In wondering why UK can't adopt the Australian Healthcare system?

[chopc]

I was talking to some friends abroad and in Australia about frustrations with our wonderful
NHS for both patient and doctor. One of them wondered why we can't adopt the Australian Healthcare system. I thought the same and checked with those using it in Australia, and I can't see any downsides to it ........

What is stopping the UK adopting the same system?

I admire the NHS principle of free for everyone. However last time I lived in the UK I was shocked at how long it took to see a GP or specialist
The Australian system is pretty good but there is a drift to privatization and increasing fee for service. The government has quietly removed services from the free list.

I am Australian and lived in Uk for a couple of years and pretty much my entire extended family still live there.

It has always boggled my mind that people in UK whinge so much about the NHS - my limited experience with it was amazing. There is so much you don’t pay for that we do.

I think our main advantage is that we do have more choice about which doctor we see and alternatives when the public system falls down. If you can pay for it.

I think all healthcare systems have their issues but none are as broken as the USA.

My experience of having used the Aus public system vs the NHS was vast. Every GP I've seen in AU have been interested in preventative healthcare. The NHS seem like wait for people to get sick before acting.

My sister was discharged from hospital in the U.K. after a lengthy stay after a significant illness. She was deemed well enough to go home and not to a rehab centre. She couldn't live independently so moved back to Australia so our Mum could help with her care. She ended up being referred by our family GP as home to a neurologist, who immediately admitted her to a hospital there as she wasn't deemed well enough to be at home 🤔

There are definitely shortfalls in the Australian system but I very much prefer it.

@DixonD

I made a GP appointment this week and was seen in less than 24 hours

Well lucky you, here is my latest experience. I tried to get a GP appointment this week funnily enough. I was pleased to only be on hold for thirty minutes, I said I did not need an emergency appointment, she said she would check when she could get me in. Five minutes later, cannot book you in at all at the moment. Call back next week and I will check the calendar again. Or, she said, you can call back between 8:30 and 10:30. I replied it is currently 9:30am, she said “so you are an emergency” (??) so I said, well yes then. I then got a telephone appointment with a GP later that day. The GP decided I needed blood tests and told me to call the surgery again the following day and book in. I duly did so, this time about 45 minutes on hold. The first available appointment, to have my bloods taken is early October.

Yes, compare this to my last experience when I lived in Australia. I walked to a doctors surgery in my lunch hour without an appointment. Was seen thirty minutes later, needed blood tests, was pointed down a corridor, sat outside for ten minutes, bloods taken.

But I did pay a small fee, some of which I claimed back later. I am convinced that having a small fee for working people would stop a lot of the wastage in the NHS. Or at least some of it, which still helps.

I needed several Gp appointments in 2019 pre pandemic and I waited at least two weeks for each one.

I have friends who work in Australia (we're doctors) who have grave reservations about the system there.

It seems especially fraught at GP level with people doctor shopping to get treatment that they want.

I think we should look to europe for solutions. Sadly, however, our govt. will take us down the ludicrously inefficient US system which delivers excellent care for the minority and fuck all for those at the bottom of society.

Look at the maternal morbidty statistics (www.who.int/data/gho/data/themes/maternal-and-reproductive-health/maternal-mortality-country-profiles) 2017 data - US 17 deaths/ 100 00 woman. UK 7. Australia 6 Albania (picked as a developing european country 15). France 8.

The US are not doing well and a lot of it is due to access to healthcare for the poorest in society.

@PicsInRed

In NZ you pay an amount towards GP appointments (however these are still free if you are low income and also for children).

This "copay" system reduced wasted/unneeded appointments and meant less waiting for those in need, and appointments within days (or same day if urgent). Unlike here, I never found myself having to negotiate, beg or push to see a GP when really sick.

It's one NZ practice I'd strongly encourage the UK to adopt.

I have to pay to see my GP here and it makes me MORE likely to go to the GP because I know I'm never going to be told off for going or told my problem didn't require an appointment.

*small fee at point of service I mean.

"It seems especially fraught at GP level with people doctor shopping to get treatment that they want."

Is it better to be told you can only use one particular surgery within your catchment and you're stuck with the doctors there even if they're incompetent or nasty?

This thread does sum up the big problem with reforming our health service- it was a thread started suggesting we move to an Australian style system and by the 7th message, a poster was effectively saying its NHS or USA style health care. Australia isn't the US, but there is a mindset in the UK that if we don't have the NHS we have to have American systems.

It is interesting the so many people fear we'll end up with a US system if we don't have the NHS, yet won't even register that France, Germany, Ireland, Spain etc don't have an NHS and also don't have the shit show the US has. The NHS might still end up being the best option, but there are more than the 2 options.

