AIBU to ask your thoughts on the NHS

[Bumblecattabbybee]

Don't get me wrong. I love and totally support the NHS. But the way it is right now just doesn't seem to be working as well as it should, and people are getting really sick, not getting treatment they need, often unable to even see a GP in good time when they have serious symptoms, and having to wait months for appointments for treatment. The whole thing seems to be falling apart.

Another issue is that a lot of the time, people don't really feel comfortable or free to use the NHS without judgement. The amount of times on here I've seen people listing some serious and scary symptoms that they or their child has and questioning whether it's okay to go to A&E/the GP. I've also regularly seen people criticising others who were in A&E/the GP for symptoms they didn't consider serious enough.

When I started working abroad, the difference really hit me. When I was sick or had a small injury or problem, I wouldn't go to the doctor because I was so worried about wasting their time, and I found that other British expats were the same. We have had it drilled into us that unless our sickness is of a certain severity or we seriously think we might have a serious, life threatening problem, or until a problem has got to the point where it's seriously affecting our wellbeing/mental health/quality of life and we can't cope anymore, we don't the go to the doctor because it's seen as a waste of NHS time, money and resources.

All my non-British friends here thought this was absolutely ridiculous - the way they see it is, when you're sick, you need to go to a doctor. You don't take risks. You don't put it off because you're afraid of wasting the doctor's time. This isn't how it should be with healthcare. You just go. The risk is NEVER worth it. Whereas I recently read an article about how this issue of people not wanting to waste doctor's time is a genuine issue in the UK - especially among older people, who end up really unwell because of their reluctance to see a GP when they first experienced symtoms.

A close relative of mine was recently diagnosed with cancer and luckily they're going to be okay, but the two issues above meant that they almost weren't. Firstly, the pressure to not waste NHS time meant that symptoms weren't investigated as soon as they appeared because relative felt the need to give it time, not make a fuss, see if things got better on their own. By the time they realised it was actually serious enough to warrant use of NHS time, it took SO long to get an appointment to see a GP. Weeks. So I've been thinking about this a lot recently - what a close call it was.

I used to be so proud of the NHS and in many ways I still am, but the above two issues really, really scare me. And from what I've seen, it's just getting worse and worse. I recently heard of someone who was given an appointment for a hospital procedure for a date at the beginning of 2023! I constantly hear of people waiting weeks for a GP appointment, and in some cases, a period of weeks can mean the difference between dealing with a small problem or a big one, dealing with mild symptoms or serious ones, and even be a case of life and death.

Here, I have to pay for heath insurance but I know that should I have any health issue, I can see a doctor that day, have tests that day, scans that day, if we can't get it all done that day then I'll come back tomorrow, and I never need to question whether it's serious enough to waste a doctor's time on because there's more a sense of, the doctor is providing me with a service which I am paying for, whereas the NHS always felt more like a privilege to use. But I can't help feeling this huge injustice over the idea of healthcare being a paid service in this way, and this scares me too.

Is there a solution? What do you think? I'm just curious about other people's experiences and thoughts.

Pandemic has caused delays & disruptions in medical treatment globally.

Over-diagnosis is a problem, too.

My dad, who was perfectly mobile, had neck surgery 8 weeks ago. He was told this surgery would save him from paralysis, prevent him needing a wheelchair in next 5-10 years. Now he has terrible neck pain when he moves around and can't walk independently for more than 6 minutes without the pain risking an unbearable threshold. He was supposed to fully recover weeks ago.

Be careful what you wish for.

I think healthcare should be free at the point of access but I don't think our system is working at the moment. I've had some pretty awful experiences with the NHS over the last year or so, including a cancer diagnosis, and frankly it was a bit of a shit show. Agree it's ridiculous that people feel they can't access healthcare because they don't want to waste anyone's time.

It’s been massively underfunded for decades so doesn’t work a lot of the time. It must be so depressing for hcp to not be able to treat patients properly so now there’s a huge shortage.
I don’t know if it can be saved. This country seems to be more and more right wing so there just isn’t the public desire to sort it out. I’m starting to think about going private more and more just so I can get some help.

I think one of the key problems here is lack of education. If school biology classes taught more about human health and less about plant cell structures, then maybe people would be better at spotting the difference between a medical emergency and a minor ailment. I'm not disparaging those people, in the main; quite a lot of symptoms can seem very scary without background information. On the other hand, a lot of symptoms are minimised. I've realised a lot of people don't know, for example, that bleeding from ears can be a medical emergency.

