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.

@user764329056, thank you, am v glad.

@LittleFoxKit and @kingofkings, may I just say agree with all you both have been saying and thank you kingofkings for your work.

My dad told me that some local lads went to Cheltenham...all of them got the viris snd one of them died. He was 50. It didn't help.

I am really sorry for your loss, OP. I am a consultant and am redeployed to a covid ward looking after around 30patients. I don't expect any hero worship, free food, clapping etc., but would have benefitted from rapid testing, adequate PPE. I am a BAME Doctor, some of my friends with well controlled diabetes and asthma are working in acute setting. In addition to working in a covid ward, I still ring my patients instead of seeing them in a clinic, ask for investigations and only see patients face to face only if it is going to make any difference to their treatment - reasonable approach as I don't want any more risk than I am already been exposed to and it is also to protect our vulnerable patients.

Very few countries have managed the covid situation better than us. We all know that some treatments are delayed but they are being slowly rescheduled and in my hospital we are still operating on cancer patients ( the number is reduced and they are triaged by cancer specialist ) and we are beginning to resume some elective work. It takes up to an hour to deep clean the room every time we do certain procedures so it will be long before we resume any normality in service.

I am generally a laid back person but am getting anxious seeing all the frontline death. Imagine working in a department where your healthy hard working colleague has succumbed to covid.
Someone who said about the percentage of death in frontline death - thanks for your consideration! We are a family with two frontline workers and young family and my elderly parents in their 80s are worried sick and nothing I say alleviates their anxiety..
I can understand your frustration in not having your cancer treatment- we have never known a crisis like this, the data from China was not entirely reliable, risk of a cancer patient having covid versus the risk of delaying cancer treatment by a couple of months is probably what has driven this decision,but going for NHS staff is not right OP.

@ProfessorLayton1 thank you for your helpful post and for the work you are doing in extenuating circumstances. However I don't think the OP's post was a personal affront to individual staff but rather to a dysfunctional system. I think that system ccould have provided better communication to the OP.

However, outside of hospitals don't you think it's remarkable that GP's have got themselves on-line with digital communication. Only six weeks ago mine couldn't refer by email, only by fax. Now they have a portal, do video calls, and triage appointment requests efficiently. I got a prescription request in less than 24 hours last week.

For 10 years when this level of service was wanted by patients they didn't have the technology, the admins weren't trained, and data protection prevented it. Those things least of all data protection didn't change overnight; the patients had never been resistant. But suddenly because it was in the best interests of the staff, it was possible to effect almost instantly. I think that's what irks people. The system is designed principally for the needs of those in it rather than for those they serve.

This crisis will definitely change the way we work in NHS. We have been asking for telephone, Skype assessment for years, now it is here we can all see how efficient it works.
No need to wait for doctors in the hospital, no driving , no need to take day off for appointments, doctors could do extra work in the evenings if they want from their home office if they want etc.,
Some good things may come out of this...

That's interesting ProfessorLayton because so too have the patients. What therefore has been preventing progress?

@OhTheRoses

Probably people of the old ways. My job can easily be done at home, in fact there are people who work for a company abroad, but from their house. But some people still just like to see bums in seats basically. If they can't see you, they assume you aren't working. I find it's usually them that are the lazy ones in all honesty.

Data security I don't find to be a valid excuse for making people go in to the office. For one thing, I've yet to find any company (and I'm talking about the big well known companies) that don't have some kind of critical security flaw in their system. For another, it's generally the employees that are the problem in security, mumsnet knows a thing or two on that. You can't prevent people from leaking data or creating a backdoor in the network while they are in the office. You can't from at home either. No difference. Yet it still happens from the office. No one is more loyal just because they are sat at a desk, you aren't minimising a risk.

However I don't think the OP's post was a personal affront to individual staff but rather to a dysfunctional system
Than why mention staff getting benefits with shopping etc... It was a very painful post to read in all accounts.

Probably people of the old ways
That! Managers have tried to enforce this for some time, but many consultant have been pushing this with a plethora of excuses as to why it wouldn't work, indeed, usually the older consultants. It's a lot more fun to see patients face to face.

Consultants are like everyone else, they get bored at their job and becoming what they see as close to being a telephone sale person is not what they've studied for.

"Consultants are like everyone else, they get bored at their job and becoming what they see as close to being a telephone sale person is not what they've studied for."

well tough.
It was only six months ago that my gp (and of course it didn't come from her it came from her practice manager and the whole ridiculous setup) assured me she couldn't possibly look at an image of my son's infected toe sent by email .... utterly ridiculous.

Anyway this is going to be bad for docs with status anxiety but good for all the medics who just want to save some kind of free service.

There are some conditions where telephone consultations would work.. thats were the technology should be used. It is already in place with some specialist nurses ringing patients even before the covid crisis. DH has been trying to implement this for some time - there is always a reason why this won't work.

Contrary to your belief, consultants views are not always taken into consideration in making service provision decisions and we constantly have to fight to make certain changes in our daily practice.
There should be lot more clinicians in the senior management roles - this does not happen. Certain groups are not represented in these roles - women, BAME for example. It is almost ' who you know ' makes the difference rather than ' what you are able to offer' in you getting these sort of roles. A lot of us choose not get into this sort of politics at work, especially if you have to work under so much pressure, have family commitments etc..

Ah... there is a lot of difference between a telephone sales person and a consultant ringing you enquiring about your health, arranging what is necessary for you after the consultation!

We have an audit capturing our patients preference, satisfaction for our non face to face consultations so we don't go to our old ways once this crisis is over... My experience is that the patients like it as well but it is good to have some data for the future rather than anecdotal experience.

