We need a new healthcare system

[FindANewWay]

Our healthcare system in the UK is shit. You have to pay into it as soon as you're earning 2/3 of minimum wage and it's an appalling service. We were already ranked way below other European systems prior to covid, and now we've got a death and infection rate on a par with Brazil.

The only strength we theoretically hsd in our terrible provision was that it was theoretically open to everyone, but actually that has proved not to be the case. Care home residents shunted out of hospitals, covid patients dying in the community and being denied treatment and admission. It's all happened. Because our healthcare system is tied up with politics. And it has failed us.

We shouldn't be clapping. We should be angry. Angry that we have been let down.

And right on schedule Imis the weekly bashing of the NHS post by someone who hasn't got a clue how it runs.

As many pps have said it's been chronically underfunded for years. What the NHS was set up to do, and what it's trying to do now are two wholly different beats. People are living longer with more complex ailments that we are now able to treat but cost more money. Medics nurses and other HCP are ran off their feet because people abuse their bodies and expect free care to solve their problems. The average clinic has a 15% DNA or cancellation on the day rate. If those 15% attended then waiting lists would be shorter.

Yes no denying there is room for improvement. We are constantly being challenged to come up with innovative cheaper ways to see more people more quickly. That's what a lot of managers are doing. They also do the reporting and validating of data for ridiculous amounts of statistical analysis deemed necessary by gov, or to prove where we are in "league tables". Better a manager on 40k do this than a doctor on £90k who could be seeing patients instead no?

Ah, welcome to mumsnet OP. How fortuitous that you are here posting one of the most emotive and goady threads in the dead of night, when MN HQ are not quick enough to delete...

Obviously you have never benefited from the NHS otherwise you wouldn’t be talking such utter bollocks.

How about you go to the states where your treatment depends on what you can pay or what your insurance will pay for.

Oh and, those Brits who retire to Spain only to come back when they need healthcare but the Spanish system is inadequate?

The truth is the NHS does need an overhaul, but it doesn’t need replacing, it needs reforming. And that is something the public will never vote for, because as well as e.g. management reform we need to start looking at treatment reform.

At the moment there is too much expectation of the types of treatment people feel entitled to. IVF/cosmetic surgery to name just two cost the NHS billions every year, and the success rate of IVF is pitiful. The NHS needs to stop funding lifestyle treatments and paying for new lives to enter into the world and concentrate more on existing lives.

But nobody will vote for that because the infertile will protest that their lives are being affected by infertility and as such they should be entitled to a baby.

Those in need of cosmetic surgery because they don’t like the size of their nose etc (not talking about e.g. breast reconstruction or surgery following serious injury here,) will affect them and so should be paid for.

There’s more but for every life that is saved another is purely enhanced.

I am literally alive because of the NHS. I have a serious heart condition, and I have recently joined a support group for this condition, and the overriding talk within that support group is the people in other countries who have to fight for every bit of treatment, every drug, every appointment.

millymollymoomoo@ you make some good points the NHS takes a top down approach to care and pay. They need to stop allowing consultants to do both private and nhs for a start. Should be one or the other.

Sorry meant top down.

@ATaleOfTwoCovids is spot on, If you want to help the NHS take a little bit of the burden off it by getting your own healthcare cover. The NHS is an amazing thing to have but it is massively underfunded and they're not going to raise enough in taxation alone (that's not going to win votes is it?) if you want to support it then take yourself off the waiting lists - if you can afford to.

OP - I think you’re lumping lots of unrelated things together.

I don’t think a lot of the covid strategy was down to nhs. Decision not to quarantine arrivals from abroad or lockdown early, late wearing mask policy, late ramping up of testing, poorly thought through enforcement. These are govt policies not nhs.

Govt decided to build nightingales - which is understandable. But they could have done the same for testing capacity if that was what they chose to focus on.

