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.

@Bagamoyo1

I’ve worked in the NHS for over 30 years and I’m not sure that a fully state funded system is viable, given the changes in society and science.

Since the NHS began, so many changes have occurred.
People live longer.
The population has grown.
People have higher expectations.
Medical science has progressed.

Back in the 50s if you had a heart attack the doctor gave you morphine and the nurse held your hand and prayed with you. Now you get thousands of ££ of intensive treatment.
Conditions that used to be rapidly fatal can now be treated with tens of thousands of ££ drugs/surgery/ITU beds etc.
It’s fantastic that these developments have occurred, it really is. But this wasn’t what the NHS was banking on when it was first set up.

And it is massively abused. People now see NHS services in the same way that our ancestors saw neighbours/family. They turn to us for basic healthcare and lifestyle advice, when in the past they’d have had a cup of tea and a chat with grandma. Urgent 2-week-was cancer referrals aren’t enough now - they want to go to A&E for immediate service.

It’s basic economics really. If you open a cafe that only serves toast, and only at breakfast time, it’s pretty easy to buy enough bread to provide enough toast for everyone’s breakfast. But if you start providing lunch and dinner too, and a full range of food options, and have more people to feed - then you’ll need to spend a hell of a lot more money on ingredients, and you’ll need more people to do it. You can’t expect to run it on the same funds and the same model as the breakfast toast option.

I love the idea of the NHS, and having come from a background that couldn’t possibly afford private healthcare I’m supportive of the concept, but I’m not sure it can survive much longer in its current form.

This. All of this.

Poverty is driving health and prospects down, with people unable to afford nutritious food and decent, stable housing.

A&E is the only option for people who get shoved around between short term lets and can't register with GPs quickly enough.

I ❤ the NHS, but we are understaffed, with people taking us for granted and doing nothing to help themselves.

Anyone who says the NHS was better under Labour has completely forgotten PFIs.

Large numbers of hospital trusts are paying for the newly built hospitals and extortionate maintenance contracts.

Temporary staffing bills are massive - there are nurses and doctors out there, but it's better money working for agencies.

Everything about the NHS, from the inefficient procurement system, to the training of new medical staff to the maintenance of the hospitals, needs root and branch reform.

Denmark has a much smaller population also citizens have a CPR number which cuts out the opportunities for fraud.

It operates under two categories: Group 1, and Group 2, which is the equivalent of PPO, preferred provider organisation. So it's different to the model the NHS is based on.

@jaspetcabbage, how has shortage of hospital beds got to do with Brexit? It is clearly because of the pandemic when so many routine operations and appointments had to be postponed.

We seem incapable in this country of having a calm, adult conversation about our healthcare system. It's not a binary choice between the current NHS or the US system, we have the examples of our near neighbours France plus the likes of New Zealand and Scandinavia to look at.

I meant for the service user. The user experience and funding method is the same, maybe with the inconvenience of having to choose a provider for certain things.

people unable to afford nutritious food

Why does this myth keep being peddled? Food in general is cheap in this country (which is why farmers are struggling). Healthy food in particular is cheaper than junk, a single chocolate bar is more expensive than an entire bag of carrots for example. Convenience is the major factor in people's choices, combined with the addictive nature and marketing of the junk.

@Beowulfa

We seem incapable in this country of having a calm, adult conversation about our healthcare system. It's not a binary choice between the current NHS or the US system, we have the examples of our near neighbours France plus the likes of New Zealand and Scandinavia to look at.

I know right! That's the only defence there ever is of the useless NHS, that makes it look even vaguely desirable. "So, you want an American system do you?"

A continental style insurance based healthcare system, where there are small charges for GP appointments and fines for no shows is the only way forward in my opinion. The NHS is logically impossible, trying to get out more than is put in. It's the perpetual motion engine of healthcare.

@DdraigGoch

people unable to afford nutritious food

Why does this myth keep being peddled? Food in general is cheap in this country (which is why farmers are struggling). Healthy food in particular is cheaper than junk, a single chocolate bar is more expensive than an entire bag of carrots for example. Convenience is the major factor in people's choices, combined with the addictive nature and marketing of the junk.

I couldn't agree more. Equating poor priorities with poverty, is highly misleading.

DdraigGoch if you are really hungry and only have 50p would you really choose a bag of carrots over 2 packets of biscuits?

Thank you to the Welsh people who have responded to my question. As far as I am aware funding for Wales is slightly lower than Scotland and slightly higher than England. NI is the highest per capita.

I've been in my local GP's waiting room, sat next to a neighbour with athletes foot. If he was charged £20/25 for his visit he'd have gone to the chemist.

@stairway

DdraigGoch if you are really hungry and only have 50p would you really choose a bag of carrots over 2 packets of biscuits?

Are you talking about a homeless person living hand-to-mouth, or the head of a family?

