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?

You could throw billions at the NHS but a lot of what is wrong with it isn’t about money.

Doctors that don’t listen.
Nurses that don’t listen.

Start with that and it will automatically save the first billion

Most people know exactly what is wrong with them so why are we then sent for test after test, appointment after appointment just to get to the conclusion that what is wrong with you is what you self diagnosed months, sometimes years before except now apart from the cost of the tests and appointments over the time instead of a simple quick fix it has become a bigger problem that needs more money throwing at it

Solve that and you will have a more efficient and cost effective NHS.

Iron out the other little things that people notice are irrelevant or complete madness and then see if more money is needed

Most people know exactly what is wrong with them so why are we then sent for test after test, appointment after appointment just to get to the conclusion that what is wrong with you is what you self diagnosed months, sometimes years before except now apart from the cost of the tests and appointments over the time instead of a simple quick fix it has become a bigger problem that needs more money throwing at it

This is complete nonsense. Most people don’t know what’s wrong with them. We have a system of clinical care in western society called evidence based medicine. If people were treated on the basis of self diagnosis via Dr Google, the mortality rate would be through the roof.

The NHS is far from ideal. Too few staff, too many managers spending too much time going to meetings.
However. lf it was properly funded and resourced, it could be amazing.
The alternative? This is a twitter post from earlier this year (not by me). The photo is from an A & E department on Guernsey. Could you afford to pay this?
twitter.com/_Zoe_Andrews/status/1140713919448850435?s=20

The director of nursing is a mandatory board position so you must have worked in some very odd trusts.

Not my trust but here's a band 9 director of nursing post on NHS jobs

www.jobs.nhs.uk/xi/vacancy/?vac_ref=915837244

Most people know exactly what is wrong with them so why are we then sent for test after test, appointment after appointment just to get to the conclusion that what is wrong with you is what you self diagnosed months, sometimes years before except now apart from the cost of the tests and appointments over the time instead of a simple quick fix it has become a bigger problem that needs more money throwing at it

Not to mention that once you finally get through to specialists/consultants, they often want to do the same tests again, adding more delay and cost. My OH was diagnosed with Myeloma (Cancer), at the local hospital after having an MRI scan, full body x-rays and various specific blood tests. They referred him to the specialist in the next town. So we went there to see their specialist - completely wasted first appointment - all he had was a simple referral letter, no test results, no xrays nor scan results, so he booked him in for full body x-ray, MRI scan and some blood tests at his hospital, meaning not only duplication of expensive tests, but also 3 more days for us to travel to the next town's hospital to have the same things done, which all took 2 months start to finish before we saw him again. By that time, he'd got the results through from our own hospital and just laughed/shrugged it off when we mentioned the waste of time/money. I really don't think the NHS staff give a toss about the money they waste.

@rockingthelook poor staff definitely make life harder for good staff as well as patients. One of my former colleagues/friends is now a mentor when trainees are on ward I’ve mentioned several times before she is increasingly finding they are unwilling to do “menial” tasks as they don’t think that’s their job, they don’t see the value in spending time with patients and don’t acknowledge the information that can be gained from eg giving a bed bath or taking obs themselves.

And yes she’s also had a number of them expecting to be able to refuse to work weekends/eve/bank holidays which utterly bewilders me - do they think the patients go home?!

@dontdisturbmenow I’m not denying it’s a significant issue but that it’s not the only one or even the main one. Also blaming patients is frankly counterproductive, it may feel right but we know from other “self inflicted” illness that shaming people doesn’t work! Fat shaming is still very much acceptable yet smokers, heavy drinkers and even recreational drug takers are treated more sympathetically. It’s acknowledged that it’s bloody hard not doing something which albeit temporarily makes you feel better and/or is tied in with addiction.

I remember watching (actually at a time when I was still effortlessly very slim myself!) an episode of Oprah when she was discussing her struggles with being overweight, trying to lose weight, being unsuccessful etc and she said something very interesting - if you have a problem with something else that’s negatively affecting your health you can just quit taking/using that thing whatever it is, not easily but you can live without drinking alcohol/smoking/taking drugs but if your “drug” is food everyone has to eat so you can’t go ‘cold turkey’ instead you’re having to deal with your addiction (there’s considerable research now to support addictive qualities in overeating) all day every day. Every mealtime every social occasion...

I am overweight myself but lost considerable weight a few years back via ww, it may be “simple” as in ‘eat less move more’ but it’s not “easy”, anyone who has attended a slimming club will know the meetings don’t merely look at which foods are less calorific and more nutritious but discuss WHY members overeat, ime most members have some kind of trauma at the root of their overeating, sadly all too often being victims of some kind of abuse, not always but often. Also things like having been very poor in childhood and there not being much food available, food being linked by their parents to reward and punishment, recovering from previous eating disorders (personally I think overeating should also be recognised and treated as an eating disorder), even culturally food is tied in to celebration, reward etc our food environment in this country is dreadful, a friend of mine is married to a non Brit and apparently he was shocked upon his first visit to a Uk supermarket by how small the fruit and veg aisle is but how many multiple aisles of unhealthy snacks and drinks there are. In his country of origin he says they rarely snack between meals but meals are big, hearty and healthy. Things we eat on a regular basis are reserved for things like birthday parties.

