To think the NHS is no longer fit for purpose

[alloutofducks]

I have just had a hospital consultation cancelled, following 6 months of extreme pain. I can apparently go back on the list, along with everyone else, in the Autumn. This is "because Covid", as the departmental secretary said on the phone.

The NHS can't cope with Covid. If it can cope with Covid itself, it won't be able to cope with the MH problems caused by lockdown. If it somehow miraculously copes with Covid and the resulting MH problems caused by lockdown, it certainly won't be able to cope with people in extreme pain for other reasons. Or people with long-term, life-limiting conditions.

The NHS was set up at a particular point in history where it worked as a model due to the make-up of the population (among other things).

There was none of the mawkish "our NHS" sentiment: it did its job, and did it reasonably well, on balance.

Now it seems that the increasing sentimentality about it is in direct proportion to its essential failure as a system.

We don't become tearful and pot-bangish about "our education system", for example. While we may sometimes feel like weeping with gratitude about the long-suffering teachers who have to put up with our DC on a daily basis, we expect the education system to get on with educating our children. Likewise, we expect the legal system (again: not "our" legal system) to uphold the law. And so on.

This is not a dig at anyone who works for the NHS (my sister and her partner do, for context). But AIBU to think the NHS simply doesn't work now and needs radically overhauling, preferably in a cross-party way?

43% of people pay no income tax.

Not sure how those 43% are planning on accessing healthcare if it’s not free.

Are private healthcare providers still doing face to face consultations?

They’re unlikely to be doing many operations. The NHS has taken all their beds.

@crispysausagerolls why did you say "lol" I was merely stating facts. Im Pretty sure the NHs was in crisis before 2010 as well.

I don't want it to be run like a business. I don't want the person who tells me I need an operation to benefit financially from that operation
I don't want an insurance company arguing that I don't need treatment
I like some other EU models but that isn't what we'll get. We have a Tory government who are looking to the US and many of who have shares in private companies. They will not give us what is good for us

@Kdubs1981 Again, please don't take this as NHS bashing. It honestly isn't.

I'm not saying it isn't coping with Covid. It seems that it is coping with Covid. I'm saying it can't cope with Covid, plus the MH problems resulting from lockdown, plus the scheduled treatments which have now been postponed, plus the 'normal' people who need their GP/A&E, plus an ageing population. And I'm wondering what the solution might be?

Honestly? I think the model is fab. It can work, if only we would elect governments that believe in universal healthcare, and undertake competent long term investment and workforce planning.

@CasperGutman The model isn't fab though. Other countries have Universal healthcare. But their system is different.

The tax most people pay over their lifetime would not cover investigation, diagnosis, treatment and follow-up for one cancer. Add to that people may also have minor ailments, heart attacks, strokes, require hip replacements, have diabetes etc and you get the picture.

Are private healthcare providers still doing face to face consultations?

Neither our private GP or private paedatrician are doing face to face. Only phone. Prescriptions sent via courier.

@ridinghighinapril

Exactly.

People do not seem to understand how much they would have to spend under a different system.

The biggest shortcoming of the NHS is that it is such a monopoly. If there were even a small element of market forces it would be able to prevent problems like this. (I'm not entirely sure there isn't, for example if you need an operation you can go elsewhere, you don't have to settle for whatever place you're allocated in your local waiting list. I think you could in theory pay for treatment in Europe and claim money back from the NHS, although Brexit and COVID have stopped that.)

I read an article where Germany's leading virus specialist said that the reason they reacted so much quicker in dealing with the virus is that they were led by market forces. Though he did balance this by saying something complimentary about the NHS now doing better than Germany in other respects.

Actually I've found it.

Q: From where you stand, how is the UK handling the situation?
A: It’s clear that testing was implemented a little bit too late in the UK. Public Health England was in a position to diagnose the disease very early on – we worked with them to make the diagnostic test – but rollout in Germany was driven in part by market forces, which made it fast, and that wasn’t the case in the UK. Now, though, I have the impression that the UK is really gaining momentum in this regard, and that it is coordinating testing efforts better than Germany.

www.theguardian.com/world/2020/apr/26/virologist-christian-drosten-germany-coronavirus-expert-interview

plus the 'normal' people who need their GP/A&E

These are very much open and encourage those that are unwell to use their services appropriately.

Routine and potentially life-prolonging treatments are being postponed because the benefits of the treatments are outweighed by the risk of the patients contracting covid and having an accelerated death. Their life expectancy is now shortened compared to the pre-covid era but not to the same extent as if they underwent treatment in the covid era - and that is shit but not related to running the NHS.

