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.

I’m always the first to sing the praises of the NHS and I honestly think the people who work in it are wonderful but the system seems so broken. My DS has a condition that needs annual investigations under GA and we are now a year and a half in and still no where near getting an appointment, but it’s so serious we aren’t allowed to fly with him and have to rush to hospital if he starts coughing up blood. Sometimes it feels like he will only get seen if he becomes emergent rather than preventative.

I also think I might have skin cancer as I’ve got a mole that’s really changed recently and looks dodgy to me but it’s almost impossible to get an appointment at my GP to even get it looked at.

It’s hard because I’ve no idea what the answer would be but it’s clearly not working as it is.

Or would it be easier to ask what isn't covered ? What do you have to pay for, other than upgrading rooms/better tooth fillings ? If you or your Mum have surgery, would a nurse come to your house and give you your daily blood thinning injection as an example ? Is there a community service that will come to your home if you are housebound to provide medical care such as giving insulin injections or end of life care ?

@frumpety

Or would it be easier to ask what isn't covered ? What do you have to pay for, other than upgrading rooms/better tooth fillings ? If you or your Mum have surgery, would a nurse come to your house and give you your daily blood thinning injection as an example ? Is there a community service that will come to your home if you are housebound to provide medical care such as giving insulin injections or end of life care ?

I have no idea what level is provided in these cases tbh. Never had to deal with that. I would assume it will be covered. The only person in my family to have massive surgery spent 3 months in the hospital afterwards so... That was taken care of. But mum get covered massages for her slipped disk, so I would guess home visit qould be covered too. But I honestly don't know.

I mean home visit like in your example. Not home visiting masseuse

We all forget that GP's (and dentists and pharmacies) are almost all private businesses with NHS contacts and always have been.

I was always a big supporter of the NHS, had a lovely GP who always listened, referred me on to the right department when required at the right time & took great care. I had investigations & had 4 operations in 9 months under the NHS choose & book system at my local private hospital. Ten years later I'm afraid that my view has changed somewhat, my lovely GP left the surgery & now you can't ask to see a specific doctor or even stipulate a same sex doctor, getting an appointment is like trying to get to have tea with the Queen. I have been chronically ill for over ten years so do need a lot of contact with the surgery. I started with some symptoms that were very worrying, finally got an appointment in October 2019, the GP spent 10 minutes talking about something I hadn't made the appointment for, When she finally drew breath I said what I had gone for & got told I would have to make another appointment, my time was up. I went to the desk to make another appointment & was told I would have to wait until January 2020, I said it was urgent & was told they didn't consider what was wrong was urgent. When I finally got to my appointment in January 2020 the doctor was reluctant to refer me to a consultant, told me I would have to learn to live with it. My legs & feet are numb & I can hardly walk, my 17 year old son is having to help me get dressed, I insisted on a referral & got told I would be waiting 2 years to see a neurologist. I then asked for a private referral & got told the letter would cost me £35, when I got the letter I made an appointment to see the neurologist & got a date at the end of March which was cancelled when Covid hit, I finally got a telephone appointment which cost me £200 for a 5 minute phone call, my neurologist transferred me to his NHS clinic & when I saw him there suspected I had MS, he booked me in for MRI scans & nerve conduction studies which took until November to be completed, when he got the results it wasn't MS but I had extensive nerve damage that was irreversible. I got told that had I been seen when it first started I would have stood a chance of getting better but now I am waiting for a wheelchair & need to move to an adapted property. GP surgeries need to change & improve or more & more people will have conditions that need referring on to hospitals & more pressure will be put on them because GP's won't do their job properly, yes part of this is due to funding but part of it is because GP surgeries see themselves as gatekeepers in ivory towers & don't want to let anyone in.

My sister is an NHS nurse and I have so much respect for them, my sister works so so hard as do her colleagues. On the other hand my other sister has hydrocephalus and is in chronic agonising pain due to what she's pretty sure is over draining of her shunt so her headaches are severe and she had to quit work at the age of 32 and has very low quality of life, the way she's been treated by the NHS would frighten you. I've been waiting to see a neurologist since July 2017 so was waiting almost 3 years even before the pandemic. I don't think the NHS is fit for purpose anymore. Fucking tories.

15 years ago exh had a heart attack while we were away on holiday, he was taken to the local hospital, it was immaculate, pristine, well run, his treatment was excellent. The food was restaurant quality, one of the nurses told him all the vegetables were grown in the hospital's own allotments. A few year's later I fell & broke my ankle at the same town, ambulance there within 5 minutes, straight to hospital, arrived there at 7.40pm, was back in the caravan all potted up before 10.00pm. You couldn't fault the service, the waiting room & toilets were clean, staff were efficient & caring, nothing was too much trouble. It was everything the NHS should be, they closed the A & E down 5 years ago & moved most of the services to a massive hospital 15 miles away which is more like a conveyor belt in a NHS factory, they call this progress.

