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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:
SchrodingersImmigrant · 06/08/2021 12:23

[quote NotPersephone]@onlychildhamster yes it’s dependent on the insurance sector being heavily regulated and not subject to political interference - which is yet another millstone for the NHS.

The problem is that people hear “insurance” and think USA. We genuinely seem to be quite ignorant about how other countries manage - see the comment upthread about falling over dead bodies - which is a daft kind of exceptionalism that prevents us copying the best examples.

The deification of “the NHS” does not help.[/quote]
Actually, I believe that many people really think there is either NHs or not being able to afford insulin.
There are million and one middle ways which work for everyone

BigWoollyJumpers · 06/08/2021 12:26

A GP perspective in Pulse:

I feel that the riches on offer to provide NHS services are not something that appeals to big companies. Because, despite many reactionary protestations, NHS bodies are incredibly efficient in providing services. What they – and I include GPs in that – provide for a relative pittance is incredible, and there is no way private companies would be able to appease shareholders with the profit margins they can make on that

www.pulsetoday.co.uk/views/editors-blog/it-is-time-to-retire-the-nhs-is-being-sold-off-bogeyman/

MissyB1 · 06/08/2021 13:19

The other thing to consider about private insurance is the premiums for those with chronic conditions or known serious conditions, those who have had cancer etc.. I've had breast and uterine cancers, imagine me trying to get health insurance?!

SchrodingersImmigrant · 06/08/2021 13:26

@MissyB1

The other thing to consider about private insurance is the premiums for those with chronic conditions or known serious conditions, those who have had cancer etc.. I've had breast and uterine cancers, imagine me trying to get health insurance?!
There are system without private insurance. It isn't all or nothing
onlychildhamster · 06/08/2021 13:31

@MissyB1 if we had an insurance system a la Europe, there would be government insurance for those with pre-existing illnesses/ unable to afford private insurance/ just don't want to pay private insurance.In Germany, 75-80% of the population are on the government's insurance plan, it is a legal requirement to have health insurance. When I applied for my visa in Germany as a NON EU national, I had to show proof of my health insurance. Even in Asian countries like Taiwan, Japan, Singapore which traditionally provide fewer benefits than Western democracies , its a statutory requirement to have some form of health insurance.

I cannot imagine if UK had an insurance system, it would go from 'free healthcare' to american style health insurance. Thats two ends of the spectrum.

marmaladehound · 06/08/2021 13:44

It's certainly a fear of a lot of British people that we end up with a US style health service. I guess it's because many people think we are closer to America in many aspects of life rather than Europe. I am not sure though, I like to think that we sit closer to Europe in our ideologies than we do America but maybe that's just me with blinkers on??

Many European health systems are certainly worth looking into and implementing here. Their access to health care is far better and then provision of health care too. We have a higher rate of still birth here than pretty much any other western country. And prognosis after a cancer diagnosis is worse here than in many European countries. Something really needs to change.

blackheartsgirl · 06/08/2021 14:49

I'm also interested to know what the prognosis is after a cancer diagnosis here and compared to say some European countries.

I'd say here it's pretty poor and so many cancers are found too late.

My dh was fobbed off so many times by his gp and a and e and felt like he was wasting the NHS time(at first was refused up to date ct scans and was told in a and e to go back and see his gp as they got quite impatient with him when in fact he had colon cancer with mets in his liver lungs and kidneys and wasn't found until 3 weeks before he died.

So I get cross when all you hear is go and see the gp. When in reality it's often too late anyway when you factor in how long t takes to get a gp appointment, lack of referral, time of referral, waiting lists etc.

I cant fault his care on the wards once he was there though, the nursing staff were fantastic.

The whole system needs an overhaul but sadly it won't and we will have a health care system like the USA.

EmeraldShamrock · 06/08/2021 15:14

@blackheartsgirl Oh my that is awful.
I'm sorry for your loss. Flowers

onlychildhamster · 06/08/2021 15:48

@blackheartsgirl www.nuffieldtrust.org.uk/resource/cancer-survival-rates

Sorry to hear of your loss. That link compares cancer survival rates across countries, and UK does not compare favourably.

