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.

The NHS had saved my life, my parents live and my brother's life. It is where it is because of a deliberate strangulation and mismanagement by the Tories to try and create pressure for the two tier systems that are being suggested in this thread. With sufficient funding and the complete removal of all business oriented organisational structures it could return to what it was truly meant to be.

Beware astroturfing.

My experience of the NHS this weekend has been awful. 30 weeks pregnant.. Left to manage severe pain with paracetamol only. No help or advice offered. Finally ended up in a covid riddled a&e as I was so desperate and no one would help.. people vomiting into bowls around me and people bent over in agony.
There was no issue with the staff as they did everything they could eventually it’s just the system that’s completely failing and some of the inexperienced staff, especially who man the 111 service.

I have just finished a job working as a call handler for part of the NHS (I won’t disclose what for) part of the job was to state I was calling on behalf of the NHS however I was employed by an agency for a statistics and research company which we’re working for a global private company called serco on behalf of the NHS. All taking their cut from our NHS budget.. and this is where the problem lies. It’s disgusting.

We will eventually lose the fabulous service to corrupt money making private companies.
It’s really sad and very worrying.

Patient expectations can be too high, it's a postcode lottery as to what services are available, i wish we had more staff and thr funding was properly managed

@SunShinesBrightly £119k is nothing in the world of medical bills. My Singaporean grandfather's medical bills would have amounted to the equivalent of £250k (in a public hospital) if he wasn't on a civil service plan; and I highly doubt that it would have cost the NHS any less if he had it done in the UK (as London and Singapore are quite similar in terms of cost of living).

As every civilized country should have universal medical care, this should simply extend to ensuring that everyone has access to it. medical bills in a Western country would be unaffordable for the majority of the population so it makes sense that the government should subsidize it/make it free. But I don't see how this extends to making it free for multi-millionaires even if the multi-millionaires pay a lot of tax

@onlychildhamster I think you have missed the point that £119k is paid every year.

@RosesAndHellebores oh i knew that. Also many people who earn at that level set up a limited company and get their wages paid through that so the tax rate is much lower. my point was that a person's lifetime medical bills can be well over a million (given that 1 year of my grandfather being in ill-health somehow managed to rack up £250k).

onlychildhamster

@SunShinesBrightly £119k is nothing in the world of medical bills. My Singaporean grandfather's medical bills would have amounted to the equivalent of £250k (in a public hospital) if he wasn't on a civil service plan; and I highly doubt that it would have cost the NHS any less if he had it done in the UK (as London and Singapore are quite similar in terms of cost of living).

Indeed.
A person earning 300K (£170,161 net) isn’t in a position pay for the treatment themselves outright but their £119k tax contributes way more than the £3,486 tax contribution I pay on my salary.

When my mother was in hospital a few years ago she was in a filthy 6 bedded Bay, with filthy lavatories, staff discussing personal issues from behind a cotton curtain with a foul mouthed woman with a foul mouthed family visiting her in the next bed. The food was dire, tea was served in a plastic cup, her IV tube for AB's was not being changed as regularly as it should have been, evidently because the staff were too busy but it didn't stop them congregating and chatting shit very loudly at all hours. When I politely asked for it to be changed I got the NHS eyeroll.

She was there because two GPs visited her at home and said she just had bad flu and the pain in her hip was arthritis. When she was getting worse after the second visit my step carried her to the car and took her to A&E. She had sepsis.

It's like living in the third world. It is totally unacceptable and the standards in hospital are shockingly filthy imo.

And for that we are supposed to be grateful and let the staff call us "love" and "dahlin".

[quote RosesAndHellebores]@onlychildhamster I think you have missed the point that £119k is paid every year.[/quote]
119K tax over 20 or 30 years is A LOT of money.

@SunShinesBrightly It may be a lot of money. but if it is between reducing services for NHS services and making richer people pay a bit more for the rare times they use the NHS. Even my DH who is merely a higher rate taxpayer uses private hospitals and has private medical insurance (as do I) so I can imagine they would rarely use the NHS. However if they do need to, I think they should pay. They have the option to go private or even go abroad.

@NotPersephone

The NHS had saved my life, my parents live and my brother's life.

The NHS didn't: modern healthcare did. We can all appreciate medical science without insisting it's only delivered via an obsolescent communist system.

