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.

What do you mean we still have asylums?

Psychiatric hospitals? MH centres/ units? acute wards?

There needs to be places where those suffering severely with their mental health are kept safe for themselves and at times others and monitored

PasstheBucket89 sorry reread your post

Yes agree that the care for mentally and learning disabled in this country needs improving and the support for families

Have a look at health care in some other places, and realise how lucky you are to have the NHS, its not perfect, and lots needs to change, but if you think that its that bad, seriously do some research!!

You haven't read about the awful abuse of autistic people in some of the privately run 'hospitals' contracted by the NHS?

I was so shocked when I read about it. One mother in particular stuck in my mind. She's fought hard to rescue her disabled son. He suffered serious abuse and neglect in one of these places and she had to involve the police on several occasions. Her tenacity was inspirational. She fought hard for her son, and for other patients like him. She campaigns on the issue, tries to raise awareness.

International comparisons show the NHS scores well for value for money (for the relatively low spend per person for a developed country) and well for access (even if in effect you can't get through the gatekeepers or get timely treatment, you are entitled to it in theory at least). We score badly on innovation, treatment of chronic conditions, diagnosis e.g. for cancer and have a noticeable postcode lottery.

The biggest barrier to improvement is treating the NHS like a quasi religion. Whenever I point out the above, easy to verify facts, some people respond like I swore in church.

Some facts about me. I am alive because of the NHS (premature baby). I have been helped with some severe chronic illnesses in adult life, only because I could throw money/insurance at the problems. I only have my daughter thanks to the cheap and efficient IVF system in another European country. I worked for the NHS in admin for some years so I know it's not just a money problem.

We are the laughing stock of the world because of brexit not because of the NHS
The NHS does more than any other health service in the world on such a small budget
It needs properly funding
It is abused by people and sometimes I think there should be some charges but then you have to add in layers of finance management so it may not actually bring in money
There should be an honest conversation about what it provides. I don't think fertility treatment should be funded and I say that as a person who needed fertility services

I decided in my 20s the system didn’t work and avoid it at all costs. Has cost me thousands over the last 20 years or so but worth every penny. My DC recently needed an op and the private care was brilliant, It made me feel so sad that most have no idea how good care should be. For those who think the private system is rubbish, they simply do not know how to work the system because you do have to be careful. In effect I pay twice which I’ve accepted because my views are in the minority. I’d love a new fit for purpose system but not sure what that would look like.

You pay for what you get. Mark Thomas recently did a very good documentary/ comedy about the NHS at 60 and the model needs more funding.

I live with a chronically ill partner ( we are both Brits but settled overseas he became sick after we became citizens) we have a public system here, it is not perfect but it works. Yesterday he fell ( he has limited mobility) and injured himself, this morning it was clear the injury needed investigating. Called doctor, got an appointment with highly qualified nurse practitioner within an hour ( she would talk with doctor if needed) ascertained a possible break in foot, ok G.Ps cost a subsidised fee here $10 around five pounds ( would be free if I didn’t work etc etc but this is hugely subsidised, kids under 18 are free not sure re pensioners). Down to hospital waited 5 mins in X-ray, highly skilled radiologist manipulated the foot, had his previous notes. Then into A and E for results, 10min wait, saw American expat Dr who spent ages checking things out and yep there was a break, organised tetanus, home care, checked medications, nurse dressed foot. This was a public hospital in a town. Our citizens pay a higher percentage of funds into Health than the UK ( we also don’t get involved in wars, buy fancy military equipment or irritate too many other countries).

Public healthcare is possible, if those of us in the higher income brackets ( yes I am one in this country) put money where their mouths are and cough up. I pay fairly low tax for my income, in my opinion and could afford and would be happy to pay more tax. I am PAYE before anyone says anything, no fancy accountants here.
I never ever in my wildest dreams thought I’d have a disabled partner at my age, But what is apparent to me for all the days, weeks, nights I have spent in public hospitals is that if those of us who can pay higher tax and vote not to, our public system will crumble. None of us know if we have a health time bomb ticking away, paying fairly, sensibly, knowing that new research is expensive, equipment is expensive and that taxation is probably the most cost effective way of paying for healthcare is only sensible.

My insurance company rips me off annually for buildings insurance, because we have earthquakes here. Do you really want to be paying/ bartering/ suing / being pursued for unpaid excesses by your insurance provider when a loved one is in ICU and you can’t afford the bills - I know I don’t and that is the alternative.

