to think that the NHS is really quite shit and that not everyone who works in it is an underpaid hero?

[Adenosine]

There is a strange British preoccupation with the NHS which I think prevents honest public dialogue about its many shortcomings. At the time it was set up it was innovative, but now there are many other universal healthcare systems most of which are better than the NHS and many of which cost less money.

It's ranked low globally and really quite shit yet few people dare criticise or. AIBU to think that we really need to be far more critical?

@randomchatter GP consultations are free in Australia using bulk billing for may practices and even allied health visits are free under chronic disease pathways.

many, not may

I feel that the NHS is the last thing that seems to unite us as country. I'm in my mid fifties and have seen how the "social contract" (with regard to universal benefits, health etc)has breaking down over the years. If the NHS goes I really worry about our cohesion, "why pay your taxes if only others benefit?" is something I'm hearing a lot of late. I really don't want to live in a US style country where churches are looked to in order to provide "charity and welfare" and no one wants to pay out "for others" by having comprehensive welfare, but I fear that is where we are heading.

My family have thankfully been pretty light users of the NHS but every time we have used there have been issues, cancellations and problems (e.g being given drugs I have an allergy to despite stating this, nurses trying to give my baby daughter drugs she had had half an hour before, GP refusing a specialist referral etc).It's worrying. Many of my extended family work in the NHS and have severe worries about care levels, funding etc. It really feels like "flying by the seat of your pants". We need to fund it properly with a higher level of GDP as other European nations do and work on retention of staff and more flexible ways of working. The NHS bank staff only system should never have been dumped in favour of allowing outside agencies to also offer workers as so many young doctors we know will only work locum shifts at eye watering rates.

Ive had good and bad experiences, seem marvellous staff and been almost killed by the incompetence of others. Thankfully a heroic nurse noticed the doctor was about to do a completely illegal and dangerous procedure on me - you trust doctors don't you?

However it's not free, we pay taxes and we are all invested in it. Too many managers, and the structure has changed - what happened to matron whom oversaw wards, and was on the spot? In meetings now I expect.

The structure has changed but can't support the needs, however each area needs a different overhaul perhaps. And if you are a tourist it should be billed back.

I like the nhs but it depends who you see and who treats you. It costs nothing to be nice and have empathy.

I don't know where the money has been spent over the last 30 years round here, the place is falling down, no equipment or one of something that's very out of date etc. Perhaps it's all gone on business consultants and senior managers. The car park makes money though. They claw it back there.

Paracetamol on prescription - I think that’s alway wheeled out! Here’s the thing. The NHS don’t pay £8 per prescription for paracetamol. I bet no-one gets it on prescription if they have to pay for their prescriptions because they know it is cheaper to buy it themselves. So the only people who will be getting it are people who are getting free prescriptions ie the elderly, people with long term illnesses etc. Probably people on benefits are the sensitive area. But if you have kids to feed, electricity to pay, maybe even £1 on paracetamol is difficult (if you need so much you have to get it on prescription). So my point it is if you pay for prescriptions you’d be mad not to just buy it yourselves and if you don’t pay for prescriptions there’s a reason why.

When I started as a hospital doctor, nearly 40 years ago, the NHS administration bill was just 5% of the total budget. By the time I retired it was 12%. The obvious conclusion is that management and office jobs have expanded at the expense of clinical care. And these jobs are overpaid - the CEO of a small local health trust gets in excess of £250K a year. That’s more than the PM gets for running an entire country.
In my own hospital, the empire building by managers overflowed the admin block. They were turning biochem labs into managers’ offices to accommodate the extra staff. None of whom contributed anything to patient care.
At the same time, we were closing wards and cutting beds and clinical staff, to try to reduce the massive budget deficit at the Trust.
I think a privatised insurance system would be a lot more efficient. And people may not realise that 95% of GPS are actually private contractors and always have been- they run their practices as businesses, and contract services to the NHS. “Private” is not a dirty word, or a recipe for poor healthcare.

@SapatSea I agree with you. I think it was a terrible idea to remove child benefit from higher earners, for example, as people don’t perceive there to any personal gain from what they pay in.

Yes, it's goady. I've had mainly great experiences in the NHS but some not so good and some really bad. I addressed the ones that were bad or fell short. That's what people with better things to do actually do.

The NHS is unique in that it's free at point of delivery to everybody. There's nothing else like that in the UK or anywhere else. This thread though will be comprised of posters who want to navel gaze and have a rant about an institution that exists to serve everybody. They don't have any alternatives but, why should that stop them?

We should be prioritising it for funding, changing it to make it efficient for certain, but not the concept of it and not the underpinning principle.

Or is this a thinly disguised back-door for benefit-bashing, hmm? Get rid and make people pay the true costs of health care... and if the can't afford it then tough shit?

There are so many utterly smug posters on MN.

What they could do is set up a GP in a supermarket, somewhere where people go and with parking, and let people pay to see them. Money goes to NHS>
GP could do a different town a day.
People often have things wrong that they just want reassurance about or to ask if they can please have antibs for their cold as it is not a virus etc. I would attend it rather than faffing with a surgery visit.

Why do people not realise that there is "free at the point of delivery" health care outside the UK? Is this some strange form of brainwashing?

My recent experiences have all been pretty good bar one this year. (2 very ancient parents so I go with them now). It was the ambulance patient transport service call centre that messed up big time and were incredibly unhelpful.

