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.

Talking of wastage, I have seen much in the last couple of years of my DM's life. My god, she got amazing service (pre-covid). She was always at the GP's, with her many issues. She was given time and medications. Boxes and boxes of them. She went into hospital, where she refused a stent, but went back in several times by ambulance, each time refusing treatment. Each time she was re-medicated, often with different medications, whilst the ones she took in were binned. She then went back to her GP to get her "normal" medications, and so binned the hospital ones. She had every test under the sun, blood tests, scans, physio, mental health. She was referred to age clinics, falls clinics, physciatry, most of them she refused to acknowledge, or to take any advice. Lots of the appointments she just didn't attend because she didn't want them. Meanwhile she spent £10k on getting her teeth fixed privately. She was 92 when she died of Covid this year, having refused the vaccine.

DH is now partially sighted in one eye because his condition was misdiagnosed for over 2 months last year. He went to a specialist eye clinic pretty much every day in unbearable agony and they kept insisting it was just conjunctivitis and sent him away with useless treatments. He had a very rare parasite from swimming with contact lenses in which has now pretty much blinded him in one eye. If it had been diagnosed and treated correctly from the off he’d still have his vision.

Their mental health services aren’t fit for purpose either. I’ve been struggling with PND and anxiety for months and have been trying to get counselling. I’m automatically top of the waiting list because I have a baby so in theory I should have had an appointment quickly. What’s actually happened is the first counsellor wouldn’t speak to me because I had my baby with me. Rearranged to have evening appointments with a different counsellor so DH could sit with baby. Had one appointment with him, he then had annual leave the following week followed by 2 weeks sickness and when he returned he said he could speak to me that week but wouldn’t be able to do another 2 weeks after due to more annual leave. I just sacked it off, I’m back on the waiting list but Christ knows how long I’ll be waiting. Just getting progressively worse as time goes on.

So yeah, I’m bitter about NHS treatment as a whole. I’d rather pay a set amount for health insurance every month or have it covered through our employers.

Agree with PP that NHS good in a crisis, but in my own experience as an employee and patient overall not fit for purpose.

There are legions of drs and nurses slogging their guts out, but I have also witnessed NHS managers working part time hours on full time inflated salaries.

I also know that the NHS is routinely abused by overseas citizens and some NHS trusts don’t even bother to bill them (as then they are responsible for chasing the debt).

I have had to go private for my son ( when we are already struggling) as CAMHS abandoned us, I also had a terrible time giving birth in a NHS hospital, which was like a production line and we were treated like cattle.

The healthcare system has been used as a political football for years, and as mentioned previously the language surrounding it is emotive. But it clearly needs a radical overhaul. I would be happy to pay more for the NHS but it needs to be managed better than it is now.

I have concerns about the maternity care I've received this time compared with 2/3 years ago in the same trust, I've raised them and was meant to be having a dialogue with someone about it but I still haven't had that.

They've bought into an app for patient records that doesn't do what the paper notes did, doesn't talk to their own systems, so patients have massive holes in the records that they can see. They have had numerous complaints, and yet don't seem to be holding the developer accountable. If they are they aren't communicating it to the complainants who are experiencing a lack of information.

The have committed to a continuity of carer model which appears to be causing staff shortages and isn't actually happening anyway, I'm on it and have seen three midwives in four appointments (routine ones, not the after scan ones) so that's great continuity isn't it. They had a planned change of staff areas but never actually informed any patients despite having an app that in theory could do.

The admin side of things has deteriorated, I got called for one scan too early by their dates which meant it was impossible to carry out one of the main functions of that scan and I had to go again. But I had to go through PALs to get that as they just wanted to fob me off with a partial blood test instead. I had one appointment letter from them that was so confusing and basically wrong that I had to phone them up to check what was actually happening.

During covid I arrived for one appointment and there was not a soul to be seen, nobody doing check in etc. Some random staff member told me I was waiting in the wrong place (the reception) until I pointed out I was following the instructions to get checked in etc. The person waiting for me thought I was a no show but luckily saw me. I only got seen at all because I popped my head round into where I knew I needed to go.
I had to travel to a different hospital for a routine blood test because I simply couldn't get through on the phone, ringing out not engaged, to mine. They got rid of their walk in/ticket system AFTER covid so I can't believe it was down to that.

All of those problems seem to me to be down to bad management not anything the frontline medical staff are doing. Writing bad letters and getting dates wrong isn't covid. Changing structures and processes and letting them bowl along despite them quite obviously causing a deterioration in safety (as per CQC inspection too) isn't covid.

It's not fair on the people who have the patients in front of them as almost all of my concerns have absolutely nothing to do with the actual clinical staff looking after me who have been as God as ever. The only service that has been resolutely decent is my GP and from what I've read on here it's because they've gone off and done their own thing that they haven't dropped a beat this whole pandemic, for me.

