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.

And that lecturing, smug, pious tone helps, doesn’t it?

The government is underfunding it in order to make it unfit for purpose. Then they can make us pay for it and we will all be grateful. Fuckers.

@Lancrelady80 I understand your concern. Which is why I also said that the NHS should for those for those who cannot afford it: 😵‍💫

‘The NHS should be a safety net for people that can’t afford healthcare.’

I would kindly ask you to reframe from insults also.

I don’t doubt for a moment that the government are at least partly to blame, but so are a lot of the systems within the NHS which add excessively complicated procedures and levels of bureaucracy.

I had to ring 111 today. I was called back twice. Three times today I have given identical answers to a long list of questions. There is no need for that. In the meantime, people wait.

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 would also add "not go private" to that list. A golden handcuff to the NHS for a minimum of 5 years.

One thing that I have really been cross about when reading some GP threads is GPs merrily stating on one hand that there is a shortage of staff and then on the other hand talking about them only doing part time NHS jobs but also doing part time private. There was even one GP encouraging someone else who was training to either go private or emigrate as soon as qualified.

@Narutocrazyfox I couldn’t agree with you more and I think a lot of people are experiencing the same thing. I see it daily within my role at a private hospital.

I am in the community. This weekend we have been very understaffed resulting in no lunch, no toilet breaks and finishing late. We don’t get paid for lunch breaks and if you don’t use it you lose it, as the thinking is you should stop for lunch regardless, when that isn’t always possible. We have a number of patients who are lonely and will have us called out when they may not necessarily be need to be seen, but you can’t just not go. We have a huge social care problem as well as a health care problem.

@RunnerDown 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.

Likewise, some doctors are happy to waste money. My OH has cancer and has a whole carrier bag of drugs every month. Several items are simply never used, i.e. anti sickness, anti diarrhoea, etc., but it's impossible to get them stopped - the consultant just says it's "too much effort" for her to change the prescription. But those are cheap drugs anyway, so probably not important. What IS important are the chemo drugs - he has a weekly one which costs over £1,000 per tablet and a daily one which costs around £300 per tablet. Both drugs were causing severe side effects so the consultant said to just take the weekly one twice a month and the daily one every second day. But she won't change the prescription, so he's getting a full months' worth of very expensive drugs but not using them all, they're just accumulating in the cupboard! He has already accumulated probably £20k of drugs he'll never use, the consultant won't stop prescribing them, and simply doesn't care. Until that kind of stupid waste is addressed, the NHS will never move forward.

After seeing staff blatantly ignore DH when he was shouting out and writhing in agony from undiagnosed pleurisy, I agree. This was pre-Covid If he had had Covid I'm sure there would have been an entirely different reaction.

@mamainthemaking

Not sure quite where I insulted you? Apologies if you read an insult in there, was just pointing out that there are many people who are not seen as struggling because not dire enough, but who would still really struggle with paying more. Not all who struggle receive benefits, it's those who just about manage (Therea May's "JAMs" ) who would be badly affected by this.

All I can say to anyone who thinks the NHS is wonderful is... get a pet! Find out what vets charge for consultations, X-rays and medication, and then consider in that light. My dog's congenital elbow problems cost us about £4,500 to rectify, spaying her (because you couldn't breed with a clear conscience) another £400, an RTA cost £900, and the ongoing complications from the elbows and the RTA have racked up a few hundred pounds more.

@Lancrelady80

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 would also add "not go private" to that list. A golden handcuff to the NHS for a minimum of 5 years.

One thing that I have really been cross about when reading some GP threads is GPs merrily stating on one hand that there is a shortage of staff and then on the other hand talking about them only doing part time NHS jobs but also doing part time private. There was even one GP encouraging someone else who was training to either go private or emigrate as soon as qualified.

I agree. Also seen posts from GPs saying that they're over-worked so they're retiring early. So, basically, just increasing the burden on their ex-colleagues who'll now have to cover their work too!

The NHS is the best you can get at the price we currently pay. If you want a better NHS, which I do, you have to accept (and government had to implement) increased costs.

The same is true for social care. Putting the cost onto NI is unfair. Most pensioners, like me, don't pay NI, but we do pay tax, if we have an occupational pension as well, which I do. So an increase in tax seems fairer.

But I don't agree with the triple lock going for all pensioners. For those that only get the state pension, loosing the triple lock is awful. For those, like me, with an occupational pension, it's fair enough and i have no problem with it.

Also, while I do agree you should have to work for the NHS for a certain period of time it is a bit ridiculous to say you can’t resign. Some people get through the training and then stay less than two years in their qualified role for a variety of reasons. People can experience burnout in their first few years; the working conditions (especially with Covid) and being chronically short-staffed are not great.

Until 4 years ago I’d have sung the praises of the NHS but having lost someone to cancer, misdiagnosed by the GP, no real treatment offered by the NHS so they went to Europe and paid for treatment, which gave them a chance which the NHS was unwilling to give. Then losing a child to negligence of the NHS, Coroner threw the book at them, I feel it’s not fit for purpose.

There is no choice, if the nhs says no then you have no fall back, yes you can go private but in lots of cases you still end up using nhs services.

@JorahFriendZone

Also, while I do agree you should have to work for the NHS for a certain period of time it is a bit ridiculous to say you can’t resign. Some people get through the training and then stay less than two years in their qualified role for a variety of reasons. People can experience burnout in their first few years; the working conditions (especially with Covid) and being chronically short-staffed are not great.

