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.

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
You mean like in the States? Obesity and diabetes is increasing everywhere. France are facing the same issues. They have to subsidised for their care. It's not making a difference.

instead of "weneed to fund things and education about self care better"
There is plenty of education. It's everywhere now. On prime time TV, in schools, in the media. It's the way society has evolved, what has become normality. It's no individual fault, but the only way forward is making changes individually. It remains that WE are killing the NHS by our lifestyle choices.

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
Well that's a poor example as the OP is not getting treatment because her blood tests are indicating she doesn't require it. It's very different to not getting it because you are not getting access.

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

You mean the whole 1-3% that I read this accounted to?

If we want to save the NHS, we need to look at our behaviours and start to treat what we can treat and prevent ourselves. The NHS is not a babysitting service.

@RosesAndHellebores

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.

my pleasure! Even so - blimey!! You're right, though. There are so many who could afford to pay for prescriptions, but are covered by a blanket exemption. Also agree that the NHS is often considered to be some sort of charity, rather than being funded by us. This leads to appalling inefficiencies and waste being written off in a 'well they're doing their best' kind of way, rather than regarded as the indictment it is.

I would be happy with a right to opt out. Eg I have seen my GP for 7 minutes in 15 years as I don't get ill and call it the £100,000 appointment (20% of our income tax goes on the NHS which never seems to be an NHS available to this family when it is needed - I have paid for all kinds of stuff for my children for private stuff the NHS will not sort out)

Frankly, if the system made to care of sick is being killed by people ebing wick, it shouldn't exist

When I qualified as a doctor, in 1980, the NHS administration bill was 5% of the total budget.
By the time I retired, it was 12% and rising.
My own teaching hospital was evicting biochemists from their labs to turn them into overflow offices for yet more managers, facilitators, coordinators…
The NHS is drowning in bureaucracy. The excellent clinical staff are being worked into the ground while money is wasted in all directions. We have worse health care and fewer doctors per head of population than most of western Europe.
The obvious solution is to learn from other countries, scrap the NHS as a monolith past its sell by date, and adopt a more efficient European insurance based system, underwritten by government.

@vivainsomnia no the point is the NHS normal range is incorrect, the treatment is one size fits all, many aren’t treated until
their TSH is over 10 when other countries would be treating you much sooner. This is all over the thyroid community. I am not doing your googling for you.

@Babdoc

^ bows ^

I totally agree.

I think there is a certain degree of underfunding, especially for nurses wages BUT there is a absolutely massive amount of wastage within the NHS. If you knew even half of the details it would make you weep.

£10,000 paid to fit a very very basic small kitchen (and a shit job was made of it too), 15 year contracts given to companies who provide a shoddy, awful, eyewateringly expensive service.

A £20,000.00 machine ordered that couldn't be sterilized as it didn't fit, therefore rendering it useless, no refund available.

Coffee at £50 per tin, rather than £10 at the cash & carry.

It's the very very tip of the iceberg. I absolutely love the NHS and want to see it continue, and thrive but as it stands I just can't see that. There is too much red time and contracts given to ministers "mates"

The problem is our NI contributions don't directly go to funding the NHS, it's just another fancy name for a tax, it's all lumped in together, it's just more palatable to have 2 different taxes rather than one tax that looks extremely large.

An American style healthcare system is just terrifying, but I fear that is where we are heading if we don't make major changes

[quote Berkeys]@vivainsomnia no the point is the NHS normal range is incorrect, the treatment is one size fits all, many aren’t treated until
their TSH is over 10 when other countries would be treating you much sooner. This is all over the thyroid community. I am not doing your googling for you.[/quote]
totally agree

My Dutch in-laws had a very modest income, but they always prioritised their health insurance contributions. They have excellent care now when they need it in their 70’s.

I’ve always defended the NHS but having used it this year I can see the cracks. Individual staff have been excellent, not criticising them, but more the level of work they had to deal with. There were too many patients being admitted and nowhere to put them. I was relieved to leave hospital, it was chaotic.

I think the UK will move to a European style insurance healthcare system eventually.