Regarding change in nhs - I think a lot has been wasted in re-Organization. Just like academies, I’m not convinced of the benefits of choice and locally independent trusts. Because although Londoners might have a meaningful choice in hospital, many people don’t (due to only being close to 1 or at most 2 hospitals). However, due to re-org costs I don’t think I would change this system at the moment. Stopping further PFI is really important (as it increases future long term costs) and small targeted low cost changes.

I agree with you OP. The NHS is a joke and no one I know abroad or who comes from abroad and lives in the U.K. would call it the envy of the world. It probably was when it was created but it definitely isn’t anymore.

My relatives in France cannot believe it when I say we still have wards (so medieval). It’s all private rooms in France, including after giving birth. I described how noisy the ward was, having to use a common toilet when peeing after an episiotomy hurt so much, etc. They were shocked.

Also in France everyone sees a paediatrician for their baby, whenever they want to, not just if your baby has issues and you get referred by your GP (which can take ages). Issues such as reflux or allergies are diagnosed much more quickly.

You don’t wait months for surgery.

Every woman sees a gynaecologist, not just the GP.

After giving birth, virtually all women have 10 pelvic floor sessions with a women’s health physio. No one accepts that it’s normal to pee when you sneeze/jump/laugh after giving birth. They are shocked to hear women don’t do anything/don’t know they can do anything about it here.

Pharmacists are amazing and so knowledgable.

GP appointments aren’t limited to 10 mins and to discuss one issue only. I took my DS once when he had an ear infection, and also did it in England for the same issue. In England it was ‘check temp, check ear, yes it’s an ear infection, here is your prescription for antibiotics, bye’. In France they checked his history, weighed him, checked other things, had a chat about his general health, prescribed antibiotics, gave me tips, etc.

There’s much more comfort (not just the private rooms). For instance, before babies’ jabs, they put a local anaesthetic patch on their skin to make it less painful.

All this is funded through tax (albeit much higher than in the U.K.) and private insurance. However, it is free for very low earners. And private insurance isn’t as expensive as here as everyone (apart from very low earners) has to have one.

Private insurance is so much better than private insurance here. It can cover glasses, contact lenses, laser eye surgery (!!), acupuncture, osteopathy (and other forms of alternative treatment), dermatology, all dental care, etc.

Don’t get me wrong, I live here and find the NHS okay for my needs most of the time, but I do have private healthcare through work and have used to not wait months for surgery. I appreciate how hard doctors and nurses work, and I clapped for them during lockdown, but this is not the issue as the system is flawed and they can’t help it.

YANBU - it’s terrible. Only people saying it’s ‘state-of-the-art’ who hardly experienced any other European ones. It has sufficient fund, but too heavy on management and there is no responsibility.
Wish it could be restructured or I could opt out. If nothing else, this pandemic certainly highlighted the issues

Unpopular belief I know, but I don't believe the NHS is underfunded just poorly managed. It was never intended as a super, deluxe, all risks insurance policy.

I have been a member of 13 different health systems because of my previous job.
When I hear shit, and I mean it, about the NHS it drive me crazy.
How dare you compare the NHS with Romania? (I’ve had family studying there.) How dare you saying BS about the NHS when everything is free?
Nowhere in the world I’ve been, healthcare was free. And yes, might not be the “bestestest” but it’s way more than adequate.
I’m not even British and I’m protective of it.
I don’t get it how you come all here and compare it “...but it’s so much worst than so and so..“ it’s NOT. I’ve been there.
When my grandfather needed open heart surgery, in 1992, he spend the best part of £5k with insurance in a Mediterranean country many Brits retire to. And that was with insurance!!!!
I had a mole removed in France, 2007, that cost my private insurance £2k!!! I paid some extra £200 to have different type of No-scar stitching.