wonkylegs · 06/08/2021 15:56

@Graphista the experience I stated may be "only one practice and one condition" as you put it but actually every story on here amounts to that. I was just pointing out you are more likely to hear about the bad than the good.
My actual experience is wider than 2 issues
Having a chronic condition that requires regular serious treatment and monitoring means I've probably seen more drs, nurses, gp practices and hospitals in a few years than many will see in a lifetime.
Every medical issue I have is more complicated from having babies to catching a cold it is more complex and requires input to a level most won't need.
I've also moved about quite a bit have family & friends that live and receive healthcare on every continent (bar Antarctica for those who are pedantic)
I'm also married to an acute hospital consultant and we have many many friends in most aspects of healthcare all around the world.
Oh yes and I've been dealing with also being a carer for my mother who has Alzheimers for the past few years which has lead to learning a whole lot about where health and social care intersect rather rapidly and I'm usually acute circumstances (it's a baptism by fire I wouldn't wish upon anyone)
I am still a massive supporter of the nhs and think it does an immense job and although there will be things it does better than others I think it's basic premise as a national health service is still good. It's main problem is politics both nationally and locally and I can't see that changing any time soon.

Kendodd · 06/08/2021 16:30

What is the point of private insurance?
Is it to better fund the health service or some other purpose?
If its to better fund the health service, then why not just better fund the health service and cut out a massive layer of admin and shareholders profits that would come with private insurance?

Graphista · 06/08/2021 19:05

@KitKatKong you're right that other systems aren't perfect either. I have friends and family all over the world and I hear the good and bad from them. I've a number of friends and relatives in aus for example and they have been complaining that the system there is becoming worse/less well managed than they're used to.

The tories want to extract profit from everything they can get their grubby mitts on

Has ever been thus. They're not interested in running the country in a way that benefits the working people except in terms of ensuring they stay productive and aren't a "burden" they are and always have been the party that represents the interests of the independently wealthy and large corporations.

Very true. Thatchers care in the community springs to mind!

Yep! That was a monumental fuck up! I was mid training when that came in and every hcp I discussed it with said it was a disaster in the making and they weren't wrong.

@minatrina those of us who've said - generally speaking - the young are less aware of the issues are meaning those young, fit and in generally good health who simply by the nature of that status haven't yet experienced much of the nhs. Of course there are sick and disabled youngsters who will have a different perspective, my own dd being one of those. I also have a few older relatives who've been LUCKY enough to not have had much dealings with the nhs too and frankly they live in la-la land as far as how they THINK it works goes. They think you just rock up to your gp having got an appointment easily that morning and the gp then listens and takes you seriously and refers you to a specialist within that appointment if a specialist is necessary. They are all white, appear to be middle class now (but were born working class) 2 of them are men and the woman is child free by choice so they haven't even dealt with the nhs from a pregnancy/childbirth experience. Whenever any of the rest of us try and tell them about our experiences they can be quite dismissive and disbelieving which is frustrating as hell!

Plus he [Blair] confused people about what left wing actually meant for generations to come.

Totally agree with this

They [patients who use a& me inappropriately] 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

Definitely!

I've lived in parts of the Uk where it's very difficult to get a gp, or a dentist or an optician even resulting in patients using a&e inappropriately - because they've no other choice!

A healthy population needs a fantastic primary health service on many levels and we just don't.

I think a major problem is our attitude/approach (as a country)

It's reactive rather than preventive. We wait until people are seriously in pain/ill before anything is done for them. Would be far better to have a preventive approach including annual complete health checks for all. Spot problems BEFORE they become lengthy, debilitating and very difficult and EXPENSIVE to treat.

The excuse usually given for not taking a preventive approach is cost when long term it would absolutely save money.

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).

Which frankly goes against the entire ethos of the nhs and should never have been allowed to develop.

When private gps at the inception of the nhs refused to participate properly and fully in the new system - but still wanted the money! - they should have been used on a temporary basis only and plans and procedures put in place to train and employ fully nhs gps to replace them. I have a strong feeling if that had happened many of the resistant gps would have seen they would be losing many of their customers and would then have likely come around to being fully within the nhs. It was a game of chicken and the govt then gave in too easily and subsequent govts have not done much better - of all colours.

@RosesAndHellebores thank you for posting cost. Another area where our govts have failed us is in allowing private healthcare insurers to have a litany of excluded conditions. I would probably not be able to get private healthcare at a reasonable price due to a long list of pre-existing conditions. The only way I could have avoided that is if I had started with private healthcare when I was 13!

I've just tried to get a rough idea but to get quotes I have to give my personal contact info which I'm assuming they then use to bombard you with sales calls, spam etc - no thanks!

