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?

I do think the NHS is underfunded and parts need updating. There are areas of best practice in various trusts, and more should be done to identify those & emulate them elsewhere.

However, I think it is a national asset of immense value. In the few months of her short life, my daughter has benefitted hundreds of thousands of pounds worth of high quality NICU & PICU care. It wasnt always perfect but it was excellent, instantly available & cost nothing at point of use. She is alive and well and would not be without it & we would not have been able to afford the care under many other systems.

Maybe not everyone is. But my friends/family who work there are heroes in my eyes.

Good for you.

Delighted that your daughter is thriving thanks to her benefiting from hundreds of thousands of pounds of high quality care. Please remind her of that when she's a stroppy teenager. (She will be; they all are, intermittently, for a while).

I've only read the op and I agree.

It's the wrong mentality. We can keep the NHS, criticise it, and improve it all whilst deeply appreciating the concept.
I certainly wouldn't say every staff member is an unsung, badly paid hero.

It needs radical over haul. Pay the best people from business to come in and change it. A huge criticism I've heard from staff is the out sourcing of cleaning staff....

People who work in NHS said it's Vile how dirty hospitals are and all because cleaning was out sourced.

I'm not happy to throw money at the NHS when it's an out of control be moth With problems that can be solved with careful management and planning and feedback from staff.

The problem is for every person who has had excellent care, another person hasn't.

It's not consistent. Feedback, complaints, pals are not good enough.

Many nurses are de sensitised and frankly not caring. I say that as someone who watched their dying father pleading for one painkiller and it was withheld by one utterly spiteful bitch nurse, then very easily dispensed by another who rolled eyes at me and was v sweet to df.

I've been in and out many times with myself and my family and I've had exemplary incredible service and then beyond a joke money wasting no joined up thinking treatment that beggars belief.

Many nurses are exhausted, overworked, underpaid, demoralised, depressed by the state the system is in ... I could go on ... that’s why they’re not caring anymore. They have no caring left in them. It’s been squeezed slowly out. What do you do for a living Comradesally?

Sure there are nurses and doctors who give poor care and should get feedback and helped to improve or advised to look at other career paths. BUT we are v short of them.

Maybe we should think of why there is such a shortage and poor retention. Maybe because their environment is bad and they have lots of work/stress and not enough time. It has puzzled me at why health secretaries do not tend to have a background in healthcare. I would like to vote for a govt that put some industry expertise at the top.

The nhs is doing its upmost best under enormous strain and financial cuts. No one will claim it is perfect, but ultimately when you really need it, it is there for you. The Tory government are underfunding it, the Tory press are slating it, to make people feel like it is failing. It's really not. The nhs is exceeding all expectations despite all the shit thrown at it. Largely this is due to an amazing workforce, who go above and beyond everyday.

Not rtft but here to say yabvvu

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Maybe some of the staffing problems would be solved by turning managers back into clinical nurses. I think there are too many managers in the NHS, and a good number of these were Nurses - and we could do with them working clinically

Create a pathway for Doctors to return to work. I left many years ago for childcare reasons and tried to return to one of the specialties that are desperate for staff. It wasn’t an acute care specialty and I could have got myself up to speed and provided a valuable service - but it was an uphill struggle to do so. No support, no guidance, no structure to return to work - meantime all sorts of people can train to be quasi doctors. Nurses can be a Nurse Specislists/ Pharmacists have a role/ Paramedics/ Physician assistants. The only group the NHS is not actively retraining is Doctors who dared to take a career break.

@formerlyfrikadela01 yes mh is also my main interest as someone who suffers from severe ocd and agoraphobia among other things. Every other healthcare system I’ve looked into there are seriously scary examples of how the mentally ill are repeatedly failed and MH services not well supported, from talking to friends and family who now live in other countries which include USA, aus, Japan and various other European countries I’m yet to hear a positive report.

“Why for example when a woman is having gynae issues does she need to see a GP before being referred to a gynaecologist?” Totally agree we should be able to self refer to far more services. My current gp surgery is better than most with 2 nurse practitioners plus you can self refer to physio, primary care mh, podiatry, midwifery and apparently they’re looking into adding audiology.

