To think the NHS isn’t fit for purpose?

[SpicyJalfrezi]

It is in no way a criticism of individuals who work for the NHS. It’s the system. It isn’t working at all. I don’t really understand why we aren’t facing this as a nation.

Truthfully most of the world has universal medical care funded via work and insurance, and it works well. In the US it's controlled by the medical establishment, so while the treatments are cutting edge, it is also very expensive. But most of Europe gets by with better health outcomes overall with a small co-payment commitment that isn't enforced for children, the elderly or the unwaged.

I totally disagree @Mamainthemaking
That way lies the US system. British health care is much cheaper than that if you take all expenses into account. It is possible for the NHS to work, but it needs serious funding and some discussion about elective procedures.

I can't fault them. They have provided everything my family has needed for the last 15 years.

They've provided good maternity care, delivered DS safely, they cared effectively for him when he had swine flu as a baby, they've provided his df with a hip replacement, they've provided great dental care for us both for the last decade, they've provided an HPV vaccine for DS, the ambulance service came to ds's call when I had a bad reaction to something earlier this year.

111 has always been there when we needed it. Plus regular smears and mammograms. My GP even saw me within a couple of hours when I found a lump.

I can't believe I'm the only one.

The NHS is losing its trained staff wholesale to Australia and NZ, people that we have all contributed to training. I have no problem helping to train the profession, but I think they should not be able to emigrate or resign for a few years after completing the training.

I have no issue discussing alternatives to the NHS but I’m not sure there’s a quick fix or whether massive changes could happen without a referendum (which I suspect is unpopular amongst those milking it and their connections for everything it’s worth).

If anything remotely resembling the NHS comes out the other side of covid I’d be surprised but I’m not sure there will be anything left to rebuild an alternative with.

I am willing to pay for health insurance, but not if the current rate of taxes stays where it is. The thing about the US is that they pay less in tax and then need to fund their own healthcare (not saying I agree with it, but that's the system). A Tory government will not only say we need to now pay for medical care, but they won't reduce our current taxes and will use the money to line their pockets and those of their mates.

I do think healthcare should be subsidized by the government. I don't think everything should be free at point of care. A lot of people waste resources by not taking care of themselves at home before ringing a GP, and the government spends tax money foolishly on contracts that aren't cost-effective. It all needs to change.

While the NHS is free, it becomes an option for the elderly and lonely and bored. Which is why the phone receptionists are dragons: my SIL reckoned she got timewasters just wanting someone to chat to, the same 15 people day in and day out.

I agree to a certain degree, some parts are excellent and others not so much. It needs proper investment and I am happy for a rise in tax to pay for this.

@Mintjulia

I can't fault them. They have provided everything my family has needed for the last 15 years.

They've provided good maternity care, delivered DS safely, they cared effectively for him when he had swine flu as a baby, they've provided his df with a hip replacement, they've provided great dental care for us both for the last decade, they've provided an HPV vaccine for DS, the ambulance service came to ds's call when I had a bad reaction to something earlier this year.

111 has always been there when we needed it. Plus regular smears and mammograms. My GP even saw me within a couple of hours when I found a lump.

I can't believe I'm the only one.

Given that you padded that list out with vaccination, a helpline, and cervical screening, it just shows that you're speaking from a place of privilege in how little you have needed from them in the last 15 years ...

I have a much longer list of fuck ups and failures relating to much more significant and life changing "care" just in my own life not my whole family unit. Failures that have changed the course of my life and left me facing a much more bleak future than I should have had.

I know I'm not the only one.

I too am willing to pay for health insurance. However, having said that I was recently diagnosed with a small and treatable breast cancer, for which my care has been quick, thorough and immensely considerate, and I am hugely grateful... to the point that I shall be making a decent donation to their charitable partner.

@XingMing

The NHS is losing its trained staff wholesale to Australia and NZ, people that we have all contributed to training. I have no problem helping to train the profession, but I think they should not be able to emigrate or resign for a few years after completing the training.

