To think the NHS is screwed

[jaspercabbage]

Elderly relative had cancer related surgery before Christmas. The surgery went well but there has been no follow up appointment with an oncologist since. Recently they have taken ill again (clearly to do with the cancer) and have been to a&e four times in two weeks. They are treated for the sickness then sent on their way for the same thing to happen a few days later.

They were admitted again earlier in the week and have been stuck on a trolley, in a bay, in a&e for two nights now due to no beds in the hospital. This is an elderly person quite possibly now requiring end of life care and they can't even have their family with them. I just can't believe it's this bad.

I'm also due to have a baby later in the year, could be complications and to be honest I am shit scared about staff shortages and aftercare. What if something goes wrong in labour and there is nobody to deal with it at the time?

How can things have got to this point? The people are crying out for life going back to normal clearly haven't had to visit hospital lately. Although this is probably to do with a lot more than covid - underfunding, Brexit at so on.

Just a rant really but interested to hear other peoples thoughts.

And it isn't free - I do and have paid for private healthcare and I wish I could choose how the proportion of my taxes gets spent on healthcare. A more flexible model needs to be adopted.

Just giving it more money won't work unless something is done to address the colossal waste, and also the colossal cost of people missing appointments - claiming for paracetamol/cal pop because they can take the piss!

Even in the evil USA, vagrants and homeless people can access free care at the emergency room. It's rudimentary... no one is going to get access to the latest techniques, top doctors and the fanciest pharmaceuticals unless they are insured to the hilt, but for those with a decent (not-gold-plated) insurance package, it does just as well if not better than the NHS. HMO cover is paid for, like the NHS per patient who joins. The biggest difference is that the patient-insured can choose where to go. I lived just outside the second biggest city in the US, opposite medical alley, and I was young and healthy then. But when I had a problem with ear wax, I walked 20 yards across the road to the medical centre, asked the receptionist for an ENT specialist with a walk in nurse service and walked out, sorted and able to hear again, 15 minutes later for $20, to go to work 30 minutes late. This is the service most people need most of the time. If anything had been odd, the nurse would have said... you need to see an MD. In the NHS locally, it would have meant holding on the phone for 20 minutes to be told you could have an appointment in three weeks.

@AledsiPad

Covid didn't do this, and until that is acknowledged nothing will change. The NHS has been fucked for decades. It doesn't work. It needs urgent reform and funding. Covid is merely a convenient scapegoat.

Exactly this. Having been alive for 50 years I have never heard that the NHS is doing well. I have only ever known concern and worry over staffing, patient satisfaction and out comes. 50 years.

@XingMing "Even in the evil USA, vagrants and homeless people can access free care at the emergency room. "

You are deluded.

Even in Democrat states, there is a horrendous problem with homelessness. You don't have to be in a wealthy city like San Francisco long to see tent cities and witness homeless people with obvious healthcare issues walking the streets. And I'm taking barefoot with manky infected feet, nasty hacking coughs and not to mention those with serious mental health issues.

Why are you pretending these people have access to healthcare??

I think I probably paid cash, because it was easier than insurance. Even in 1984, there was a $50 deductible to claim on insurance. People did not visit the doctor without good reason.

@Imnotafemistbut non resident foreigners are charged for using the NHS. My colleague's mother was charged for using the NHS. When my parents visit me, they get travel health insurance because the NHS is not free for them. Immigrants pay for their healthcare using the surcharge which is £400 per year in addition to thousands in visa fees. The route to ILR is at least £7000-10,000 per person over a 5 year period.

The UK has had free at the point of use healthcare since the 1940s. dismantling the system would be very difficult. I have lived in 2 other countries and had health insurance in both. I still have private health insurance in the UK as well as health insurance in my home country. People spend a lot more in health insurance systems; that can be a good thing as outcomes are superior. But the question is- are British people willing to do so? The current system is actually quite cheap if you rarely get sick. In other countries, you have to spend quite a bit of money on health insurance even if you never get sick. In my home country, singapore,we even had health savings accounts which accounted for 8% of wages plus had health insurance on top of that and also a co-pay. It has been rated one of the best healthcare systems in the world with one of the lowest levels of government spending but yet there is still universal access. However it is a very different system which requires the individual to plan carefully- while health insurance is mandatory and will cover some healthcare costs, there is a cap for most procedures/treatments and you would have to pay the rest whether through the health savings or private savings (so the individual is expected to do some financial planning i.e. opt for more comprehensive insurance if private savings/health savings is lacking and vice versa). This cap is to prevent health insurance costs from spiralling; in European countries where everything is covered, the premiums are very high and government has to step in to make up the difference. I feel that UK would be more suited to the European approach; but at the same time, I don't think brits would want to pay the necessary high premiums.