The summary of the German system posted by Guylan is good and mostly accurate - just a few things: the total amount is more like 16 per cent (as statutory insurers are allowed to add a supplementtary contribution of about 1% and most do), and self-employed people pay the full amount, usually based on a fictitious minimum amount (or you had to jump through a lot of hoops to get your contribution reduced to reflect your actual income), which used to be very difficult for low-earning self-employed people until the threshold was reduced recently. I am self-employed and my contribution is a considerable chunk of money - which I am happy to pay. The 10 euro per quarter fee has been abolished.

Talking about 'premium' contributions that cover 'the full range of benefits' is also a bit misleading. Ordinary statutory insurance covers what most people would consider the 'full range'. You can supplement that with additional insurance for things like your own room in hospital, guaranteed treatment by the most senior medics, or things called 'individual health services' which may be nice to have but aren't deemed necessary.

It's also really important to note that people who are unemployed or on benefits continue in their statutory insurance, which the state pays for, and continue to receive the full range of services. It's possible, but fairly difficult, to be uninsured in Germany. Also, statutory insurance covers all children up to 18 (or higher if they are in education and without income), and also one's spouse if they are earning less than (I think) 325 euro/month, at no extra cost.

About time the NHS and GP surgeries got themselves online and dragged themselves into the 21st century.

But working people in germany do pay more per much in health/tax then the UK.

roughly 8% of wage goes on compulsory health insurance. Then on top of that their income tax rates are 14% rising to 42% if you earn over approx €57000.

Therefore they pay out nearer to 30% of their wage in contributions (there are also other contributions I've not included which take the amount higher).

That is the trade off in Germany for having a effective health system. So if people are already annoyed at paying income tax and NI then I cant see people being happy with paying out even more pm

Very few countries have managed the covid situation better than us.

What are you basing this on? The U.K. has higher death per capital and fewer tests per capita than loss of countries. Including Australia, NZ, Germany, Canada, the US, Singapore, South Korea, the Netherlands, Switzerland...

I live in Australia where numbers are likely limited by living on an island with closed borders but the public health responses have been robust. Where I live specialists who normally work in completely different areas but whose surgeries have been cancelled are also helping out with public health.

It is a useful comparison. 20% of our income tax/NI goes for the NHS (and about 20% welfare). So if you pay 42% tx/NI as your upper rate for example then in that income band then 8% is going on NHS and for your lower rate tax band about 6.6%.

it is interesting above the 8% of wage in Germany goes on your health insurance. So that seems to be very similar to the UK expect we probably get a worse service in the UK. May be we should swap to the German system if this happens and I like the German right to opt out (writing as someone who pays heaps of tax and has been a GP once in 15 years as I don't get ill, not fat, don't drink etc.)

I just hope this middle road very high spending Tory party will not use this crisis as a reason to get us into even more debt than we have to next year -although we all know nurses, teachers, doctors and the rest of us will be facing massive tax rises to cover all the new debt and costs.

@ Xenia can you answer this and not avoid

Do you use routine NHS Services such as smear tests, mammograms, vaccination for you and family. Would you go t A&E if you had an accident?

Totally agree that people need to take responsibility for their own health- in terms of lifestyle etc - but many people who get ill do not choose it at all.

You keep repeating that you pay loads of tax and do not get ill ( which is beginning to sound really sanctimonious tbh ) and do not use the NHS. But if you had that car crash it would be there. Or god forbid you got cancer.

Yes I would also like to know what you would do in the event of a serious car crash requiring ambulance transfer to hospital Xenia if you could and did choose to opt out, considering private facilities don’t do emergency treatment?

You keep repeating that you pay loads of tax and do not get ill ( which is beginning to sound really sanctimonious tbh ) and do not use the NHS. But if you had that car crash it would be there. Or god forbid you got cancer.

I'm not Xenia, obviously. But using preventative services is actually pretty cheap (they're carried out in bulk by technicians mainly) and if you were to allocate hypothetical NHS services they'd certainly be based on lifestyle factors.

Her argument that she should be able to opt of paying certain tax for certain services is bizarre. It’s as bizarre as saying I don’t claim benefits, I haven’t used the fire brigade, I haven’t been a victim of crime or used social care services, I don’t drive or use public transport, so why should I pay to tax to fund justice/welfare/social care/emergency services/infrastructure etc? If you want to live in a country like the U.K. you have to pay for it.

So sorry for what you’re going through.

Can only comment that our GP is still operating face to face, one patient at a time after telephone triage and it’s easier than normal to get an appointment. The attached pharmacy is delivering all prescriptions too, at no charge.
I received a letter from my breast surgeon giving me a new dedicated telephone number to call with any concerns and the breast clinic is receiving emergency referrals.

I have acute sciatic pain at present which i'be been trying to manage for two weeks. Emailed GP through portal at 8.45 this morning summarising symptoms and what I was doing to manage. GP rang at 9.40 confirmed my assessment of sciatica was probably correct, talked through why it probably didn't relate to an old injury. Exercise sheet will be emailed later and prescription for neuropathic painkiller on its way to pharmacy.

A zillion times better than phoning the surgery for 40 mins three mornings in a row. I hope the service stays this way!

Her argument that she should be able to opt of paying certain tax for certain services is bizarre.

No one can opt out, no, but the idea that people don't reduce their usage of the NHS by leading a healthy lifestyle unless they sign these hypothetical, non-existent waivers doesn't make any sense either.

Catastrophe can strike anyone, that's the point of risk-sharing. It doesn't mean that you can't move your odds around.