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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To think the NHS is screwed

398 replies

jaspercabbage · 25/01/2022 08:42

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.

OP posts:
NumberTheory · 26/01/2022 01:59

Just wanted to correct the impression that aristotlesdeathray gives of the US being a privately funded system with the majority of people covered by privately funded health insurance.

Before covid, in 2019, the US Federal Government spent $1.2 Trillion on healthcare. That’s over $3,600 per capita. In that same year the UK government’s spending on health care was £177 Billion, that’s £2,641 per capita or $3,561 at today’s exchange rate.

So the US Federal Government actually spends more money per person on health care than the UK spends on the NHS. Gets less in return and it’s States and private citizens spend about twice that again and still get worse outcomes.

AutomaticMoon · 26/01/2022 02:16

France has 3.4 doctors per 1000 people and nhs has 3 doctors per 1000 people so I don’t understand how this can make such a tremendous difference in outcomes

Floraflower3 · 26/01/2022 02:17

[quote Floundery]@newstart1234 I am a former cancer patient married to an oncologist.

10 years ago I had to privately fund a drug (Avastin) which had been routinely available in Europe for years. It's still not routinely available here.

You can get lucky, get on a clinical trial and beat the odds (much more likely if you are in London) but the routine treatment of cancer in this country is - as a general rule - appalling.

And yes, delays in diagnosis caused by poor/non-existent primary care is part of the problem.[/quote]
I found a story similar to yours here www.google.co.uk/amp/s/inews.co.uk/news/real-life/woman-denied-cancer-drug-nhs-extend-her-life-not-available-388804/amp

Unfortunately NICE could not recommend it for everyone on a cost vs benefit basis from the evidence they reviewed. As it says in the article however, things may change once it comes off patent and can be made cheaper.

It had its indication for treatment of breast cancer removed in the US due to safety concerns I believe.

That article showed that private healthcare isn’t infallible as her insurance company would not fund the drug as they have to be able to provide a fair service for all…

Floraflower3 · 26/01/2022 02:30

Imnotafemistbut your tax covers benefits, state pension, etc plus a contribution for the NHS, you have no idea what you’re contributing.

halloweenie13 · 26/01/2022 03:19

I'm not going to say too much other than I work for a CCG which is soon to be a blended ICS and healthcare is going to begin to become slowly privatised in subtle ways from April. We simply cannot afford not too in order to sustain patient focused priority care which isn't being given currently due to the cuts from the conservative government.

VelvetChairGirl · 26/01/2022 07:25

US healthcare, £800 for insulin that costs £12 here, people reluctant to call an ambulance because it cost the same as buying a small car, conditions not covered by insurance, people having to have yard sales and fund raisers for treatment, biggest cause of bankruptcy in the USA, and as for all the companies providing health insurance who are they passing that cost on to? the customer and paying their staff less.

plus USA system consistently ranks worse then us in the WHO statistics, highest maternity deaths in the first world and to cap it off the entire system costs the USA tax payer far more then the UK system despite all the extra private insurance needed.

We can have a decent working socialist healthcare system if we want to, but like everything else in this country the tories dont want to, they are parasites who want to sell everything off to profit themselves at the expense of the people and the nations wealth, they always have done, thats why our utility bills are so expensive and why our trains and buses are over priced and crap.

private all ways puts profit first and looks constantly to increase that profit, they wont update equipment, they will priorities the most profitable things to treat and neglect other things and they will absolutely fleece us.

the USA healthcare system is widely considered one off the worst in the world, we dont want it here, what we need is the Tories out.

DdraigGoch · 26/01/2022 07:57

if you go for a private-led system then you also need to pay for an entire ecosystem of billing, pricing, and return on capital.
That was going on already until very recently, thanks to the Internal Market

Cheeseplantboots · 26/01/2022 08:18

Yanbu. A disabled relative went in for something simple in December. When we visited the ward was filthy, the toilets were filthy and his bed sheets were filthy. In 3 weeks he wasn’t bathed or showered. Just before Christmas he got pneumonia and died a week later. Death certificate states hospital acquired pneumonia.

Alexandra2001 · 26/01/2022 08:49

@AutomaticMoon

France has 3.4 doctors per 1000 people and nhs has 3 doctors per 1000 people so I don’t understand how this can make such a tremendous difference in outcomes
Its 2.8 vs 3.4, Germany has 4.1

For my village parish, thats one extra GP, or for Plymouth Derriford Hospital - 35 extra doctors.

On nurses, OECD36 avg is 8.8, uk has 7.8 Germany - 14 !

I'll leave you to look up beds per capita and scanners - even more shocking.

