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AIBU?

AIBU to not understand the english attitude towards the NHS?

388 replies

EggplantsForever · 05/11/2018 23:04

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"?

OP posts:
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givemesteel · 06/11/2018 07:35

The NHS was an absolute godsend when a member of my family was seriously ill last year. We are SO lucky to have it. We all need all need to be willing to pay more towards it.

This is the attitude of a lot of people - the NHS helped them in x scenario so it's wonderful. They think the alternative is not getting help at all.

Even journalists / the media won't really criticise the NHS, it is truly astonishing.

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SofiaAmes · 06/11/2018 07:35

Of course, you do have to go to the trouble of signing up for Medicaid or Medicare...it's not automatic, but there is a huge amount of support to do so. And just like in Austrialia, if you don't bother to sign up, you don't get the care free at the point of delivery.
Though actually, I think that there should be a nominal fee or some sort of non-monetary hurdle at the point of delivery so that the system isn't overburdened with minor complaints.

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SillySallySingsSongs · 06/11/2018 07:36

It’s interesting that when it’s seen as a negative issue, the English are very quick to explain Britain/the UK to everybody.

Interesting considering you don't know where I come from.

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kaytee87 · 06/11/2018 07:39

It's also interesting that the Scottish/Irish/welsh are very slow to explain it in similar circumstances.

Really? I'm Scottish and I hate it when people refer to Britain as England. I was just about to tell op that too. No matter what the issue is, it's very irritating being referred to as English when I am not.

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grasspigeons · 06/11/2018 07:39

The political leaders want the American system as they can profit from it. I've no doubt other countries are better but we are afraid of losing what we have which is better than the American system.

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Branleuse · 06/11/2018 07:40

The constant criticism of the NHS is taken as reason and excuse to privatise it more though, not improve it.

Of course it could do better. Its massively underfunded right now. Its on the verge of being bloody sold off to private companies. Thats why its being compared to the US and not france/norway etc

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anniehm · 06/11/2018 07:40

Sofia

In the USA cover is appalling, even with the affordable care act and private insurance you can be bankrupted by daring to get sick. Drugs are often not included so my uncle for instance still is working at 80 because he has over $1000 of drugs a month to pay for. It's crazy. Giving birth to my daughter was an eye opener, we received the bill, €25k (18 years ago) despite having zero drugs and a midwife (unusual in the USA) thankfully our health insurance picked up all but $100!

We returned to the U.K. partly because our dd has a variety of medical issues and every trip to the dr cost us $15, plus for developmental issues our insurance stopped at 8 years old (go figure). The nhs is far from perfect but it's so much fairer and if you have the money you can top up with private insurance.

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PiperPublickOccurrences · 06/11/2018 07:40

I agree with what the OP is saying. The NHS is considered a totally sacred cow by many which should not be criticised. Ever. By anyone. Or you get the "poor hardworking nurses" argument - yes, some nurses are amazing and others are crap. Just as with any profession. Also there is a lot more to the NHS than just nurses and doctors.

We are living in a very different UK to when the NHS was set up. People are living longer, with more complex health problems. The system is huge, unwieldy, and creaking. It can't go on the way it has - and I don't believe that throwing money at it is ever the answer.

I have UK born friends who live in the Netherlands, Germany and France and all say that the health systems there are better and more efficient. Yes many workers have to contribute through insurance payments, but this is no difference from funding the NHS through taxes, which are taken from wages. For a government to suggest switching to an insurance model would be political suicide though.

We have private medical insurance through DH's work but it doesn't cover everything. It doesn't cover routine GP appointments, or anything acute which you'd need A&E or minor injuries or. The difference between private and NHS is night and day though. I had a major op privately a couple of years ago. I could choose an appointment at a time to suit me, scans and tests were done immediately, the operation was scheduled in very quickly, the hospital environment was comfortable with en-suite rooms and good food. Aftercare was amazing with physio appointments and as many checks as I needed.