An UTI in Japan, 2003, landed me with £1k for a course of a COPY Noroxin Medication, not even the real medicine. (It was the most clean organised amazing hospital, I’ve ever been. Doctors and everyone in indoor slipper to keep the place clean. I’ll give them that)
Many countries might look better but when even crossing the threshold of a doctor’s office costs you €50, for a repeat of a prescription (online methods like here are not as advanced yet), then you’d all change your tune.
When even popping a sprog will land you with €10k bill and that’s for normal birth, C-Sections are €13K upwards, you’d prefer the midwife holding your hand.
So please, the NHS might need a bit of restructuring and funding but it’s awesome!
Please Brits, find something else to complain.

The NHS is not costly. The system allows much better scientific services and training to HPCs. If you add in the cost of these it’s cheaper than Comparable European countries (which pay for these things from different pots). Outcomes are better in some European countries for many reasons, including that the population take an active role in their health care. Also, in many cases the level of care available depends on your employment status/membership of union, something that would not work well in the UK. The NHS is clearly superior to the Danish health system, which is similar to the NHS just provides fewer services to patients (albeit to a higher standard) at a (much) higher cost. I think a change in society and culture around valuing a healthy lifestyle would be good as well as funding the NHS to an appropriate amount (other comparable countries pay much more per person - it’s hardly any wonder they get more 🙂). Change the model? - a big mistake.

Go private then

@RainbowMum11

YABU definitely. If it had been properly looked after and funded, it would still be the envy of the world.

This is a Tory country with mostly Tory governments who are ideologically opposed to the NHS. Its the only thing left pretty much that hasn't been properly privatised.

Therefore it doesn't work as it won't be looked after.

We don't need a new health care system to be blunt people who think just throw more money at the NHS are just stupid . You could throw money at the NHS all day long you would not solve the problem .
It's complelty abused service
People need to better life style choices with food, drugs , alcohol and smoking .
All of the above have a massive link to poor mental health which again puts a massive demand on our health service .
Us as a nation need to take responsibility for this .
YES there are people that have made poor choices due to life events. You do have people with mental health issues again to life events or a predipostion . There are lots we could do to reduce the demand on the NHS

The amount of waste in the NHS is staggering .

Obesity and smoking linked to many cancers and heart dieseases .
Drugs and alcohol linked to mental health .

Staff I have 3 friends who work for the NHS not one of them earns under 50K have more holidays and better pensions than any of our friendship circle . Yes in our jobs some have life and death responsibility as well .

You don't wait months for surgery
I'm waiting for Boris's next announcement about his 'war on obesity'. Quick diagnosis, prompt and effective medical treatment, and no more waiting lists for surgery. People can't exercise or maintain an active lifestyle when immobile or crippled with pain.

Social care system needs review for all ages
People living longer, some with multiple illnesses for several years

I have no complaints about NHS

To add fuel to the fire here...we need to stop being it the International Health Service and sort out the admin to charge those who aren't resident.

I lived in Belgium for 13 years, where the provision for payment is via a Mutuelle/Ziekenfonds; so it's part state and part private. You pay via your salary into the Mutuelle and can top it up if you wish. The system is fast, effective, and responsive. They are also very much into prevention as opposed to cure. Yes, you pay to see a GP, and prescriptions aren't as cheap as chips as they are here, but I was impressed. It's all very joined up, unlike here.

When you attend hospital, you register at a central reception, so they know you are there, and that you can be billed properly. My Mum had to go to A&E once when visiting us, and the bill was in Devon before she was. You have to show your ID card if you have one, and if not, some proof of where you live.

As in France, the pharmacists are very knowledgeable and can dress wounds, so when dh was badly bitten by his bosses unpleasant little dog, the pharmacist patched him up.

As for hiving off bits for scans etc, there are clinics like that in Belgium, founded by local GPs and the local hospital where you can go to see a nutritionist, a cardiologist, have an ECG or an XRay etc. They have labs as well for blood tests from local GPs, so I could get my blood results in 24 hours. It takes the pressure off the hospital.

We moved back to UK last year. It's been a bit patchy so far.

