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?

I pay tons of tax and rarely use the NHS but when I do I want it to be the best it can be. £150 billion a year... we should be able to question how it can be better.

Getting defensive and saying you can go private is exactly why I think for some it is a religion.

Silly comments like it will be sold to the US doesn’t help.

Mawkishness and sentimentality are a phenomenon of the general public and have no bearing whatsoever on the efficiency and effectiveness of the service.

Can any service cope with a sudden and acute increase in demand? Actually lots of the NHS does seem to have coped - there have been enough ICU beds etc.

It was decisions to stop other disciplines of care, but I am 100% happy with the way our (big regional foundation) hospital has managed my Dc's important but not life-threatening needs during lockdown.

I have also been astounded by the level of expertise and care my Dc has received over more than 15 years. I have got to know the team and how it works really well. Have seen the effects of rising costs / increasing demands / budget cuts...and also seen how the hospital has adapted and improved the service where possible.

I think it is a brilliant model. I can't understand why you would want to mess with the model. Look closely at its priority needs for resourcing and find the resources - yes! Replace it with anything like the U.S system...not in a million years.

I'm really sorry that your appointment / operation has been cancelled, OP.

It is horrendous to live in pain and I am so sorry that you have to.

It’s not the NHS that’s failing. It’s the fuckwits at the very very top, like the health minister who has fucked this up more.

They knew what was coming back in January. By March plans should have already been in place. Not let’s arrange bullshit meetings. Oh course if they bothered to show up.

Nothing to do with funding. Nothing to do with previous whatever.

Any issues NHS are facing are caused by the current government. They did nothing. And when they finally started to act, it was too little too late. Managers instead within the NHS, ignored by those voted in, were at a ignored.

Had they listened to government advice, things would be a whole lot worse.

I am so thankful for the NHS. I will fight to keep them and over turn the government if needs be. Without the NHS I would be dead. Yes, really.

OnlyFoolsNMothers as one of the mass of uncontrolled immigrants I thank you for your sentiments . You're clearly a Brexiter - but you cannot deny that EU nursing staff have left the NHS and have stopped coming and that this will have had an effect on staffing.

Without immigrants the NHS would have collapsed decades ago. Thank God for them.

I could go with insurance if we had a system like Germany but knowing our government, we're more likely to go the American way. I hope it never happens.

I can't hate the NHS too much. My brother would be dead without it.

pointythings I’m not clearly anything- why can’t people see both sides of an argument. Of course there are brilliant care workers from the EU, there’s also a bunch of non-tax paying abusers from the EU.
The nhs is a great institution but it is not without its problems.

I’ve been in private hospitals, NHS wards, and side rooms including paid.

The Doctors and nurses are the same. All trained together, there’s no private schools for nurses, or at least not that many.

The facilities are lacking. I mean surgery without a&e is risky. Scans etc all at the NHS hospitals.

The food. People always talk about the terrible nhs food. At least they cater to everyone, I had to have food brought in last time I was there for a week.

Waiting lists aren’t always as short as you think. The difference can be as little as days. Depends on operation, and of course the patient. To give me a fighting chance NHS helped me to improve slightly to survive live saving surgery.

Private are supposed to be taking care of my kidney. I was transferred by NHS after a routine op went wrong.

If I left my care to private I would have died. I’ve had to fight to get sent back to NHS. 🤣 And thankfully my nhs doctors surgery are all NHS because they’ve stepped up when private has failed.

OnlyFoolsNMothers the statistics on the likelihood of EU immigrants using the NHS and not paying taxes are well known. The rules on EU immigration prior to Brexit were also well known - it was the UK who chose not to implement the rules around making people leave if they weren't paying their way. You choose to believe the stories around immigration causing the problems in the NHS. It's far from that simple. FWIW there are also a 'bunch' of non tax paying British people using the NHS. It's a service based in residency. Want to change that? Then by all means look at the way systems are in France and Germany. And prepare to pay a lot more income tax.

it was the UK who chose not to implement the rules around making people leave if they weren't paying their way I completely agree. The issue I had was you saying the mass influx would have zero impact on a struggling nhs. I wasn’t saying it wasn’t the U.K. governments fault.

FWIW there are also a 'bunch' of non tax paying British people using the NHS. It's a service based in residency couldn’t agree more, unfortunately you can’t ship out British layabouts!

pointythings as I’ve said I actually support tax rises in the U.K.- however I agree with another poster who said it has to be spent more wisely!

I have experienced the brilliance and the utter incompetence of the nhs. A mother who was in both private and nhs hospitals for 3 years until she died when I was a child, a father who was an alcoholic who was placed under psychiatric care and let down, a cousin who died at the fault of nhs negligence, myself who had an ectopic pregnancy which was put at risk through no scanners at the wkend but was ultimately saved, and most recently the brilliance of a&e and a London children’s hospital who is treating my baby’s epilepsy. I just want the nhs to thrive but that requires blunt open discussion and debate.