But generally speaking, we shouldn't waste the NHS's time, and I have a lot to say about A&E departments filling up on Saturday nights with the remnants of hundreds of pissed-up fights, but that's possibly for another thread and another day

Problem is that it's just not fit for purpose and needs overhaul. But someone, somewhere made sure that the criticism of the organisation and it's functionality is quite silenced by making people put together NHS and nurses and make it an emotinal issue so when you criticise NHS functionality (or the lack of it) you end up being shit down because "poor nurses work their arses off and you are spouting this poison! Heroes to zeroes, eh!"

It's really like if people were attacking others because they criticise Amazon and that surely means they must hate their workers, iyswim.

Health care system should NOT be such emotional issue people try to blackmail others or accuse them of ruining it by not being healthy etc.
"omg what's wrong with you? People like you are the reason NHS is on it's knees!" is common to see. Shame the people don't realise that it's actually them who are the reason NHS is "on it's knees" because they blame the wrong people for the issues.

Politicians play on these feelings well too. "Save the NHS, stay home". Use of emotive language just makes it easy for them to shut down critics and not having to better the system.

I know many people who pay private in their native countries. At least they get an actual treatment.
Shame though. It's famous for paracetamol amongst foreigners. There are some great gps like my old one was, but overall it's just sad affair. My female friends couldn't believe they can't just go to gyno when they have issues. Many, incl myself once, just fly back to our native countries for gyno care.

I do however think that hella lot of people go to a&e when it's not an issue for a&e, but then I remember that for many it's impossible to get their gp, let alone specialost. Basically, to get a specialist care, sometimes person has no other option than a&e.
Sad.

I come from system where everyone pays a bkt in, it's taken off like your taxes, so free aylt the point of entry. If you don't work, state pays it for you. Like nin here? Never have I heard any of this emotive language in there. Never have I heard someone guilt someone into not taking Healthcare system's time. And while we greatly respect the staff, I also nwver aeen anyone running around with "I 😍Healthcare System" stickers on cars.... Maybe start calling it National Healthcare System instead of NHS in discussions and see the difference how people talk about it.

I’m starting to think about going private more and more just so I can get some help

It's not always that easy. I'd love to go private to help my ASD teen who's currently being neglected by CAMHS and her psychiatrist. The nearest child psychiatrist is several hours away and has a waiting list so long that they're not taking on new patients.
I can't even throw money at this problem; there's no help at all.

The NHS has been underfunded and under valued by the Government for years to the point that they have run it into the ground and we are at crisis point.
The public on the whole will not admit this (they are scared of paying higher taxes to fund a decent service), so they pretend (absolutely convince themselves), that having an NHS simply isn’t viable anymore. They also blame staff for “wasting money”.

The sad thing is we could have a first class first world NHS, but this Government have absolutely done a number on the public. They have gaslighted people quite successfully it seems. Now the public refuse to demand the great service they could have. I’ve come to the conclusion they don’t really want decent healthcare, or they are just happy to pay private perhaps?

But the way it is right now just doesn't seem to be working as well as it should, and people are getting really sick, not getting treatment they need, often unable to even see a GP in good time when they have serious symptoms, and having to wait months for appointments for treatment. The whole thing seems to be falling apart
People have been saying the same about the NHS for more than 20 years! It's still going.

Sadly, many people do waste NHS time. Except for a number of vulnerable, uneducated people, the majority have access to good information about conditions and advice on how/where to seek treatment. Many ignore it and yes, there have been posts here of people thinking they needed urgent care when their condition didn't at all.

As for cancer diagnosis, again there is a lot of info and promotion mean to encourage people to seek help early. Many people don't by denial. I do agree that getting to see a GP at the moment is a nightmare and the system is in crisis, but this is an even better reason to ensure that people only seek to see a GP where there are no other alternatives. They often are.

It saddens me to say it but I agree with you OP. I love the NHS and everything it stands for but sadly it is not fit for purpose anymore. It’s underfunded because it’s a behemoth, a money pit. Short of bankrupting the country, no amount of money will be enough. It’s not just the NHS, our social services desperately need more funding too. It is a worthy model but not one fit for the 21st century. We really need to have these conversations as a country so we can find a fair and reasonable model of replacement, something ensuring a good level of universal healthcare. I worry that because it’s so politically unpopular to say it out loud that NHS reforms are being pushed in through the back door, without proper democratic discussion. I don’t want to wake up one morning and find that we’ve incrementally slid into a two tier, US style system.

