AIBU - the NHS isn't fit for purpose any more and needs to change

[perplexedagain]

Hi, before I start, i know that we are lucky to have the NHS and I don't want loads of posts just saying 'be grateful we have it'.

But I wanted to debate whether there's a better way to deliver healthcare as personally I think the NHS is unsustainable as is and not fit for purpose. So many things are offered free then it costs too much money to deliver so rules come in to limit expenditure or there's rationing by making the waiting lists so long, or making it impossible for people to get an appointment. Then you have the problems of a massive bureaucracy, lots of middle management, and poor administrative systems.

So to give an example, the NHS gives me a voucher towards the cost of my son's glasses. It does not cover the cost of thinning lens down (and DS has a high prescription) - we have to pay for this separately despite the fact DS glasses are pretty much unwearable if we don't thin them down. So the NHS is not free in our case. We can afford to pay - others can't. So why doesn't the NHS provide what's needed or put in a charging policy that's fair for all?

Likewise I've just tried to make an appointment for DS to get his eyes tested. There is no longer any leeway to go in a 1 week earlier than our recall date - the rules have changed. So the NHS is in effect delaying tests by insisting they take place after the set recall date. On this occasion we got a appointment soon after the set date but I can see situations in future whereby we might be waiting 2-3 weeks to get a time with our named optician. GPs do the same by making it so difficult to get appointments. It's rationing because of an unsustainable system.

I think the NHS is broken and sadly think free healthcare for all is a thing of the past.

I think the NHS is being systematically underfunded to lead people by the nose to the exact conclusion you've come to. A properly funded NHS is affordable, it just won't make profit for the super-rich. Whereas an American style insurance system will cost us all more than we pay in taxes, leave the poorest without health care but it will make a fat profit for a select few.
I prefer the first option.

The NHS is being required to be all things to all men and it understandably can't cope.

I don't wish to be inflammatory, but I don;'t think the NHS should be paying for your DS's glasses, nor hearing aids, wigs, or anything that isn't immediately a threat to life.

A friend actually has moxibustion on the NHS FFS.

It really does need to be reformed in line with its original aims, not this great sprawling behemoth that it has become.

I think the NHS is being systematically underfunded

The NHS is being properly funded to provide essential services.

That budget is being spread far too thinly and attempting to cover things that should really be provided by the individual, not the State.

The NHS pays for glasses?

The NHS pays for candles to be lit close to people's feet.

I shit you not.

Actually I think everything for children should be funded by the NHS.

Do we really want to be like American where a kidney transplant costs £80,000 and you have to pay it up front or your child dies? And the meds after are £3,000 a month?

That budget is being spread far too thinly and attempting to cover things that should really be provided by the individual, not the State.

Seems the NHS feels mental health and chronic pain are under the umbrella of those. I'd have paid to not have been beaten to the ground mentally for trying to get help. Actually, I'm leaving the UK to go get proper care with the last of my savings.

Because your son doesn't need thined lenses - that is cosmetic and as such you should pay for them.

The NHS pays for glasses? yes, childrens glasses and those on low incmes etc, in receipt of certain benefits

I don't wish to be inflammatory, but I don;'t think the NHS should be paying for your DS's glasses, nor hearing aids, wigs, or anything that isn't immediately a threat to life.

So a child who cant see the white bord or hear the teacher, isnt worth paying to have corrective devices and thus accessing an education.

Shit me! Who knew.

The NHS pays for my daughters glasses, for which I am thankful, and, pays for her eye tests .. it’s not a problem to wait a week or two, I doubt her prescription will change in 2 weeks.

I

I think the NHS is being systematically underfunded

The NHS is perfectly well funded, it is chronically mismanaged; and if Tony Blair hadnt had the PFI idea, it would have even more money to spend.

I need a fridge in the office. I know I can go and get one on the high street/amazon for 120 quid. But I have to go through procurement - £768 - how is that right? this is the waste, endless bloody waste. Chief Nurse will not sign off 120 petty cash, has to go through procurement.

but I don;'t think the NHS should be paying for your DS's glasses, nor hearing aids, wigs, or anything that isn't immediately a threat to life.

Are you shitting me? A child that can't see can't learn. Especially one whose sight is so bad as the OPs.

My son gets "free" NHS specs. Except they aren't free. He is too big for free frames so we pay the balance over the voucher. The vouchers don't cover non reflective finish, or the light-reactive finish, to protect his eyes from UV. Or thinning, but he doesn't need that.

I can afford to pay the balance (I think his last "free" specs cost me £100) but many can't.

And we beside you if your kids specs break, as they do much more frequently than for adults.

Bloody ignorant post, Cat.

So a child who cant see the white bord or hear the teacher, isnt worth paying to have corrective devices and thus accessing an education.

These things should absolutely be paid for, but by the parents/parents' insurance policy, not the State.

I think the NHS needs to re address what it funds, I dont personally agree with people being prescribed paracetamol, that's just one example. I think people should be charged for missed appointments (even £5 per appointment I bet they would make a fortune!). I dont think the NHS is necessarily doomed to fail I think there are ways to make it brilliant for everyone again, they just need the right people to tackle it.

