staff - not fun when they're being paid to work, not fun when it's preventing them DOING THEIR JOB.

"We need a stronger family culture first and foremost to take the pressure off - families supporting their elderly relatives." How the hell is that meant to happen when the tories are set on everyone working full time until they're at least 70 themselves?

Theredjellybean - hell I'd settle for patients being referred to gynaes when they're presenting with symptoms that clearly indicate common gynae conditions! Fwiw much easier for a man to get a urology referral than a woman to get a gynae one.

Guess which family members are expected to look after elderly relatives? Oh yeah, that'd be the women doing time as unpaid carers, as daughters, daughters-in-law, wives, neighbours.

But if you think that's what women should be doing, campaign for it. Always the patients' fault.

@nolongersurprised please correct me if I’m wrong but the hospitals are free if you have a medicare card and or pay health insurance. It doesn’t surprise me that this Australian doctor asked this question because (in my experience) they seem to like to know how your health care is funded and what you’re entitled to, and there’s nothing wrong with that. I’ve been to the Gp 3 times, the hospital twice, and two scans, all 7 times without failure, cost was discussed.

bluelady but asking which system you’re choosing to use to acess for your non-urgent care (private or public) is different in context from asking if you can afford it, like the doctor supposedly asked the ill person with pneumonia. With the inference that if she couldn’t pay she couldn’t be treated, which is laughably wrong, as Australia has a free public health system.

The number of people in Australia without a Medicare card are vanishingly small, especially if they live there as a “host parent”.

www.humanservices.gov.au/individuals/enablers/who-can-get-medicare-card/39456

“Can you afford it?” when referring to an admission is very different to, “Would you like to go public or private?”

was that not what I did when I said about my midwife appointment being interrupted to talk about cost.

Yes, sorry I worded my question badly. I was more after the context as I just didn’t understand what cost the Dr could possibly be referring to if you were being treated under Medicare as people who use the public maternity system don’t have costs. That’s what I was asking regarding examples - the cost discussions in this scenario.

Even if you wanted to enact private insurance in the public system, and for sure they could ask if this is applicable as some people have it but choose to go public anyway, it would not involve a discussion re cost as there is none (the public system will waive any phi excess, not that many people seem to know this and hospitals certainly are not going to tell you if you don’t know).

The other scenario is that you had decided to use the private system for maternity where you would of course expect a discussion regarding the cost.

Sorry, but it is very confusing as your initial post was basically coming across as there was a discussion regarding cost in order to be treated which does not make any sense.

I agree OP. I'm British (born and raised there) but left the UK when I was 22 and have now lived out of the country for 10 years (France for 9 years, the Netherlands for 1).

Both the French and Dutch systems are superior to the NHS in pretty much any way you can think of.
My immediate family still lives in the UK and my sister is an NHS doctor so I consider that my knowledge of the British health service (even if not my first-hand experience) is fairly up to date.
Any time the NHS is given a funding injection my sister dubs it "a piss in a bucket". It's true that it is severely underfunded and is pretty much only able to run as it does now because of the good will of its wonderful staff.

HOWEVER...
...the UK is a very different country now to when the NHS was originally founded. It has far greater population density, and people are living for longer than they did when the NHS was created. Yet they are not healthier. So longer lives + a wider range of health issues = greater strain on the NHS; this is compounded by apparent refusal among the general population to take responsibility for their own health (not just in terms of day-to-day health such as obesity but also in terms of e.g. rocking up to A&E because you can't get a GP appointment when actually you could have just gone to your pharmacy - people seem to forget that pharmacists are also medical professionals who can advise on a range of day-to-day ailments).

People really need to look at the systems in Europe, compare them to the NHS with a more critical eye, and see what can be done when governments are prepared to invest and citizens are prepared to take greater responsibility for their own health - and as such see that the American system is not the only alternative to the NHS.

I don’t think the NHS is above criticism and I don’t think the vast majority of people in the country think this either. I think it’s something of a straw man/woman argument to say that this is the case. Nor do I think if you criticise the NHS you are necessarily advocating a different way of delivering healthcare. If you do do the latter, then it behoves you to say why you think the model you are advocating is similar. Lots of different models that, for instance, contain an compulsion to insure yourself using a state owned or private insurer are often very expensive. As a consequence, the services received are much better in scope and quality - you get what you pay for.