In other professions where the training/exam costs are paid for, there are usually clauses in the contract requiring you to make repayment of some/all of the training costs according to how long you continue to work there. I.e. if you leave within 1 year, you pay all costs, then it tapers to no repayment if you stay for 5 years. That provides an "escape route" for people who really want to leave, but also recovers some of the costs of training.

@Lancrelady80, you might not consider £30 pm cheap, but would you consider it money well spent if it meant you could see a doctor of your choice at a time that was convenient? And if £30 pm were an adult charge, and care for your children remained free?

I'd be in favour of moving to a European style system - I grew up in the Dutch system, where most people pay but there is cover for long term chronic conditions. My dad had Parkinson's and under a US style system no-one would offer him cover, but he was covered and it was affordable.

Thing is, the Tories can't be trusted not to move us to a US style system, which is the worst of all worlds.

Stop PFI. Private companies are milking it - costs a lot more over time.
Other systems like Aus/NZ will require more payment overall I reckon.
Re-organisation will cost money to do - and I’m not convinced it will save money.

One positive about nhs is some sort of uniformity - yes there is still a postcode lottery - some gp surgeries are better than others; some hospitals are more efficient etc. But there is relative standardisation. NICE do in depth reviews of evidence. National registries. The structure is fairly similar across the country and can be beneficial for doing research - eg dexamethasone for covid.

Private policies are as low as £30p/m, (granted for young and healthy).
It is a very optimistic perspective.
Firstly, private care and the NHS care in the UK are provided by pretty much the same pool of doctors. Changing to private will change the cash flows, but won't change the problem at the country level.
Secondly, private policies don't cover a whole lot of conditions and treatments. Primary care, for example, is rarely covered. Childbirth and pregnancy. Pre-existing conditions. Routine check ups.
Thirdly, as you said yourself, it is for young and healthy, I.e. for someone who is unlikely to require medical care in the first place.

This is not to say that an element of co-payment / co-insurance would not change things for better in the existing system; only that it is quite a naive view.

How much is health insurance does anyone know? Like they have in America for instance, do they pay a set amount and then pay per Dr's appointment /hospital visit or is it all covered?
Here, with the NHS, especially at the moment it seems like you've got to battle to get seen for anything.

[quote Badbadbunny]**@RunnerDown* 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.*

Likewise, some doctors are happy to waste money. My OH has cancer and has a whole carrier bag of drugs every month. Several items are simply never used, i.e. anti sickness, anti diarrhoea, etc., but it's impossible to get them stopped - the consultant just says it's "too much effort" for her to change the prescription. But those are cheap drugs anyway, so probably not important. What IS important are the chemo drugs - he has a weekly one which costs over £1,000 per tablet and a daily one which costs around £300 per tablet. Both drugs were causing severe side effects so the consultant said to just take the weekly one twice a month and the daily one every second day. But she won't change the prescription, so he's getting a full months' worth of very expensive drugs but not using them all, they're just accumulating in the cupboard! He has already accumulated probably £20k of drugs he'll never use, the consultant won't stop prescribing them, and simply doesn't care. Until that kind of stupid waste is addressed, the NHS will never move forward.[/quote]
That’s very poor practice . It would take very little time for the Gp to be informed that the prescription was changed. And surely a letter should go to the GP every time there is a change in treatment so that they are aware of what’s happening. I am a retired consultant and that’s what I would expect.
I don’t think NHS staff are perfect . And maybe privatisation would introduce a management system that would be much more effective in ensuring that staff were providing excellent care standards . But it does again come down to what system is introduced and what their priorities are .

NC for this as never told this story before. I agree with some of the comments about efficiency (although the NHS is clearly underfunded in addition to this). When my DC were very little and I was working myself into exhaustion my mental health took a very sudden nose-dive and I started saying some odd things, behaving differently and generally my DH was extremely concerned. The GPs were absolutely amazing and referred me quickly to the community mental health team. By the time I had my first appointment with two nurses I was, quite frankly, extremely unwell seeing ligature points everywhere and delusional. They wanted to send me on my way after a brief chat back to GP care. I stood there in disbelief and sobbed "you can't leave me like this" and ONLY because I actually refused to leave the building did they get the psychiatrist to see me. He was in the next room doing admin work. I was prescribed antipsychotics within 10 minutes. Had I left (and not killed myself) I would have bounced back to GP care only to inevitably need to be referred to secondary or tertiary services again. It's not only inefficient but destroys lives.

@PinkTonic I do agree to a point and we have had some appointments that have been challenging to attend, but we were warned we would be bumped if we missed two in a row (and I agree that allegedly not all patients receive there appointments). I don't know if they actually enforce that bumping though, as to us, it was to risky to miss them.

Financial penalties is only one option, and as per the poster above it would need to be fair and be applied consistently. Calculating that algorithm is likely beyond the capacity (or willing) of our current government though!

In my experience its not just the services the NHS provides. It's also the peripheral elements that increase missed appointments such as not being able to find a car parking space (example the barriers being broken so all the office workers using the car park); or having outdated contact information. In our current circumstances we are seeing 2 different hospitals and a GP and none of them share the same records (even the nurses at one of these hospitals was frustrated at this).

Ah the drip drip drip making the UK accept the ditching of the NHS. I take it someone is getting paid for these monthly threads now?