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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

AIBU to ask your thoughts on the NHS

364 replies

Bumblecattabbybee · 05/08/2021 08:46

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.

OP posts:
knitnerd90 · 06/08/2021 08:50

@Spanielstail

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.

I work in the US health system. I can assure you that what you propose would be a disaster.

(By the way, what you ought to fear may not be the insurance companies. It's giant hospital conglomerates.)

It's the same with "people should go private". If it were profitable to run more services, they would do that. The UK also only trains so many doctors, nurses, etc so expanding the private sector would come at the cost of the public sector.

Pazuzu · 06/08/2021 08:52

I love the NHS and it's been great (albeit slow but that's covid for you) for me in the last couple of years.

Is it underfunded? Personally, I don't think it is, rather it's so dysfunctional because there cannot be rationalisation because of the emotions and political fallout.

Don't scream underfunding when you can't manage the money you've already got e.g. ruinous PFI contracts or failed IT systems and the like.

onlychildhamster · 06/08/2021 08:57

I wonder if MN is representative of the UK population. That would be a huge change..it used to be said that the NHS is the closest thing the British have to a religion.

Kendodd · 06/08/2021 08:58

Your suggestions would only serve to widen the gap and again, only the wealthy would benefit

I would argue even the wealthy wouldn't benefit, apart from the super rich maybe. Even them though. It's bad enough having to step over homeless people in the street (who should be better provided for) . Can you imagine having to walk past people dying in the street on the way to the shop. Horrific! Also, I can't see how a system like that wouldn't result in increased crime.
I'm quite comfortably off. And I'm fit and healthy and don't think I've seen a doctor in ten years. Likewise the rest of my family. Even I benefit directly from poor people (and everybody else) having access to free health care and would very happily pay more tax to fund it properly.

Debetswell · 06/08/2021 09:11

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

We also have ageism.
My 90 year old df is currently being badly let down by his gp.
His mental health is terrible, his medication isn't working and his mobility has started to fail.
He had a phone appointment 4 weeks ago and the gp said df should carry on as he is.
As far as the NHS is concerned unless you're a Prince old people are not worth helping.
My df will probably lose his independence sooner now because we can't get him the treatment he needs.

Moraxella · 06/08/2021 09:31

@Seasidemumma77
Regarding your point 3: it’s unsafe to staff operating theatres for routine work 24/7 (if you have a particular interest google NCEPOD). There’s an emergency theatre that runs 24/7, for life and limb threatening things overnight. I wouldn’t have a routine procedure by choice overnight.

Secondly, in order to staff theatres 24/7 for elective work you would need to hugely increase the number of staff to account for safe rest after working nights and illness/annual leave etc. Also, probably not what you meant but hospitals are staffed with doctors 24/7. I work a lot of nights, and I enjoy them. BUT they are also very bad for your health, and to do more means I have to magic more childcare that isn’t available (overnight childcare that runs 7:30-10am to cover my shift and commute).

Also, lots of day time operating lists being cancelled as hospital is full of patients and no beds to move the people who have just had their operations into. Therefore the list goes down and there’s a staffed theatre going unused. Day case unaffected as they go home. This is mid summer and usually used to only happen in the deep winter. Now we’re never out of code 20/black/whatever they rebrand it as.

marmaladehound · 06/08/2021 09:42

@Debetswell

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

We also have ageism.
My 90 year old df is currently being badly let down by his gp.
His mental health is terrible, his medication isn't working and his mobility has started to fail.
He had a phone appointment 4 weeks ago and the gp said df should carry on as he is.
As far as the NHS is concerned unless you're a Prince old people are not worth helping.
My df will probably lose his independence sooner now because we can't get him the treatment he needs.

I'm really sorry to hear about your fathers lack of treatment. Ageism is pretty rife throughout society.

I am lucky my 87 year old mum has a wonderful GP who is far from ageist. I sadly think it's luck of the draw.

DanielTigersMummy21 · 06/08/2021 09:59

'I love and totally support the NHS'

Isn't that part of the problem? It's an organisation, all this rhetoric around protecting the NHS stops us assessing and addressing the issues caused by its underfunding.

NotPersephone · 06/08/2021 10:01

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Bluethrough · 06/08/2021 10:16

@DanielTigersMummy21

'I love and totally support the NHS'

Isn't that part of the problem? It's an organisation, all this rhetoric around protecting the NHS stops us assessing and addressing the issues caused by its underfunding.

How about addressing the decades old underfunding?

Labour had 10 years then the global financial crash, takes years to train staff, a decade plus to train a consultant.

Its a pity the main parties are so far apart on healthcare, as a 30 year plan agreed by all political parties would stop the yo yo funding we get.

But if we continue to charge HCPs 50k to train, then the market rules and that isn't so good for most of us.

NotPersephone · 06/08/2021 10:27

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Effybriest · 06/08/2021 10:42

Many of the posters on here are wealthy. Admitted they earn six figures. City lawyer married to a consultant who's unhappy about his wage because it's too high Hmm. An insurance based system really wouldn't affect these types of people financially but the average earner more so.
Some of the comments about nursing staff are just nasty and add nothing to an important discussion.
Same old names popping up, what a surprise. Last thread only recently a poster on here was trying to tell us we (nurses) didn't deserve a wage rise, we were well paid. Didn't have a clue about the job, the immense pressures etc just spouted gossip off her 'he's a consultant don't ya know' hubby.

