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?

What an interesting post, OP. You might think there is an election coming up...

Yes, the NHS needs reform and updating. Yes, there are other systems that work well. But actually we don't pay a lot of tax in the UK. Imagine what the NHS would look like with Scandinavian levels of taxation put into public services.

If people have a good job then they can choose to pay for private/private health insurance in UK? In US they don’t have much of a choice?

Maternity care has a strange mixture of overbearing paternalism, with shocking conditions for the actual care. Having been on a post-birth ward I was astounded at the humiliating and painful conditions for the new mothers. And the staff were not "overworked", they did not give a fuck. It was like misogyny writ large.

I’m due to give birth next year and having read some of the threads on here, the thought of having to be in hospital for any length of time is causing me far more anxiety than the pain of birth itself. I’ll be discharging myself as soon as I possibly can.

@pointythings

Imagine what the NHS would look like with Scandinavian levels of taxation put into public services.

Probably no where near what it should look like if the money was out it as the NHS is notorious at getting ripped off and mis spending money. A result of it being this huge slumbering giant

The German system delivers much better health outcomes for all.

It is a compulsory, means tested insurance model. So you pay according to your means up to a ceiling. If you have no money you pay nothing. If you have a lot you pay more. Employers contribute 50%. This is similar to the UK NI scheme.

Where it differs is that ALL income is assessed, not just earned income. So the self employed or those whose income comes from property, pensions and investments also pay unlike in the UK. Also wealthy people continue to pay post retirement even if they are no longer working. There is a specific element for adult social care. The system is much better funded than the NHS.

All those legally resident in Germany get a card to show their entitlement to health care. Illegal residents, health tourists etc are limited to emergency care.

Health outcomes are better.

Like the weather, the British talk and complain about the NHS all the time! The problem is we're plagued with competing political dogma.

We must compare like for like though... ie 'free at the point of delivery' as we've built a society around this concept..

The NHS is starting to be affected by the obesity crisis, this is not anything with funding or staff numbers it is people eating themselves to death.

And it is not all poor people, it seems to be a huge number of the population

Namechanged for this.

I've experienced the health care systems in the UK and Germany, and though the German system has it's problems (unnecessarily complicated) I much prefer their system. The main problem with the NHS, imo is the waiting times to see a specialist or get surgery.
In Germany, GPs and specialists have their own practices all over the place, and you can get a same day referral and an appointment within a few days, generally. I've always had joint problems, and I remember when I lived in the UK I had to wait weeks to see an orthopedic surgeon in the hospital, by which time the problem had worsened.

In Germany, you just google and pick one out in your area, go to your GP for a referral (you get that right away) and make your specialist appointment. Done. Gynecologists have their own surgeries on the High street, you just pick one, (I always pick a female) and make an appoinment. Not even a referral is necessary.

I had severe hip pains in 2017-2018 and needed a hip repplacement. No problem. I got it done last August in a leading Hamburg hospital, followed by three weeks inpatient rehab at a seaside resort, with many hours of physio etc every day, all covered by my insurance.
I've been told that under the NHS, it can take years to get a hip replacement.

Yes, the German system does have problems but that has to do with how it is organised, not in the actual care. Given a choice between the two, I'd take Germany any day.

I believe other EU countries have even smoother systems.
I do like the simplicity of the NHS, however. The automatic cover, no need to research insurance companies etc,

Obesity and ageing is a larger proportion now. And will get bigger - well the latter is on an upwards trend as proportion of population which is fairly worrying.

@leckford

I agree that if we all took more responsibility for our own health the burden on the NHS would be much lighter

Obesity, excessive alcohol consumption, smoking, drug use, immobility - these are all issues we could all examine in our own lives.

For those of us with pets to look after ,and the cost of routine appts/check ups and medication ,this would be the cost of a private healthcare service! We have family in Canada ,and there is a cost of around £25.00 per visit to the GP there.Many people in the US are uninsured or cannot afford the correct amount to pay. NHS isnt perfect but its a damn sight better than this!

I am pleased we have the NHS and think that healthcare should always be free at the point of need for UK citizens/residents. However, it does need to improve and there needs to be a review of things such as the price paid for drugs by various trusts. A good attitude and the personal quality of being a caring person needs to be a pre-requisite for most roles and my experiences don't indicate it is. (Two official complaints upheld and apologised for by the CEO of the trust).

I agree that the staff are not all underpaid heroes. I'm not sure I regard any of the staff as heroes - aren't they all just people doing a job of their choosing? Some staff do their jobs really well and are hardworking and caring, some are crap, some are adequate, and some are exceptional.

At an outpatient appointment a few months ago, I was led by one nurse into a room to be weighed, and there were two other nurses in there. One typed my weight into the computer and the other stood doing nothing.

