AIBU to get a bit fucked off at having to protect the NHS?

[Santaclauswhosthat]

This is a healthcare system I've paid into all my life. I don't think everyone who works in it is a hero and the vast majority of them aren't underpaid. It's ranked 16th in the world and has the worst cancer outcomes for any developed country. It's not very good. Nonetheless it's the only healthcare system open to me right now. But I can't access it. My operation had been cancelled and I can't get a consultant appointment. The GPs aren't seeing patients face to face. I've already had one tumour removed that was on the turn. I'm worried that I may have another. I have no way of finding out if this is the case. A family member has already died of covid 19 after being denied treatment for three days during which repeated calls to the ambulance service were made whereupon his mother was told she should only ring again if his lips turned blue. He is dead. Right now. The NHS didn't protect him. It isn't protecting me either. What is the point of the NHS, exactly? Most clinics are closed or running at half mast. GPs aren't seeing anyone. NHS staff get shopping hours and free food and fuck knows what else and we are all dying protecting them.

Care and health take up nearly half govt spending, far higher than education, defence, etc. How can you say "contributing as little as possible?"

You do realise a HUGE amount of that funding goes to the sectors of the NHS which have been sold of and privatised, right? And not just into the NHS as we consider it to be?

Also 50% of public spending DOES NOT go on health. 29.6% of funding goes on public health spending as per the latest IFS report on public health spending.

But I agree to some extent a over reliance on the nhs is a huge problem, specially when people are calling ambulances instead of 111 or going walk in center. And when people are using GP appointments for things that them chemist could treat. It's all part of a much wider issue.

Just to clarify...
29.6% of the government spending goes on BOTH health and social care. So that's NHS, social services adults and children, elderly care, carers, carehome funding, respite and community care for disabled adults and children. Children's homes.
Theres a LOT of hugely important areas that combined actually recieve quite a low amount of funding from government spending.

What has to change is the perception throughout the NHS that they are doing the public a favour because it's free. It is not. For all those who are not on benefits or under 18 or just in receipt of the state pension, there needs to be a small charge at point of delivery that is refundable through the insurance system. This would stop the abuse of the system. We also have to instil more individual responsibility into the British public.

Let me five an example. I attended a menopause forum. All the women there said it was really hard to get optimal treatment. I said I had spent £400 seeing a gynaecologist privately who recommended a balance of HRT. They were aghast at the expense and ventured they couldn't necessarily afford that. Looking round the room at least half had highlights or gel finger nails. When I said it was a question of putting one's health before discretionary spending there were awkward looks. Ultimately however it's a question ofpriorities and if individuals aren't prepared to optimise their wellbeing why should everything be funded by the state?

My DC are grown up now but in the late 90s/early 00's when both of them suffered indescribably with ear infection after ear infection the GP was insistent they didn't need an ENT referral and grommets wouldn't help. We paid privately. Post grommets both children turned the corner and were well again. DS had more problems at 8 and suffered a burst eardrum. The NHS were not interested. He had another burst eardrum ski-ing in Austria where it was routine to immediately see an ENT specialist who cleaned the ear and prescribed ABs. On return GP not interested so we had him.referred privately. The ENT consultant explained the drum was not healing at the right angle and due to a condition called choleastasis (I think from memory) one of the tiny bones would calcify with each rupture leading to worse hearing and eventually deafness if nothing were done and of course a much more complex operation. One little grommet allowed the drum to heal in the right position.

Just one example of low level negligence that wpukd impact disproportionately and then be swept under the carpet after much suffering with a "well the operation has restored the hearing, so what's the problem".

We also need to get rid of the GP "gatekeeper" role which adds delays and wasted appointments.

My son had a bad ingrown toenail. I knew it (or part of it) needed removing as I had two as a child. We took him several times to the GP surgery (various different practice nurses, nurse practitioners and GPs) and got different "advice" each time. Some suggested antiseptic cream, another suggested salt water baths, one suggested Schol toe nail softening solution. None worked and as the weeks passed, it inevitably got infected and DS could hardly walk, so GP prescribed anti-biotics. Finally, managed to persuade the GP to refer him to podiatry for it to be removed (or part removed) - GP made a big fuss saying they had long waiting lists, blah, blah, but I insisted, so a referral letter was sent. A week later, I phoned podiatry on the offchance of a cancellation and she said they had no waiting list and they could see my son the next day - so went in, they confimed it had to come off, and booked him in for the minor op the following week - so finally, all done and dusted, full/quick recovery, when he finally got the proper treatment from the proper specialists - such a shame the GP surgery faffed around, causing a number of pointless/unnecessary appointments and a lot of suffering. I think people should be able to self-refer to specialists like audiology for hearing aids and podiatry for foot problems in the same way they can make their own appointments for dental and eye treatment under the NHS!