By contrast, the NHS are still sending me increasingly cross letters telling me that I'm a naughty lady for missing my smear, despite about 6 phonecalls telling them that my cervix has disappeared on a surgeon's tray but they're more than welcome to look for it if they wish.

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anniehm · 06/11/2018 07:43

As for Australia, to get the decent cover you have top up insurance, my bil gets great coverage but only because he pays $300 a month in premiums. He said the base cover was really bad

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TooOooOnaStubbs · 06/11/2018 07:46

Tbf to OP, the NHS can be regarded as English. NHS Scotland is a separate entity devolved to the Scottish Parliament.

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PiperPublickOccurrences · 06/11/2018 07:49

NHS Scotland is a separate entity devolved to the Scottish Parliament.

This is true.

And it's a separate entity which has just the same problems as the English NHS.

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redsummershoes · 06/11/2018 07:51

often I cannot afford to use the nhs.
dc has a chronic health condition that needs regular blood test and check ups.
nhs would mean 2 days a month dh and I have to take off work plus dc off school.
private means we can drop in for the blood test whenever and we see the consultant via face time or face to face at a suitable time.

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easyandy101 · 06/11/2018 07:51

fc301 what an odd thing for a doctor to say in Australia. All Australians get their health care free ( yes I know, taxpayer funded but the patient doesn't pay anything for hospital treatment). So no doctor would ever ask a patient "can you afford it"unless they had specifically said they wanted to go to a private hospital, or unless they were not an Australian citizen.

My partner got free health care in Oz after reacting badly to a spider bite. She's not Australian (I am but it's not like they confer my nationality onto her)

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Gwenhwyfar · 06/11/2018 07:53

"tbf to OP, the NHS can be regarded as English. NHS Scotland is a separate entity devolved to the Scottish Parliament."

No, that's rubbish. The NHS was founded by a Welshman and it was based on miners' hospitals in his part of Wales. It's definitely not more English than British.

Yes, NHS Scotland is devolved, but does that make it less part of the NHS than NHS England. NHS Wales is devolved too and run by Labour, BUT the decision on budget is made in England (Scotland and Wales receive an amount based on percentage of population).

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PoshPenny · 06/11/2018 07:53

I am frustrated by this feeling that the NHS is a sacred cow that nobody is allowed to criticise without someone jumping down your throat, but honestly right now I don't have anything I want to criticise. My mum is 87 with dementia, she fell yesterday and we had to have the ambulance, her care was first class. From the ambulance straining very quickly to waiting at the (very busy major trauma centre) hospital for processing. There was never ever that feeling of nothing happening around you that I find so frustrating, it was clear people were being "processed" at all times and once it was mums turn it was all very professional. I was confident she was in safe hands when dad and I left last night, All my experiences with the NHS this year have been excellent actually. I think it's being very well run in our area at any rate.

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PoshPenny · 06/11/2018 07:56

Straining = arriving

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Gwenhwyfar · 06/11/2018 07:56

"I have UK born friends who live in the Netherlands, Germany and France and all say that the health systems there are better and more efficient. Yes many workers have to contribute through insurance payments, but this is no difference from funding the NHS through taxes, which are taken from wages."

I used to live in Belgium. I paid for my healthcare THREE TIMES. One through taxes, two through mutuality contributions (social insurance) and three at the point of delivery. It was better care, easy to get GP appointment, can go straight to a specialist if you want and serious illnesses would be covered completely, BUT it is very expensive. Many people also had private insurance in addition to paying in the three ways I've already mentioned.

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TheStoic · 06/11/2018 07:58

Interesting considering you don't know where I come from.

True, although I wasn’t (just) referring to you. Where are you from?

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NotTerfNorCis · 06/11/2018 07:58

Criticism of the NHS is used as a lever to sell off and ultimately destroy the NHS. It's already been partly privatised for ideological reasons.

Most people don't want a private health care system. Watch Michael Moore's 'Sicko' to see what can happen in a private system even if you have insurance.

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LakieLady · 06/11/2018 08:01

There are 2 problems with the NHS, and they're closely connected.