But also as I said before I’m not convinced unhealthy lifestyle is the whole or even the main cause of type 2 diabetes, given how obese & unhealthy we are as a nation if it were I’d expect higher than a 10% incidence.

I hate the blaming of patients for their health.

Very few health conditions are completely “blameless” in cause. Most cancers, heart disease, stroke, lung disease... are down to unhealthy lifestyles but those patients aren’t blamed in the same way as those with type 2.

@Frumpety nurses became “allowed” to do certain tasks as a way of reducing the pressure on junior Drs, not sure what age you are but when I was training/first working it was a big scandal that junior Drs were working insane hours and being expected to do too much, the effect on patient care (dangerously so in too many instances) and that they were literally dying in a few cases of overwork was why the govt was under pressure to sort it. That too was under a Tory govt. it was PRESENTED as giving nurses more responsibility and recognition for their abilities but the real reason was the outcry against what was happening with junior Drs.

“Another issue is the gateway of the GP system” I’m kinda labouring the point I know but I really hate this aspect of gp care. Most patients know what’s wrong with them. I’d strongly suspected the endo years before I got an official one.

A&e however I think would greatly benefit from better gatekeeping.

But then there’s also the fact that many patients are attending a&e with issues best dealt with in gp surgery because they can’t get appointments! If gps weren’t being gatekeepers to specialists those appointments would be freed up, patients would be more likely to get gp appointment and not end up in a&e either out of frustration or WORSE because the condition has deteriorated to the point they now NEED emergency care

@andysbestadventure I’ve thought for several years my weight is at least partly due to a thyroid issue, but even with a family history of thyroid disease I’m treated like a hypochondriac, occasionally blood has been taken and tested and all I’m told is “it was fine” I’ve asked on numerous occasions for exactly what was tested and the results and been repeatedly stonewalled, I believe because I have mh dx. It’s not my area of expertise but from reading loads online I know the nhs levels considered within an acceptable range are considered differently in other countries. And that it’s not always the right things that are tested for. (Sorry having a fuzzy headed day can’t remember some words/terms)

“Doctors that don’t listen.
Nurses that don’t listen.” TOTALLY agree with this! I have just this week had yet another issue relating to a prescription, in part because the dr I spoke with kept assuming what I was going to say INSTEAD of LISTENING!

Among the best Drs and nurses I’ve met have been the ones that said “what do you think is the problem?”

The Drs and nurses who asked that were the better listeners too.

Alsohuman - a good dr/nurse will listen and be able to explain to a patient why what they think is wrong couldn’t be- instead too many of them are dismissive and even rude. The first time I mentioned the possibility of endo to a dr he literally laughed out loud and told me I was talking complete nonsense

One of my former colleagues/friends is now a mentor when trainees are on ward I’ve mentioned several times before she is increasingly finding they are unwilling to do “menial” tasks as they don’t think that’s their job, they don’t see the value in spending time with patients and don’t acknowledge the information that can be gained from eg giving a bed bath or taking obs themselves.

I've found this too. Especially since the bursary was first cut then went altogether. We get more straight from college types than we ever did before, cant remember the last time I mentored a mature student or even one that had some previous care experience.
I always make it clear from day one that theres not a single thing on my ward that nurses are above doing. Even our ward manager mucked in when a patient trashed his room and smeared faeces everywhere. We're nurses, the basics are what we're supposed to be best at.

Not my trust but here's a band 9 director of nursing post on NHS jobs

If you read the ad you’ll see it should have Divisional at the front of the job title, so not a director at all. It’s a vanity title.

@Graphista, diabetes IS the highest cost to the nhs and is predicated to soar. More statistics: 4.7 million people around n the uk, almost one in 14 suffers from it. The cost of diabetes related medication has double from 10 years ago.

Who talks about fat shaming? It's nothing to do with shaming but for people to open their eyes to the reality instead of trying to blame everything else.

The first step to enabling a change is to recognise the problem in the first place and as this thread shows we are still very far from that point.

@FormerlyFrikadela01 yes I've other ex colleagues/friends still working in nhs but not mentors but they're working with the students/new nurses and saying the same - they think they're above doing the basics!

Diabetes (Type 2) is as I said earlier largely genetic.

If you know you are at risk then you have options to reduce the risk. Problem is we live in an obesogenic environment where food is highly processed and palatable. It's designed to be that way,

Lots of current research is showing that obesity is not the simple "you eat too much" issue that people always thought. It's far more complex than this and includes hormones which tell us when we are full and not full. There are also inflammation issues at work too.

In addition diets don't work as 95% of people who lose weight will regain it within five years. Around 40% of these people will gain additional weight on top.