I’ve never had good care on the NHS. Bo the my births were horrendous, care of my children when ill was terrible. I would never be without private healthcare now. My dad has just recovered from bowel cancer. He went private. Faultless care from beginning to end. Now he has to see the stoma nurses on the NHS and they are rubbish. Uncaring and too busy to look after him properly. The bill for his cancer privately was over half a million pounds. Think of the number of people that have cancer and how much it must cost. The NHS isn’t sustainable anymore. There has to be an overhaul for a better system even if we have to pay more.

I also live overseas, we have public healthcare so anyone can get free medical attention much like NHS. But it’s no frills and you might have to wait. Most people that can afford it also have private health insurance and the private service is fantastic. We use a bit of both.

Staff retention is a major problem, which leads to people going off sick and staff shortages. Recruitment is significantly easier. On nursing courses they’re increasing the amount of students to a level where it’s going to be very difficult to an an adequate level of experience due to the shortages of placements and where to put the students! So that’s just going to create another problem in itself.

Can only speak from personal experience, but I love it. Meant I didn't have any worries about care during my 2 pregnancies, and I know that it's there for me, my children and all my loved ones if needed, giving me peace of mind for their health.

@onlychildhamster I wouldn't have an issue with that because I believe we would use the NHS when needed. I would, however, have an issue if despite a very large balance I was told there were no services available as we were when DD developed MH problems and despite making huge contributions, we had to fund her MH health care personally. As indeed we had to do post botched birth for me - after the GP set smile "now dear, let's see how you feel about it in a year after some physio"? OK what's the waiting list - oh about 12 weeks for a consultation then more physio, then 12-16 weeks and the last lady was cancelled twice. "OK then make the referral now, and I'll do the physio while I'm waiting". And exactly the same when I crunched a vertebrae - "Well dear we wouldn't usually refer unless the pain hasn't resolved after 12 weeks" waiting list 10 weeks and the form slammed on the desk when I noted that could mean me not working for 22 weeks and if I lost my job the NHS would stop benefitting from my shed loads of tax. The attitude too often beggars belief and is not pragmatic.

I think it would be very helpful for every individual to have a health care account on their medical records so costs were more transparent.

Over the years the NHS has refused the following for my family:

Grommets x two children
DD'S MH care
DD's ingrowing toenail

Additionally I have had a pro-lapsed bladder, rectocele, and incompetent anal sphincter arising from DS1's botched birth during which he very nearly died. I also therefore do not feel the NHS provides wonderful care in childbirth all for free. It provides cheap care that often results in potentially life long problems which it sweeps under the carpet, does not account for and corrects too infrequently. It provides sub-optimal care with some very poor post natal provision. Shrewsbury, QEQM, etc, much of which is cultural rather than funding related.

@NotPersephone

No point imposing higher taxes on the average person

But that’s exactly what needs to happen to raise any amount that’s going to move the dial - there simply aren’t enough HR taxpayers to go around and they already account for a huge proportion of the total tax take.

People are always keen to raise taxes - starting always with those who earn a little bit north of them…

Absolutely.

@NotPersephone

No point imposing higher taxes on the average person

But that’s exactly what needs to happen to raise any amount that’s going to move the dial - there simply aren’t enough HR taxpayers to go around and they already account for a huge proportion of the total tax take.

People are always keen to raise taxes - starting always with those who earn a little bit north of them…

The number of very wealthy people in the UK has shot up since the Pandemic, so perhaps rather than criticise the NHS, we need to look at how taxation works in this country.

But regardless, there is, currently enough money to have a european standard health service, its just that we want lower taxes, HS2 and Trident rather than better health.

Thats not at Government level, thats what we, the electorate, vote for every GE.

Germany has 3 x as many nurses per 100k than the UK, ditto GP's and beds.
Some Polish friends of mine, who went back home after Brexit (both were in NHS) say their health system is significantly better, even accounting for CV.

@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....

That's just not right. This is what I was talking about in my post above. While people should take care of themselves the "People are killlllliiing it" is exactly the pr spin the state needs to do "well what do you wnat us to do when you all fat🤷" instead of "weneed to fund things and education about self care better".

People ebing fat shouldn't exvuse lack of access like in my aforementioned example of gyno care.

Honest thoughts, it's not for for purpose and should be overhauled massively.

I believe a true full private healthcare system should be a second option to the NHS/run alongside. And they should offer everything including maternity services and it should be available nationwide.

This would allow those who can/want to pay and want better service to go private, and the NHS would benefit from less patients to see because some would have gone private. The NHS could then begin to improve its service and streamline operations.

Fact of the matter is the NHS was set up when the population was much smaller, the population is now huge and the NHS doesn't have the infrastructure to support the ballooned population.

They also need to scrap a lot of middle management who are soaking up eye watering wages for basically fuck all.

Great for public health, vaccines, serious illness and emergencies, dreadful for chronic illness. Chronic fatigue/ME, thyroid issues totallly neglected leading to the loss of about 5 years of any quality of life. I almost lost my job from ill health and fatigue but hung on by cutting literally everything else out (social life, hobbies, exercise). GP offered me ADs or exercise therapy only. Turns out I only needed thyroxine and vit D to feel human again. I got that by going private. I avoid the NHS now because I can afford to.

