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.

No. I simply expect to receive the service for which I have paid when my family and I need it. Point out the hatred rather than the statements of fact.

I imagine you are newly qualified, probably sub 30. In another 30 years you may understand what humans have really suffered as part of living. Those humans are entitled to respectful care which sadly often isn't there.

May I respectfully suggest you reflect a little and constantly improve. Nobody at the start of their career practices to perfection. Think a little.

@OhTheRoses

Why do you think its deteriorated?

Because the funding is no longer adequate. There is a IFS report recently released, which even states just as much. Funding is not adequate due to inflation and population growth and the changing needs of the population (eg aging populations, higher rates of chronic long term illness).

I keep seeing everyone going on about managers in the NHS wasting money and resources but where is the evidence of this other then hearsay?

Managers cant do much when they have ridiculously tight budgets to work within. When they have staff literally combusting due to exhaustion, stress and bullying due to the culture that is a result of being over worked and underpaid.

And unfortunately the nature of the beast is that when there arent enough resources or finances to go around either some departments are funded and run well and others are tragically underfunded and fail, or across the board no department flourishes but most have moments where they let someone down. That is what happens when the money isnt there to adequently fund resources, equipment or even staffing levels. And that's without considering potential staff shortages post brexit.

OhTheRoses it's a shame you have become embittered rather than gained wisdom over your lifetime.

No one has refused you medical attention. You are being incredibly entitled.

Complaining about a HV from 25 years ago is ridiculous. In any case they often call in to visit new mums to assess how things are in the home without preparation.

What most organisations do when funding isn’t there is either make more or offer less of both. The NHS managers don’t do either. That’s why it needs reform. It has had more money. The population uses it when it’s not necessary to do so. That means others cannot access it. Users have no idea how much any service costs. The drugs budget is out of control and drugs worth £ millions are thrown away every year because they go out of date. Expensive nurses are hired through agencies. Run your own agency. Make sure all people trained by the state stay working for the state for x number of years. There is a lot to look at and management should do more than wring their hands.

Stakeholders isn't a negative thing, and it's not only used in business. Are you thinking of shareholders?

Stakeholders equals users and tax payers.

Embittered. I have nothing to be embittered about. When the NHS has failed to provide a service I have been able to fund it.

It was an example. But actually, an HV has no legal right to enter a new mother's or parent's home without an appointment in the absence of a safeguarding issue in which case a formal ss inquiry would have to have been opened.. There is no right to simply "drop in".

I may be many things but entitled is not one of them. I have been entitled to nothing in my life for the simple fact I have worked and paid my dues. Therefore thebonly thing I have ever been entitled to is to receivethe services I have funded.

Have I always received excellent standards or even adequate standards of nhs care, clinically and pastorally, well no. Should I be grateful for that. Well no, why should I.

I assume you provide your services free rather than in connection with a contract of employment for which you receive reward. Just as I do, except I don't expect gratefulness from my customers for doing my job.

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

I actually think GPs should be able to charge a small fee (refundable through Universal Credits / NI) before we can book an appointment. GP surgeries are outside the proper remit of the NHS anyway - if wastage here can be managed it could make a big difference in the quality of referrals made to other medical specialisms. I also think GP surgeries should use technology more - telephone / facetime appointments are far less likely to be cancelled for example.

It’s not been underfunded but we have to start thinking about adopting the German model. Privatisation doesn’t mean America and the left always mention that to scare people. It’s bullshit.

@Letsdrinkgin, undoubtedly German model is v good - though not perfect as no model will be - and there are management problems with the NHS. However, you have to recognise Germany is better funded. Germany spends around 11.3% of GDP on their healthcare, the UK 9.3% of GDP. Problems with NHS are not binary, it’s underfunded or it’s poor management but both.

I am left wing. I would not be against discussing a healthcare model like Germany as one option, I also would want to discuss and acknowledge that NHS needs more funding whether it continues in its current form or something like the German model. However, Labour probably don’t dare discuss other universal healthcare models. Germany provides almost universal, care, 0.1% of the population have no cover. As for Conservatives, as many of their MPs have links with American healthcare companies, pamphlets recommending the American healthcare model written by Conservative MPs who are now cabinet ministers, Pritti Patel, Rabb, and their silence on other European models, it’s clear to me if they do try and switch to another funding model it’s the 100% profit based American model they want. This is of huge concern to me, horrifying in fact. NHS has it’s faults and needs more funding and improvements in certain areas of management but if it’s a choice between American and NHS every time.