Were you aware that in effect gps are financially disincentivised to refer to specialists? That’s all kinds of wrong in my book!

And such policies don’t even save money!

I’m certain that referring me to Gynae within the first year of my reporting textbook endo symptoms would have saved a hell of a lot more money than what did happen which resulted in 14 years prior to dx of gp surgery appointments every 2-3 months for contraceptive pill (which merely masks most symptoms), reviews, meds for pain relief, migraine and to reduce blood flow, meds to treat the diarrhoea, treatment for the minor injuries caused when I’d fainted due to symptoms, several a&e admissions when I’d collapsed and was unconscious and the people with me were naturally concerned and even called ambulances, 2 mc, the first complete but caused some distress and made symptoms worse for several months, then an ovarian torsion which required surgery (admittedly begs the question why THOSE Drs didn’t see/dx), then another mc which was incomplete and required d&c then it was discovered it had been twins, one embryo was ectopic and needed to be removed so more surgery, was at this point that (excellent!) surgeon saw the endo, dx and scheduled me for another surgery to assess how bad, then another to remove as much of it physically as possible SHE referred me to gynae who were some strange mix of shocked and unsurprised, mine was a particularly bad history but it was also not uncommon. When I moved again (ex was army) I had such a rigmarole because the new gp REFUSED to accept the dx! They only set me up with an appointment with that gynae dept when I threatened to take legal action. Then the first gynae I met there claimed to have never heard of endo (where the fuck he trained for that to be the case I don’t know!) I’ve spent the last almost 20 years SINCE dx arguing with gps and nurses in gp surgeries that whatever treatment/regimen I’m currently using as advised by the SPECIALISTS is “allowed” and yes that’s even though they have letters from consultants TELLING them what treatment I’m currently using.

In addition if I’d been referred and dx early on I wouldn’t have needed anything like as many gp appointments as I did - given one of the Major issues raised by patients and gps alike is that there aren’t enough gp appointments surely not having patients have to make numerous appointments for the SAME condition because it’s going undx and untreated due to lack of specialist referral makes sense? Thereby reducing the number of gp appointments needed. This is also often the case with the thyroid and gallbladder disease histories I’m aware of - the patients went back repeatedly to the gps with the SAME symptoms and were often fobbed off, at best given meds to treat symptoms without bothering to id a cause and in the worst cases misdx as being mentally ill!

It should not be this bloody hard!!

“because a lot of gynae stuff can be managed perfectly well by GPs” I seriously beg to differ! Mostly they fob girls and women off! Currently there are major issues with the hard sell on LARC which frankly imo should be a loud national fucking scandal! Women being pressured into having them
Implanted, pressured into keeping them in their bodies despite horrific side effects, having to threaten to remove implants and coils themselves before gps agree to do so! It makes a mockery of bodily autonomy - and oh what a surprise there’s financial incentives for gps to have more patients using these and not having them removed within a certain time frame.

But I STILL don’t want it to go. It needs change, it needs to be properly resourced (including bringing back nursing bursaries utterly disgraceful to get rid of those!) but i do believe it CAN be reformed.

It needs to be made a NATIONAL health service again none of this trusts and postcode lottery nonsense! It’s pointless having no waiting lists in one area and huge ones in another! Resources need to be allocated according to need. Procurement needs addressed, the antiquated admin systems need addressed, its completely ridiculous in this day and age that most communication is STILL snail mail and even faxes! Frankly the technology is available and has been for some time for most communication and record keeping to be electronic. We all already have nhs numbers as unique identifiers they could be used to maintain confidentiality IF the govt would bite the bullet and pay for a decent, secure, nhs wide IT system. Eg it’s ludicrous that if eg you’re holidaying in another part of the Uk when you take ill that your records cannot be easily and quickly accessed out of hours.