Imnotafemistbut · 26/01/2022 08:56

@Floraflower3

Imnotafemistbut your tax covers benefits, state pension, etc plus a contribution for the NHS, you have no idea what you’re contributing.
The NHS receives roughly 20% of total tax revenue. So yes, I do have a very clear idea of how much I'm paying towards it.

So no-one else is paying for my health care. I'm a net contributor to the NHS. I pay far more in tax than I get back

I wouldn't have to worry about the cost of expensive treatment if I could use that money to buy my own insurance, and I wouldn't have to worry about it being rationed either.

Imnotafemistbut · 26/01/2022 09:16

@VelvetChairGirl

US healthcare, £800 for insulin that costs £12 here, people reluctant to call an ambulance because it cost the same as buying a small car, conditions not covered by insurance, people having to have yard sales and fund raisers for treatment, biggest cause of bankruptcy in the USA, and as for all the companies providing health insurance who are they passing that cost on to? the customer and paying their staff less.

plus USA system consistently ranks worse then us in the WHO statistics, highest maternity deaths in the first world and to cap it off the entire system costs the USA tax payer far more then the UK system despite all the extra private insurance needed.

We can have a decent working socialist healthcare system if we want to, but like everything else in this country the tories dont want to, they are parasites who want to sell everything off to profit themselves at the expense of the people and the nations wealth, they always have done, thats why our utility bills are so expensive and why our trains and buses are over priced and crap.

private all ways puts profit first and looks constantly to increase that profit, they wont update equipment, they will priorities the most profitable things to treat and neglect other things and they will absolutely fleece us.

the USA healthcare system is widely considered one off the worst in the world, we dont want it here, what we need is the Tories out.

We can have a decent working socialist healthcare system if we want to

No we can't. You may, or may not have noticed that the NHS was established a long time ago, as a model of socialistic redistributionist ideology. The actual quality of people's experience was never a consideration. The NHS has never been "decent". That's why, despite the NHS being the first national, universal health care model, no other country has copied it, not even communist China.

The basis of the NHS is the Marxist presumption that you can somehow get more out than is put in, and that is absurd thinking of the first order. Of course as an individual you are free to indulge in the fantasy that you can, but in the real world, that is known as crackpot magical thinking that only appeals to those that feel entitled to have other people pay for them.

SkidmarkOnTheHeadboard · 26/01/2022 09:31

I think euthanasia should be an option.

Also we do have options for care provision. Used to be called long term care annuities, they may be called immediate needs annuities now

Fr0thandBubble · 26/01/2022 09:42

[quote AutomaticMoon]**@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.[/quote]
Oh for God’s sake. When did people stop taking responsibility for themselves and start being so pathetic?

Alexandra2001 · 26/01/2022 09:49

@Imnotafemistbut Complete rubbish, many countries have a fully tax funded healthcare system, also like ours a privatised element.

My Gran used to tell me what "healthcare" was like pre NHS... & people like you want to go back to that because you can afford the costs of private care...fuck everyone else... hence all the talk of Marxist crap.

VelvetChairGirl · 26/01/2022 10:04

@fillitup

We have to ask why are Doctors going off to Australia - it can't just be the weather - must be economic benefits too. The same as any well trained individuals.

I think unfortunately we will see this more & more. A brain drain from the UK for better quality of life.

Do what they do in kenya (i think its kenya) and make it mandatory to serve x amount of years in the health service before they can bugger off.altho which ever nation it is I am thinking of doesnt charge them for the education so its serve x years to pay off your training or get saddled with a massive bill
Imnotafemistbut · 26/01/2022 10:07

[quote onlychildhamster]@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.[/quote]
Yes, that's what is meant to happen, indeed there are rules and regs but they are not being followed! We do a roaring trade with Nigeria btw, I wonder how that mother of quins is getting along with her re - payments?

So who bills those who turn up from abroad to be treated? Who collects the money in the NHS?

My cousin is a GP and a west London A&E and she freely admits that they treat people all the time, with absolutely no idea as to whether or not they're entitled to "free" health care treatment. Her response is always : "it's not my job to be asking people for money". Don't believe me? Then perhaps you'd like to see this. A public group of NHS doctors freely admitting that they refuse to collect any of the information needed to charge foreign patients:

www.docsnotcops.co.uk/

VelvetChairGirl · 26/01/2022 10:17

@Floraflower3

Imnotafemistbut your tax covers benefits, state pension, etc plus a contribution for the NHS, you have no idea what you’re contributing.
And war and paying Seco 38billion for a shambles as well as going into the pockets of other tory mates
Imnotafemistbut · 26/01/2022 10:23

[quote Alexandra2001]@Imnotafemistbut Complete rubbish, many countries have a fully tax funded healthcare system, also like ours a privatised element.