Of course you should be grateful, they are doing the best they can and increasing their chances of getting the virus in doing so. disgusting post but you are angry and grieving so I guess that's why.

user1470132907 Sun 26-Apr-20 09:47:01

@acquiescence teachers, supermarket staff and postmen aren’t getting a national standing ovation every Thursday at 8pm though^

Did any of these people individually or as a group ask for this or is it a PR stunt by the government?

Nobody has to participate in this sillyness either.

If we pay for a gp appointment then can we get our money back/sue if we don’t get the correct diagnosis?

I find you have to go several times before the GP will do something.

How will that work.

Do you get free goes if it is about the same thing and nothing was done the first/second/third/twenty seventh time.

I’ve read the post, but it doesn’t get over the fact we had space available, we didn’t max out capacity but yet we still told people to stay at home too long, which had lost a lot of lives. People have passed away at home or in hospital because they’ve waited too long. If we have beds/equipment available why not give them to people who need them. Now we are saying the peak has gone and people are to now go into hospital if needed and not to wait too long. But we can’t forget these errors have cost lives. Maybe to us it’s just a number but it’s someone’s mum/dad/brother/sister etc.

@LeaahLey, sorry if I did not express myself well in my comment to you. I am not disputing that decisions were made to massively reduce care for non CoVid cases and lives will have been lost by that. A few weeks ago the big fear was that the NHS would pass surge capacity. They then under a lot of pressure no doubt arranged things so that didn’t happen including deploying staff to work with a CoVid patients and switch more critical care wards to wards ready to take in CoVid patients. . A few weeks down the line they realise they can provide more non CoVid care and by sounds of it are making changes.

I appreciate that can’t come soon enough and how dreadful it must be for those who have lost lives due to these changes or may still do, but I don’t know whether at the time of the decision they felt they had no choice. There will be some learning as they go with such a huge public health crisis despite preparations. Some of their choices may prove to be wrong, some may have meant they had no choice initially. Pandemic planning and under funding also will I imagine show failures.

@LittleFoxKit, I agree with your comments. I don’t believe the problems in the NHS are mainly due to management problems as a portion of people always seem to on here. I am sure they exist but they cannot be discussed without acknowledging the NHS has been underfunded and structurally changed by govt legislation. This undoubtedly will have put a big strain on management.

@BubblesBuddy please read the latest IFS report on health and social care spending in the UK. That will explain all the points you have made about how although funding has supposedly increased, but spoiler: in real terms it hasn't.
Increases in funding have to be offset against inflation, the population increase, the changes in population health eg aging populations, different illnesses becoming more prevalent, increased costs of equipment (for example you know how phones ten years ago cost a fraction of what they do now, apply that same logic to hospital equipment), and soooooo many other variables.

Agree LittleFoxKit, PFI under Blair’s govt turned out to be costly and a big mistake but does not preclude that the Condem and subsequent Conservative govt gave the smallest annual increases to NHS funding, 1.1% and 2.3% respectively, between 2010 and 2018 since the inception of the NHS 75 years ago. Theresa May in 2018 and then this govt under Johnson pledged an annual 3.6% increase to the NHS budget. The Institute of Fiscal Studies though said that increases of at least 4% a year on average are needed in order to meet the NHS’s needs and see any improvement in its services.

To add to my comment above, in case I didn’t make it clear @Bubblesbuddy, NHS has had annual increases since its inception 75 years ago. The lowest annual increases in those 75 years were from 2010 to 2018. Even Thatcher’s govt gave a larger annual increase than between 2010-2018. LittleFoxKit has explained well why the various increases are needed annually and with a growing ageing population and ever more expensive equipment and treatments those increases will need to be even bigger than hitherto.