@onlychildhamster we also pay six figures in tax every single year and pay for private treatment out of net income where we can. My DS is disabled and receives zero NHS support - no OT, no therapy, no help to manage his sensory issues, his anxiety, dyspraxia....that costs us about £700 a month all in. Middle rate DLA is about £250. WTF are people on low incomes meant to do?

Pretending the NHS will provide when it so frequently doesn't is utterly mendacious.

A means tested medical care system would help people in your bracket the most.. It would mean the NHS can afford to provide more services and you would still pay less than if you go private.. A strong public healthcare system is still good value for wealthier individuals even if they have to pay because the sky is the limit for private healthcare.

the problem with the NHS isn't just the waste due to privatization/abuse of the system. It gets more and more expensive every year due to aging population and advances in medical technology. In the past, the state only had to pay for the treatments for a few years before the person sadly passed on, now someone can live for 20-30 years in ill health. So we need to find a way to pay for it and usually the people who can afford to pay have to shoulder the burden (just like how taxes are likely to increase for higher rate taxpayers after the pandemic). No point imposing higher taxes on the average person

[quote onlychildhamster]@SunShinesBrightly It may be a lot of money. but if it is between reducing services for NHS services and making richer people pay a bit more for the rare times they use the NHS. Even my DH who is merely a higher rate taxpayer uses private hospitals and has private medical insurance (as do I) so I can imagine they would rarely use the NHS. However if they do need to, I think they should pay. They have the option to go private or even go abroad.[/quote]
As I said, I pay £3,486 tax on my salary each year. I think paying 119k a year is already contributing ‘a bit more’ than I do.

I'm not sure of the point you are making Hamster.

I would happily pay a means tested premium if it meant easier access to pre 9am appointments or post 7pm appointments, cutting edge pain relief when I have a procedure (I was told when I had a colonoscopy at a private hospital that the pain relief/sedation was better than it would have been on the NHS) and certainly for a private room if I had to stay in hospital and the option to pay for better food, enhanced cleaning and hot drinks to be served in a China mug rather than a plastic cup and for nurses who don't screech all night at the nurse station.

I don't care if the care is free at the point of delivery, I would like it to be civilised as well.

There is plenty of money it's just in the wrong place.

This is no different to the truism that 80% marketing spend is wasted. If we knew in advance which that is, it would not be spent.

The US system of private insurance provides really top class service for those who can afford it, while inflating costs across the board and seemingly glorying in the absence of provision for those who cannot afford it. That is no way to have society run.

The European model of state underwritten health insurance appears to work well. It does cost more overall, nothing like the cots in the US and manages to both do away with the queues which are such a feature of the NHS and provide a good quality safety net for those without jobs such as pensioners and the unemployed.

The service provided is sufficiently good to provide very little appetite for private provision, only for people such as whose jobs with international corporates who include private health care provision where ever in the world they are posted or the very , very top end personal physician end of the market.

Not unlike the provision of education.

If the public provision is regarded as good, it dispenses with the desire for private provision for the vast majority producing a more cohesive society.

Worth consideration, depending on what kind of society we really want to build.

@RosesAndHellebores

I'm not sure of the point you are making Hamster.

I would happily pay a means tested premium if it meant easier access to pre 9am appointments or post 7pm appointments, cutting edge pain relief when I have a procedure (I was told when I had a colonoscopy at a private hospital that the pain relief/sedation was better than it would have been on the NHS) and certainly for a private room if I had to stay in hospital and the option to pay for better food, enhanced cleaning and hot drinks to be served in a China mug rather than a plastic cup and for nurses who don't screech all night at the nurse station.

I don't care if the care is free at the point of delivery, I would like it to be civilised as well.

I am from a country which means test (Singapore). And yes there are different classes of ward so yes you can get a private room even in a public hospital. The standard of care offered across all wards are the same.

I have lived in 3 countries and I feel that the main problem with NHS care is that while it is great that it is free at the point of delivery and I never need to worry about payment when I use it (and its also there as a backup no matter how poor I become), it seems the current level of taxpayer revenue can't sustain it. At the same time, drastically increasing taxes to fund the NHS may not be a good solution, who knows what the government would actually use it for. Means- testing would funnel in more money to the NHS and not penalize the poor.