It is expected to work for a huge population with little change to number of staff or sites to use. The number of hospitals with no A&E is ridiculous. My surgery is expected to look after over 16000. One surgery with 5 GP’s. The other thing we have forgotten is that the advances in medicine mean that we live longer with more complex health conditions which require a lot more time and usually involves multiple team's. And whilst I agree that people shouldn't sit at home not wanting to waster the NHS time, there are a number who want a fix and now and have no clue what an emergency is, or how to self care when appropriate. The NHS are expected to pick up the slack as well for poor health choices. When you hear that they have to see people with gaming addictions personally feel it's all gone too far. People don't like to take responsibility for their health choices so obesity etc are almost normalised because we don't want to offend or upset someone. It's easier to suggest anyone overweight has an imbalance or genetic issue rather than face the fact that for most, obesity is over eating and lack of exercise. Which leads to heart issues, diabetes, shortness of breath to name a few. Some of us want immediate miracles, where some won't ask. Ultimately if you think you are in need of medical help it's down to us to seek it and not ignore it. I know that's easier said than done. I'm not sure what the solution is when we keep building house upon a house with no expansion of the services needed to feasibly see people in a timely manner

The sad thing is we could have a first class first world NHS, but this Government have absolutely done a number on the public. They have gaslighted people quite successfully it seems. Now the public refuse to demand the great service they could have. I’ve come to the conclusion they don’t really want decent healthcare, or they are just happy to pay private perhaps?

So true @MissyB1 although it's not just this government, this shit goes back to Thatcher.

I think the NHS is on its knees. Last week my mums husband is very ill with diverticulitis (infected intestine wrinkle) with the complication of poorly controlled diabetes that got out of control because he couldn't eat. He was vomiting blood and passing out at home for 10hrs waiting for a paramedic, then kept on A&E all weekend because no space on a ward, waiting times in A&E that weekend were 7hrs. Then when on the ward he was repeatedly told they were discharging him when he was clearly too ill, my mum was spoken to very badly by nurses and doctors when she said she wouldn't take him home without them writing up a care plan to help her look after him. He was discharged the next day, still vomiting and unable to eat or drink much, with blood sugars at 25. Scans had found a tumour on his kidney, that's not being looked into until mid September. He's had no follow up at all since being at home. The GP hasn't returned 2 calls.

@Indecisivelurcher Christ, that's awful. Systemic failure at every point. So sorry.

I work in both private and NHS GP.

The latter is unsustainable, many of my colleagues are tired of running a £150 per patient per year all you can eat low quality (ie low access) buffet that on average delivers 6-8 consults per year and pays for the rest of the surgery.

The UK public doesn't pay enough for primary care. Seeing me privately costs nearly that for a single consultation.

So as the public you're not happy, we're not happy (GP recruitment and retention is abysmal) so it's time to scrap it and move on. The Australian system seems to work well.

But don't expect the new system to cost £150 per year.

I work for a private company, however we are located on the hospital grounds and will be sent NHS ward patients to treat.

I've had some terrible experiences with these ward patients. A lot of it is lack of communication between staff and also being so under staffed. Appointments get missed, the patient isn't prepped etc.

Also the NHS patients who are referred to us (in or outpatient) sometimes they miss the appointment, yet don't get charged for the waste of appointment time!! It's around £900 for this treatment and the NHS is funding it!
I believe that any missed appointments (within reason) should be charged to the patient for missing the appointment.

@vivainsomnia

But the way it is right now just doesn't seem to be working as well as it should, and people are getting really sick, not getting treatment they need, often unable to even see a GP in good time when they have serious symptoms, and having to wait months for appointments for treatment. The whole thing seems to be falling apart People have been saying the same about the NHS for more than 20 years! It's still going.

Sadly, many people do waste NHS time. Except for a number of vulnerable, uneducated people, the majority have access to good information about conditions and advice on how/where to seek treatment. Many ignore it and yes, there have been posts here of people thinking they needed urgent care when their condition didn't at all.

As for cancer diagnosis, again there is a lot of info and promotion mean to encourage people to seek help early. Many people don't by denial. I do agree that getting to see a GP at the moment is a nightmare and the system is in crisis, but this is an even better reason to ensure that people only seek to see a GP where there are no other alternatives. They often are.

We really should blame people for not being able to adequately self diagnosed.

Maybe we could just do away with nhs and let people do their own treatment...

I've come on to say that I couldn't praise the NHS enough at the moment.

My Ddad died last week after a 2.5 week stay in hospital with acute pancreatitis (no known cause or warning). When he collapsed on the 11th, the paramedics got to him in ten minutes. He spent a day in A&E while they waited for an ICU bed and then he was in a brand new, fantastic ICU single room until he died.