The first is under-resourcing. The UK pays less, both per capita and as a proportion of GDP, than most comparable countries. This means waiting lists for non-urgent care and delays in treatment for emergency care. Cutting resources when we have an ageing population with a high level of complex need is just madness.

This has led to big problems with staff recruitment and retention, which makes the first problem worse. It's created a vicious circle as staff leave because of stress, long working hours and poor conditions, and the service struggles to replace them.

Making nursing a graduate-only profession and abolishing the nursing bursary was a stupid move. Doctors qualifying with huge debts and much slower career progression because of reductions in the number of senior posts is making things far worse.

Despite all that, my experience of the NHS has been fantastic. I'm very lucky to live in an area with excellent orthopeadic services and I've had two operations in the last 10 years that were carried out by surgeons quite renowned in their field and with a wait of only 3 months for the first and 5 months for the second. We have a fantastic minor injuries unit, staffed by nurse practitioners, where you rarely wait for more than an hour and can often be seen almost immediately. I can get a telephone appointment with my GP on the same day, or the next day if I don't phone until later in the day, with a face-to-face appointment within 24 hours if that is what is required.

And no-one is refused treatment because their insurance cover has reached its limit, or because their insurance is inadequate or non-existent. No-one has to contribute towards the cost of medication or treatment. I think that's fantastic. No-one goes bankrupt because of medical bills.

And for anyone who wants an insight into the US system, I recommend Lionel Shirver's "So Much For That".

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SofiaAmes · 06/11/2018 08:04

anniehm what part of "you only had to pay $100 for a $25k procedure" is appalling? Do you think that a cs costs the NHS much less....just because you aren't paying for it at the point of delivery? Perhaps the NHS should give out statements declaring the cost of each procedure and maybe people would have a better understanding of what healthcare costs. And I do not know what your uncle's specific situation is, but he should be able to get his drugs for a lot less than $1000/mo if he is 80. If he's paying that much then something is not getting done right. Perhaps he didn't sign up for the Part B/C/D of Medicare. My parents who are both in their 80's probably end up paying a $1000 a year for all their medical care and that's including care for a rare blood disease and multiple operations.
In any case, coverage has improved drastically since you lived in the USA with the introduction of the Affordable Care Act. Our system is far from perfect, but at least it's improving and there is general acknowledgement that there are issues.

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TooOooOnaStubbs · 06/11/2018 08:04

No, that's rubbish. The NHS was founded by a Welshman and it was based on miners' hospitals in his part of Wales. It's definitely not more English than British.

"The NHS in Scotland was created as an administratively separate organisation in 1948 under the ministerial oversight of the Scottish Office, before being politically devolved in 1999. This separation of powers and financing is not always apparent to the general public due to the co-ordination and co-operation where cross-border emergency care is involved".

🤷‍♀️

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Gwenhwyfar · 06/11/2018 08:07

Ah, thanks Too, so NHS Scotland has been separate from the beginning, not a matter of it being devolved then.
Doesn't Scotland's funding also come from Barnett consequentials though meaning the Scottish government can only spend as much money as it gets and that is decided by the Tory government in England?

In any case, a separate organisation still doesn't make it 'not NHS'.

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kaytee87 · 06/11/2018 08:08

Tbf to OP, the NHS can be regarded as English. NHS Scotland is a separate entity devolved to the Scottish Parliament.

Oh come on. Op was using England and Britain/U.K. interchangeably.

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MyBrexitIsIll · 06/11/2018 08:09

If you wonder which country the OP is referring to, France is like that.
Children are also fold by a paediatrician, not a GP. Babies/toddlers have regular check ups done by the paediatrician, not a HV.

The system is just as free as the NHS because
1- because the ‘carte Vitale’ doctors and pharmacists are paid straight away. No payment up front by the patient
2- there is a system to support any other payment you might need (some non essential medicines such as cough syrup) that is cheap and often paid for by companies anyway. No payment for essential medicines such as antibiotics etc.. too.

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