San Francisco has horrendous and worsening social problems, as does LA. People flock there for the lifestyle. It's desperately expensive to live there, and the politicians are more concerned about identity politics than social provision, despite astronomically high taxation on companies and anyone earning decent money. That's why so many are moving to Texas where the social care network is threadbare. 15 years ago I saw more people living in their cars in California, in pretty coastal cities like Santa Barbara, than I've seen in the third world. The social problems of the US are running sores, I agree, but Vancouver isn't much better. And most of the vagrants and derelicts are addicts in their later stages. I really don't know how the system helps them, or if they can be helped.

My DD works in a stroke rehab unit, there are people waiting weeks to get funded care in the community, there are no carers and few CH places, her former part time employer is handing back contracts as soon as they can, even private funded home help has a 6 week wait.

Why? because no one wants to work for £10 ph and have to run their own car.
Its an easy fix but whilst the Tories can find billions for false business loans, they can't find the funds to pay staff.

the NHS is shite because it has been under funded pretty much for 50 years, 1 or 2 % than is required but over time..... now they will ensure another 70k staff will leave the NHS and double that in SC.

Covid has allowed the Cons to dismantle the NHS right before our eyes.

for those that say "insurance funded model" how does that work for millions with pre existing conditions?

@lightisnotwhite It was better in the 2000s when funding was double over historic averages.
Mum had a series of ops back then, by the late 2000s the NHS was as good as its ever been.

We have the lowest number of Doctors per capita in Europe - thats down to lack of cash.

[quote Alexandra2001]@lightisnotwhite It was better in the 2000s when funding was double over historic averages.
Mum had a series of ops back then, by the late 2000s the NHS was as good as its ever been.

We have the lowest number of Doctors per capita in Europe - thats down to lack of cash.[/quote]
Well in 2001 it was back to panic stations. After a flu crisis in previous years.

www.theguardian.com/politics/2001/oct/28/health.politicalnews

I'd rather have a system like in Germany or France.

I do not want one like the USA, it's barbaric. You can be charged for skin to skin contact with your own baby after birth. It's outrageous.

@tfresh @james85 Obesity is often caused by gut bacteria, alcoholism is a disease in itself, smoking is also an addiction which is a disease and many people are self medicating trauma with these as real treatment for trauma is non existent from the nhs.

@EllaVaNight I heard the French system is much more logical. Even the Russian healthcare doesn’t have these waiting times, it’s unheard of, even during my childhood in communism you could access treatment and care v quickly. You might have to ‘pay’ the dr a bag of coffee, but I’d prefer that at this point. I’ve not been able to access healthcare from nhs, left me disabled for a decade with an embedded UTI because the dipstick tests miss 50% of infections.

@Alexandra2001 I also remember reading years ago about how there were not enough spaces at medical school, this one British lady had to go to med school in Romania even though she had all the right grades, etc.

There should be more walk in clinics. This whole waiting a month for a simple appointment is absurd. But the nhs was already destroyed before covid, this should be recognised. And doctors think it’s persecution to have to see people face to face... it started with labour saying they didn’t have to do home visits and now they don’t even want to see you in person and have the cheek to claim it makes no difference to diagnosis... 🙄

@AutomaticMoon

There should be more walk in clinics. This whole waiting a month for a simple appointment is absurd. But the nhs was already destroyed before covid, this should be recognised. And doctors think it’s persecution to have to see people face to face... it started with labour saying they didn’t have to do home visits and now they don’t even want to see you in person and have the cheek to claim it makes no difference to diagnosis... 🙄

But it’s not the same everywhere is it? I’m NW .....I regularly needs GP appt....I phone at 8am ( admittedly I am often 12th in a queue)....but always get a telephone spot same day and a follow up face to face if needed....that’s my experience and that of all my local family.....there are several walk ins where I am....one in my local town....one in next town 5 miles away....and the next 2 in our nearest city 7 and 8 miles away ( different directions) and one of the city ones has a paediatric team ( although they will all see children) .....during Covid my adult son had to wait 3 hours at a walk in to be seen..but generally you are seen in 2 hours.....so not everywhere is the same

@lightisnotwhite since when did 2001 become the "late 2000's?"

@AutomaticMoon

There should be more walk in clinics. This whole waiting a month for a simple appointment is absurd. But the nhs was already destroyed before covid, this should be recognised. And doctors think it’s persecution to have to see people face to face... it started with labour saying they didn’t have to do home visits and now they don’t even want to see you in person and have the cheek to claim it makes no difference to diagnosis... 🙄

No it wasn't.