Your grieving, it's shit, I lost my Mum at Stafford hospital, I am bitter, but I can separate some issues from the NHS as a whole. I recognise that without the NHS you would have paid a kings ransom for these failures. 16th in the world... in the world! Have you any idea how many countries there are... 197 countries recognised by the UN. So 16th is amazingly high considering how underfunded it is. When I lived in the USA I paid $1000ish a month for my family of 4, 10 years ago, friends are reporting nearer $2000 a month now for a family of 4. And I was their during the sine flu and it was shocking how bad US hospitals where are dealing with it.

There is a world wide pandemic it is uncharted territory, the government are failing and the NHS is trying to deal with it. On your cancelled treatment, I personally think that is shit, by now the government should have been bringing in hot and cold hospitals so some routine but urgent treatment can go ahead. And on being hero's I am a bit on your side, it is the staffs job after all. But then again I have signed up to go back to the NHS when I could just stay at home, I have a job, working from home for a private health company, my job was working from home long before covid. I am doing this for £12:77 an hour on my days off, no I am not a hero but equally I don't have to do it and put myself and my family at risk, so every healthcare worker is in the same boat they could leave and protect themselves and their families but they don't because they are hero's, some of them go further and have stopped living at home, one of my friends has at 47 left her family home to live in a horrible shared house in one room with no tv or WiFi's and she has no idea how long this will be.
Oh and GP's are not NHS they are private and contracted to work for the NHS.

*Swine flu

Also @Bubblesbuddy, note analysis of 2014 figures showed that while the UK spent 9.1% of its GDP on healthcare in 2014, the European average was 10.1%. Germany spends the most on its healthcare in Europe at 11.1% of GDP.

No., it is not the Tories to blame at all and thank goodness we have a Tory Government in charge now too

I know @Xenia you are a big Conservative supporter. I don’t know how a Labour govt or Labour/Lib Dem govt would have done in this crisis but I do know this Tory govt have made an absolute hash of it.

Guylan, I agree

Why are panels of them from across the NHS not being brought together and being made to work together to seek strategies to avoid waste and improve outcomes?

@PenfoldsFive, I would guess because over the last 3 decades the NHS as one central organisation has been slowly dismantled by successive governments. Even further private sector involvement was introduced in the Health and Social Care Act 2012 under Cameron.

It doesn’t have to be one or the other of two extremes though. It’s not just the NHS on one side of a coin and the American system on the other - many countries have found a sensible middle ground between the two, leaning much further towards our NHS system than the American model.

@Pinkblueberry, it doesn’t but I wish people lauding other European models would take their blinkers off and see that is not the road successive Tory govts since Thatcher are taking us down but a gradual switch to a US for profit model. It terrifies me. And yes I am quite aware Blair’s govt were not blameless in this regard but Blair’s govt has gone and we have had ten years of a Tory coalition and then Tory govt who are ramping up the switch to the American model.

I thought the German system was "better" because so many are paying insurance?

@LilacTree1, from an article about the German model in case of interest who it must be noted spend the highest percentage of GDP on healthcare in Europe and whose insurance system for 85% of its population is v different to the American model.

“healthcare is not a state run system like the NHS but only 15 per cent of it is comprised of private profit based insurance. 85 percent of Germans are insured through the public, statutory insurance program. There are about 100 insurers who are non-profit, non-governmental organizations that operate autonomously. The government does play a key role in setting standards. For example, all sickness funds are required by law to offer the same comprehensive benefits package, which covers virtually all health care needs. But it is a non-governmental body, the Federal Joint Commission, which decides what benefits are covered.

People earning over around 62,550 Euros gross salary can opt out of the non profit insurance system, plus some other groups like self employed, and pay for private profit based insurance companies. Germany spends something like 11.1% of its GDP on healthcare, whilst the UK is I think around 9.8% if you include both NHS and private care.

Most Germans' health insurance contributions are deducted from their paychecks by their employers. The amount, however, is capped at 15 percent of a person’s salary, split fifty-fifty between the employer and the employee, so 7.3 percent each way. But coverage is not dependent on the employer, so when Germans change or lose their jobs, nothing changes in their health insurance. Premium contributions, moreover, cover the full range of benefits. Co-payments do exist in Germany, but they are limited. For example, Germans have to pay €10 per quarter for outpatient care, between €5 and €10 for prescription drugs and €10 a day for hospital stays.”