My experience of the Dutch insurance based system was good but it wasnt free at the point of contact. Every visit to GP or nurse was chargeable. Not a huge sum but still a cost - fine if you are on a good income, not so good if you arent.

The one thing which struck me was its use of GPs. All contact started with the GP even for emergencies. GPs would make emergency house calls if necessary and would treat minor injuries themselves. Anything they couldnt deal with was quickly referred on to a specialist.

In my experience a lot of what should be GP services have been dumped on A&E in the UK. In my area you cant see a GP out of hours. If you are in pain mentally or physically in the night or at the weekend you have to struggle on until morning and hope to get a GP appointment or go to A&E.

A&E has become the service of last resort. They will deal with the crisis in front of them but they arent there to deal with underlying causes.

No we don’t, we need to treat our pretty bloody great health system with a bit more respect and fund it properly. We need to educate people to take better care of their own health, stop handing out prescriptions for things like paracetamol, and use technology better. What we don’t want to be doing is razing the whole thing to the ground for the sake of implementing a health care system that will cost us ten times more and see profits go into the back pockets of American fat cats and their British hangers on.

Yabu. Our system is incredibly cost effective. The demand for healthcare is almost infinite admittedly but it works very well. Other countries all have their own problems too and often costs a lot more. There's very few countries that treat you free at the point of contact.

More privatisation in the NHS, or full privatisation of the NHS won't help. Allowing companies to ever-growibg make profits out of health services isn't right imo.

We need some reorganisation, some decisions about what is and isn't an NHS responsibility but most importantly realistic funding. Our NHS is underfunded, and deliberately so by successive Conservative governments since the 80s.

Almost everyone will be much much worse off if we move to an insurance model.

@FindANewWay

Rankings are subjective to the criteria used and that is political often. I've seen rankings placing us first because we treat everyone, even France as co pays

I agree, OP. The NHS isn't fit for purpose. And why posters continue to argue that the only alternative is the American model, I don't know.

I've been very impressed with Australia's healthcare system and similarly that in France. The care is excellent, the outcomes are better and waiting times are minimal.

I've elected to pay for private healthcare for my family as I don't trust the NHS to deal with anything not immediately life threatening. I had an emergency appendectomy last year on the NHS - fine. I also had to wait 10 months for spinal surgery, in excruciating pain throughout, before it was finally dealt with. This horrific experience confirmed that I needed private healthcare so I never go through that lengthy, agonising pain again.

Throwing money at the NHS is not the answer. It's inefficient, the bureaucracy is ridiculous and there is no joined up thinking. I would love a government to take the bull by the horns and introduce a new model of healthcare - along the lines of Australia - where a system like Medicare is supplemented by private health insurance.

No-one is suggesting that the American model should ever be emulated. No-one is suggesting that poor people be denied treatment. But the blinkered view, that the NHS is somehow superior to healthcare systems in countries like France, Australia, Germany - anyone who truly believes that is deluded.

Yanbu

It is not the envy of the world. Other countries have better health systems. We should look to France and Germany both have superior healthcare. We shall have to pay more.

I struggle to believe it’s the most cost efficient I see on a daily bases how much money is wasted and the culture of the NHS is so set that won’t change unless it has a complete overall change

At times it can be great other times it’s poor

How the nhs changed to deal with COVID was incredible we changed how we worked overnight how it dealt with the pandemic lack of testing, sending patients to care homes without tests is shocking (political too)

All my colleagues believe it desperately needs to change even if we are passionate about the NHS it doesn’t mean we think it’s works well as it isn’t and just needs more money it needs far more than money

Im always very uncomfortable with the hero worship of NHS workers. The front line staff are more deserving in this case, but there are very serious and disgusting human rights abuses towards the mentally and learning disabled in this country we still have asylums just under a different name, the people putting DNRs in Autistic peoples files were NHS workers, highly paid consultants, before covid the learning disabled were 4x more likely to die young of preventable death. some desperate intervention is needed.