My Gran used to tell me what "healthcare" was like pre NHS... & people like you want to go back to that because you can afford the costs of private care...fuck everyone else... hence all the talk of Marxist crap.[/quote]
No other country has copied the NHS model. Tell me another country where anyone, [and I do mean anyone], can just rock up to their nearest GP clinic and get an appointment for free? Without paying a small fee, without showing an identity card, without proof of health care insurance, or without valid proof of exemption?

Your foul language and your strawman point, [about my wanting us to go back to a pre-war situation], just shows your desperation. I'm advocating for basic public service combined with private insurance.
This is the only way forward that can result in a good quality service.

Tell me, what happens in Switzerland, France, Germany, Australia etc? Anyone who can afford the costs of private care gets it and ...fuck everyone else... ?

To use the modern vernacular, you might need to educate yourself.

onlychildhamster · 26/01/2022 10:23

@Imnotafemistbut that link was about the windrush generation and other vulnerable people being charged for healthcare. Sorry you are a xenophobe and I do not engage with xenophobes.

I hope you ask to see your doctor's papers before you get treated by the NHS. Fair is fair after all. My colleague was billed as she is a resident in the UK. Believe it or not, people from developed countries tend to have better healthcare than in the UK; my parents are now refusing to visit me in the UK as they don't want to be in a situation where they get covid and may require NHS healthcare. To them, NHS healthcare is akin to that of a third world country; its harsh and maybe not an accurate picture but they are comparing it to what they have and they would rather not take the risk. People from non developed countries with very few exceptions tend to require visas to visit the uk even for short term visits and would be required to take out private insurance for the duration of their stay. Do you actually think sick people from New Zealand or Australia or Taiwan or Singapore or Israel would want to come here to take advantage of NHS healthcare?Do they have a death wish?

I keep my healthcare insurance in my home country for a reason! I am in my 20s and healthy so fine with substandard NHS healthcare. Hopefully I stay healthy for many years. In my later infirm years, I may move back where I can get good healthcare or another European country where DH has right of residence. Right now, good healthcare is less of a priority, may look into private for maternity. Trust me when I say that for people from other countries, they would much rather not use the NHS, its more of a disadvantage of living in the UK that we have to put up with. I have spoken to second gen immigrants who agree; when they visit relatives overseas, they also get medical procedures done privately rather than rely on NHS.

Imnotafemistbut · 26/01/2022 10:29

Floraflower3 The subject under discussion is: how a better healthcare system can be brought about ?

There are probably other threads better suited for anti Tory rants.

Imnotafemistbut · 26/01/2022 10:38

[quote onlychildhamster]@Imnotafemistbut that link was about the windrush generation and other vulnerable people being charged for healthcare. Sorry you are a xenophobe and I do not engage with xenophobes.

I hope you ask to see your doctor's papers before you get treated by the NHS. Fair is fair after all. My colleague was billed as she is a resident in the UK. Believe it or not, people from developed countries tend to have better healthcare than in the UK; my parents are now refusing to visit me in the UK as they don't want to be in a situation where they get covid and may require NHS healthcare. To them, NHS healthcare is akin to that of a third world country; its harsh and maybe not an accurate picture but they are comparing it to what they have and they would rather not take the risk. People from non developed countries with very few exceptions tend to require visas to visit the uk even for short term visits and would be required to take out private insurance for the duration of their stay. Do you actually think sick people from New Zealand or Australia or Taiwan or Singapore or Israel would want to come here to take advantage of NHS healthcare?Do they have a death wish?

I keep my healthcare insurance in my home country for a reason! I am in my 20s and healthy so fine with substandard NHS healthcare. Hopefully I stay healthy for many years. In my later infirm years, I may move back where I can get good healthcare or another European country where DH has right of residence. Right now, good healthcare is less of a priority, may look into private for maternity. Trust me when I say that for people from other countries, they would much rather not use the NHS, its more of a disadvantage of living in the UK that we have to put up with. I have spoken to second gen immigrants who agree; when they visit relatives overseas, they also get medical procedures done privately rather than rely on NHS.[/quote]
But you are engaging with me. And the only person to bring up race is you.

I'm talking about people who who are not entitled to NHS care, receiving it and paying nothing for it. This includes foreign nationals. Indeed it can include British nationals living abroad. I'm talking about the fact that no one in the NHS sees it as their responsibility to recover these costs.