This - I've never understood why funded health degrees don't come with a golden handcuff for X years to ensure that graduates contribute to the system that funds their training.

I also don't understand the concept of paying to see a consultant privately almost immediately or waiting years to see him / her on the NHS

Until very recently the only poor experience I’d had of the NHS was the birth of my first child, when I was treated very badly and there was medical negligence on several counts by the hospital.

Otherwise, in my 40 odd years, I’d found the NHS reasonably good and always thought it was a brilliant if imperfect system.

Then I experienced a loved one getting cancer. He died last week and after seeing the poor care he received all the way through, and particularly near the end, I am devastated that this is the reality of our healthcare system. Slow, cumbersome, bureaucratic, understaffed. The majority of staff seem so stressed and burdened they aren’t really providing proper care anymore. The majority were horrible. I can’t believe they are all horrible people, so it must be the system they are working within that has made them behave that way.

I can’t even begin to go into the catalogue of awful things that my loved one had to endure. His life was not respected. I am now terrified of another relative or friend (or myself) getting seriously ill and relying on the NHS. I’m a lifelong Labour supporter, but am now considering whether I can afford private healthcare for my family as I just cannot watch another person I care forgo through what my relative suffered.

You need to remember that private health care doesn't cover chronic conditions and ongoing medical care. After the initial diagnosis and specific care that's it. We have the NHS to thank for continuing to provide this. I would like to see an introduction of some form of penalty for missed appointments. Waiting for bloods there was a comment on the number of people who had missed their slot. People should be accountable for these in some form, which could be a financial penalty for repeat offenders or bumped to the bottom of the queue (I appreciate financial penalties don't work when you can't get blood out of a stone or people can't genuinely pay). It needs to be a hybrid model of private versus funded.

This is the NZ system, there's plenty the UK does better but this isn't it.

In NZ, it was always quick to get an appointment, same day when urgent, in person not over the phone...and the receptionists were lovely.

www.govt.nz/browse/health/gps-and-prescriptions/paying-for-doctors-visits/

@cardibach

I understand why people fear paying for healthcare means a US system, but there are alternatives. Our private healthcare in the UK currently works differently than it does in the US. (I won’t bore with the details. I work for an American private health provider that owns hospitals here in the UK and see the differences.)

If we kept our current private system which could work with/along the NHS I can see a more sustainable NHS in our future.

After all, medicine is expensive and I don’t think we can tax our way out of it. For example, a total hip replacement is £10,000 excluding physio and take home medication if patient goes home after three nights (which they rarely do). Bed blocking is also a big issue and I don’t think the NHS can operate at its optimum until the social care issue is resolved; but that’s another argument.

The Australian system is an example of how this could be implemented without having a US system.

That said I do completely understand your argument.

At the moment everything is "free".

That's not sustainable.

Critical services should remain free, but non critical should go down the insurance route.

I've lived in Germany for the last 20 years and the healthcare system works really well. I've been amazed talking to family today who can't even get a face to face Drs appointment.

@Mamainthemaking

The NHS is a product of its own success. By providing absolutely all healthcare free at the point of access, people are living longer and with an ageing population it’s unsustainable.

People are worried that if we talk about introducing payment for parts of the service that’ll it’ll become like the US system, but that is the other extreme.

I think we as a society need to rethink how we look at healthcare. Private policies are as low as £30p/m, (granted for young and healthy). However people are completely unwilling to pay that, but are happy to pay £50+p/m for a phone contract.

The NHS should be a safety net for people that can’t afford healthcare or who’s insurance won’t cover the treatment. That way the NHS will be sustainable for the future.

That’s my very humble opinion having worked in healthcare for 10 years. Just an opinion.

Absolutely agree. I find myself going private more and more these days as its the only way to get a decent service. Exactly the same with dental. Unfortunately some sort of private health insurance is the only way forward and people need to adjust to the fact they need to pay more towards their health.