Oh and needlesss to say we had a Labour government in the late 90s/early 00's. I believe grommets are now recommended for repeated ear infections. Well done that Labour government who scrapped GP fundholding just as it was beginning to work well and introduced PCTs and PFI. Big slap on the back chaps. Oh yes, and who was advising them ...........wait for it Simon Stevens as he was then.

Where is Sir Simon Stevens btw. He's been very quiet since early March. He isn't usually.

Why are appointment letters sent out as hard copies

Surely it’s not hard to understand that not everyone has a mobile phone to receive appointment texts.

I went on my tax account today and for the last tax year on there about 20% was NHS and about 20% on welfare (of income tax and and NI).

My neighbour has no computer nor mobile phone so appointment letters would have to be posted to her - she is 85.

Why are appointment letters sent out as hard copies

Surely it’s not hard to understand that not everyone has a mobile phone to receive appointment texts.

People who have a mobile number or email address on their record should be contacted by those methods as a default. If we keep being told the NHS’s undeniable failings are due to lack of money, that’s a way to save some, right there.

The key difference, for me, of insurance-based systems is that you can actually choose which insurer/ mutual / assistance you are paying. And they have an incentive to introduce better processes, reduce bureaucracy and admin burden, improve service etc - as people are able to vote with their wallet.

I get my appointments through an app. All my test results etc are on there too. It's pretty good.

I get an email to tell me if anything new is on there and to go look

I’m sorry for your loss, and what you are going through just now.

I think though in the UK there is no perception of what healthcare can actually cost or what the service is like. The grass definitely isn’t greener.

When I still lived in the UK I could get doctor’s appointments fairly quickly, medication refills, and had life-saving treatment without any delay or worry about cost.

I now live in the US. We have great insurance coverage, according to more than one medical provider. But it costs several thousand dollars a month just to have the insurance, and then we still have to pay another $5000 out of pocket in deductibles and co-pays before the insurance company will pay up for treatment. I had to wait months to get a mammogram, and months more for follow up. When the insurance company screwed up paying for my medication, I went three months without it. Women’s health care is a disaster area. Right now I need a refill on a prescription, but I can’t get it because the doctors office won’t issue a prescription unless I see my GP, but my GP practice has closed down because of Covid19. Can’t get hospital treatment here either if it’s not for Covid19. There is no PPE here either, and a shortage of equipment. And this is in an affluent area with fancy looking hospitals.

Why are appointment letters sent out as hard copies

Some people saying not everyone has access to email or mobiles - fair enough. But what about letters that are sent out too late? I made all but one of my DS’s vaccination appointments well before the letters arrived, so one issue is obviously that they are pointlessly automated. For one of them I did wait for the letter - and was reprimanded by the receptionist for ringing much too late to make that appointment, even though I got the letter that day. What is the point in those letters? Just a minor example of the waste of money and lack of basic organisation within the system, and I can’t understand why pointing that out is so offensive to some?

Sorry op that you have had your operation cancelled it must make you angry and scared, yabu though I think of the poor folk stuck in hospital with this virus taking their last breath because there families are not allowed with a nurse weeping beside them. Whst ever job you qualify for working in care it doesn't prepare you for watching a patient that you have fought for take their last breath, their human being too they feel our pain, I've sat in the scubu crying my eyes out over my baby and the nurse has sat holding my hands crying too. My dad also works risking himself for the nhs he is 58 and actually is very vulnerable if he caught this virus he may not make it so I worry thinking of him going to a call without protection! The doctor quite often drops a changer and the fact that the patient has covid symptoms does not get told to the paramedics, my dad and his partner attended the same call last were and now his partner is fighting for his life in hospital. I said dad why dont you go on the sick I csnt bare loosing you if he catches it hes fooked and he said he would never forgive himself if someone died because of not having enough staff because he was hiding away, he is choosing to go to work knowing he may well catch this virus because he cares and wants to save people, there are nurses and doctors like this too so yabu I believe they are heros, walk a mile in there shoes. All the best op and hopefully once things are back to normal you will get your operation

You are grieving but I also have grieved but I don’t feel the need to be nasty to nhs staff. Wow a shopping hour. Take your grief elsewhere.

I both agree and disagree with your post OP.

I disagree that most NHS workers aren't underpaid- the majority of workers are nurses, Healthcare assistances, porters and cleaners- they are underpaid and over-worked. Some consultants are very well-paid but they constitute a minority of NHS workers.