OnlyFoolsNMothers I agree that immigration will have some impact - but it's dwarfed by the impact of demographics. Immigrants tend to be young and healthy and use the NHS less. We have an ageing population with ever more older people who have complex long term health conditions. The vast majority of them are British. If I go to my local surgery, 70% of the people I see in the waiting room are elderly. That isn't a criticism, it's just how things are. The NHS hasn't kept pace with demographics, and that is down to successive governments.

In Germany on the other hand there is now a hypothecated tax payment intended to pay for care in old age. We need to move in that direction.

And I'm originally from the Netherlands, which has an insurance based system. It works reasonably well; it paid for 60% of my late dad's very excellent dementia care and my parents were allowed to top it up to cover the rest so that he got the best possible. The fear I have is that the Tories don't want to move to a system like this. What they want lies on the far side of the Atlantic - full blown medicine for profit, with the poorest left to rot.

I love the NHS and have received very timely, professional and caring treatment.

However, i think it's mismanaged at a senior level and needs to be run more like a business philosophically but remain public. A private business wouldn't be sustainable with the massive inefficiencies and poor purchasing practices that the NHS has. Sadly I think it has also been abused by health tourists.

Immigrants tend to be young and healthy and use the NHS less agreed but they will age, even more reason for the need to reform the nhs to be able to
cope.
I actually don’t think any government dare privatise the nhs, even partially-it would be the death of whichever party did so. Sadly I think the UKs blinded passion for the nhs will be the demise of it.

NHS Procurement was shocking long before the market became involved. The NHS is completely undermanaged. Doctors & especially consultants should not be managing. Their role should be analagous to a machine in a factory.

Yes, immigrants will age. At what point do you think they have a 'right' to use the NHS in their old age? I've worked in the UK for 22 years and have another 15 to go before I can retire. Is that enough? Especially when there are Brits who won't have that much of a work history?

There's a case for reform - the list of things the NHS pays for could be reviewed. But most of all we need massive changes to taxation so that we pay for what we get, and we also need massive change to the benefits system so that it's more contributions based. In the Netherlands, benefits are calculated on your last pay and length of service. You basically get up to 75% of your last salary, one month for each full year of employment. That means you aren't suddenly plunged into poverty. You can pay your bills, you can afford to go for interviews, you have a better chance of finding another job.

We also need to crack down on the gig economy and the wage multiplier between the top and bottom of any organisation. It isn't OK that some people are paid more money in a year than a normal person could spend in a lifetime. You'd have to be Michelangelo to deserve that kind of money - it just becomes a way of keeping score.

At what point do you think they have a 'right' to use the NHS in their old age? huh?! Everyone in this country has the right to use the nhs. Your missing my point, I’m saying the numbers of people in this country has shot up, we are so densely populated. Our services need to be able to accommodate such. I personally feel we also need controlled immigration- but as I said we need to pay more tax, close tax loops holes AND spend money more wisely. Blair’s party pumped the nhs with money but all in the wrong places.

Your argument re: benefits is interesting- doesn’t it just keep the poor/ disadvantaged, poor and disadvantaged?

Your argument re: benefits is interesting- doesn’t it just keep the poor/ disadvantaged, poor and disadvantaged?

It does and it doesn't. It means you're getting a much higher level of monthly benefits than you would in the UK system. Minimum wage is higher in the Netherlands and there's no 5 week wait for a first payment. Getting a guaranteed level of payment straight after you lose your job just makes it easier to get another job. It gives you an incentive to work your way up the career ladder too, because if you work your way up and then lose your job, you get more.

There's also the fact that the Netherlands has a 13th month system - everyone gets a 13th month's pay. Even people on benefits. It's an acknowledgement that living costs tend to be higher in holiday periods and is intended to cover that.

In terms of population, the Netherlands are more densely populated than the UK. However, I agree that the way the Blair government managed the 7 accession countries was a huge mistake. Doing what the other EU nations did would have allowed the accession countries to catch up economically and evened out the flow of migrants.

The NHS has not been fit for purpose for a long time. The lack of a decent IT system is an example. 6 letters sent for 1 cancer appointment. Turn up and no clinic is running (luckily consultant was on site and saw DH).Appointments sent for hospital x at the same time as he was booked to be an in patient at hospital y

6 weeks wait and constant refusal to get a GP appointment (and then only secured as out of hours doctor told us to lie to get an appointment). 6 hours after the GP appointment being told you have cancer.

Cancer patients discharged on Thursday to free up beds for the weekend (was told would be in for 14 days- discharged after 4 - re-admitted 3 times including being readmitted on Saturday at 4 am after 8 hours in A&E. It was a club- we met the same cancer patients in A&E week on week.)

@Bathroom12345 My point is, be careful what you wish for. American hospitals are run as businesses.

I get its bad your appt was cancelled but its in part to avoid the risk of you catching it in hospital.

The NHS doesnt need any more "reform" it needs funding at a level comparable to other economies with an aging population.

No health care system in the world can cope with a pandemic. However governments that reacted promptly and effectively can and have made a tremendous difference - New Zealand anyone?

Government still not seeing that everyone in care homes is taking vitamin D failing its population yet again. The virus is a Tory wet dream, kills off the old, the disabled, the BAME population and oh yes a good few health professionals too.

Any excuse to bash the health service and try to distract attention from ongoing government failures.