There are so many problems with the NHS that it's hard to know where to start.

1. Fully funded training for nurses, doctors, paramedics, pharmacists, dentists etc in return for at least 5yrs service to the NHS after qualifying.

1. Massive overhaul of computer system, so all Patients can book appointments online, order prescriptions, upload photos. Doctors/nurses/consultants being able to view a Patients complete medical history, share xrays, blood tests etc

1. Run 24hr hospital/doctor, to maximise expensive operating theatres etc, at the same time overhauling NHS staffs working hours to ensure they are getting the best work/ life balance.

1. Huge investment in hospital buildings. Government taking over funding of air ambulances.

1. Patients need to be better educated as to how to access the right help (GP/111/practice nurse/A&E/pharmacist). Patients need to understand their responsibility in looking after their own health, and understand the consequences of the choices we make. Patients need to understand that the NHS shouldn't have to fund everything, those who can should source there own osteopaths, podiatrists, etc.

Perhaps we should all be looking into private health insurance. I for one wish I'd taken out insurance before my diagnosis, too late now no one will take me on. If I'd had healthcare insurance I wouldn't still be waiting for surgery that I was told was urgent in june2020.

I can't speak for the NHS however there are similar if not worse problems within the public HSE here.
People have been opting for private insurance for years, there has been a huge increase of new private clinics and hospitals opening throughout the country.
I don't have health insurance but do pay privately for treatments for my DC we are never waiting over 8 weeks, there is lots of scan clinics you can have an MRI or cat scan for €250 then skip the public list, it is a case of having too, or wait an extra year.
It is still a joke for those who can't pay.
A huge amount of patients are diagnosed with cancer in a&e while waiting on a public appointment.
It has pro/cons.

Institutionalised mediocrity is the best way I've heard the NHS described.

Why is nobody willing to divulge how much their healthcare cost's them in other European countries.
My Dsis pays €6000 per year for a family of 3, this covers everything except consultant fee. A consultant fee will cost €250 per visit her MRI, neurologist, endocrinologist investigation and hospital stays were covered.
Her DH has had surgery private room no wait time no excess cost.
Her pregnancy was fully covered private consultant, midwife, private room, in the main maternity hospital.
80% back on all therapies - main incentives pain today is investigated asap.
Dental isn't covered.
My Dbro pays €5000 family of 4 - semi private inpatient care.

The average annual cost of Irish health insurance was €2,059 in 2019 according to a survey by the Health Insurance Authority. This figure includes both family and individual policies. Study 19 May 2021

Private hospitals should start offering every kind of healthcare instead of quick turnover treatments like joint replacements, gynae ops & general surgery, anyone who can afford private healthcare should pay a reduced rate of NIC in return for paying private health insurance. NHS should have major restructuring, better procurement systems where everything other than medical equipment is bought wherever it is cheapest, not from whoever gets the contract. Cut management & executive roles to a minimum, get rid of CCG & stop postcode lotteries for treatments. Run all NHS GP surgeries & hospitals on the same lines as private hospitals, improve hospital accommodation, single rooms for all patients, increase funding for NHS by reducing waste in all other state run businesses, improve staffing from the bottom up, domestic staff, nursing staff, physiotherapists, Radiographers, OT's etc then doctors under consultant level, then consultants & management & executive staff last. Offer free tuition for nursing & medical degrees with bursaries for living, pay student nurses & junior doctors for time working on wards in return for 5 years working for the NHS after qualification. Make the NHS somewhere attractive to work by better pay, flexible working, family friendly contracts. Make IT systems joined up so there isn't time & money wasted for things like referrals, prescribing etc, be more efficient when discharging patients so they aren't waiting up to 48 hours for drugs & letters. Do more enhanced recovery treatment plans to get patients home quicker & back under the care of their GP.

I have to say im utterly dismayed and saddened by the state of the NHS and fully blame the goverment.

I don't. I blame the people who vote for the government.

@Kendodd

I have to say im utterly dismayed and saddened by the state of the NHS and fully blame the goverment.

I don't. I blame the people who vote for the government.

This is risible.

You think it will improve under Labour. Keir Starmer who is willing to throw women's identity in the toilet and “introduce self-declaration for trans people”.

You think women's health care will improve when we no longer have an exclusive right to call ourselves women under that stupid bastard?

Honestly I despair of some people. May Labour never be elected again because of that.

I think that if you weedled out the poor performers and the layer upon layer of middle management there would be far more efficiency and funding available.