SchrodingersImmigrant · 06/08/2021 10:59

I believe the discussion about functionality of the health service would be much more peoductive if we stopped mentioning the workers and wages. They are not the same. A nurse isn't an NHS and NHS isn't a nurse. It's just adding the emotional layer and a tool to shut down criticism.
Also, it's not just nurses working there...

Imagine if someone criticised Nandos for being bit shit and overpriced and some group would start ahouting "Stop looking down at the waitress! It's a hard graft!". It's the same principle. Biylt ridiculous

MissyB1 · 06/08/2021 11:18

@Effybriest

Many of the posters on here are wealthy. Admitted they earn six figures. City lawyer married to a consultant who's unhappy about his wage because it's too high Hmm. An insurance based system really wouldn't affect these types of people financially but the average earner more so. Some of the comments about nursing staff are just nasty and add nothing to an important discussion. Same old names popping up, what a surprise. Last thread only recently a poster on here was trying to tell us we (nurses) didn't deserve a wage rise, we were well paid. Didn't have a clue about the job, the immense pressures etc just spouted gossip off her 'he's a consultant don't ya know' hubby.
Absolutely agree. I no longer answer that particular posters goady comments by the way, I totally ignore them.

And yes for average Joe just trying to scrape by, earning enough to live on but nothing left over, health insurance would be nigh on impossible. But I’ve realised so many people don’t give a shit about anyone else.

NotPersephone · 06/08/2021 11:19

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EmeraldShamrock · 06/08/2021 11:21

Thank you @EmeraldShamrock do they have to pay to see a GP ?
Yes it is €60 a visit she gets tax back and 40% back off insurance.
Referrals are €30 she just pops an email requesting whichever procedure the gp will arrange through a private hospital.
We often jeer her she'll be sick from the mri/ct radiation before any cancer she has had scans everywhere.

Effybriest · 06/08/2021 11:24

I agree. But comments up thread slagging nurses off for gossiping has nothing to do with the issue but always rears its ugly head.
The main problem is that everything is stretched in the name off efficiency. You want decent care, where patients are attended to promptly and compassionately you need more bodies on the ground, appropriately skilled staff. Enough staff to be able to do the job properly like give mouth care 2 hourly or turn patients 2 hourly, to talk to relatives at length, to chat with patients rather than rushed interactions where the patient feels like an inconvenience.
Have your insurance based system if it funds the ‘health service’ as it should do.

NotPersephone · 06/08/2021 11:29

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EmeraldShamrock · 06/08/2021 11:30

PAYG private is an option too.
An example I've maxillary sinus damage after dental surgery, my appointment for an initial assessment is Feb 2022 I'd be transferred for CT waiting list another year before I saw the consultant again.
I paid €225 for a private CT scan.
I'm now on the surgery list, it isn't fair but I'm in pain shortening wait time by at least a year.

onlychildhamster · 06/08/2021 11:31

@NotPersephone I think what most people are worried about is if the government would truly cover the insurance premiums for the lowly paid. Given that its the tory government, I would not hold my breath and my official position is that I support the current set up as at least I know everyone is theoretically covered (and we have private insurance just in case we can't get treatment quickly enough). If there are insurance premiums, the government of the day could easily remove their support and the poor/low income might have to make up the difference.

I do know other healthcare systems are better, having lived in singapore and germany. My aunt was a very lowly paid secretary (earning 1000 SGD per month) and recovered from third stage cancer twice under the singaporean public health system. She could afford the fees as they were means-tested. In the UK, she would probably have died. Its a really difficult question

EmeraldShamrock · 06/08/2021 11:35

I think what most people are worried about is if the government would truly cover the insurance premiums for the lowly paid.
There is both options available in Ireland and by those who can afford to pay choosing private shortening wait time for public patients.
Public hospitals still very much exist alongside the private hospitals.

NotPersephone · 06/08/2021 11:35

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PickUpAPepper · 06/08/2021 11:43

@frumpety there is information about the Netherlands health system, including costs, at www.expatica.com/nl/healthcare/healthcare-basics/healthcare-in-the-netherlands-100057/
Expatica's pretty reliable, it's the bible for loads of people. They have a German guide too www.expatica.com/de/healthcare/healthcare-basics/german-healthcare-system-103359/
On the question f what happens if people can't pay upfront, I'm not very familiar with that side of life on the continent unfortunately but there are exemptions for those on benefits. I seem to remember there was something in the news a while ago about that very question - might have been in continental news, I can't find it immediately - and the Netherlands, in fact the Benelux, did an awful lot better on accessibility than Germany, and all Europe was more accessible than America.

@Spanielstail if your vision comes to pass more and more will be asking the questions of just what the hell we are all working for exactly. Many of us would be better off under the medieval agrarian system than that. Having a large group of your country's citizens with no reason to want to support your system is not a particularly healthy place to be.

PickUpAPepper · 06/08/2021 11:53

It wasn't this, but the UK's position on pg 7 in regards to out-of-pocket, direct expenses on healthcare is not particularly flattering. I do wonder how much capability the UK has to administer any system at the moment, because it is too centralised and too interested in allowing the richest to exploit what they can, but the administration of vaccines give hope. If only we can keep the bloody government out of it.