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"?

Port1ajazz
“IVF is not an illness nor life threatening ! The NHS is for sick people”
Isn’t most fertility due to a part of a body not working properly? Why is it only the reproductive bits of bodies which shouldn’t be fixed?
The NHS treats eczema, alopecia, tennis elbow, anxiety, none of which are life threatening. Should they be

*pressed post too soon
Withdrawn from NHS cover too?

I’m currently living in Australia and all the health professionals ever go on about is the price of everything.

Can you provide examples?
I worked in the system for 30years and find this very confusing.

If you go to the GP are you choosing a private practice (user pays) or a bulk billing practice (free)?

If you are choosing to see specialists in the private system then yes, the focus will be on cost as that is the nature of the system. There will be discussion regarding costs as you will need to pay.

If you are seeing specialists in the public system I am very confused regarding any discussion of costs as it is all free.

As an example my mother and sister are frugal. The thought of paying anything for health related matters absolutely horrifies them. They have never once paid for a GP visit, any test, x-rays, mri’s, pathology, specialist visits, any hospital visit, any procedures and my mum is in poor health and has had quite a few major operations, uses hospital clinics quite a bit for chronic conditions etc. They opt to only use the public system. The only exception is the dentist which is not covered under our free Medicare system.

I, on the other hand choose to use the private system when possible. I have paid shitloads for the privilege over the years both in private health insurance and all the gap and out of pocket expenses which are generally huge. Yes, I have discussions with my healthcare providers regarding money because I’m the one footing the bill. But this is my choice. It’s important to me to have the specialist of my choice rather than the one assigned to my case which is what would occur if I was treated for free in the public system. It’s important to me to have a hospital with a private room with nice curtains and nice food so I’m prepared to pay for it. But it’s all a choice and if I make these choices then my visits with my chosen healthcare professionals will involve discussions around cost. On occasion I have had to use the public system as the private system did not have the expertise I required for my surgeries. In these instances there has never been any discussion regarding cost. The only time it has ever come up was once if I had an mri privately then it would cut my wait for surgery by a month as while my surgery was deemed priority with no wait in the surgical queue there was a backlog for the MRI machines and there were others in that queue with higher priority and it would take a month. So I made the choice to pay privately for the MRI. Had it have been my mother or sister they would have made the choice to wait a month. Obviously it was not immediate life or death or I would have gone up the MRI queue accordingly but it was impacting my ability to live normally and work and I’m fortunate enough to have the money to pay.

One of my kids is treated in the public system. Three of the specialists they see (for free at the hospital) also do private work. All charge more than $500 for an initial consult if being seen privately. One operation my child had (for free in the public hospital) would have been around AU$15K out of pocket privately. That’s after we would have already paid a considerable amount out of pocket for MRI’s etc which they had for free in hospital. Another surgeon charges considerably more. But they happily see them for free and cope just fine with a shared ward and public hospital food .

Of course there are issues - any entity of the size of the NHS would have significant issues.

But I have had world class care when I was ill.

My son sees a specialist who is a world leader in his field .

My daughter sees a dental surgeon who is gifted beyond belief.

My 85 year old mother is given treatment that few countries would give to the elderly

I could go on - and on - and on .

@ginghambox I bet your one of the people who use the nhs all the time and just moan moan moan (are u over weight, smoking, couch potatoe?)

Isn't the whole point of the supposed 'romantic' view of the NHS is that there is a memory of a time before the NHS and it was not a pretty world- I mean that in terms of either elderly relatives or friends or the work of something like 'Call the Midwife'.

The problem with the UK is that there are already huge disparities in wealth here. If insurance-based healthcare came in then a lot of people would be struggling. The cost of housing alone is something that is financially crippling young people and a loss of the NHS would not mean lower taxes so it would mean that people would inevitably lose out on healthcare, I am certain of that.

My partner nearly died in Germany- when he fell into a coma and could no longer pay for the best level healthcare he had to go onto the state healthcare- which would pay for nothing above basic level care and standard hospital accommodation with junior level doctors etc.- not what you need if you have an extremely rare and complicated illness which requires isolation for example. Anyway the outcome of this two-tier system was that the basic state healthcare would not pay his hospital bills so he ended up bankrupt and asset-stripped by the German state to the tune of hundreds of thousands of Euros. This is a real life story and an example of how insurance-based healthcare ruins lives.