Angelil agree with your sentiments about people taking care of their own health. I would be happy to get I’ll in France as there system ranks high in the world .

The French do have though a different way of attending pharmacies rather than doctors and this would have an affect on not clogging up doctors surgeries and a&e

I think the biggest problem with people not wanting health insurance is that they will be looking for a loophole NOT to pay out.
That's the nature of insurance.

The idea of the nhs is brilliant. However it is no longer working as it should and something needs to be done.

@nolongersurprised was “bluelady” supposed to be me? @hoppingpavlova
I feel a bit like we’re going in circles and speculating a lot over what the Australian doctor specifically said, what wording he used etc. I mean who even knows how accurately the poster remembers how he mentioned cost. All I’m saying is cost is mentioned in Australia by the health professionals and I happen to think it’s a good, nice thing that they care to ask if people can or are happy to pay. That is how it’s come across to me anyway.

Having lived in both America and England, I feel very grateful for the free healthcare. I do not complain about it, even though sometimes I think it's horrible you have to wait 2 weeks to see the GP.

When I've visited the ER in America the first thing they do is get your payment information. I never had to worry about it because my parents had health insurance and money to afford treatment. Even with health insurance every trip to the GP cost $25.

My mom has a long term health condition and they went to get her some new medicine that would help, however it cost $1,000 for 1 month worth of it so she just goes without the medicine.

Are you sure you meant Australia? I had no insurance when I went there and got treated for next to nothing and then got it back from their social security. My friends that live there praise their health system.

The NHS was founded on the principle that everyone should be able to get free health care.
No it’s not perfect but it’s the best we have unless you want a 2 tier health care system. I know a very good senior radiography with 15 years experience not just in A&E, she also works in the theatre, as well as doing post mortem on infants and young children, and doing her usual shifts in x-ray last month she worked 150hrs + overtime which is unpaid, she already has to do so many hours a week compulsory overtime and has only had 2 Christmas days off in 15 years. As well as doing all that she is going through a management program and is the practice educator for the students from the local university and she also has to lecture at the university.
The NHS has been screwed up and over time and again by government bureaucracy. So many people within the NHS Work Bloody hard 24/7 to give the best they have to offer. Perhaps there might be more money available if people stopped passing the buck and took their responsibilities more seriously. Many children who end up in A&E with broken wrists, arms, ankles are from landing on home trampolines which have not been put together properly or have not been supervised by the adult in charge.
Smokers, why are people who smoke still surprised when they get various lung diseases and cancers, people who drink well over the recommended limits are stunned when they’re liver starts to give up. PEOPLE PLEASE TAKE SOME RESPONSIBILITY FOR YOURSELF AND YOUR FAMILIES. I know this is a Nanny state and we are being brainwashed into playing the blame game when something happens. I have had to use the services of my local NHS hospital many times over the years since I had an accident and was disabled by it, and no I was not happy occasionally ie when a Doctor or Hr treating me could not only speak or understand what he was being told, I went in with head pain and he checked my legs and then despite being given my medication box with all my meds clearly written on it he prescribed a medication I was already on at a dose taken with my normal dose would have killed me. So not a great experience but should he have been allowed to work without supervision when his understanding of and ability to speak English was so poor?
On the other hand when I had to ask for an elective cesarian I cannot fault the care that I received. I had a happy healthy ds and the ward nurses were fantastic in their duty of care. So it’s swings and roundabouts if you don’t like the Service offered do them and those of us who are proud and grateful for the NHS a favour GO private!!!

Are you using English as a generic term to cover other countries in the UK? If so, do try to get it right next time.

It's NOT free healthcare. Nothing is FREE. It's just "free at the point of delivery." Someone is paying for it somewhere. And if there aren't enough people paying for it and too many people receiving it, the system will collapse.

OP I agree with you. It’s like some kind of weird cult. There is also an odd double-standard. Most people will accept that the NHS can’t continue in its current form because it’s doing too much and we have an ageing population. But if any party (usually the Tories) float the possibility of outsourcing or privatising any aspect they are treated as traitors. It going to need to happen in part eventually and shutting down that important analysis just pushes the NHS towards a crisis. It’s also bonkers that the systems fights against supplementing public services with provate top-ups, which many employers are willing to offer and which would take some burden away from the public purse.