I would agree that there is a general feeling that nobody should dare criticise it and we should be thankful we have it at all. I don't entirely agree with that POV, we all learn from our mistakes and will also apply to the NHS as well. It seems my local parts do try to keep improving, so overall I'm happy. I should have formally complained about the ambulance transport that was over 5 hours late taking mum and I back to her nursing home though, I had to go to work and my 94 year old dad had to drive in and take over escort/carer duties whilst I drove his car to work, then I followed one of their transport ambulances with one passenger on out of the city right back to mum and dads village. Fair to say I was pretty cross about the call centre after that

YANBU op and I do not feel greatful that we have the NHS. So many people are let down by its delays. I understand many cannot afford to pay and so it is needed at some level.

Paracetamol on prescription - I think that’s alway wheeled out!
Well it was 'wheeled out' when I was sitting in the walk in clinic with my DS the other day, on their big screens, so it's clearly happening and the NHS is clearly trying to stop abuse of the system.

In Germany here. Love the system. Paid 50 a month when I was low income. Pay several hundred a month now. Totally worth it.
Whoever said you have to pay for childbirth is wrong. When I had my baby the health insurance paid ME to fill the gap between my normal salary and maternity pay.
I can go to the doctor whenever I want and swap doctor when I'm not happy. Same with hospitals.
My dad is in the UK and recently got DVT. Kept getting sent away from the hospital and told to go to his GP. GP receptionist told him he didn't need an appointment and could wait a week. If he was so ill he should go to hospital. He had DVT!!! How is this a working system?

The NHS is unique in that it's free at point of delivery to everybody. There's nothing else like that in the UK or anywhere else

That’s just demonstrably untrue. There are other countries that have ‘free’ healthcare.

personally I think it seems worse since nhs trusts were introduced . As long as its free at point of service then how the nhs buy in should be open . they need to get value for money . I know someone who sells a product to the NHS and in his words "its like printing money" because he sets his own margins and no competition. At the moment it seems shortage of beds - ie nurses is the problem . They need help with housing and also better shifts for nurses returning to work . on a good point this week I have had contact with a team of nurses who help the elderly in homes so that they ( as happened to a relative this week)are not rushed into hospital in the middle of the night - not found a bed - and then returned to the home early in the morning with no treatment - twice! it was about the patient making decisions about care and helping the home administer more help in the home and making decisions . The nurse was lovely and very helpful .

@xmasfudge 'bulk billing'? Sounds like there are financial or at least administrative implications.

Look, I'm not suggesting that there aren't issues with the NHS but we can't expect to meet the levels of service of other western nations when what we spend on healthcare as a percentage of GDP is substantially below that of other economies.

I’m a doctor in Australia who has worked in both private and public systems and the poster who finds the private system brilliant is seriously, seriously deluded.

At no stage would I undergo significant surgery in the private system, just as an example. As a high risk obstetric patient I would not dream of giving birth in any private hospital in this country either.

I have no doubt that people with no medical knowledge whatsoever find the smooth bedside manner and nice carpets/cafes of the private system lovely. They don’t know enough to know what shoddy care they receive, or how often it is frankly immoral. I have no idea why people who presumably grasp that a business exists to make money forget this when it comes to healthcare.

I recall one particularly good seminar on running a private medical practice which reminded us that you need to set a high price and have an apparently long waiting list (we were encouraged to manufacture this list) in order to convince people who have no idea about medicine that they are getting good care.

Fortunately there are vast numbers of gullible people who keep the private system extremely lucrative and swear blind that ‘my consultant’ is ‘the best’.

LyingWitchInTheWardrobe so you have had many great experiences so all is ok then

What about all the staff that have experience day in day out saying it needs reforming (that the vast majority of colleagues I know)

Alternatives have been mentioned over and over again France/German/NZ/Australia

@randomchatter no, this means the patient pays absolutely nothing and the GP surgery is paid directly by Medicare. This is similar to the way Departments and GP surgeries are paid here by the NHS pot.

Canada is ‘free’ as well

My greatest concern is the conservative governments talks with Trump. It’s all over folks if this goes ahead but that’s ok because some of the NHS is shite
I work for the NHS and will finish my career within it so I have a very good
understanding of the good and bad.

I have also lived overseas where I have had to buy health insurance and pay £350 for dental care each visit and £500 for ambulance cover and despite bulk billing for GP still had to pay for every appointment. Shock to the system of also having to pay for prescriptions which for dd and I ran into £££ every month. As I live in Scotland these costs are absorbed into NHS funding. So having experience of both I’d say let’s not feed into this pre election crap that the the OP is hoping for and let’s vote to keep what we have for the benefit of the many and those that can should happily buy additional health insurance. Let’s have a discussion on why it’s not working effectively now that’s a whole different story and don’t get me started on the self righteous and entitled amongst us who expect the world on their plate for a runny nose

TrixieBelden are you talking about Aus or UK or both when you talk about the private system?

@trixiebelden77 I do take exception to that. My father was a private consultant in Aus and was an exceptional Doctor and provided exceptional service. He also offered rural and probono care for those in need and volunteered for immigration centres. When he died, over 500 people came to his funeral and the local medical centres all closed for the funeral so staff could attend.

the local medical centres all closed for the funeral so staff could attend
It was all lovely until this point.
This just sounds irresponsible