I agree with the OP

There is this weird untouchability about the NHS and all who sail in her. Nurses are saints or angels and doctors are gods. Don’t dare criticise, this is a “free service”. Don’t dare challenge the way things are done, we know best. Don’t complain - you should be grateful. How dare anyone think about closing x hospital - no matter how bad it is, no local hospital should ever be closed down.

Nurses are NOT angels, doctors are not gods. They are not all hard working, committed, competent, kind and underpaid. Some of them are unpleasant and/or incompetent and deserve to be sacked. Others (I’m thinking particularly about certain doctors) are overpaid. Some hospitals are filthy, badly run and dangerous, and probably should be closed down. But anybody who even attempts the open the conversation about whether we’re getting value for money from the NHS, or whether the system needs changing, or who criticises anyone or anything, generally gets shouted down immediately....

And your actual complaint is??

I think you rest your case, Pickleup. Couldn't agree with you more.

@HoppingPavlova I don’t know what you mean by provide an example, was that not what I did when I said about my midwife appointment being interrupted to talk about cost. I posted in response to other people’s response when another poster said about her host having pneumonia, and the doctor mentioning cost. Other posters like yourself queried this and I’m simply saying they do talk about cost in Australia, it is a thing, I’m not saying it’s a bad thing, and you don’t seem to be denying it is talked about so I’m confused now tbh. I was happy with the NHS and I’m now happy with Australia’s service (although no one checked my blood pressure until I was 4months gone and asked them to, but maybe that’s the norm here). I honestly don’t want this thread to turn into an England vs Australia thing, there’s no need, and people need to remember that each individuals experience with each health care system across the globe will differ even within the same systems in the same countries, it doesn’t mean people are biased or lying. It’s like when you read reviews about a holiday on trip advisor and some differ so greatly, you can’t believe they’re talking about the same place! It’s the same for experiences with healthcare. Also bad management and a bad system are two different things.

RainbowInaCloud - not all nhs staff are working as hard as you claim. On the thread recently asking posters for suggestions to improve/save the nhs several posters had personally witnessed ridiculous situations where admin staff clearly weren't working at full capacity, having time to blether about weekends/holidays, to waste time (and I'm talking hours) "decorating" waiting/reception areas for other staff members birthdays or other celebrations (completely unprofessional and unnecessary in my opinion - not only a waste of time but seriously dubious wrt to infection control and obscuring of important posters containing information for patients - I've personally seen it where Christmas decorations obscured the Christmas opening times), or telling patients things like "well I do this part of your admission and then you need to speak to my colleague SAT NEXT TO ME and trained on and using the EXACT same IT system - ludicrous waste of man hours and extremely inefficient.

As for Gp's I have had some appalling experiences and there's actually another thread running with op debating whether to complain because her father died because the GP fobbed him off (throat cancer iirc) and several other posters on that have had similar experiences. My own thread discussing the dismissiveness women face from medics many of the stories relate to GP's not taking patients seriously, refusing to refer to the appropriate specialists (an issue close to my heart due to my own personal medical history and my dds & I've recently learned my mothers) - in many cases the SAME conditions being REPEATEDLY missed, stories of patients presenting with ailments that if the GP had even done a basic physical examination would have become apparent...

THEN you add in that it's INCREDIBLY hard to complain about GP's and patients genuinely risk (and I've seen this happen in real life) ending up effectively "blacklisted" by all their local GP's being left unregistered until the official body steps in! That's outrageous treatment of patients and frankly shouldn't be allowed!

I have occasionally had excellent treatment from GP's who've gone above and beyond - but honestly that's been far less frequent than the opposite. It shouldn't be like that.

And it should be MUCH easier to get rid of or at least properly discipline incompetent even abusive or dangerous GPs than it currently is.

To be honest my personal experience and reading many similar stories on mn and elsewhere it feels like they're becoming a bit of a law unto themselves.

If even other GPS aren't able to effectively raise concerns what the hell hope have patients got?