Treating diabetes and even helping people reduce their risk is therefore complex and involves more than sending people away with an instruction to "go on a diet". The NHS doesn't do well here as it pushes diets rather than pushing movement and exercise which has equal if not better effects on reducing overall blood sugar control. Nutritional education helps but isn't the be all and end all.

FormerlyFrikadela01 I think that’s just a “new grad” thing tbh - we had house officers who were too good to do cannulas/rewrite drug charts back in 2001, DH has had juniors too good to do the IT equivalent.

I think a lot of people have an idea about how the working world is going to be and then get a shock when 50% of it is either pointless makework or tedious drudgery (I think that’s true of most jobs - I’m sure even Batman spends most of his time taking the Batmobile for a service and inventorying and re-ordering stock in the Batcave).

I don't think it's all shit, Addenbrooke's were great to my mum and I've never had any staff be arseholes to me for any of my suicide attempts. I was in A&E for 12 hours last time but I put that down to it being busy. I agree GP appointments are ridiculous though. You have to go down there in person first thing if you want an appointment. I also agree that there are too many useless managers. Some of the ones in the hospital where I worked were terrible and could have been cut.

@sashkin That's such a shitty attitude. I was a Band 2 admin worker and OK, it wasn't the most exciting of jobs, but someone has to do it.

T2 diabetes was very rare 50 or 100 yrs ago.
Genes haven't changed, but lifestyles have changed.

Genes haven't changed, but lifestyles have changed.

As has all the additives, flavourings, colourings, preservatives, etc., that are put into food. Processed foods are now often cheaper than fresh alternatives (not to mention time saving). Personally, I think most of the problem with obesity, diabetes etc is the crap that's being put into food.

I think it's time that VAT was added to processed foods and foods with artificial additives. That'll make the unhealthy stuff more expensive and encourage people to buy fresh/raw foods which are almost certainly far better for you. It'll also increase public awareness of the negatives of additives/processing, etc.

I always think people who slate the NHS are the ones who have never been very very ill. When you are near death's door, you see a different side to it - one that is truly amazing. Please don't slate the front line staff whether they are the lowest skilled or most, they do a bloody hard job, all hours and should be respected

I always think people who slate the NHS are the ones who have never been very very ill. When you are near death's door, you see a different side to it - one that is truly amazing.

Err No. We lost my mother and father in law due to NHS blunders which led to them being at death's door, and witnessed, first hand, the "can't care less" attitude of some of the staff allegedly caring for them, and the sheer inefficiency leading to delays in treatment, etc. Re FIL, he needed a chest drain, waited 2 days for it to be put in, then it didn't work, then he was transferred to a different hospital without us even knowing (we were there visiting in the afternoon, left at 4pm and he was moved at 5pm - not a word said to us that moving him was even a possibility) - at least in the next hospital, they quickly realised the chest drain had been put in the wrong position which is why it didn't work! That's just one example, there were countless others until he finally died after several months of mistakes, misdiagnoses, operation cancellations, etc.

fablaura incorrect. I nearly died because of the NHS and was treated appalingly badly by them. My uncle was treated really badly when he had TB and was in quarrentine. He is elderly and they left him covered in vomit all night that he slipped in as he vommited on the floor and hurt himself. When my aunt questioned them in the morning visit they shrugged and said it had nothing to do with them its the night staffs responsibility. I also used to be a care assistant and saw the shocking treatment of one of my residents even when they inserted the wrong catheter causing him pain and they laughed.. its not a one off. The nhs is disgusting. For every one positive story there will be a negative.

It does depend where you go. My ex-girlfriend had terrible experiences recently at St Mary's when she had a gynaecological problem. by contrast, Wythenshawe Hospital have always been great.

Is private healthcare that much better?

For an insight into what goes on in some hospitals, this book is a "must read" about the hounding out of a respected surgeon by his NHS Trust.

www.amazon.co.uk/Whistle-Wind-detriment-dismissal-whistleblowers/dp/1082231967/ref=sr_1_1?keywords=whistle+in+the+wind&tag=mumsnetforu03-21&qid=1575319807&sr=8-1

Type 2 diabetes isn’t genetic
Type 1 diabetes is

Type 2 diabetes can be genetic. If you are south asian or west indian descent you have a huge genetic predisposition. My entire family have been affected by it. Type 1 is an auto immune condition and you can get it if you contract a virus.

Teaching assistants earn more than a newly qualified nurse. This is not teacher bashing but don’t tell me a teaching assistant has accountability and responsibility for sick patients and their lives. So yes we are underpaid.

I believe the genetic association is STRONGER for type 2 diabetics than type 1. However lifestyle factors (weight loss, exercise) can impact requirement for medication MORE for type 2 than type 1. So some people are more prone to type 2 diabetes than others (of the same age, weight etc).

www.diabetes.org/diabetes/genetics-diabetes

Both my parents are type 2 diabetic and have had good response with weight loss. I better watch out and take steps now - found out that I can only fit into a few of my smart clothes!