To ask why prevention isn't a bigger deal in the UK?

[willisurvive3under2]

Posting here for traffic really.

I moved to the UK as a young adult and I was used to a different health system. Have lived here a long time now and I can see pros and cons of the NHS. My question is, why isn't there more of a prevention culture? Of course I don't expect the NHS to pay for it all. I understand it wouldn't be possible.

In my home country, private healthcare is very affordable and often subsidised. So for example girls have a routine gynae check up once a year... a bit like a dentist check up. You can get an abdominal and breast scan as part of it. It will set you back no more than £100. Wouldn't most people go for it if that was the case in this country? A few years back I had to have a private mammogram in the UK (I'd had a scare but the GP wouldn't refer me for a follow up). I spent £340 at the Nuffield. This is ridiculously expensive, I think everyone will agree. Why can't I pay a reasonable amount of money and have a mammogram every 1-2 years?

Someone I know has gynae issues which are impacting her fertility. If these had been monitored in her 20s, things might be different now. I'm angry on her behalf that she might not be able to have children because of this.

Why can we not pay £30 and have yearly bloods like they do in a lot of countries? Things like high cholesterol and low iron would be picked up easily, saving a lot of money and resources down the line.

I'm just interested to hear others' opinions on this.

**NHS isn’t a limitless pot

The NHS is only a tiny player in prevention in England.

As it should be - they treat the sick!

A very interesting topic which, to fully appreciate, you probably need experience of living in a country where private healthcare is the norm.
I am a Brit living abroad (Europe) and I am often pleasantly surprised about how things are done differently here.
However, ime, it’s not about screening, it’s about carrying out some simple procedures that could have a positive impact on health, rather than ignoring the patient until things get really serious (as I feel the NHS tend to do).
Examples of this that I’ve experienced and come to mind are:
Extensive physio after even a small break or sprain to reduce the risk of arthritis later in life.
Special after-birth courses to get pelvic floor and stomach back in order to reduce problems in years to come.
Immediate referral to a psychologist after mentioning just once to the doctor that I was struggling slightly.
A 3 week kind of health farm stay with the kids after aforementioned appointment.
Regular bottom exams from age 40 as my grandfather died of bowel cancer.

I wonder how outcomes compare?

@Stealth Well I think it’s generally accepted that the country I live in has a considerably higher standard of living than the uk and healthcare must surely be a major contributing factor in any study that draws these conclusions.

Weather thanks, yes, I remember it now. I don't fill in anything requiring that much personal info, but colleagues were baffled by it, 20somethings comparing themselves with 60somethings etc.

If postcode is in there, that is bonkers.

the poster talking about bottom exams - tell the doc about your family history and I guarantee you'll have your bottom thoroughly examined!!!

Although long term prevention saves money in the cross over period of many years you're paying for pith the prevention. Scans, tests and the like plus treatment. So it costs lots of money to bring in. Like millions if not billions. The NHS are just keeping afloat financially.

You seem to be suggesting people pay for this themselves which many could afford but there are people who can't. So this would potentially massively increase health inequalities, which are massively determined by social economic status. Also I think the government are reluctant to start with the whole pay for extras thing. As it is a politically bad move, it makes people question what they pay their taxes for. You could end up with a much bigger uptake in private healthcare which would leave the NHS dealing with the sickest and poorest. I think it would be hard to argue (politically) for the level of funding to be maintained for the NHS if say a third of people didn't use it.

Also I'm fiercly protective of the NHS even with its problems. Many other counties who think they have better healthcare actually have really poor outcomes for vulnerable people and people who are poorest. So it does get my back up when people act like it's shit. Which your question sort of implies. Yeah you might pay 30 quid for blood elsewhere but you also pay that or more every time you see the GP.

@ohyesohyessyyesyes where do you live?

So google tells me Finland comes top of the pops for quality of life. The UK is by far the largest and most densely populated country in the top 10 and comes in at number 9. The NHS is seen as one of the drivers of its high position. Life expectancy in all of the top countries are very similar.

www.weforum.org/agenda/2016/07/these-countries-have-the-highest-quality-of-life

Finland is indeed feted for its preventative health strategy. However this article suggests preventative health policy is actually much more about education, housing, income inequality etc etc than actual health service spending, screening etc. In fact Finland spends less on its health service than the UK.

www.theguardian.com/commentisfree/2018/oct/17/life-expectancy-rising-finland-uk-scandinavia

@BuildBuildings- I agree with you. The point of the NHS is that everyone has equal access, no matter their socio economic status.

Honestly, going back to the original post, the OP wasted her money on a useless follow up. Guess why they have you coming back each year in another country? To make money! There are hospitals in the UK that have patients coming back for pointless follow ups all the time - it boosts their income. Private hospitals (who do work for the NHS) are the worst for it. They really are playing on patients anxieties for profit and it isn't right. Private hospitals are also much more willing to undertake surgical intervention compared to NHS trusts, again .. money! There are so many pharmaceutical and health companies just waiting to profit on fear and misery.

We are extremely lucky to have national free access to healthcare. As I said earlier, I think prevention is more to do with healthy lifestyles.

@howabout that's really interesting- to me it completely makes sense that if you invest in preventative health policy and make sure people are happy, healthy and empowered to care for themselves, spend on health interventions is inevitably lower than countries with less preventative measures in place. I'd love to see more focus on that in our country.

Also comparing countries with massively varying population density isn't particularly valuable.

I work in primary care. Screening is valuable and early detection is a large factor in outcomes for many diseases.

However until Joe Public wakes up and smells the coffee health prevention is fighting a losing battle.

Too many people drink too much, smoke, eat too much especially of nutritionally inadequate food, do too little exercise. The obesity crisis is IMO the single biggest timebomb in health terms. All the screening in the world won’t help if people won’t help themselves but too many people don’t want to take any responsibility for their health.