@CuckooCuckooClock

It’s been massively underfunded for decades so doesn’t work a lot of the time. It must be so depressing for hcp to not be able to treat patients properly so now there’s a huge shortage. I don’t know if it can be saved. This country seems to be more and more right wing so there just isn’t the public desire to sort it out. I’m starting to think about going private more and more just so I can get some help.

This. Not the only reason I left my career as a HCP but it certainly didn’t help. Knowing you’re spending 12.5 hours without a wee or a meal, and are still providing crap care, because you’re caring for 19 women and 11 babies, because some poor woman needs recatheterising but the ward’s run out of catheters (again!) and you don’t have any staff to go and hunt one down on another ward. The constant fire-fighting, the constant near misses, the constant apologising for the unacceptable level of care women have received. This was pre-covid. You leave because you cannot bear to have so little pride in your work anymore.

[quote Berkeys]@vivainsomnia no the point is the NHS normal range is incorrect, the treatment is one size fits all, many aren’t treated until
their TSH is over 10 when other countries would be treating you much sooner. This is all over the thyroid community. I am not doing your googling for you.[/quote]
The woman in that thread had ba TSH of 2.2 and a T4 of 11.9 (12-22 being normal).

It was a stupid example.

This person has hit the nail on the head, paitent care no linger, to understaffed to properly care. Rushing about mad that head goes blank, dripping in sweat. And we supposed to be a caring profession yet wheres the care for staff? Unrealistic paperwork tragets, blatant neglect, uncooperative workmates who have just given up. A shift where a worler isnt left in tears means its been a good day- those are rare.
4 staff, 2 nurses and 2 hca to look after 24 paitents, 6 a falls risk, 18 needing double staff, 3 wandering about. Thats your nhs right there

@TatoAndBeans perhaps if pg and birthing women were not made to feel they had to be so grateful some of it would be sorted out. I remember 26 years ago being on a post natal ward and shouted at because I'd rolled off the bed cover thing and got blood on the sheets and shouted at again when I wanted a bath and I reported it was covered in blood and told that's how a patient had left it so clean it up with paper towels and vim. There were more midwives than women Xmas 1994 and frankly the care was shit then. Scroll back and read how they very nearly killed ds1 and caused great damage to me arising from a botched birth. It's about midwifery co.petence and culture as much as funding.

I can assure you that if my dd is spoken to like that and I hear it, I shall immediately telephone the CEO and photograph the state of the bathroom that women are expected to clean less than 8 hours after giving birth.

Never have I encountered so much rudeness as from midwives both ire and post natal.

The main thing wrong with our health care system is it's chronic underfunding and under staffed. It doesn't need constant reform, and is judged to be very efficient by international standards with little waste. It just needs more money and staff.

@privateandnhsgp and yet I have a TSH of 3.3 and have benefitted tremendously from 25mcg of levothyroxine going from a cold aching depressed exhausted shell of a person to a functioning human. If you are a GP then no wonder you are so defensive as you are part of the problem.

I have to say im utterly dismayed and saddened by the state of the NHS and fully blame the goverment.

I took my 1 year old daughter to the GP when she was unwell and she called an ambulance for potential sepsis/meningitis. They argued with her on the phone then eventually agreed after she shouted at them that she was a doctor and gravely worried about this child, she had to call them back a second time as they hadn't arrived within 20 mins.
However the hospital were fantastic and we got outstanding care but they are at their limits.

I am so worried about the state of the NHS for my children.

The NHS needs to change, but as soon as change is suggested, people start screaming leave "our" NHS alone.

So things can only get worse.

We should look at the systems in different mainland Europe countries to get ideas.

The UK spends less per capita of the major industrialized countries. It gets what it pays for. For whoever complained about money being eaten on wages--NHS wages are far too low. It contributes to an exodus of trained staff and encourages consultants to perform low volume private work to top up their NHS pay.

The problem with the political debate is that it tends to be either the US or the NHS. The US system is not one to copy for far too many reasons for me to list; the insurance system is only part of the problem. (The US also suffers from a lack of investment in all social services which then dumps the consequences on the health system.) As PP have said--there are other European countries. (I would not copy Australia actually as the incentives for private insurance have exacerbated inequality.)