From a brief look inc on which? Where I am a member none of my main conditions would be covered, not just under pre-existing clauses but because private healthcare simply refuses to deal with certain conditions - eg asthma

That absolutely should not be allowed

@Nat6999 sorry for all you have been and are going through. Absolutely should not have happened. A constant issue with gps in my experience too this adamant reluctance to refer to a specialist. And it's not because they think it's unnecessary it's a combination of cost and crappy NICE guidelines in many cases that seem clearly to me to have been designed by neither hcps with recent practical experience nor people who've experienced the conditions. It's a farce

@Seasidemumma77 very good points/ideas. What the hell their IT system is I don't know but it's shit! I've twice been prescribed medication I'm allergic to. One time I noticed myself and told the dr, another it was sheer luck the pharmacist noticed (it was prescribed under a new brand name I didn't know) - and yes I do mean allergic not a preference I'm allergic to penicillin and twice was prescribed it by 2 different drs. That pharmacist literally saved my life. Mistakes like that shouldn't be possible and certainly not twice in one year!

Re point 3 - did you ever see a documentary that was made some years ago where a business consultant was reviewing how a hospital was run and he was horrified at the waste, stupid decisions and poor running? Iirc one of the things he noticed was operating theatres only being used 4 days a week. When he asked why he was told they were closed on Fridays so the consultant surgeons could get in their tee time! And the person telling him this wasn't joking/being sarcastic.

@Moraxella those supposed reasons could all be addressed by better funding, more staff and better organisation. Yes would cost more initially but in the long term would save the country even more money by reducing waiting lists and getting patients operated on and functioning better faster.

@EmeraldShamrock where does that irish system leave people like me? I'm almost 50, disabled, mentally ill and unable to work and on benefits. Not sure I want the answer but I'm asking anyway.

@ActonSquirrel if you are under the impression that the tories aren't also fully on the twaw bandwagon AND deeply misogynistic anyway including when it comes to health and social care you're sadly mistaken. Who do you think started all this recent self identification crap? Who is implementing it already in practical terms? They've been much more underhand about it but it is absolutely the tories to blame too. I don't think ANY of the major political parties AREN'T drinking the koolaid on that one!

I think the care you get should be tiered depending on what you have paid in.

Extremely callous and frankly stupid idea.

The people who need the most care are those least able to work and contribute. How would this work with children born with severe disabilities for example? Or those with chronic conditions that limit/prevent their ability to work?

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.

Again - more research is indicating that even type 2 has more of a genetic than a lifestyle basis, there's also some research which appears to be finding that it might be that type 2 CAUSES a slower metabolism and therefore weight gain, water retention etc rather than being caused BY being overweight.

And would you also apply such "worthiness" judgments to drivers, motorcyclists, sports enthusiasts, people who drink alcohol but not alcoholics etc?

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.

Wow! Are you even aware of the many multiple issues that make it harder for the poorest in society to achieve and maintain good health? This seems a shockingly derogatory and prejudiced comment

@SchrodingersImmigrant Are you talking Blair's Labour was the time you immigrated? Blair was honestly just Tory lite you're right to some degree re separating the organisation from the staff, but some of the issues are staff based.

Can you imagine having to walk past people dying in the street on the way to the shop.

Already happening Thanks to cuts to public services all round

I only have experience of the Swiss system (in Europe at least) but it works well.

I see this kind of comment frequently. Those who post them never have knowledge or more importantly experience of how very low or non earners are treated in those systems and how accessible healthcare is for them.

@onlychildhamster I agree I absolutely don't trust tories to ensure the low paid and unemployed will still have access to decent healthcare under a privatised or even co-pay type system

Yet you also say

I cannot imagine if UK had an insurance system, it would go from 'free healthcare' to american style health insurance. Thats two ends of the spectrum.

You really believe the tories WOULDN'T move to a USA system? When they have already been apparently machinating that way?

I certainly don't!

@wonkylegs I agree the nhs as an idea in principle is fantastic and many of the staff working within it are too - I used to be one. But in certain ways it is not working well or as well as it could at the moment. There are key areas that need to be overhauled I would say particularly primary care and as you say where it intersects with social care - a long term issue I am well aware of having worked mostly in elderly care myself plus the experiences I've had with elderly relatives.

We need to hold onto it but it also needs to improve massively.

My experiences with secondary and tertiary care have on the whole been excellent.

My experiences with primary care have largely been absolutely abysmal and have been since the early 90's

onlychildhamster · 06/08/2021 19:30

@Kendodd I think when we were talking about insurance- we were talking about how the majority of the population would be on a government insurance plan and the rich would be on private insurance (which would cover cosmetic stuff and non essential operations and fancy private rooms). This is how it is like in Europe.

The idea is that competition between the public and private insurance systems would lead to better overall healthcare. There is less wastage as people are more mindful of costs. People who opt for private healthcare are able to leave more spaces in the public hospitals for poorer people. The key however is that health insurance MUST be compulsory and the government must pay the premiums for those who cannot afford it. Government health insurance needs to be comprehensive.

marmaladehound · 06/08/2021 19:35

@blackheartsgirl I'm so very sorry for your loss and all your DH went through.