Because of covid there is currently no visiting but the doctors and nurses encouraged us to call and facetime as much as we wanted. After a week, it was clear that he was on a downward trajectory and they allowed us to visit and sit by his side as much as possible even before it got to official 'end of life' stage. The staff were all fantastic, couldn't do enough for us and when I first went into his room I praised the NHS for the amazing array of machines keeping him alive (and trying to heal him obviously).

On his last day, the ICU ward was short-staffed and we could tell as DDad's nurse had to keep leaving to assist with other patients but we (DM, DBro and I) didn't mind as it meant we had time just with him.

So really, I couldn't praise the NHS enough at the moment.

I will say though that in the many chats we had with the different nurses, quite a few said they knew of colleagues who had left/were leaving after the pandemic nightmare and others who said they would leave if it happened again :(

The solution is supplying the funding to train more staff. As there is a huge staffing shortage and that’s the main cause of the crisis.
I would have loved to train as a doctor but I never bothered applying and chose something less competitive as it’s impossible to get a place on a graduate entry course. There’s not a shortage of people wanting to do these roles, there’s a shortage of places.
The government took the bursaries away too that’s another factor.
Now people are leaving or retiring and the problem is going to get soo much worse as the more experienced staff leave and there’s not enough new people being trained.
I was listening to Jeremy Hunt on the radio the other month talking about the staffing crisis and it made me cry how bad things are going to get. He said he opened up training for more doctors and nurses when he was health secretary but as they take so long to train we haven’t seen the benefits yet. But in reality it’s still not enough.
It’s impossible for the NHS to survive the numbers of staff who are going to leave in the next few years.

And recruitment is too slow. We lose one person in our department and you’re lucky if you have a replacement in 6 months. Then it takes at least 6 months to train them (without distractions). So we’re always a person down.
Pay for the lower rungs is too low, so people leave pretty quickly. These aren’t easy jobs which you can train their replacement in a couple of weeks. My old job took a year of training and I still was not fully trained as there wasn’t enough spare time to complete it all. I was earning barely above minimum wage to do an complicated job which has a direct impact on patients health.

The NHS is nothing without its staff.

It needs an overhaul.
SO MUCH MONEY is wasted in the NHS.
Greedy private companies have been allowed to take over parts of it and deliver a crap service for £££.
It’s fragmented.

If I had relied on the NHS I would have been disabled and wheelchair bound by the time I am 40.
Because I'm lucky enough to be able to borrow enough money, I paid for surgery and can now continue to raise my children, walk my dogs, drive my car etc.
I hope to never have to rely on the NHS, but feel that without improvement it will start to do more harm than good.

My mum went into heart failure during the very first lockdown. She was in an assisted living flat due to losing a leg from diabetes, but was independent and didn't have carers. Paramedics wouldn't even take her to A&E & encouraged her to sign a DNR. They said our hospital was so overstretched with covid patients she'd likely be stuck in a corridor till the end & no family could be with her. They just left. I struggled to care for her for days before she got a hospice place & nhs help in the community was terrible. Mum sadly still passed away alone as the hospice didn't allow visitors in lockdown.

It breaks my heart that it’s falling apart but it is.

How much would you all be willing to pay for a visit to a GP ? £20 , £30 or more ?
If you only need to go once in a blue moon this might not be an issue, if you have a chronic condition that needs more frequent visits, it will be a tax on ill health and most people I know with chronic conditions are still working so would be outside the threshold for free care. Do we decide that certain conditions mean you can get free or discounted care a bit like certain prescriptions are free regardless of means testing ?
If private healthcare suddenly becomes the norm, what happens to people who already have chronic conditions or who have recently had an acute illness or have been diagnosed with a life limiting disease ? Will providers have to take them on at reduced rates and full cover or will people be left with no health cover for conditions they already had ?
How much can people afford to pay for healthcare monthly out of their wage ? It is unlikely that taxes would go down if a private healthcare route is taken, so you will be paying an additional amount on top of tax and NI.

The NHS is a crap-shoot. Some regions have good healthcare coverage. Others don't even have an NHS dentist.

Another issue is people thinking the NHS is free. People tend not to value something they think is free, which is why there is so much wastage. Every year the NHS pays out staggering amounts in medical negligence claims. Some hospital trusts are effectively bankrupt.

The NHS doesn't work any more. There are too many people and not enough healthcare provision.

It's been treated as a political football ever since I can remember. Meanwhile people are dying every day because they cannot access quality healthcare.

The healthcare system needs an overhaul from the ground upwards. More mental health provision, both community and wards would ease a lot of pressure elsewhere, and then more GP access, along with out of hours support for minor issues. Add in care homes for elderly, hospice care and support at home, and then hospitals might have half a chance of treating more serious cases. All this costs money though, for training and running costs and equipment etc.