Underinvestment in the NHS goes back decades; the last decade is just the worst of it. The question is whether the structure of the NHS is such that it can cope with the investment it needs or whether the structure needs to be different entirely.

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

The right talk about the deserving/non deserving poor and the left talk about the deserving/ non deserving NHS patient. Quite a disturbing parallel.

You can see it on this thread.

I disagree entirely in the last 48 hours on this site I have seen people annoyed that they cannot get a GP appointment to check if they have earwax, being incensed that they they've been told to pay for iron tablets and multivitamins themselves and there is a thread right now with someone wondering if they should call an ambulance because of their anxiety.

The first person hasn't even started with a pharmacist and earex drops are less than £5.

The second person doesn't want to pay £1.49 for iron tablets and a couple of pounds for multivitamins

The third person if they need emergency mental health services can make their own way to A&E but want to call an ambulance instead.

The NHS is fit for purpose if people would stop taking the piss with it.

I work for the NHS. In my area patient care is terrible, waiting lists so long I’ve had to go private for my own health. I’ve never met my current GP in person, just one 5-minute phone call as she’s so inaccessible!

I think the NHS is only performing well in certain areas and in terms of emergency treatment (but many health conditions could have been caught and treated earlier if doctors were more available in the community and actually listened to patients).

I’m fed up with not being able to see my GP when I’ve worked on the wards throughout the pandemic, with covid patients. I had covid and now have long covid on top of other chronic conditions.

The amount of money wasted in the NHS makes me angry. It’s often down to poor management, incompetent people being stuck in positions of power and bullying cultures, so of course they can’t retain staff. Some hospitals can’t even recruit. Budgets are often wasted on silly things. Maybe if they paid staff better they’d inspire a better work ethic.

We all pay for the NHS with our taxes and it feels this money is often poured straight down the drain.

For example, certain teams like community mental health or inpatient CAMHS are always understaffed because the job is so draining, physically and mentally. Restraining people, getting injured trying to help people because you don’t have enough staff, witnessing suicides and self harm, the huge responsibility if you’re the last member of staff to see that person alive.

Then the people who treat A&E like a walk in clinic, who hold up triage for those with more serious conditions. The time wasters who can’t put a plaster on their paper cut or treat their ingrown toenail at home. Or passed out drunk in the street.

Being fobbed off with ‘we don’t know what’s causing the pain but come back for a scan if it’s no better in - let’s see - the earliest appointment I have for that is 5 months away! Here’s some codeine to help while you wait.’

I’ve seen it on the wards, patients not cared for properly because no staff want to work there.... and those who do are often agency with no idea what to do.

MDT meetings that drag on for hours, taking staff off the wards, away from our patients and jobs.

The lack of flexibility eg with hours or start time (you can put a flexible working request in but it’s usually declined). Shift work, trying to juggle a family. It feels like the NHS doesn’t care.

I’m so burnt out and fed up working for an employer that fails to recognise all the effort and overtime I put in, the extra miles I went, the sacrifices I made to meet their requirements. Perhaps it’s compassion fatigue but I’m not sure how much longer I’ll last with this job.

It’s underfunded. I would not be against non profit European insurance model but zero discussion on this. This govt inching us towards creeping privatised profit healthcare model. No thanks!

“Main points

In 2017, the UK spent £2,989 per person on healthcare, which was around the median for members of the Organisation for Economic Co-operation and Development: OECD (£2,913 per person). (38 members of the OECD)
However, of the G7 group of large, developed economies, UK healthcare spending per person was the second-lowest, with the highest spenders being France (£3,737), Germany (£4,432) and the United States (£7,736).
As a percentage of GDP, UK healthcare spending fell from 9.8% in 2013 to 9.6% in 2017, while healthcare spending as a percentage of GDP rose for four of the remaining six G7 countries.
The UK’s publicly funded NHS-based health system contributes to the UK having one of the highest shares of publicly funded healthcare (79%) in the OECD.
In 2017, the UK spent the equivalent of £560 per person on health-related long-term care, which was less than most other northern or western European countries, but a similar amount to France (£569) and Canada (£556).”

www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29