What insurance policy, cat? What if the parents can't afford insurance?

These threads always present the same false dichotomy:

That things should either be paid for by the State, or the DC goes without.

The alternative, namely that the parents take responsibility for themselves and their own family is always ignored, or a million reasons presented as to what that is too hard.

Its a bitter pill to swallow, for sure, but the alternative is that we lose any form of NHS.

Surely its better to exercise some restraint than risk losing the NHS entirely (which is what will happen unless we have a radical change in perspective)

I don't think the NHS is underfunded, I just think money is being spent in the wrong places. My friend is a hospital consultant - he recently went to a seminar where only 9 people out of over a 100 worked in frontline care. The rest were all middle managers. It does need a huge overhaul but throwing money at it is not the answer.

My thoughts on this aren't likely to be popular but I think there is a real danger in the public sector that things don't always run as efficiently as perhaps they should as there is no real drive to cut costs to be competitive.

I absolutely believe that healthcare should be free for everyone at the point of use, but I also think that there could well be more efficient ways to provide this service, to give better levels of service and better value to the tax payer, than the current structure of the NHS.

My jury is out on what the solution should be- whether it needs a total reform within the public sector or whether it would be better to allow more private operators in. I think in some places in Europe (who, despite the Daily Mail's strapping, do not see the NHS as enviable), the government effectively provides insurance and treatment is provided privately for free.

If I said what I don’t think the NHS should pay for I’d be flamed for eternity. If the biggest problem is a child having to wait three weeks for an eye test and having to pay for cosmetic lenses, it would be doing well. Sadly it’s insignificant in the great scheme of things.

I had cataracts and could only be put on the waiting list when I couldn’t see well enough to drive. Fortunately I could afford to pay for the surgery. Should I have had to? Of course not but that’s life unfortunately.

saying someone doesn't "need thinned glasses" is a bit ill informed.
my dd's prescription is so strong, that with out the lens' being thinned they would be so heavy as to be unwearable. so we have to pay extra to get them thinned. we are lucky to have an opticians the refuse to make money out of her disability, so are cheaper.

I just think money is being spent in the wrong places

Agreed. I earn well into the 6 figures, but have a Medical Exemption Certificate (so all my prescriptions are free) because I take the lowest dose of Thyroxine for an underachieve thyroid.

I can't bring myself to do it, so I get it on my firm's medical insurance policy...

(my dd is an adult with a disability)

Here’s a stupid example.

I have a coil for period control not contraception. Its stuck because the string snapped and GP can’t get it out so I had to be referred.

First, the hospital insisted on a scan to prove its there, despite the GP telling them that she could see it but her tool is too short to grab the string.

So I go for a scan.

I then get called for an appointment at the community hospital. Off I trot thinking they are going to remove it and change it.

No, it was a coil consultation appointment with the local family planning service. I didn’t need a consultation, I’d had one already and it was on my records. Ok, so I’d have to be booked in for a second appointment to have it changed.

Except, when she clarified it was for period control not contraception, I was told they can’t change it as they can only do it if its for contraception.

So I have to have another appointment with the GP to refer me to gynaecology which will almost certainly need another scan and at least two more appointments.

This is just one way in which the NHS wastes money. Since I doubt I’m unique, I can only imagine how many other cock ups happen.

My mother could write a book over the administrative cocks ups she’s had over the last 10 years concerning her hip and knee replacements. Except no one would believe her and tell he she’s making it up.

As many other countries with excellent health care do, we should be charging most people modest amounts for GP and A &E visits, and pensioners who are well able to afford it - there are plenty of them - should not be getting free prescriptions. I know of a case where literally dozens of free items were accumulated - and later binned - over and over, and this was a person who could easily have afforded to pay the standard charge.

As they do in Sweden, there could be an annual cap for anyone needing a lot.

However I can't see any govt. of whatever colour ever having the guts to do it - the howls of protest would echo to the moon. Too afraid of voter backlash.

But if we want to avoid creeping progress to total NHS privatisation, it's going to have to happen sooner or later - or else general taxation will have to rise.

I dare say the layers of management and general inefficiency should be sorted out, but I don't know enough to comment in detail.

Why they still send appointment letters by post instead of by email to the vast majority who have it, I don't know. And they complain about the number of missed appts., but I know of more than one case where the letter was sent to a very old address (despite their having the new one on record) or the patient being sent to the wrong hospital/clinic for minor surgery. This happened to dh, so that was another appt. wasted through no fault of his own. All down to careless/inefficient admin.

Also I have heard so often of appt. letters being sent directly to someone with dementia, despite staff being repeatedly told that the person will never remember/will hide or destroy the letter, and that a relative must be informed as well.

It is astonishing that there isn't simply an allowance for thinning on the NHS over a certain thickness of lens.

Like I say, my son's prescription doesn't make thinning an issue, but some kids really really do.

Still waiting to hear about this insurance.