This. Most of my family work for the NHS, a mixture of hospitals, hospice and in mental health services. We ALL have experience of middle managers paid to do nothing, fat pensions, lack of accountability, nurses just sleeping all shift and leaving the health care assistants to pick up the pieces, my sister works in NHS procurement and it sounds diabolical with nothing being joined up. So many work shy staff going on long term sick over nothing, useless people who would never cope in the "real world." Of course there are so many wonderful, talented, dedicated people in the NHS but not all of them and so much money is wasted. It isn't a popular opinion and you get blasted for voicing it but having seen it on the inside you have your eyes opened. I can totally understand why Government don't want to throw more money at the problem, as a PP said in Gordon Brown's time when they did there was no output in quality, it just got swallowed up and disappeared.

@CarolinaWeeper

I think that if you weedled out the poor performers and the layer upon layer of middle management there would be far more efficiency and funding available.

This. Most of my family work for the NHS, a mixture of hospitals, hospice and in mental health services. We ALL have experience of middle managers paid to do nothing, fat pensions, lack of accountability, nurses just sleeping all shift and leaving the health care assistants to pick up the pieces, my sister works in NHS procurement and it sounds diabolical with nothing being joined up. So many work shy staff going on long term sick over nothing, useless people who would never cope in the "real world." Of course there are so many wonderful, talented, dedicated people in the NHS but not all of them and so much money is wasted. It isn't a popular opinion and you get blasted for voicing it but having seen it on the inside you have your eyes opened. I can totally understand why Government don't want to throw more money at the problem, as a PP said in Gordon Brown's time when they did there was no output in quality, it just got swallowed up and disappeared.

I work in the NHS too and I could not agree more.

Thank you @EmeraldShamrock do they have to pay to see a GP ?

@Kendodd

I have to say im utterly dismayed and saddened by the state of the NHS and fully blame the goverment.

I don't. I blame the people who vote for the government.

^this a 1000x!

How many people moaning about the NHS, voted tory over the last few GE's?

The Tories never wanted the NHS, they blocked its inception and have underfunded it ever since.

The changes (many) posters want require staff and funding, (even if you want an insurance based system) something the tories have not even began to address after 11 years in power.....

How much more time will you give them before the penny drops????

What the fuck has trans to do with the NHS? again the Tories have been in for 11 years, they are responsible for the trans mess we have seen in recent years, not Labour.

I don't think a socialist system is sustainable long term. Everyone uses it the same but doesn't pay into it the same and there is insufficient funding because it's too expensive to do this.

I think the care you get should be tiered depending on what you have paid in. So we don't let anyone die but if you want to choose consultant etc you have to have paid a certain amount in.

I think instead of it being funded direct from tax, everyone pays in directly. You pay for GP & A&E directly and then make an insurance type contribution into the system each year. If you don't pay in, you don't get full access.

I also think their should be lifestyle considerations. E.g. if you are obese you can't just keep having free type 2 diabetes drugs.

The insurance companies now advertise the fitness watches where you get a discount on your premium if you exercise sufficiently. I think something similar would be ggreat.

We need much more personal responsibility for health. People don't exercise and don't eat 7x fruit and veg a day and then complain that they are unwell???

Not everything is preventable but we could focus a lot more on the things that aren't if we a took a bit more care of ourselves.

It's a terrible system that those who pay least in are more likely to take more out as health responsibility is worse in poorer communities.

@Spanielstail

Why is health any different from education? which everyone has access too or for that matter roads?

If you remove the so called socialist aspect of healthcare, then people will die and suffer unnecessarily (more than they do already)

It's a terrible system that those who pay least in are more likely to take more out as health responsibility is worse in poorer communities

Err left them out of poverty? novel thought i know but hey..... or we make poor communities poorer?

People keep saying "fucking tories" but I came here before ghe last tory govs and one of the first things other immigrants told me was to not even bother with gp because i can buy a paracetamol myself...
This has been going on for much longer thsn people thing. My gyno back in native country told me he had lots of women flying back to give birth bev of better care. Again.. Well before Cameron.

On what you pay for my NHS doctor father who was a consultant and gave his life to the NHS had to pay £130,000 in his last year of life out of income taxed at 40% + for care at home. He used the last of his life savings and died just as they were exhausted. In terms of what you pay in the UK it is 20% of your income tax bill which for some MN people will be zero and for some of us absolutely vast sums for services we do not seem to need and when we need something is never available for that thing. let people like I am opt out and spend our 20% elsewhere.

Spanielstail

I sincerely hope that the system we have does not demolish into anything like you have described. We already have enormous inequalities in health and wealth.
Your suggestions would only serve to widen the gap and again, only the wealthy would benefit!