On the subject of Ivf - I'm willing to bet - and again know of situations in real life where the fertility drs agreed - that a lot of the time the women needing to go down that route it's because gynae issues that they flagged YEARS earlier were dismissed and ignored! So in all likelihood at least some ivf treatment could be avoided if GP's were referring to gynae more promptly!

“I posted in response to other people’s response when another poster said about her host having pneumonia, and the doctor mentioning cost”.

But this poster said the doctor asked whether the patient could afford to go to hospital to have their pneumonia treated. Other posters are querying it because hospitals in Australia are free, just like in the U.K.

@graphista wow, admin staff talking to each other, putting up birthday banners and Christmas decorations - what a disgrace. Another winger

@ShaftOfWit my two experiences of pregnancy and child birth in the UK are the same as yours was in NZ apart from choosing my Midwife but if I hadn’t of got on with her I could of 100% said so and got a different one because I know two women who did this in the UK, and I was told I could. No doubt there are people that have had bad experiences in England and no doubt there are people who have had bad experiences in NZ. The generalisation that some believe of entire nations or systems, or experiences never ceases to amaze me. How could anyone possibly say that one countries system is better than the other, unless they have personally interviewed each countries resident at length??

NaturalSpirit - no not whinging pointing out where supposedly hard working staff AREN'T working.

I'm not meaning a quick chat to be social and and reduce the monotony of the working day, I'm meaning lengthy conversations where they've shushed/ignored patients. Iirc there were posters on that thread who'd had similar experiences to me where receptionists too busy gassing have caused it to look like the patient was late for their appointment and therefore either missing it or at best getting a telling off from the dr.

Making mistakes because they're not paying attention.

And yes I think spending HOURS farting around with birthday balloons when they're meant to be working IS unprofessional, unnecessary and unacceptable and frankly a piss take!

@graphista well if these are your only complaints I think the nhs is doing well (admin staff - from now on please do not acknowledge anyone’s birthday, or have any fun)

EggPlantsForever - suggest you read the New York Times take (www.nytimes.com/interactive/2017/09/18/upshot/best-health-care-system-country-bracket.html) on the comparative merits of leading healthcare system models. UK didn't win the competition but should reassure most (reasonably objective) thinkers. Your wikipedia reference is comparison of cancer outcomes and cardiovascular disease and not a proxy for any serious comparative outcomes of healthcare intervention effectiveness.

The Swiss system won the NYT analysis, but it is probably only appropriate for smaller systems (Swiss population = 8million, ie similar to London's.)

Sure, the NHS can (and must) be improved and should be vastly more open to analysis, discussion and reform. But it works surprisingly well.

@NaturalSpirit82 - you perfectly illustrate what we are all talking about. Especially the point that patients get blamed, all day long, for NHS fuck-ups, bad management, appalling attitudes and so on and so on. It is ALL THE PATIENT'S FAULT.

We need a stronger family culture first and foremost to take the pressure off - families supporting their elderly relatives. We need supermarkets to cut out all the high in fat and sugar foods causing obesity and subsequent health issues drowning the nhs. Better education so that people are not STILL going to their Gp for coughs colds and ear aches. Pressure reduced and then the accidents, emergency’s and chronic and acute illnesses can be focused upon.

@arudeterribleperson what is your first hand complaint please?

Where is the utopia the OP was describing?
As to the idea that every woman needs an annual gynae reviews.. Its nonsense and encouraging people to be ever more health anxious or phobic.
You don't need to see a specialist for every thing, yiy don't need to see a gynaecologist yearly... I notice no one suggests men go to a urologist yearly just because...
If we move to a system whereby nothing is managed in primary care and patients can be referred to specialists just because they want to be, we will end up with no GPs, after all that would effectively demote them to medical typists.. And we'd all have to pay huge amounts more for more specialists to see all those people who feel they need one. Despite the fact they have a GP who can manage multiple problems with recourse to a specialist

And what are you doing to change things, as an NHS employee, @NaturalSpirit82?

Daily educating: eat well, sleep well, exercise, balance. I wondered what your bad experience was? Why are u unhappy?

@arudeterribleperson Daily educating: eat well, sleep well, exercise, balance. I wondered what your bad experience was? Why are u unhappy?

You could try educating your colleagues that kindness to others is good for one's own health. This has been scientifically proven.