What we need is

a) proper funding

b) to make all non clinical staff spend some time on the 'front line', ie the top managers should have to spend 1 week a year as a HCA doing a late shift, followed by an early, followed by a split shift followed by a night shift and then they might find out a blanket in a pillow case is no substitute for a pillow.

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

One hospital I worked at started a 'save us some money' scheme, I got a payment for a suggestion, this should be rolled out nationwide.

Things like uniforms should be universal. At the moment you leave a job in one hospital and go to another you leave your uniform behind and get a new one at your new hospital.

If all uniforms were, well uniform, and went with the person it would save money, and I know everyone's uniform would need to change but it doesn't have to be all at once.

@quodvox

Problem with our NHS is too many managers, doing Sweet FA, unable to manage or cope when there is something major. Top execs get paid ££££££ (have a little google at their pay) Most of the time they are busy having frightfully important meetings to organise more frightfully important meetings, and then meeting to discuss the last important meeting. Meanwhile clinical staff, and those who actually turn the cogs and keep things running, are bashed on all sides. Sure be angry OP, but at least aim your anger where it is warranted. Far too many managers in the NHS, on huge salaries and unable to, quite frankly, organise a piss up in a brewery. But watch how they blame everyone else for their inability to actually do the job...remember that old proverb? Those that do, do, those that can't manage!

...and may I just add that we should cancel the PFI contracts. Those leeches continue to make money hand over fist, they’ve had enough now, just cut them out.

We need to stop treating the NHS as a sacred cow. There needs to be cross party talks that try to tackle the ever growing demands made upon it by an ageing and increasingly unhealthy population. Most of the much vaunted European health care systems are mixture of private and state funding.

We also need to look at the whole attitude of the population towards the demands they place on the NHS because quite frankly there are an awful lot of people who take the piss out of it. Data shows more than 15 million consultations are being wasted because patients fail to show up and the overall expense of patients not cancelling appointments could pay for the annual salary of 2,325 full-time GPs. Ambulances are demanded for non emergency events, people stroll into A&E because they cant be bothered to go to their GP etc. Throw into the mix an increasingly fat population and the raft of health implications that brings we need to seriously frank conversation as to how we proivde a 'free' service.

I've used a lot of private healthcare in the UK over the last 12 years and it's more efficient in terms of you can get a diagnosis and treatment promptly, there's little if any waiting time and you can choose times and locations so they're convenient, but it's not always better organised or even politer! A surprising number of NHS staff are very pleasant considering the conditions they work under. And the consultants are essentially the same people as in the NHS, doing private practice. The main difference is purely that you can get the treatment in a timely fashion and you can ask for it rather than waiting to be deemed worthy. There is a big long list of things from varicose veins to decent hearing aids to eye care to fertility to mental health that essentially aren't covered under the NHS and you certainly can't get any kind of proactive health advice or checkups for your children.

Yabu and yanbu.

Yabu to moan about paying into it. Some countries pay health insurance on top of social insurance and taxes, some have it in taxes, some only private. Either way, it has to be funded from somewhere🤷🏻

As PP said, you need better funding. In fact I think what people pay into the health care system in here is too little and it should be bit more.

an increasingly fat population
Hence the need for the proactive preventative care provided by the better healthcare systems abroad. You tend to get fat when you're involuntarily sedentary whilst waiting 10 months for an operation. After several years of pain and decreasing mobility whilst battling to get a diagnosis.

We need to be more like Europe and Australia when it comes to healthcare.

What? I love the nhs? Have a go at the MPs with three houses not the health service!

@PastMyBestBeforeDate

The NHS is one of the most cost efficient systems in the world. What we need to do is fund it properly and most importantly decouple it from political interference. A politically motivated reorganisation costs billions. Let medics and business minds run it, not politicians. Most of the Covid problems were down to political dithering and funding cuts.

This

PFIs are ridiculous money pits and the contracts are opaque and weighted towards the money providers (obviously!). But they came into being because successive UK governments had let healthcare infrastructure get out of date to the point that the sums that would have been required through tax to build hospitals directly would have been so enormous, they would have been politically impossible. PFIs are basically mortgages, but with no asset at the end of them but you do get the new hospital to use during its lifetime.

I am always uncomfortable with the argument that if people somehow treated the NHS better there'd be plenty for all. It smacks of victim-blaming to me. If all the supposed "do not attend" people turned up the queues would be even worse. If primary healthcare was better or pharmacies did more, fewer people would be at A&E or the minor injury unit to get basic healthcare.