I was then led by the nurse to a different seating area about 15 feet away. As this waiting area had only 5 seats, once filled the nurses had to wait for someone to go in to see the doctor before they could escort another patient to be weighed and then take them to this area. Having nothing to do for about half an hour, the 3 nurses joined 2 others on the reception desk in the first waiting area and chatted.

I definitely wouldn't class these people as heroes. I don't know what they are paid but, for what they were doing, they certainly didn't require a degree or even an 'A' level. It was such a waste.

I'd prefer these people were trained to look after others on wards. This is the kind of thing that gives nursing a bad name.

I'm sure many do work hard but there are also plenty who don't.

@electricwhisk just saw your post! Yes, paying for the German insurance can be a headache; I'm retired but have self-employed income as well as my pension so I have to pay a lot more than if I just had my pension.

There is a strange British preoccupation with the NHS which I think prevents honest public dialogue about its many shortcomings.

You’re absolutely right. And while it continues, there can be no meaningful conversation about change.

My brother is permanently disabled and brain damaged due to NHS negligence. My parents successfully pursued a court case against the hospital but it took over 10 years- important documents went “missing”, it was delay, delay delay. The sad thing is the incompetent, negligent care during his birth has happened to many other women but most don’t have the money or time to pursue it.

My entire family now has private medical insurance but sometimes we still have to use the NHS. My brother’s care ranges from good to truly abysmal. Specialist children’s hospitals like GOSH and Evelina are good but even they don’t always have adequate levels of staffing. Local children’s wards have been dire.

The thought of giving birth in an NHS hospital or ever having to stay on a ward, fills me with fear.

Although NHS funding is rising in real terms, current plans mean that 2009/10 to 2020/21 will be the most austere decade in NHS history. Total spending on the NHS in England increased by an average of 1.2% a year under the 2010-15 coalition government (0.9% for the UK), and is set to increase at the same rate under the current Conservative government. Between 2009/10 and 2015/16, spending increased from £109.1bn to £119.0bn and is planned to rise to £123.2bn in 2020/21. This growth rate of around 1% is below the historical average for the UK of 3.7% per year.

I would hardly describe a 1% growth rate in spending firehosing money

I’ve worked in the UK, USA and Holland

USA was horrific for those without means; I sent someone with obvious cancer away to get health insurance ASAP so they could get treatment and never saw them again.

Holland is pretty decent but costs a bomb.

UK is fabulous if you have an urgent or serious need but a bit clunky for the more day to day. It is misused ++ by the less enlightened members of the public (multipleDNAs, wasting prescription items, using a &e when gp more appropriate) so there is scope to redeploy the wasted cash to help the non-urgent care and do some health promotion and lifestyle interventions which is what would really make the difference.

Cradle to grave healthcare at point of need is a bloody miracle in an aging population with myriad new expensive interventions and medicines shown to be the most effective and thus needing to be commissioned.

I switch off when people start laying into the NHS.

I like the German system, although the insurance seems quite expensive to us if you aren’t a student or unemployed, and it’s a little difficult to navigate. One thing you might not be aware of is that you have to pay when you have a baby. I am not sure that you pay the real cost. I think insurance picks up some of it as I think my colleagues talked about paying about EUR 2,000 per birth, which is much less than private births here.

I refuse to believe that the only alternative to what we have to this is the US model.

We sometimes talk about it like a state religion that cannot be criticised or changed .

I agree with @Adenosine.
The systems in Germany or France are 100 times better and no more expensive than what we pay here.

Until we are starting to actually take stock and be honest about what is happening, it will stay crap. Or rather it will get worse because no one has dare acknowledge the selling of the NHS, the standards going down compare to 10 years ago and the fact the whole system (as in systematic, not the concept itself) is a failure.
I’m actually always amazed that people are still refusing to accept that many systems work better wo falling into the trap of ‘look at the USA’. There are other contres and systems to look at that are just as relevant.

I agree with the OP. The NHS isn't a sacred cow which can never be criticised at all, ever.

I also hate the viewpoint that it's either the NHS or the American system. No shades of grey, nothing in between. That's just nonsense. I have experience of the German system and it was excellent. MOst other western European countries have systems just as good as the NHS or better.

German inpatient care last weekend was a nightmare. Absolutely awful.

Just saying.

The ideology is good but I think staff sometimes could be better. I appreciate resources are stretched but I have been having a lot of scans recently and what I have noticed is that even if I have the first appointment of the day they are always running 10–15 mins late (for no good reason) with no regard for the fact that many people are getting time away from work to attend appointments. If the first appointment of the day is already running late that is just lax staff.

I'm no hero but I do my best and patients always like me and ask for me again.
When I worked privately in my field I earned £5000 a month. Back in the NHS recently I earn £1600 a month. I don't need the money as Ive paid off my mortgage and have no debts but people with kids and a mortgage would really struggle to keep their heads above water.