More here - www.mumsnet.com/Talk/general_health/4314705-to-buy-medication-online?pg=1 - people buy meds online because GPs won’t treat them. It’s all over the thyroid and ME communities sadly. So much unavoidable suffering.

They did however lance a boil for me because my GP enjoyed doing it.

Politically, I massively support the NHS but I think it is underfunded and also in some more political areas it pays for ‘lifestyle’ treatments that it really should not.

I completely agree with you there's not enough resources I think the nhs is great but I think it should only provide free health care for certain things eg everyone under the age of 18, births , and cancers , heart problems etc. I watched a programme once and I watched people who had ate their way to diabetes were morbidly obese stroll into the hospital to get custom made shoes because their feet no longer fit into regular shoes ..... at a total cost of £800 per pair. The system is so flawed and everyone is overworked it would work so much better if they only provided certain services for free and did it well but I'm not sure if the nhs will ever get an overhaul . I remember being in greece and having a water infection and paying 50 euros to see a doctor and got the best care and service I've ever had with full detailed explanations of what happens and why they were giving me certain antibiotics and probiotics because I was prescribed antibiotics, it's such a shame because the nhs staff work so hard and get the flack when they can't fit everyone in , it's not even a new problem my grandma lives down south and it once took her 6 months to get a gp appointment and 2 years to get an operation she's waited another 3 years after that to even see the consultant again to get something rectified from the first surgery.

I've never had any problems with the NHS, personally. I've had three babies on the NHS, happy with the care each time. My daughter receives psychiatric care as an outpatient, happy with that too. I don't have any serious illnesses though, perhaps I would feel differently if I did.

I work for the nhs and as an employee its an absolute shambles. We are understaffed yet you have matrons and the likes swanning about doing fuckall paitent care, while we are run ragged. Get these out of offices and onto the floor. We all pay for a service that is not fit for purpose, nurses and hcas leaving in droves because they are sick to the back teeth of the shit they get. On top of that they the good old nhs promote the biggest bullies which leaves staff dejected and fed up with it. Those that dont work there are only scratching the surface, theres a problem within the nhs and its needing a good weeding otherwise its going to rot

@Marguerite2000

I've never had any problems with the NHS, personally. I've had three babies on the NHS, happy with the care each time. My daughter receives psychiatric care as an outpatient, happy with that too. I don't have any serious illnesses though, perhaps I would feel differently if I did.

Pray you or your family never, youll be left swimming in your own bodily fluids, and im not joking on that.

Yeah the solution is - let's go back in time and un-do the systematic underfunding of the nhs by various governments, pay freezes and general poor treatment of services and staff. The cherry picking and selling off or commissioning of some services to private providers. Bob's your uncle - love from someone who has worked in the NHS most of their working life

I've haven't had one good experience with the NHS, in fact I've been treated appallingly at times. I had to battle for two years to get one of my DC some very basic treatment which resulted in her suffering unnecessarily. It was purely penny pinching and was inexcusable.

I have family who live abroad (ex pats in Europe) who pay a very small fee for healthcare. They can see a doctor the same day and a specialist within a week. They've had operations and treatment that they would never have got here.

I don't know what the answer is. I personally would rather pay a small fee for accessible treatment rather than have it free but nigh on impossible to get. At the moment the choice is very poor care for free, or extortionate prices for private that is above the means of most.

Compare and contrast
UK - burst ear drum - ooh emergency Dr - yeh, it's burst, no need to do a thing. Give him calpol. Ear absolutely streaming gunk and child in acute pain. GP, well it's burst nothing more to do, oh have some AB's if you insist.

Austria: seen immediately by physician, sent immediately to hospital where the ear was examined by a specialist, gently cleaned of gunk and AB's given with a follow apt. 48 hours later.

Back in UK - saw GP - no point referring, ear drum burst - can't exactly grommet can we. I insisted on a private referral as there had been two perforated eardrums in 1w weeks.

Private consultant
Hmm, ear drum is healing at an angle and there's a little bit of bone beginning to calcify. The crooked eardrum is indicative of an inherited condition called cholea(and I can't quite remember the full name without googling). If the drum keeps bursting more and more bone/calcification will build up and lead to deafness. That will mean quite a significant operation but I can insert a grommet to relieve the pressure and that will allow the drum to grow straighter. No support whatsoever from the NHS - all done privately - in the 21st century.

DH's grandfather was Stone deaf by the age of 30 BTW. It was put down by the family to boxing. Probably not.

Anyway aside from examples and personal disappointments, I think it's a sacred cow that has turned into a behemoth.

It needs root and branch reform and we need a cross party review of where it is, where it needs to be and how it's going to get there. It cannot carry on as it is, expectations have to change a little and personally I think there are elective procedures that should be means tested (gastric bands, for example). I would favour a social insurance/European system personally and believe firmly that there has to be some form of underwritten payment to primary care services.