We have some of the lowest number of GPs in Europe, they cannot do home visits for people who can otherwise get to a surgery.

In 1972 5% of appointments were at home, by the 80s, under Thatcher, that figure was less than 1%..... by 2019 GPs voted to cut home visits even further....

Might be a good idea to look up who has been in power over this time period? no i'll tell you, from 1972 to present the Tories have been in for 33 of those 50 years.

So, before blaming Labour or the GP's look at who we have been voting into Government?

15 years ago I saw more people living in their cars in California, in pretty coastal cities like Santa Barbara, than I've seen in the third world

I'm quite well off and actually dream of living in a van. Sorry! Completely misses point of thread.
Also, it's all about choice. I have one and they don't.

@Onaloop

I think the German public health insurance model is good- you do pay more but the quality of care is a lot better. Altogether 14% of your earnings go to social security - if you are employed you pay 7% of your earnings towards it and your employer pays the other 7% (and the full 14% is a deductible expense if you are self employed)

The healthcare is better here, I've found appointments have been easily available throughout the pandemic and they've solved medical issues for me which were not addressed in the UK (I was given tablets for the symptoms in the UK, in Germany they found the root problem).

The payments also go towards maternity/paternity leave up to 14 months, sick leave etc.

Does social security cover benefits and pensions as well as NHS? That seems astonishingly low if it does.

It's hard to make comparisons because different countries have different ways of funding health, even when it's a state system. I think our NI payments are for pensions, benefits and now social care but iirc the NHS is funded from general taxation.

The bulk of employees are paying 12% NI, plus 13.8% paid by the employer, and 20% in income tax. That gives a total tax take on workers of 45.8%. I'd be intrigued what the comparable rates are in Germany.

One of my friends is officially resident in France, and she's a big fan of the French system. You pay a bit when you see a doctor, but she says everything else is free and you get seen straight away. She hasn't had anything other than a pretty minor ailment so far though, so she may not have an accurate picture of the true cost!

@XingMing

This has been an interesting discussion and I've particularly enjoyed reading your posts. Very perceptive and well written. I agree with almost everything you've said.

The NHS won't survive people are living a lot longer some people are now having dementia for 10 years before death. People are doing whatever they can to prevent having to prevent paying for care which is fair enough but it's not sustainable. It's either huge tax rises or some privatisation.
We are probably going to have to look at a semi private model like Australia , Germany or France.

The NHS won't survive people are living a lot longer some people are now having dementia for 10 years before death. People are doing whatever they can to prevent having to prevent paying for care which is fair enough but it's not sustainable.

Dementia is the most brutal and cruelest of illnesses. 30 years ago a family member was diagnosed with dementia, they lived for 10 years, 5 at home and 5 in a home.
The last 3 years of her life were awful, no clue who her family or DH was. Awful.

You'd be up in court for cruelty to animals if you let a dog suffer like she did.

Euthanasia would have been kinder than waiting for her body, to give up, her soul was long gone. I know it's a hard line to draw and at what point quality of life went in favour of quantity but somewhere it happened.

But it depends on the type of dementia too I know of others who still know family and have some quality of life even if they aren't capable of caring for themselves.

@crossstitchingnana

And don't get me started on NHS dentists. Mine has decided to go private. Suddenly my family has no dental care and no chance of getting on another's books.

My DH is an NHS dentist and if you saw the way the government treat them, you wouldn't be surprised they've gone private. Every year they have to work harder and get paid less. DH is currently earning £20k less than he did 10 years ago for twice the amount of work. He has also decided to make steps to go private. There's also a lot more to it than money. They get screwed over so much, you wouldn't believe.

@Lockdownbear DH's grandma suffered with dementia for over 10 years. She died in her sleep in a home during the pandemic..This was in Germany, and from what I know, they have care insurance in Germany which she paid into so even though they chose a very expensive care home near the family home, it amounted to 2000 euros a month, did not have to sell the family home or anything like that. I wonder why we don't have a scheme like that. I wasn't too impressed with the home but it does seem better than a lot of the homes that Mumsnet posters talk about. It was clean and she seem cared for even though there wasn't many staff.

DH's grandfather has had multiple operations during the pandemic. His area in Germany has so many old people that I feel like I am in a giant old age home whenever I visit. Yet I have never heard of any delays to the many medical procedures he needs, DH's mum is constantly flying over to help him out when he has another operation.

Yes we have an ageing population but so do other countries..the NHS delays are not normal even for an ageing population!