I agree that outcomes in the NHS are worse than in some other countries. The NHS has been underfunded and under-resourced by the government and basically run into the ground- it could be so much better.

I agree that your family member did not receive the treatment that he deserves and there were situations like this, even before Covid. For example I know of a 30 something who died from sepsis because of inadequate and delayed treatment, despite being a nurse herself; and presenting with 'query sepsis'.

I'm also so sorry for your current situation and the delay to your operation- that is absolutely awful and shouldn't happen.

I think that there are lots of great people doing a great job in the NHS but that the system has been intentionally run down and people are getting seriously ill and some dying as a result.

** Healthcare assistants!!! not sure why I wrote 'assistances'- that's not even a word!

I think too many NHS staff use their jobs as a catalyst to air their political views and that is wrong. I have been politically active for my entire adult life but I do not take my politics to work and air them with my stakeholders.

I recall my hv being late for our first appointment. It was because of underfunding by the Tory Government in 1994. The apt was the 10 day old baby one and it was at 9am. It wasn't due to underfunding it was because she arrived at her 9-5 job late. I won't go into the fact that she should not have provided an apt before 10am and did not ensure it was mutually convenient. I was informed of it by letter at 8.52. Had she said she'd arrive at 9.20 I'd have been washed and dressed and not caught on the back foot. Simple bad manners and lack of respect.

@OhTheRoses

Was she chewing gum too? 😂

YANBU.
Not for for purpose but has become a religion in this country.
Antiquated bureaucracy that meant that private firms trying to get equipment to them were instructed by their rubbish procurement people.
Needs massive overhaul.

And yes -letters! The n the 21st century when could be done by text.
Appointments to 'give results' when you could log in to a portal.

I think too many NHS staff use their jobs as a catalyst to air their political views and that is wrong. I have been politically active for my entire adult life but I do not take my politics to work and air them with my stakeholders.

• well we know what the system is like

I recall my hv being late for our first appointment. It was because of underfunding by the Tory Government in 1994. The apt was the 10 day old baby one and it was at 9am. It wasn't due to underfunding it was because she arrived at her 9-5 job late. I won't go into the fact that she should not have provided an apt before 10am and did not ensure it was mutually convenient. I was informed of it by letter at 8.52. Had she said she'd arrive at 9.20 I'd have been washed and dressed and not caught on the back foot. Simple bad manners and lack of respect.

• it was 1994 ? Time to let it go hardly material for complaint 🤷🏼

There is a certain department in our area that sends out letters for appointments... after the appointment.

It lists when the letter was dictated. It lists the date it was typed and the day it was sent to be posted.

The appointment had already been missed by the time it was sent to be typed.

You then have to call up and make another appointment on the phone.

There is the missed appointment notice The numbers run into something like 1500 appointments missed each month.

When you point out you missed the appointment because you hadn’t recieved the letter the response is “That’s always happening”

No one does anything because that’s just the way it is always done.

I know there is supposed to be a time scale that is worked to if you visit the doctor and have cancer but that is only if the dr actually refers you. It could take several months trying to get that referral

it was 1994 ? Time to let it go hardly material for complaint

26 years later and it's still the same. I was "told off" by a GP for missing an appointment for my son. I know, for a fact that my OH phoned to cancel and rearrange it because I was sat next to him when he phoned the surgery to change it. The receptionist had obviously not cancelled the original appt. Another time, I had a 8.15 am appt - the place was in darkness until the receptionist strolled in at 8.30 and then the GP wondered in at 9 and promptly stood idly small talking with the receptionist for 10 minutes before he called me through. Their attitude is all wrong - it's all the "you're getting it free so put up with crap service" mentality.

User - that's strange GOs don't even start work until 8.30 am what did the receptionist say?

hVs are different - they sometimes just call in on spec in the area.

@packetandtripe That's not correct where I work nurse, phlebotomist, HCA, physician associate, AnP, GP, are seeing urgent cases, In fact for the very vulnerable we are doing home visits, and care home visits, that includes phlebotomist going out. Urgent things get done in my trust, referrals happen after telephone consultations, same as USS, ECG, etc. Kids have their immunizations, people have their B12 jabs etc... I guess it depends where you are based. Medications need to me modified quite often, bloods need to be done and review before and after a certain period of time when starting new drugs that can have severe side effects... our practice has around 30000 patients, only one GP, one PA, and a HCa/Nurse a day, some days an ANP too. It's just very easy to judge but it is quite challenging and upsetting that people don't realize of the stress of having so many people to care for. We try to push to have everything done, if appointments with consultants have not happened we do another referral and add a consent for video telephone consultation with them, some surgeries have to sadly be postponed but we move patients around if we are aware any site is doing them...