Have you lived in the USA? It's an absolute nightmare unless you work for a major wealthy employer. We only had my exh's insurance covered so it was $420 a month for myself and the kids plus $15 a visit and $15 a prescription, we were lucky as some people have to pay 20% of the bill meaning cancer can bankrupt you

Imnotafemistbut I’m talking about those on a very low income and why historically and currently healthy food choices are not always made by those with little money to spend. I don’t think it’s just down to convenience at all.

@stairway

Imnotafemistbut I’m talking about those on a very low income and why historically and currently healthy food choices are not always made by those with little money to spend. I don’t think it’s just down to convenience at all.

"Very low income" or not, if you've access to cooking facilities, which the vast majority of people have, biscuits would be a very poor choice.

@gogohm

Have you lived in the USA? It's an absolute nightmare unless you work for a major wealthy employer. We only had my exh's insurance covered so it was $420 a month for myself and the kids plus $15 a visit and $15 a prescription, we were lucky as some people have to pay 20% of the bill meaning cancer can bankrupt you

Yes

And my view is the same

91% of people in America are covered by insurance for their medical costs

The treatment I received in the US was far superior than the NHS

Since coming back i now have to pay more than I did in the US for private health coverage here.

Most of us would welcome the NHS getting anywhere close to US outcomes. The service we get now is absolute crap.

I’ve found a lump in my breast.

Eventually I managed to see my GP who instead of referring me to the breast clinic she wants to see me again in 4 weeks said lump is now bigger.

Now I know it’s probably only a cyst but still I think I need to be seen….

My treatment over the past few years have been majorly disgusting…

@stairway and @Imnotafemistbut... The example of a person taking up a GP appointment slot for athlete's foot is a good one. Far too many people don't go to the pharmacist first to be told what simple over the counter remedy would fix what ails them, because if you are exempt (over 60 or under 16/18 or unemployed) you'd get a free prescription.

A simple reform would be to ban prescriptions of OTC medicines by the NHS. I had a private prescription a few weeks for a skin condition (not for an OTC product) and it was £2 cheaper than the cost of an NHS prescription. Surely, it is bonkers.

@gogohm, but you can offset the cost of your private medical insurance against your income tax in the US when you file your 1080 in April. Or has that changed? You can also claim back for an uninsured loss.

@ChristmasTreeBee

I’ve found a lump in my breast.

Eventually I managed to see my GP who instead of referring me to the breast clinic she wants to see me again in 4 weeks said lump is now bigger.

Now I know it’s probably only a cyst but still I think I need to be seen….

My treatment over the past few years have been majorly disgusting…

Oh lord that's terrible. Unfortunately you're story is a common one. My family has encountered chicken pox mis-diagnosed as allergy, pneumonia completely missed, diabetes completely missed, and cancer mis-diagnosed as stress.

"Our" NHS is a cesspool of incompetents who would n't survive in a system that provided economic consequences for failure. But what can we expect from an organisation that can just shrug off premature deaths, do a few Tik Tok dance routines and demand more money?

[quote XingMing]**@stairway* and @Imnotafemistbut*... The example of a person taking up a GP appointment slot for athlete's foot is a good one. Far too many people don't go to the pharmacist first to be told what simple over the counter remedy would fix what ails them, because if you are exempt (over 60 or under 16/18 or unemployed) you'd get a free prescription.

A simple reform would be to ban prescriptions of OTC medicines by the NHS. I had a private prescription a few weeks for a skin condition (not for an OTC product) and it was £2 cheaper than the cost of an NHS prescription. Surely, it is bonkers.

@gogohm, but you can offset the cost of your private medical insurance against your income tax in the US when you file your 1080 in April. Or has that changed? You can also claim back for an uninsured loss.[/quote]
True. All good points XingMing.

Between walk-in clinics and use of A&E, we get about the same health "care" from the NHS as is provided to a typical vagrant in the US -
but we pay thousands for it through tax. Time to privatise it, let people buy good health care that they need.

@Floundery

I agree *@Imnotafemistbut*

Everyone knows the downside of the US system, but the upside is that it also provides the best care available anywhere.

If everyone had to self-insure (and this is not my preferred alternative) there would at least be a market for full private coverage. At the moment it’s skewed because the private providers use the MHS as a “last resort” when things get too costly.

Whatever happens, we’re going to need WAY more hcp’s and doctors.

Sure, there are always problems. I've relatives in France that are constantly complaining about health care there. They'd sooner it got half as good as it is now, than exchange it for the useless NHS though.

The NHS is providing shit service, our cancer survival rates are dismal, and we deserve better than have some fantasists telling us that stuffing another 20/30 billion PA down its greedy neck, will somehow make it efficient.

The NHS is massively inefficient. It is not underfunded, but it is extremely wasteful. It does not need more money, it needs to make better use of the money it has.

Just imagine how much more money the NHS could have if there were no tax avoidance schemes.