I agree with you OP. Personally I think the NHS is massively abused. It's a system that is taken advantage of and needs a massive overhaul in how it works. I agree with others that austerity has not helped but I don't think it's the only factor and I don't believe simply pumping more money in will not.solve all the problems. I'd like to be in a better position to advise on the best route forward - can we not look at other European models (many of which work pretty well and far better than ours ) instead of always taking the US As a point of comparison?

YABU, they need the funding promised by Boris...

If we didn't want an underfunded health system, we wouldn't have voted Conservative.

It's hugely underfunded.

They took in loads of locum posts that cost £1500 per shift. Hence why no drs wanted to work on. Friends are drs.

It needs a huge cash fund

I have a life long limited condition. I've had all my appointments cancelled. I'm in horrific pain too. My gp is desperately trying to tide me over. Bless her. But it's going to come to a head.

The problem with the NHS is years of tory governments bleeding money out of it, and privatising it by stealth. The services and people who work there can be great - but you cant starve a system of money and then expect it to be perfect. Whoever you vote for, everyone needs to be asking what they propose to do to help the NHS recover.

Exactly what @PinkyAndTheBrian said. The spin which is being used to obfuscate the chronic underfunding is breathtaking.

So in that respect, YANBU. The NHS is not fit for purpose because it has been systematically starved of cash for a decade. And before any apologists want to come and tell me that it's bad management and waste that has caused the financial crisis in the NHS - have a word with yourselves. I'm not denying that there is waste, it's all but inevitable in such a behemoth organisation. But it's a drop in the bloody ocean.

Yes, the NHS is severely underfunded. Yes, there is a fair bit of poor management and sloppy admin processes. I think it is coping pretty well so far.

The politicians? Not so much.

Neither our private GP or private paedatrician are doing face to face. Only phone. Prescriptions sent via courier.

To be honest 99% of NHS GP appointments should be done online or via phone - absolutely no reason why most appointments have to be face to face in this day and age and I imagine would take up a lot less time and resources.

The NHS also needs to stop writing prescriptions for medications which are available cheaply over the counter - when I was pregnant they kept trying to give me a prescription for aspirin, which as I was pregnant I would get free - but it's 85p from Boots!!! So I always refused the free prescription

The NHS also needs to get rid of the grossly overpaid managers and middle managers

I don't think our NHS works, no. That's partly why I'm happy to prolong the lockdown. Because we're not very successful at medicine in this country, taken as a whole (not withstanding pockets of brilliance). However. I'm deeply grateful to HCPs in this country who are working in dangerous conditions and I think we should support them all we can. Not because they're the NHS but because they're helping us. I'm highly uncomfortable with taking any action that will cause a rise in their death toll as I find it unconscionable. And I don't really see why mental health problems in people safely at home should be used as a reason to send hard working nurses and doctors into the fray again without our even having the decency to wait until supplies of PPE (in insanely large quantities) are sorted out.

so many of the new Nightingale hospitals aren't even close to capacity
My friend works in an admin capacity for the nhs and was deployed to the nightingale. She said they have lots of beds, drs and nurses but not enough icu nurses and have to turn people away because of this. This is an example of nhs mis management.

Do you know if you can’t tolerate the NHS then go private.
I have 4 of my best friends on the frontline at the minute 1 of which has 2 severely Autistic non verbal disabled children both her and her husband are frontline they both now have covid both chomping at the bit to get back to work as they now how much they are needed. It’s demoralising to read Threads like this which half the moaners wouldn’t dream of working on the frontline

It is underfunded but more than that there’s too much waste

Too many people having free access

Too many people getting free prescriptions eg I get free medicine because I’m hypothyroid but I can pay and why are they all free? Why not just thyroxine

As for currently, I have 3 friends who are nurses, one a junior doctor and one a consultant and all have told me half the wards are empty

That’s ridiculous

Half the time the nurses esp say they’re twiddling their thumbs

Wtf!

You see, @LadyLightning, I don't think that's the right question to ask (Whoever you vote for, everyone needs to be asking what they propose to do to help the NHS recover)

I think I would re-phrase the question along the lines of "how can we build a health service fit for the 21st century"?

And I do very strongly believe that it shouldn't be along party political lines. The guiding principle should be how to match the needs of society as it is now with the staff and specialisms that are available (and how to plug the gaps, where they exist).

I think the link between the health system and party politics has contributed to the problem, whichever way you vote.