But it’s not just within the nhs change needs to happen, I also think education of patients/general public would reduce unnecessary appointments for minor ailments. I think a good clear campaign on media and sm explaining which hcps can deal with what (eg a lot of people have no idea just how much pharmacists can do) but also self care for the majority of conditions (eg unless you have other complicating health issues you really don’t need to be seeing a gp because you have a cold/flu/sore throat which I am sure is the main reason for most gp appointments in the winter) and minor injuries etc

I was raised by parents who really didn’t go to the gp or take us unless it was really necessary:

winter bugs - fluids, rest, OTC and natural remedies for symptoms

Sprains and strains - RICE for first day or so then move as comfortable

Cuts and scrapes - clean and dress, change dressing regularly, lavender and calendula in the bath can aid healing as can aloe gel (I always have some in the fridge cos it’s great for burns too)

Bruises - arnica, cold compress

Indigestion - depending on kind milk, baking soda or prune juice

Most minor ailments can be treated at home or at most with the support of your pharmacist.

OK....

Anyone not believing the Tories have intentionally making the NHS attractive to private investors through years of austerity /no investment and lowering standards so any private system will start looking attractive regardless of the expense....
Theres two documentaries here... By Dr Rob Gill a GP and activist ;

The great sell off
The Great NHS heist

www.youtube.com/channel/UCMxZjyb-HZxBauSi_vx2ASg

I don’t agree with all you say op. I’ve personally been in hospital 3 times (over 30 years, gynae and maternity) and am sorry to say this but in my experience most nurses were pretty idle - I and other patients had to unlock ward doors for visitors because the nurses were watching Coronation Street; despite asking, I couldn’t get painkillers after an episiotomy because nurses were too busy chatting at their work station; whilst in SCBU with my newborn, the nurses did nothing but moan - how hard done by they were, how hard they worked yada, yada, yada - although I didn’t witness any of this, far from it.
I worked for the NHS for 18 years - it’s badly structured, poorly managed and doesn’t have a long term strategy. I have met Chief execs who manage multi million pound budgets but have never received financial training.
I’ve witnessed executives who think nothing of bringing in individuals on temp contracts of £80k plus to ‘help out’ the exec.
I’ve seen year end spending sprees - to purposely get rid of cash so that next year’s budget isn’t reduced. I was asked what was on my ‘wish list’ and was forced to have new office furniture (although the old would only be classed as ‘tired’) so that the office would look nice.
The NHS needs a total restructure. Throwing even more cash at it is not the answer.
I would also suggest we ask ourselves some very hard questions about how and where we should spend NHS funding and what our priorities as a society actually are.

I would also suggest we ask ourselves some very hard questions about how and where we should spend NHS funding and what our priorities as a society actually are.

What do you mean by this? Do you have any thoughts or ideas.

I've lived in the US all my adult life and the healthcare here is fantastic - but you need to buy health insurance if you're self-employed, as I was most of my working life.

But if you’re not self employed, you’re obliged to use your company’s health insurance, which may be utterly shit, may not cover certain procedures then you may have to fight bills for thousands because your insurance tries to dodge paying out for a valid claim.

Every hospital I've worked at had contracted out cleaning to private firms. The contract regularly comes up for tender, the winning firm then comes round, rips out the soap dispensers, loo roll holders and paper towel dispensers. The ones installed by the previous firm were binned.

• why the waste? Each company has a proprietary set they must use
• wonder who was paying for this waste?

Each time the staff get tuped across, with yet another teeny tiny fragmented pension scheme, more targets and less time to do the work. Staff turnover noticeably increases.

Not sure private is definitely better.

The NHS is an awful waste of money & resources. The way they quickly diagnosed, treated & cured my Dads bowel cancer not once but twice was just outrageous. And the way they have given me access to high quality antenatal care, including late nights and weekends is just deplorable. Get rid. I’d love to pay hundreds of thousands in bills if I’m ever in an accident (touch wood I don’t be).