In my experience most people with money or insurance are doing their level best to avoid the NHS anyway while still contributing through tax.

Why do people still peddle this 'envy of the world' crap. Its objectively, in recent studies, about 35th best in the world. As measured by life expectancies for various cancers, detection rates for diseases that are treatable with early detection etc. There are not many countries that envy our healthcare system any more.

It's got to the point where you have to be in such a state to be treated that it causes other problems in the long term. For example people that can't walk because of a bad hip being denied a replacement because its not yet too painful to keep them awake all night. Surely that's going to cause depression and obesity etc.

They do need to look at alternative ways of funding it. I'd rather pay a tenner when I go to a and e and wait an hour than wait for 6 and get it for free. I realise everyone can't pay, but a lot can and I think should

I live in France, my health insurance costs 70€/month, for the 30% my carte vitale doesn't cover, but

I'm having a tooth crowned, but the tarif is 170€ and the cost over 500€ and I have maximum dental cover.

I need new glasses, takes a year to get an appt with an opthalmo as opticians don't do all the eye checks and the no of specialists is limited by govt. The last pair I got in the UK were £250 at Costco, frames and varifocals at +3/+5. Here each lens would cost 500€+. I'd need 2,obviously.

As in the UK, in rural areas it can be nigh on impossible to find a GP with places available.

Due to low income I've had govt help with the cost of top-up insurance, but the basic cover used to be 10% of income.

There is also a shortage of gynaecologists. One I know always has a petition on the waiting room wall about the shortage.

Regarding pharmacists, in France all vets, dentists and pharmacists are qualified at doctorate level.

Contraception is also not free.

On balance, I prefer the French system (despite 3-bed rooms in hospital), but it's not perfect by any means

I don't think we need a new one, but it needs radical reform, and no one will because of the emotive and sentimentality of our NHS; and any changes for some reason people assume will be selling to the US. Because it's free at point of use some people do abuse it, even with all of the education in the world around what service is most suitable, some people still to to A&E with a stubbed toe. Mental health care needs urgent and drastic reform, there isn't much ground between receiving zero care (it's so hard to access) and being sectioned with then little support afterwards. Procurement needs sorting out, there are so many uneccessary monopolies for certain drugs etc that means we are forced to pay a ridiculous amount, and no, this isn't the same everywhere- plus until it's fully centralised we won't get any economy of scale etc which means we pay more for more or less everything. Training for nurses etc needs sorting, plenty of people with relevant experience cannot access the degree because they have families to support and cannot afford it; seen as though they do so many hours on wards anyway, pay a fair bursary. Funding should be looked at, as a high earner I wouldn't mind paying an extra % if it was guaranteed to go to the NHS. The truth is that the model was great at inception, but now, technology is expensive, it will never be funded enough this way. Running an MRI machine, for example, is so expensive, but it is an incredibly useful bit of equipment. However much money is magic-ed up won't be enough, there needs to be a steady, secure income stream that isn't just relying on finding a few extra quid in the treasury and the current way.

We do need to put more money into it, but is anyone willing to raise their taxes to do so? Honestly I'm not, because the government are unlikely to spend the extra money on the NHS. Maybe that's just my lack of trust in the tories.

I am from Europe and you are deluded. You are being brainwashed in thinking the NHS is first class. The TV adverts during the pandemic confirmed that to me.

The country I am from has dealt with Covid much better. Test and trace actually works. If you have symptoms you get a test NOW either at the doctors or someone comes to your house. You don't wait 48hrs for it to arrive in the post, do the swab yourself and post it back and wait 24hrs or more for the result. Relatives have had non urgent operations weeks ago.

If you are seriously ill, like cancer, you get an appt now and don't wait for some letter to arrive in the post to inform you of your hospital appt in two weeks time. You don't pay to see a GP or consultant. Private health care as a top up is unheard of.

You are being gullible.

I don't think we need a new system. The care side and hospitals do an amazing job but the running and management need a good shale up and restructure.
Seems very wasteful in many areas. Too many chiefs and not enough indians.

You tend to get fat when you're involuntarily sedentary whilst waiting 10 months for an operation.

63% of adults in the UK are overweight. Were they all waiting for an operation?

@DillonPanthersTexas

You tend to get fat when you're involuntarily sedentary whilst waiting 10 months for an operation.

63% of adults in the UK are overweight. Were they all waiting for an operation?

Don't. This never ends up well