I think a big part of the problem with poor comparatively poor cancer outcomes is due to late diagnosis. It's pretty well known that an early diagnosis has a better prognosis for the majority of cancers. In some cases this is people not presenting to GPs, but a lot is about poor access or postcode lottery and luck of the draw.

Disneycharacter · 06/08/2021 20:24

Maternity services are appalling, dangerous, outdated, understaffed, undertrained and not fit for purpose.

SunShinesBrightly · 06/08/2021 20:37

@Disneycharacter

Maternity services are appalling, dangerous, outdated, understaffed, undertrained and not fit for purpose.
Without question understaffed and therefore dangerous and not fit for purpose.
onlychildhamster · 06/08/2021 22:32

@Disneycharacter would you recommend going private for maternity care? I am not pregnant or actively TTC but since I am going to have that 1 child, is it worth to get private maternity care? Its not covered by insurance, i checked before.

EmeraldShamrock · 07/08/2021 08:07

The idea is that competition between the public and private insurance systems would lead to better overall healthcare.
Keep public with an option.
There is less wastage as people are more mindful of costs. People who opt for private healthcare are able to leave more spaces in the public hospitals for poorer people.

It works well here.
The key however is that health insurance MUST be compulsory and the government must pay the premiums for those who cannot afford it.
If they keep public hospitals open, mostly public hospitals here have a private service option within them.
My DD saw a consultant in temple-street DC hospital depending on the urgency he'll put her on public or private list after the private consultation.
The difference is wait times.

Disneycharacter · 07/08/2021 08:53

@onlychildhamster. Only if it involved consultant led care. Absolutely not a private midwife as their indemnity insurance will not cover birth injury if they are negligent, and they seem even more to buy into this nonsense of ‘natural’ childbirth, disregarding decades of research into safer childbirth. The majority of women are able to give birth safely and let nature take its course, but the amount of birth injuries have a lot to do with staff shortages and an attitude of not listening to mothers and thinking they know best. The number of midwifes who can’t properly interpret CTGs is appalling. I never got to even go into labour as the midwife ignored the fact I was bleeding internally and fobbed me off, and now my child has cerebral palsy. I honestly don’t know what to advise, because most midwives do a very good job and will pick up problems, but god help anyone who hits the labour ward on a busy night with low staffing levels and no consultant cover.

Kendodd · 07/08/2021 08:54

I posted a question up thread asking what was the purpose of private health insurance and if it was to better fund health services or something else.
Anybody have an opinion on that?
My thoughts are that if it's to pump more money into the system then why not just pump more money into the system directly without bothering with the massive about of extra admin and shareholders profit an insurance system would cost?

Disneycharacter · 07/08/2021 08:56

Ironically her care under the NHS with neurologists and neurosurgeons, orthopaedic surgeons, gastric surgeons, expensive medication (£15 per tablet twice weekly) has been outstanding. Pity she would have needed none of this if her care had been better.

marmaladehound · 07/08/2021 09:35

@Kendodd

I posted a question up thread asking what was the purpose of private health insurance and if it was to better fund health services or something else. Anybody have an opinion on that? My thoughts are that if it's to pump more money into the system then why not just pump more money into the system directly without bothering with the massive about of extra admin and shareholders profit an insurance system would cost?
Maybe look into Scandinavian health care systems. I found this article which I have not yet had time to read which explains how each one works. All pay high taxes but not sure if any additional costs are incurred? Maybe someone on here has some more knowledge. But the NHS premise of equal care for all regardless of ability to pay may be closer to the Scandinavian more socialist approach.

healthmanagement.org/c/it/issuearticle/overview-of-the-healthcare-systems-in-the-nordic-countries

Tuscancat · 07/08/2021 09:38

Germany pays 50% more per person for healthcare, France 30% more. That is the difference.
Jeremy Hunt is the architect of many of the issues we face today with the NHS so I wish he would bugger off and stop dispensing his wisdom.

FangsForTheMemory · 07/08/2021 09:39

I'd bet money that half the people on this thread criticising it have private healthcare or a vested interest in seeing the NHS sold off.

It was 'overhauled' during the Thatcher years, meaning lots of managers were brought in. It funding has been cut drastically. What it needs is adequate funding and a structure that is aimed at providing the best results for patients and staff, not senior manager.

Tuscancat · 07/08/2021 09:39

I agree Ken Dodd.
Also there are swathes of managers that don't really add anything.

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