Non non-EEA visitors and migrants receiving care payment for which is not recoverable, runs at approx £300 million PA

fullfact.org/health/health-tourists-how-much-do-they-cost-and-who-pays/

VelvetChairGirl · 26/01/2022 10:47

*No we can't. You may, or may not have noticed that the NHS was established a long time ago, as a model of socialistic redistributionist ideology. The actual quality of people's experience was never a consideration. The NHS has never been "decent". That's why, despite the NHS being the first national, universal health care model, no other country has copied it, not even communist China.

The basis of the NHS is the Marxist presumption that you can somehow get more out than is put in, and that is absurd thinking of the first order. Of course as an individual you are free to indulge in the fantasy that you can, but in the real world, that is known as crackpot magical thinking that only appeals to those that feel entitled to have other people pay for them.*

care to look at the price of drugs to the NHS vs the USA?

half the services are already in private hands and the costs go up and up to fund them and the wealth of the nation goes down and down because the Tories sell off all the nations assets to their mates.

I am sure the national train operators in the EU are laughing at us, several of them own our rail lines now charging us exorbitant fares far above that which they are allowed to charge in their own countries, while the Tory government pays out more in rail subs then it cost run British Rail in the first place.

when you go private you go bust, companies priorities ever increasing profits and the shareholders meetings above providing a service.

get out more then you put in, no thats capitalists thinking short term always about money.

we built council housing to encourage good health, give people a decent place to live and you create healthier more capable soldiers and more productive workers who arent suffering so many health problems.

we opened hostels and half way houses to help prisoners rehabilitate into normal life and earn a keep, helped others to get a good grounding after being homeless etc.

we opened homes for the elderly to give them the care they needed in their old age and to reduce the burden on the families so they could continue to work and the hospitals whom would be stuck with them otherwise.

we created the NHS to help keep the population healthy and productive by treating their illnesses.

we created state nurseries so parents could work.

we introduced breakfast and after school clubs so parents could work.

we had free higher education so people could better themselves.

now thanks to decades of Tories.

over 86% of social housing has gone whats left has rents pegged to 60% of the average in the area so scumlords can under cut it.

the hostels and half way houses are gone.

the homes for the elderly are priced out of reach of the families.

The NHS is being systematically dismantled or sold off, take the mental health services for example, mostly gone there is sod all left, you can go to IAPTs (a private firm) to get 6 sessions of mindfulness for your depression that comes from downloading advice from the internet, or maybe the equally bad CBT also ripped straight off the internet, then after you 6, 30 min sessions over 6 weeks you can go straight back round the system again because 6 weeks isnt enough for anyone, or you can be forced if you have the money to step off the merry go round and pay hundreds for private health (from the same companies contracted by the NHS for substandard care).
maybe we can look at the disability aids services also privatised better get fundraising 2k your medical boots cost to make that you cant walk without.

we are now pricing parents out of being able to get nurseries as they cost more then people earn. the same applies to the school clubs, where you need to earn 3 hours of wage to cover 1 hour of club.

and no one is allowed to better themselves because even the OU costs 5k+

do you see where the problem is now? and why all the wealth of this country is getting funneled upwards, if you dont you have your head in the sand deliberately.

newstart1234 · 26/01/2022 10:49

But you don’t need to change the model of provision to cut fraudulent use. Just bring in ID cards - I’ve never understood the problem with them tbh. Any private insurance cover would require you to verify your identity to get care anyway so it’s not like you can avoid it either way.

AFAIK the nhs doesn’t check eligibility but that’s because of lack of resources not by design. It’s a flaw in the system (which can be fixed with a bit of effort) not with the system, like to poster above who discussed issues with cancer care waiting lists.

VelvetChairGirl · 26/01/2022 10:53

*Yes, that's what is meant to happen, indeed there are rules and regs but they are not being followed! We do a roaring trade with Nigeria btw, I wonder how that mother of quins is getting along with her re - payments?

So who bills those who turn up from abroad to be treated? Who collects the money in the NHS?

My cousin is a GP and a west London A&E and she freely admits that they treat people all the time, with absolutely no idea as to whether or not they're entitled to "free" health care treatment. Her response is always : "it's not my job to be asking people for money". Don't believe me? Then perhaps you'd like to see this. A public group of NHS doctors freely admitting that they refuse to collect any of the information needed to charge foreign patients:*

but how much do they cost compared to how much the government has saved taking highly skilled people from other countries, whom in many nations have actually been trained for free or at a vastly reduced amount compared to here

newstart1234 · 26/01/2022 10:54

Also, sorry to bore on about this but Denmark does provide free universal cover to anyone that turns up at the doctors office.