The fact that the NHS belongs to the people is what is great about it, but is also what will cause it to fail.

To give a little balance, though, I lived abroad for a year and had comprehensive free healthcare. The doctors were desperate to give me medication, to schedule more appointments and have pointless tests. I had a blood test done as it was needed for thyroid and the doctor ticked almost every box on the ‘testing form’ so my test cost US 800 after all the repeated screening was done. Guess what- bloods totally fine! It was such a cash cow and did make my stomach turn. That type of system wants people to be sick to it can profit from the treatments.

I live in Belgium where healthcare is very good (not waiting lists, can choose any GP etc) However we pay for it! Pay cash to dr and claîm some of it back through insurance. We have private hospital cover (as do most) which is not mega expensive. Otherwise you could be landed with a bill of thousands for a routine op/ emergency. The service is good. But I do think people in UK constantly criticise the NHS but it is free (at source at least!)

This is hard to argue against. The view from the US.

www.forbes.com/sites/sallypipes/2018/10/01/u-k-s-healthcare-horror-stories-ought-to-curb-dems-enthusiasm-for-single-payer/?

Ok - while clearly I am not a blind supporter of the nhs I'm also against the instigation of anything even resembling an American system.

Let's take that article in Forbes linked and the various points raised.

Lack of staff recruitment and retention - very much deliberate lack of prior planning for the number of hcps needing to be trained, add to this the removal of the nursing bursary - again an ideological choice - designed to make the nhs look as if it's not fit for purpose. Add the brexit shit show and hcps who are eu nationals being lost and it's very much a Tory cock up!

Waiting lists - far from ideal. I'd love to know what "interminable" actually means - weeks? Months? Given there are many in the USA that can't even hope to get on a waiting list because they're too poor and disenfranchised to even get that far. Yes it can and should be improved - I'd still far rather have a health service that serves ALL not just those with the means and ability to access it.

A&e waits - as per my link upthread USA not necessarily better on this score! In fact if you go on averages as the many articles returned did on USA times when I tried to get info on this, is actually about the same as the USA - and again Nhs is serving EVERYONE.

Delays in cancer treatment - again not significantly different on average in USA.

www.oncologynurseadvisor.com/general-oncology/cancer-treatment-delays-are-increasing/article/669957/

And again - they're not treating everyone. And again I'm certainly aware of cases in the USA where patients weren't tested/dx early enough and outcomes worse as a result. Among those who can/do access healthcare in USA seems to me the averages are again about the same.

And the reference to scots figures is plain wrong! Even the article it links to states that this figure relates to patients waiting more than the target of 6 weeks (which btw is also the average wait time in USA for similar procedures).

Regarding the supposed discontinued procedures - not 17 and not completely discontinued. And are they really expecting us to believe that USA health insurers give the go ahead to all procedures? Come on! We know that's not true!

The higher death rate stat is linked to a DM article (and we all know how good they are?!) and even they admit the comparison is faulty as its comparing nhs patients with varying demographics whereas the American patients included in the stats were all privately insured patients who were likely "wealthier and healthier" and so not actually comparing like with like.

I'm also aware via several channels that American health insurers are quite risk averse in terms of eg not wanting to risk GA in higher risk patients for non urgent procedures.

Oh - and the writer? Seems to me works for a right wing think tank with an emphasis on lower taxation and individual responsibility.

Not so hard to argue against after all.

@threatmatrix I’m currently living in Australia so yeah I’m fairly certain that’s where I’m talking about. It’s nice of you to mention your friends praise for the Australian health system, although a little unnecessary as no one on this thread including myself has said anything negative about It. Whether you payed a little or a lot, whether you got it back or you didn’t, Cost Was Mentioned and that is all I’ve been fricking saying. I’m more than bored of this thread now so don’t take it personally if I don’t respond. Lots of love from down under

“When I lived in Australia my host had pneumonia. The Doctor came out & his first question was not "she needs to be in hospital" but "can you afford it?". I've never forgotten it”.

bluethis was the original post from fc. Do you think this makes it clear that Australia has a free public health system?

You seem a bit touchy on this subject. I’d rather pay more for the great service I received over there and the cleanliness of the hospitals.