The situation with health in England

[Incandescent2]

AIBU to be quite pissed off and scared about the situation and thinking that we may need a rebellion?

It has been insanely difficult to get to a GP in the last 18 months (everyone in hospitals and emergency services have been busting their asses but GPs can't go to work?), we know that there is a huge build up of patients that have not been able to access treatments, it has been reported that it will take years to catch up, and now they are saying that the NHS is, shockingly, rationing chemo.

This is all freaking scary.
I was talking to my French friend and she just laughed saying that people in England are just too apathetic and that in France people would have been demonstrating a long time ago. She might have a point.

Why is it that other European countries seem to have health under control (in general, i'm not talking about the pandemic specifically) and we can't. Why are we not copying other European health systems that work better?

What we need is more hospitals, surgeries, and the doctors and nurses to staff them. Not a rebellion.

Unfortunately the public consistently vote for a political party who won't pay staff properly and who, thanks to their austerity policies, have closed no end of hospitals.

I don’t understand why the HGV drivers have stopped working, they should get back to work and stop being so lazy, everyone else has!

(Obviously sarcastic and trying to point out the ridiculous GP bashing that the media has fuelled. GPs are working hard, as are HGV drivers - there are just not enough to meet demand).

I agree it’s a real concern - the NHS is failing and realistic discussions and solutions are needed. Unfortunately I don’t think any political party will be brave enough.

Can only speak for germany as I used to live there. We paid health insurance and it's a much larger chunk than NI even though DH was earning very little at that time. Unemployed people get their health insurance paid for them but most people spend more money on healthcare.

More money means many hospitals esp in richer areas like Bavaria look like hotels! DH went to A & e in Berlin was seen within an hour. Never waited less than 4 hours in UK.

Almost all conceivable treatments are covered by government insurance and some cosmetic treatments by private healthcare. The hospital's know the insurance companies will pay out so have an incentive to take on more patients. Different to single payer healthcare where more patients can be a liability.

GPs have significantly more patient contacts per week now than pre pandemic. There are also fewer qualified GPs per patient.
Oh, and 75% of the Covid vaccination programme has been delivered through primary care.

There is absolutely a crisis in healthcare - huge mismatch between supply and demand in both primary and secondary care. It isn’t because “GPs can’t go to work”. That sort of narrative is really dangerous - GPs are facing increasing numbers of verbal and in physical assaults, perhaps driven by that media narrative and morale is lower than ever.

I’ll admit a bias - I am a GP doing 12 hour days with at least 40 contacts a day, mixture of face to face and remote. We’re trying really hard.

Lockheart

What we need is more hospitals, surgeries, and the doctors and nurses to staff them. Not a rebellion.

Unfortunately the public consistently vote for a political party who won't pay staff properly and who, thanks to their austerity policies, have closed no end of hospitals.

Yup. Couldn’t agree more. To have a well functioning NHS we need a well funded NHS. I’ve worked in the NHS all my life and consistently, in every department, the message is ‘do more, with less’ with a few small exceptions.

Tax the rich...

The Tories have been deliberately running the NHS into the ground for years because they want us to pay for healthcare. Unfortunately people keep voting for them.

Of course GPs are at work, they have worked throughout all the lockdowns.

There is a huge national shortage of doctors and nurses.

Instead of protesting, vote for a political party who will prioritise the issue.

@chinateapot

GPs have significantly more patient contacts per week now than pre pandemic. There are also fewer qualified GPs per patient. Oh, and 75% of the Covid vaccination programme has been delivered through primary care.

There is absolutely a crisis in healthcare - huge mismatch between supply and demand in both primary and secondary care. It isn’t because “GPs can’t go to work”. That sort of narrative is really dangerous - GPs are facing increasing numbers of verbal and in physical assaults, perhaps driven by that media narrative and morale is lower than ever.

I’ll admit a bias - I am a GP doing 12 hour days with at least 40 contacts a day, mixture of face to face and remote. We’re trying really hard.

You have my sympathy , friend worked as a GP 30+ years and walked out when she said she was asked to personally triage and assess and advise/treat 150 e consults in one shift - only ‘allowed’ to see a maximum of 16, the rest she was told had to be telephone only or wait til the next shift . Not allowed a break or to even use the loo (some aspects of workplace bullying) .

It is absolutely horrendous - she was physically ill with the stress of it . Absolutely awful .

It’s an utterly thankless job unfortunately - GPs seem to be seen as miracle workers and the answer to all and every problem and indeed they are not.

We need to promote self care, pharmacy, promote self referral to primary care mental health, CAHMS, weight loss services, sexual health, podiatry, physio, OT, SLT and away from this position of GP being expected to do absolutely everything .

Allowing people to make referrals directly rather than going via the GP.

Allowing a top up healthcare system where people are encouraged pay for private treatment through tax breaks.

Less middle management and “strategic” consultants who cost a fortune for ideas that aren’t feasible.