The concept of care free at the point of delivery is good, and it is important in ensuring that people on lower incomes don’t put off seeking treatment because of financial concerns. However a system like this now needs to be funded adequately because in a modern world people live longer and there are many more effective and complex treatments. So to maintain the NHS in its current concept everyone needs to pay considerably more tax.
The patient is also important in this. Patients waste resources by not turning up for appointments, not taking care of themselves or even not taking prescribed medication. This all wastes massive amounts of time and money. People often have no concept of how much things cost. Maybe if they had to pay they would be more mindful.
A private system does risk inequities to those who can’t afford adequate insurance. The American system always seems to me to be the worst in this respect- with many people being unable to afford adequate treatment - esp those with long term conditions.
I don’t think the NHS is fit for purpose, and a massive overhaul is needed . I don’t know the answers but there needs to be an open debate about how we achieve a better service .But the current government are already privatising by stealth, and the model they will adopt will be one where there are huge profits for private companies but at the detriment of “ ordinary” people. If you don’t want our NHS to be sold off to wealthy businessmen who only care about profit now is the time to speak out.

Always I'm a practice nurse and had four missed appointments on Friday. Three of the four were pensioners. The other was in his twenties.
I think if you're going to charge one you charge them all. But oh no, there would be outcry at the older generation being charged. So the same poor sods paying for their prescriptions and the bus to get there would be the ones paying the fines as well. Regardless of individuals ability to pay.

@AlwaysAReader

You need to remember that private health care doesn't cover chronic conditions and ongoing medical care. After the initial diagnosis and specific care that's it. We have the NHS to thank for continuing to provide this. I would like to see an introduction of some form of penalty for missed appointments. Waiting for bloods there was a comment on the number of people who had missed their slot. People should be accountable for these in some form, which could be a financial penalty for repeat offenders or bumped to the bottom of the queue (I appreciate financial penalties don't work when you can't get blood out of a stone or people can't genuinely pay). It needs to be a hybrid model of private versus funded.

Before penalising people for missing appointments maybe they could work out how to assign convenient appointments in the first place instead of posting them out and making it virtually impossible to call and change. People already get bumped to the back of the queue for allegedly missing appointments they either knew nothing about or spent hours trying to reschedule.

I think we as a society need to rethink how we look at healthcare. Private policies are as low as £30p/m, (granted for young and healthy). However people are completely unwilling to pay that, but are happy to pay £50+p/m for a phone contract.

£30 per month is not what I, or many other, would consider cheap. Especially if you multiply that by the members of a family. Especially if any of those have ongoing conditions or are not young/fit/healthy. 3 of the 4 of us have a genetic micro-deletion that may or may not be clinically relevant. There is hypermobility, hypotonia, eczema, asthma, PCOS, a history of depression and self-harm (v. specific set of circumstances, no longer relevant.) All these things have v little effect on day to day living but would either cost a bloody fortune with insurance or simply not be covered. (Basing this on travel and life insurance quotes.)

And noone I know has gone anywhere near £50 monthly mobile contracts. Oh and I have never paid more than £25 and are currently paying £10 each.

Perhaps look at the world around you a bit more widely. There are plenty of people who don't qualify for any support but are only just getting by on wages and have little wriggle room to pay more.

Definitely I work for them too ! My colleagues mum collapsed last week with agonising stomach pains was taken to a & e and was discharged with painkillers, no scan or anything, she's still in lots of pain and had to wait all day for a doctor to call her back. My colleague couldn't even sit with her in a & e despite working at the hospital because of bloody Covid. My next door neighbour called an ambulance this morning after her son fell banged his head and was drowsy and was told there was a ten hour wait for ambulance !!! Where is it all going to end ??

Never mind. The government is selling off large chunks of it to American companies, and what they'll do with it will REALLY make you appreciate what you've lost.

@TheHouseILiveIn

Can't we use the £350M a week we are saving by not being in the EU?🤔

Even if it were there, it's a mere drop in the ocean. The NHS is a bottomless pit, a leaky bucket, etc. More money isn't the answer without some proper reform and efficiency.