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.

keepournhspublic.com/

@ActonSquirrel so, you don't think us plebs should have political opinions? I wish I could be that vacuous

[quote minatrina]@ActonSquirrel so, you don't think us plebs should have political opinions? I wish I could be that vacuous [/quote]
You are too vacuous to know when a comment was tongue in cheek 🤷🏼‍♀️🤦🏼‍♀️

@ActonSquirrel I know it was tongue in cheek, I still think it's vacuous

[quote Graphista]@ActonSquirrel 2 points ;

Privatisation of the nhs actually started under Thatcherism in modern times. Going back further the Tory party resisted the very idea of the nhs from the beginning and have never supported it

New Labour - were frankly tories in disguise! Blair was never a socialist minded person or politician. In my and many others opinions New Labour destroyed the Labour Party and perpetuated many Thatcherite policies including how they dealt with the nhs
[/quote]
Very true. Thatchers care in the community springs to mind!

Tony Blair was one of our more right wing prime ministers. He was a neoliberalist who gave some cash away and continued the sale of public assets. Plus he confused people about what left wing actually meant for generations to come. If you have a look at political history since World War Two it's fairly obvious that so-called 'right' and 'left' are rarely that far apart at any one time, and that cultural trends, as dictated by those in higher places, dominate political thought, not what us plebs need.

Back to the op, my first thought was that this must be someone in media or someone linked to Johnson's government loosely trying to gather up opinions to justify the continued running down of the NHS predatory to starting an American system. However I have experience of the European-style insurance schemes and they are far superior to what passes for our health service now. No disrespect to any of the NHS staff, either the amazing ones or those just doing the job as best they can, they are being absolutely bloody shafted, as are we all.

...of the NHS, preparatory to starting an American system ...

@PickUpAPepper

Tony Blair was one of our more right wing prime ministers. He was a neoliberalist who gave some cash away and continued the sale of public assets. Plus he confused people about what left wing actually meant for generations to come. If you have a look at political history since World War Two it's fairly obvious that so-called 'right' and 'left' are rarely that far apart at any one time, and that cultural trends, as dictated by those in higher places, dominate political thought, not what us plebs need.

Back to the op, my first thought was that this must be someone in media or someone linked to Johnson's government loosely trying to gather up opinions to justify the continued running down of the NHS predatory to starting an American system. However I have experience of the European-style insurance schemes and they are far superior to what passes for our health service now. No disrespect to any of the NHS staff, either the amazing ones or those just doing the job as best they can, they are being absolutely bloody shafted, as are we all.

I agree as an NHS HCP, my in laws get far better health care in the Netherlands than they would here. They pay more for it, but they receive treatment quicker and have better access to primary healthcare.

To those saying we need to adjust our expectations and stop wasting NHS time, I have worked in A&E for 17 years and certainly have seen some people who don't use services appropriately but that's a massive over simplification of the problem. They are a minority and part of the problem here is actually access to health care, which actually comes down to the structure of the NHS as well as funding. A healthy population needs a fantastic primary health service on many levels and we just don't. There simply is too much demand. The fault lies with the government not the general public's use of the NHS.

@privateandnhsgp

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.

This!

@ActonSquirrel

I guess the difference is we could do without corporate layers but quite difficult to go without HCPs

You do realise that it takes years and years to become a consultant and doctors can get stuck as SAS (old staff grade), making far less and no private income either?

As for GPs the NHS relies on them to gatekeep because there aren't enough secondary services for everyone who want them. British GPs have a high workload and are often expected to take on tasks that GPs/family doctors don't do in other countries, to reduce the load on secondary services. They've been trying to shed duties in recent contracts because they're handling higher patient loads and more complex cases.

Actually for what it's worth there haven't been any significant reduction in GP duties since 2004, which is when the last major GP contract re-write was.

What some practices are doing is declining to take on previously paid-for activity that is not in the core contract (eg enhanced services) or stopping activity that isn't funded or contracted at all (eg blood tests, ear syringing).

@BigWoollyJumpers

Underfunded?

underfunding goes back decades and even 0.5 to 1% differences p.a are billions in just a few years, such are the size of budgets.

If you have 40k less nurses than you should, than that indicates long tern underfunding and will effect patient services.

nhs consistently comes out as one of the more efficient health systems in the western world but poor outcomes.

It’s nice to have it free at the point of access and I used it for my pregnancy and delivery and generally if I need a GP appointment but for anything else I am so glad of private healthcare. Waiting times are so long on the NHS that early diagnoses are fewer and further between.

Why is nobody willing to divulge how much their healthcare cost's them in other European countries ? I am not even sure if OP is in a European country, did they say ?

Also plenty of people are happy to say they would pay more, but also rarely quantify it with a figure ?

How much would you be willing to pay for healthcare, each month for you and your family ? Do you think employers should pay towards it , like they do in some other European countries ?

My company AXA PPP is £169 pm with exclusions for thyroid, breast disease and osteoporosis. Company pays. DH funds himself and family out of pocket otherwise it would be about £600pcm and we have enough money to take a punt.

@frumpety

Why is nobody willing to divulge how much their healthcare cost's them in other European countries ? I am not even sure if OP is in a European country, did they say ?

I think 13. 5%. That includes employer contribution. So on 100, 000 (for easy counting) a month you pay 4,500 and employer pays 9,500. Eu country.

The rates for countries are quiet easy to google.

Oh, in France we pay as we go on top of EHIC. Not domiciled but always have some travel insurance.

Are you in the UK @RosesAndHellebores ? When you say the company pays, do you pay tax on that as a benefit ?

Yep UK and yes it's declared on P11D.

@SchrodingersImmigrant thanks, so when you look at your pay slip, how much is taken for healthcare ? Do you have to pay for any children you have ? Are there any restrictions on cover like in RosesAndHellebores case or does it cover all pre-existing medical conditions ? Can you top up if you wish ?

[quote frumpety]**@SchrodingersImmigrant* thanks, so when you look at your pay slip, how much is taken for healthcare ? Do you have to pay for any children you have ? Are there any restrictions on cover like in RosesAndHellebores* case or does it cover all pre-existing medical conditions ? Can you top up if you wish ?[/quote]
Children (up to. 26 if in ft study, unless that's chamged in last few years) are covered by state. So are for example OAPs an bunch of others incl unemployed. There are no restrictions on pre existing conditions. My mum didn't even know what would private insurance do when I asked her about them tbh. Afaik you can pay for extras like better tooth filling or premium rooms in some places (i paid for the better fillings, kids and pregnant don't have to I think).

Oh so is dentistry included in your healthcare @SchrodingersImmigrant ? That's interesting , what else is covered ?

@frumpety

Oh so is dentistry included in your healthcare *@SchrodingersImmigrant* ? That's interesting , what else is covered ?

Well, it's healthcare. Everything health care is included in the healthcare. It's kind of like uk health service just... Better? Like you get regular check ups with dentist and gyno. Gp as well, but not every year I think. It's been a while I was part of it... I am quite helth ok. And can't have to EU insurances. Ooooh, brexit positive 😱 must check.