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.

We really should blame people for not being able to adequately self diagnosed
No need for dramatisation. There is a gap between self-education and awareness, and self-diagnosis. The first would make a huge difference though, and that's not even going into self-care and how the NHS would be in a so much better place if people adopted healthier lifestyles. So much of NHS appointment and care is to people who are there before of poor life choices.

This doesn't mean that this can eradicated but an small improvement would make a big difference already.

@Vanilla1Cookies because I’m a work at 8am so can’t just access the website at that exact tine. I don’t wantmake an appointment that day I just want to be able to make an appointment in the next few weeks

@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.

Yanbu. The only way I can see to fix it is for the government to stop trying to run it in to the ground so private healthcare companies can take over. They need to stop trying to make a profit from it, cut out loads of unnecessary management and red tape, cut out the wastage - I saw a tender for supplying them with pens, I've seen one to provide ONE stapler - and get back to the grass roots.

They also need to stop supplying care to people that aren't entitled to it. In europe you don't get free care willy nilly.

I've always been well served by the NHS, but obviously it's going to be having problems right now. Mental health provision has always been a massive issue as it's never funded enough. Can't say I've noticed lots of people abstaining from seeking help for fear of judgement - TBH if that's a thing it's more a problem created by the Daily Mail than the NHS. But it's better than having to avoid care because the cost could bankrupt you!

I'm not honestly sure the NHS can remain free at source to everyone - we may need a German style system where people above a certain salary (and this would include our household) do pay some sort of health insurance to cover ourselves and those who can't pay, but making sure we avoid a US-style situation where suppliers bump up costs massively when insurers are paying, or where employers have control over it or indeed where it's linked to employment at all.

I say this because the NHS was set up in a time when very old and frail or otherwise unwell people couldn't expect to live long, kids born with severe disabilities usually wouldn't live long, and also there was usually someone (aka A Woman - mum, wife, relative or even neighbour) available to look after frail, ill or convalescing people. Obviously it's great that life expectancy for older people and people with disabilities is so much better and that women are generally expected to have other things to do with their lives than care for others constantly, but this does put a lot of stress on a totally free healthcare system. The vast majority of acute service users and GP users are the elderly, and there's going to be more and more of them (one day I will be one of them!) and they will live longer with more complex needs.

I'd gladly pay a national health insurance to enable everyone to get the care they need.

The NhS is a sacred cow that needs radical reform. I’ve had excellent care in both Switzerland and the US which was frankly better.

That’s not to say it’s terrible. It’s just...mostly adequate. And that’s not good enough.

And I would be happy to pay for doctor visits. I am not, however, happy to pay more for what we currently have. And given the amount of mismanagement, that’s all we’d get with higher taxes.

[quote frumpety]@Goodallsfolly can I ask you how much you pay for your health insurance, how much is subsidised by the state or your employer ?[/quote]
The social security contributions (NI equiv) paid by both employer and employee are much greater in W Europe than in the UK and so it is not really comparable. The health insurance in my European country for example is mandatory, state subsidised and state regulated eg every person in the country has it without exception, and is covered by social security contributions but you can choose to pay a top up to cover for extra procedures and treatments not covered by the state. I hope that makes sense.

If you Google "comparative social security contributions across Europe as compared with UK" you will get a better idea; I think Deloitte publishes a table like this each year.

What really annoys me are the number of NHS staff who think they are providing a free service and tell you so when you attend an appointment. It is not free, it is free at the point of delivery.

I recall once attending an apt and and NHSE poster was on the wall. "Not everyone is entitled to receive free care". Actually nobody does receive free care - it is free only at the point of delivery.

It begs the question of how stupid do those who run the NHS think people are?

I appreciate it's a sensitive subject and perhaps one that could be used to support a national identity card.

@HunkyPunk thank you for pulling me up; over £100k that should have said. Still ridiculous that both DH and I are eligible for free prescriptions whilst still working and earning well.

In other words Frumpety (sorry, meant to add this below) it's not like the American system where you pay a premium for health insuranc. The European style mandatory health insurance is covered by your social security contributions which are much higher from both employee and employer in Europe than in UK.

People don't wantbto pay more taxes so vote tory and the circle continues. However, thete are more of us aging so no wonder its's at breaking point. We have the option to go private in this country. At least its an option.

People see other people's health as " not their problem. "

I don't think free healthcare for everyone is sustainable when we have an ageing population, more complex and more expensive treatments. We also have too many people for the model without huge tax increases.

I think a mixed model of free for the poorest and insurance would be better longterm.

My experience with the NHS has made me not bother with doctors, unless I really need to. Don't get me wrong as they are great at what they do, but I have already said on here my various experiences with them. Some good, some bad and some downright awful.