I’ve lived abroad and had private healthcare. For GP visits, I paid less than the cost of a UK prescription & for a overnight hospital stay for kidney stones, including 3 scans, paid £200. My work paid £200 per year for this.

The NHS is marvellous but other systems do work well too.

As already mentioned this is what you get for chronic underfunding of the health service over at least a decade. Where are the 5000 extra GPs the tories promised? Instead numbers have fallen by over 1500. I
Know that most GPs are working longer and harder than they ever have done - more patient contacts, more ill people waiting for secondary care/surgery, more work being dumped by secondary care, all with fewer staff and constant abuse from the papers and public. What do the government propose to do about this? It is a huge national issue, which seems to be taking a massive backseat.

I think you are BU, as it is not the GP's fault we are in this mess, but YANBU to suggest healthcare is in a mess. Again we blame each other, instead of the government for not funding the NHS properly and making healthcare an unattractive industry to work in due to this. I think one of the main things that attracts people to healthcare is the pension and I'm not sure many young people think they are even going to get one in old age at this rate, so that isn't exactly going to persuade them.

Yes I think the public need to do something other than post their discontent on websites like this (for the whole catalogue of their failings, not just healthcare) but I'm really not sure what the answer is as I don't think protesting works, we need to withdraw something they rely on. I actually think if we all say nothing online they might worry more!

There has been a lot of protesting in other European countries, so it's not all a bed of roses there either. The cost of living is high and there is still a lot of inequality too.

@MaverickDanger

Allowing people to make referrals directly rather than going via the GP.

Allowing a top up healthcare system where people are encouraged pay for private treatment through tax breaks.

Less middle management and “strategic” consultants who cost a fortune for ideas that aren’t feasible.

I’ve lived abroad and had private healthcare. For GP visits, I paid less than the cost of a UK prescription & for a overnight hospital stay for kidney stones, including 3 scans, paid £200. My work paid £200 per year for this.

The NHS is marvellous but other systems do work well too.

Agree with this.

Can I add though that people can self-refer to NHS or private services but they either don't know that they can, can't be arsed to (the GP will do it!) or don't want to pay for it.

People don't want to see a private podiatrist-they want an NHS referral so they don't have to pay, same for Dietitian, etc, etc. People would rather wait years for care rather than seek it privately and, although there are lots of people who can't pay for it, there are many, many that can but won't.

This gives the actual data

www.pulsetoday.co.uk/news/workload/non-vaccination-gp-appointments-increase-by-3-5-million-in-june/

We have 76 GP per 100,000 ppl. Portugal a considerably poorer country with a population of around 20 million has 244 per 100,000

I don’t think it’s a lack of staff that can be the NHS’s problem, nor is it the amount of money they get! Anyone who’s ever had any contact with them must surely realise that they’re just super inefficient from top to bottom?

I think it's a variety of factors: ever increasing demand, lack of money, inefficient use of money, disorganisation and inefficiency in how services are managed and run, lack of equipt, not enough beds, hospitals/clinics/Practices too small/not fit for purpose.

Lack of staff is a biggie though and likely the main reason services are reduced, cancelled.

@chinateapot I am probably also biased as I have had health issues and have suffered from misdiagnosis (yeah have a look at my breast on zoom and conclude it's nothing) and lack of access to a GP. But agreed, it's a problem with lack of GPs and too many patients.

Still: How do we make waves and communicate that we will support a government that commits to support the NHS and how do we communicate that we want them to look at Europe as an example (as opposed to the US where an illness can bankrupt you)

I understand that improvements will come via more taxes and I think that's ok as long as it's done the right way (more pressure on those that can afford it including me ect)

I work on a multi agency autism diagnosis team. Before covid we had managed to reduce the waiting list to less than 6 months. We were unable to do face to face assessments during first covid lockdown though we did what we could remotely or via two way mirrors etc, adapted our processes, etc. However school closures seem to have triggered a bunch of children who were apparently just about coping and not being referred to us for diagnosis who are now unable to attend school or not managing or highly anxious etc. These are all appropriate referrals and it's not simply a backlog of kids we couldn't see - though of course that compounds the issue.
We now have an 18 month waiting list and lose a huge amount of time dealing with parental complaints about the wait or pleas to be fast tracked. I have immense sympathy as I have an autistic child and waiting for over a year for the diagnostic process to begin would have been horrendous. But trust me, we are not sitting around twiddling our thumbs. We are working incredibly hard.

What damn wrote.

There are lots of other sustainable, well-functioning systems for healthcare all over the world. It’s not the NHS v the worst stereotypes of the US system and that therefore we must cling to the NHS at all costs.

It is ridiculous to say that there is no staff shortage in the NHS. And yes more money is needed to pay for more staff.

@SweetBabyCheeses99

I don’t think it’s a lack of staff that can be the NHS’s problem, nor is it the amount of money they get! Anyone who’s ever had any contact with them must surely realise that they’re just super inefficient from top to bottom?

That was a reply to this post.

Perhaps people need to start taking some personal responsibility. We are one of the fattest and unhealthiest nations in Europe, no wonder our health service can’t cope.