The underfunding message is a red herring. We are somewhere in the top of the table on OECD average, and that is with the mostly public funded service. Others above us have a higher proportion of private expenditure. Everyone always defaults to "funding" as it is the easy answer, it's not. The issues are historical and structural, and need refocusing on 21st century health problems.

I don’t think it’s under funded - it’s over consumed
People want quick fixes, and expect nhs to pay to solve everything
Eg rushing children to gp for mild high temp, people expecting antibiotics when actually the right answer is allow your body to fight it due 72 hours m instead, hate to say it but obesity - causing huge financial pressure on nhs re things like diabetes, strokes, blood pressure and people expecting nhs to fix the symptoms rather than they take responsibility and fix the cause, etc etc - these are just a few examples
Add to that the bureaucracy, the wastage, the terrible contracts that gave historically been negotiated - the nhs just isn’t fit to provide everything free of charge anymore against the expectations people have it it
We should be able have an honest debate about what the country needs and can afford - but unfortunately we don’t appear able to

It's an interesting discussion, but not one that many people are willing to have mainly because as PP said, to criticise the NHS is to apparently criticise hardworking nurses.

My opinion is that the NHS is exceptional in times of crisis. Years ago, my relative had an organ transplant. She had to be airlifted from her rural village and taken to a big hospital in a large city and given exceptional treatment and obviously it didn't cost a penny. To me, that is absolutely what the NHS is for. The alternative for someone like her if she lived in a country like America and had no insurance would be heartbreaking.

I think the NHS is also marvelous to enable women to have babies without having to spend thousands of pounds. To know that if you're hit by a bus, an ambulance will be there to help you. To offer treatment for cancer/heart attacks/diabetes etc

However.

We are an aging society. I personally believe that's partly why the UK was so battered by covid deaths last year. Treatment is there for everyone which means that we are all living longer when historically we would have passed away years ago. That means that there's more pressure than ever before on the NHS because the population is living longer.

I recently damaged my back with a slipped disc. It took multiple visits to the doctor and the NHS physios to diagnose and treat me, and every single person I saw told me something different. Within two sessions of going to a private Osteopath, the issue was resolved, I was able to improve my movement and I was off all of the painkillers. My experience of the NHS in those circumstances were bloody awful, but no one dares say that because no one wants to criticise it.

Personally I would be happy to pay more taxes if it meant that the NHS would be improved but I genuinely don't think that any influx of money would improve things. Theres too much wastage and it's a system designed for 20th century healthcare, not 21st century. Without being looked at holistically, I can't see how it can get any better.

But if it's means tested the standard for everyone would have to increase because it wouldn't be a choice. And actually as a family with a regular tax bill of £250k per annum I think we pay more than enough already towards the NHS and I would not willingly pay more without an increase in standards across the board.

@RosesAndHellebores would you mind if instead of paying 40% taxes, a portion of your tax monies went to a medical fees bank account that is in your name- which is then used to pay your means- testing premiums. That is what we do in Singapore- we all have medical savings account which is used to pay medical insurance premiums/routine care; highest tax rate is 22%. This also cuts down on wastage- if its your money, you are not going to A & E willy nilly. But the money is there if you need it.

I think the European insurance system is good too, its just extremely expensive, but it depends if we as a nation are willing to pay it.

These discussions always sadden me greatly. To see an amazing institution criticised when the main reason for its crisis is people own doing. I am always repeating myself, but the biggest cost to the NHS is diabetes. 90% of diabetes are so because of their poor lifestyle choices.

The NHS is overwhelmed because of US. WE are killing the NHS.

Yet I know that this post will be ignored because despite being a fact, it's one people hate to acknowledge. it's so much easier to blame the system, managers, politicians....

@vivainsomnia

These discussions always sadden me greatly. To see an amazing institution criticised when the main reason for its crisis is people own doing. I am always repeating myself, but the biggest cost to the NHS is diabetes. 90% of diabetes are so because of their poor lifestyle choices.

The NHS is overwhelmed because of US. WE are killing the NHS.

Yet I know that this post will be ignored because despite being a fact, it's one people hate to acknowledge. it's so much easier to blame the system, managers, politicians....

But the point is that people do tend to take more responsibility for their own health when they have to pay a modest (state subsidised) amount for treatment.