DP is a GP trainee, we are fully saving and expecting to have to pay for private healthcare in the near future. The NHS is currently running on goodwill of doctors and nurses, with the overtime they work due to staff shortages.

The current government have run the NHS to the ground. Anybody who votes Tory but can't afford private healthcare absolutely blows my mind.

@malificent7

People don't wantbto pay more taxes so vote tory and the circle continues. However, thete are more of us aging so no wonder its's at breaking point. We have the option to go private in this country. At least its an option.

People see other people's health as " not their problem. "

Yep it’s the “me me me” attitude. It became very popular in the Maggie Thatcher years with the every man for himself, dog eat dog, poor people are just lazy propaganda.

@ChunkySloth

They also need to stop supplying care to people that aren't entitled to it. In europe you don't get free care willy nilly.

Absolutely. Looking at this the other way around, my bil who earns above 300,000 a year in the UK, still sees a gp free of charge and has been to A&E recently free of charge. He can afford to pay for his healthcare - or at least make some contribution towards it - why shouldn't he? He paid for his cat to be operated on a couple of years ago and I know that cost about £300. It's a mad system if you think about it!

I think a mixed model of free for the poorest and insurance for the rest would be better

I think people who say this actually have no idea what that insurance would really cost, and who would be classed as “the poorest”.

I agree with @roarfeckingroarr and also think the system is heading that way so let's be a little more honest about it and deal with it.

DH and I both still work full-time. We simply do not have the time to spend endless hours phoning the GP surgery for routine things and attending appointments 20 miles away from our workplace at 2pm in the afternoon. Would be perfectly happy to pay an enhanced rate of NI or tax for a service that better and more conveniently meets our needs but if so, I would not expect the person behind reception to be chewing gum, generally not bovvered with a good morning, etc. And if I need a procedure I really don't want to hear about the nurses' private lives which a gaggle of three have time to discuss but are put out if they are asked to do their actual job.

I have lived in 4 other countries and in my experience the UK has the worst healthcare system of all of them. The NHS is completely unfit for purpose.

Absolutely. Looking at this the other way around, my bil who earns above 300,000 a year in the UK, still sees a gp free of charge and has been to A&E recently free of charge. He can afford to pay for his healthcare - or at least make some contribution towards it - why shouldn't he? He
paid for his cat to be operated on a couple of years ago and I know that cost about £300. It's a mad system if you think about it!

I’m sure he would argue that the yearly
£119,960 Income tax
and
£9,879 National insurance
he pays on his 300K salary more than covers his contribution to the NHS.

Quote fail!

Absolutely. Looking at this the other way around, my bil who earns above 300,000 a year in the UK, still sees a gp free of charge and has been to A&E recently free of charge. He can afford to pay for his healthcare - or at least make some contribution towards it - why shouldn't he?
He paid for his cat to be operated on a couple of years ago and I know that cost about £300. It's a mad system if you think about it!

I’m sure he would argue that the yearly
£119,960Income tax
and
£9,879 National insurance
he pays on his 300K salary more than covers his contribution to the NHS.

There is no solution because the first step is to admit the massive, shocking and catastrophic failures in the NHS. That's not to insult the staff, most of whom are dedicated and skilled. But it's usually taken as an insult if anything negative is said about the NHS. Or taken that you are some kind of extreme right winger who hates free healthcare and thinks that anyone without money should die on the street. I have a friend who is a GP and she works double her paid hours under huge pressure in a completely broken system. We have to stop waving fucking flags and admit that it's broken beyond belief. If we can't admit the problem, we can't fix it.

Quite right @SunShinesBrightly. Whilst everyone gets the same NHS service it isn't right that it's absolute crap for everybody.

On the other hand here in the US I have private insurance through work, that I pay $350/month for my husband and I, and we both also put off seeing a doctor because it's going to be too expensive even with the insurance. My recent miscarriage cost us about $1800, and my insurance refused to cover an ultrasound to check I'd passed everything because it wasn't 'medically necessary' despite my doctor saying it was and the consequences of retained products are sepsis, hysterectomy and death. At the time I was too upset to fight them and that could have cost me my life. I was lucky.

I think the NHS is a fantastic service and i hope we never have to face Britain without it but
I feel that we expect too much, it needs to be stripped back to provide medical care, People need to stop relying on it for every little thing, if you can afford to buy a bottle of calpol then do so. We need to put more value on the staff and the work they do.

Education is key, we need to reevaluate as a society what the nhs is actually for and educate people as when to place demand on it and when to not. We also need a better care system put in place.

I dont agree high earners should need to pay for health care as they already pay a huge amount in taxes. Everyone should be able to access free health care as and when they need it.