The French seems much better.

The issue is that if you have a preponderancy to abuse painkillers for example the lack of joined up primary care means you can traipse round multiple providers and get them.

And if one GP suspects this and starts to control your supply then you just move on to the next one and there is no central record system so the new doctor only has the information the patient presents.

It's dangerous.

Seems unlikely that all the doctors in one practice will be incompetent and /or nasty.....

Another issue with our health system is that despite skin cancer being so prevalent in Australia and there are people who die from skin cancer; skin cancer clinics here are not regulated. Following is a paragraph I copy and pasted from the Cancer Council website:

Skin cancer clinics are not regulated in Australia, so it is important that you check the practitioner’s credentials when seeking screening or treatment in a clinic (establish whether the practitioner is medically qualified, and the extent of their qualifications in general practice, skin cancer medicine, surgery or dermatology).
www.cancer.org.au/cancercareguides/basal-and-squamous-cell-carcinoma#:~:text=Note%3A%20Skin%20cancer%20clinics%20are%20not%20regulated%20in,general%20practice%2C%20skin%20cancer%20medicine%2C%20surgery%20or%20dermatology%29.

First have to get past the co-pay principle
This is main stumbling block for NHS reform
British people really are extremely mean with money or too many are borderline destitute, I guess

Only After co-pay is accepted in principle, could then discuss the merits of German vs. French vs. Aussie etc.

@Penistoe

The French seems much better.

I heard you don’t even pay for pre-natal vitamins in France.

Here (Aus) I went public both times and the only thing I paid for is the 12 week tests (the nuchal translucency one). So I thought we had it pretty good. Then my friend moved back from France and was lamenting having to pay for her own pre-natal vitamins this time! So there is that. Turns out from a French perspective it was not as free as I thought.

Nostalgia in the UK for the NHS even though other countries have far better health care. Typical British attitude unfortunately in a country that is obsessed with past glory

I love being able to choose my GP. When I worked and lived in London, I lived in SW London and worked in SE London. To get a repeat prescription of the pill, I used to have to take a half day holiday from work, to see the Dr near where I lived, wait for over an hour, then go into work, 45 minutes away.
When I moved to Sydney I just picked a dr near my work, would pop in during my lunch hour if I needed anything.
Now I have a dr near where I live as I mainly work from home so I asked around as to where was good, ended up choosing a great practice with a number of Drs, a nurse on site, a pathology lab on site etc. And it’s all free.

Thanks for the input everyone. Given lots to think about

The Belgian system is pretty good. It is one of the things I miss about Belgium.

If the NHS was better funded, and the tories weren’t trying to get their hands into the pot to increase their individual wealth, this conversation wouldn’t be happening.
Like quite a few things that once were good about this country, it’s being abused by the right-wing.

My dd is a doctor now working in Oz. Having been trained and worked in the NHS she was vehemently opposed to private healthcare but less than a year on has changed her mind -the Australian system just works better, and the staff are not expected to do hours of unpaid overtime. The NHS is broken and the people who work in it are treated like shit. Any system except the American one would be better.

@Dontevenstart

If the NHS was better funded, and the tories weren’t trying to get their hands into the pot to increase their individual wealth, this conversation wouldn’t be happening. Like quite a few things that once were good about this country, it’s being abused by the right-wing.

The trouble is the demand is infinite and the funding will never be enough. It really is very well funded. But a Conservative government will never be able to make the changes that the NHS needs to work better because of this kind of political nonsense. It will take a brave Labour government to reform the NHS, they get away with it, Conservatives never will.

My DH has lived and worked in both systems and would never go back to the NHS. He is horrified by the care his young family member with complicated medical conditions is getting in the UK.

I work in Australian health care as well. There’s a misunderstanding that it’s either/or with public and private. It’s common for people to access Dr X as a sub specialist publicly but see Dr y as a coordinating physician. There’s no public/private conflict, at least not where I work. You don’t need private Heath to see a private specialist but you do need to pay. It’s not always faster but some people prefer to see the same person every time.

If I order X-rays, they are reported within 24 hours, blood tests can be copied into GPs and private results accessed by some of the public settings. These are generally free to the patient, exceptions being things like complicated genetic testing etc.

Lol if Australia and NZ had a system like the UK NHS, or Canada or even the flawed ones in India they would have been able to vaccinate their relatively tiny populations.

I was under the impression that the UK had to vaccinate quickly due to covid being so rife - at the same time it wasn't in Australia and NZ so there was no urgency. Despite what you might think all of Australia is not full of covid, and in most of NZ we haven't had a case for over a year.