@Graphista yes the average number of times patients present at GPs with the same symptoms before referral is shocking for some conditions. Also agree with you re gynae issues - sure, GPs can prescribe the pill and tranexamic acid etc but that isn't actual gynae treatment. If a woman has menstruation issues that are impacting on her quality of life she should see a gynae specialist. I was actually specifically thinking of endo when I made this point and I'm sorry you've had so much difficulty getting medical treatment for a medical problem.

MH services are an interesting area because diagnosis and treatment of mental distress is inherently culturally bound and also subjective in a way that conditions with clear physical pathologies are not. In that sense and at the risk of being over simplistic I can well understand that MH services in Australia are less than ideal, given the cultural context they occur in, while in France they are good. If you ever read a French psychiatric report it's almost metaphysical in nature; like I say, different cultural mores and preoccupations.

I’d be paying off my treatment for years to come pretty much anywhere else in the world. Yes, I know we pay NI and not at point of service, but having covered the entire floor of several cubicles in blood when half my leg was sheared off, I was glad nobody was harassing me to complete an insurance form.

I do think different trusts vary widely. I was at the Royal Free for my main operations but at a different out of London hospital for initial treatment. I was very happy to be transferred to a specialist unit. The care was mostly amazing, bar one nurse who gave me the biggest bruise I’ve ever had, injecting anti-coagulation meds, twiddling the needle while humming and looking round! The pain was astonishing.

I don’t think we pay too much NI, I think it’s a total bargain that you just turn up to your GP and be seen then get a prescription for under a tenner.

I am currently in something of a battle with my GP practice to get pain treatment, and my experiences are along the lines of interstellar I have had exceptionally good experiences with NHS, but there is a lot of utterly ridiculous bureaucracy and some of their systems are antique. I have come to the conclusion that my GPs ( usually see locums) are useless. Too many medics work part time, managers frightened to properly manage staff. I had the same awful chit chatting nurses ignoring patients while I was in for childbirth, have observed a lot of workshyness. The principle is great, the execution leaves something to be desired. We would get improvements if we were more direct about the problems, on both the left and the right. Saying “oh poor NHS, starved of money” won’t solve the organisational/ structural problems, nor will opening it up to US pharma.

Everyone in it an unsung hero? Agreed, definitely not. The same as any workplace there is a mix of people, but the majority I'd say are normal every day people doing their best.

Is it a bit shit? It's not perfect. By a long stretch. But I like that it's free at the point of access, and i don't have to worry about finding money before I make an appt.

I think the structure of it's various arms, walk in etc. is poor and open to abuse. It's underfunded, and struggling. The things put in place to try and mitigate this, like triaging over the phone at GPs surgeries for example, has had devastating effects on a&e pressures. I think as well that communication is shocking between these different depts, and savings could be made there.

When I lived in SE Asia, I broke my toe. I went to an orthopedic hospital, was seen in 10 minutes, xrayed, into room next door immediately, to talk to doctor who was looking at xrays. Prescription was cheap and simple to get. I was well impressed. A few months later I realised that it was fantastic for things like this, but had I been diagnosed with cancer it would have been very different, and all assets would have to be liquidated and treatment would stop when the money did.

I have lupus, that's never going to go away, and causes lots of problems with joints and organs that you have to have surgery and appointments with different specialists for, as well as rheumatology. My immunosupressants are life changing, and cost a pittance. My concern would be for life changing diagnoses like cancer, and long term conditions like mine. Insurance is difficult for me to get, and becomes more difficult every time the lupus causes something else. Of course working is not always possible so that adds another layer of difficulty.

All other models are based on insurance as far as I know, or am I wrong?

I don't see as we have any other options, and I think when funded and respected it will do just fine.

YABU.

The NHS is uniquely wonderful in that everyone living in the UK can access it for free. Thats in itself is incredible. It's unfortunate that it's so stretched and underfunded and of course everyone is not an unsung hero. Not at all.
I live in another country where my health insurance is 80% paid for by my employer for me and my family. The healthcare is incredible and fast to access but it's private. There are one or two things that aren't covered and it's been eye watering to pay for. I love the concept of the NHS and I wish it would be properly looked after.