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.

Denmark also funds health care in the same way (though operated differently) so is in that way comparable. Danes just accept that late stage cancer is not treatable and they don’t throw money at it at all.

It doesn't matter what model is used and who pays for it - there is not enough trained staff to provide healthcare to the current population.

Trained staff takes years to train. Making healthcare private doesn't suddenly provide you with extra staff. It'll be decades in the making.

@aristotlesdeathray

YANBU

I'm at the point where I'd welcome a fully funded model like in the US

Having had hospital treatment in both the U.K. and US it's far superior In every way possible

The NHS we all knew and loved is dead, time we move on

What about people who die because they can't afford treatment ?

So what about cutting the treatment option for late stage cancer and pile all the resources into early diagnosis? These are the difficult questions that need discussion because the nhs can’t provide it all. It’s really difficult. I personally have benefitted from the danish system but like I said my friend has benefitted from the world class cancer research in the uk. They can’t do it all - the cancer outcomes are one of the worst out there.

Ultimately they just can’t do it all. The system can be changed (at least in theory) or we could have a national discussion about what can and can’t be prioritized.

@aristotlesdeathray

YANBU

I'm at the point where I'd welcome a fully funded model like in the US

Having had hospital treatment in both the U.K. and US it's far superior In every way possible

The NHS we all knew and loved is dead, time we move on

Sounds great if you like being charged $50 to hold your own newborn after birth. . I think there is also enough inequality already. It weird how the people who want a private care model the most are reluctant to go private and pay when they do need the care.

It just needs to be funded well. The lack of funding means some aspects of the NHS have not progressed or moved with the times, but you can't magic funding out if thin air, our government need to see a need for it and unfortunately they have just seen how much they can get out of the NHS with as little investment as possible. That is the issue.

If you fund preventative measures, such as early intervention care, less pressure builds on the system and you aren't dealing with a bigger strain later down the line through health issues that have not been addressed. Bed blocking and a lack of housing, social care funding and holistic care are also an issue.

It really isn't rocket science, but our government don't get it.

@Floundery

It's not the norm to receive "world class treatment" for cancer in the UK. You may be lucky enough to be treated aggressively on a clinical trial, but there are fixed clinical pathways for each type and they are currently overwhelmed.

To give you an example of the mendacity in cancer "care" in this country. Everyone agrees that diagnosis takes too long so targets of seeing patients within 21 days of diagnosis are set.

Patient A - waits 18 days and is squeezed in at the last minute.
Patient B - waits 21 days and there are no appointments.

Patient B is then sent to the bottom of the list because he's breached target. Patients C, D and E are seen first. It's an absolutely farcical system that largely ignores clinical need.

And the hordes of people being treated for piles and IBS via Zoom by their GP's will not get a good outcome no matter how "world class" their treatment is.

That's not how it works though. Not on any pathway, let alone a cancer pathway

If you breach target on any pathway you are NOT sent to the bottom of the list.

On a cancer pathway, you are would be tracked and expedited to ensure you are seen as soon as possible.

Yes there have been horrendous issues with treatment delays during the pandemic, but please don't make up a load of nonsense!

I don't think anyone is advocating that a sick person should go without healthcare for inability to pay. No one here is suggesting any such thing. The discussion (as I have read it for the last two hours) is about how we can do better, without beggaring the country.

The PP saying than Denmark doesn't fund radical or costly therapy for late stage cancer because all the data says it achieves very little speaks sense. It makes much more sense to treat cases that can be cured by catching them early. The new diagnostic centres (I think the nearest to me in the rural SW is in Taunton) should fast-track a few thousand people each year.

But with an estimated 800,000 elderly people living with dementias, plus existing chronic conditions like my DMIL whose quality of life has been sh*t for years a candid cool-headed discussion of the treatment options is needed. As it happens, she went into care just before the first lockdown and is much better than when she lived alone, but being looked after costs her (self-funded, from the sale of her home) £50k a year.

[quote Floundery]**@Elasmotherium* I am not* making anything up. Why would I? The point is that patients who have waited less time are prioritised without any consideration of clinical need.

It's batshit.[/quote]

But that's not true.

There are strict rules governing the management of waiting lists that mean that the situation you are describing (where a patient that breaches waiting list target is sent to the bottom of the list) categorically does not happen.

@jaspercabbage I'm due a baby in April and have opted for a c-section for this exact reason, I had haemorrhaged with my 2 previous induced births and want to know I am in a safe space with the people that know how to save my life, the thought of them being understaffed and haemorrhaging has kept me awake at night!

Talk to your midwife about it op!

@Elasmotherium, Floundery has explained that she is married to an oncologist, so I think you need to accept that it happens... if not in your area.

[quote XingMing]@Elasmotherium, Floundery has explained that she is married to an oncologist, so I think you need to accept that it happens... if not in your area.[/quote]

IF it's happening (and a consultant probably wouldn't be the person I would ask given that waiting list admin isn't their job) then people need to be hauled over the coals for not adhering to NHS national guidance.

There are previous examples of managers being fired for attempting to fudge waiting list figures.

[quote Floundery]@Elasmotherium I am also a former patient who had to fund her own drugs and follow-up because the NHS was so utterly inadequate. I am speaking from personal experience.

The irony is that I sued successfully and recovered well above the amount it would have cost to provide decent, timely treatment - if only anyone could have been bothered.[/quote]

That's awful to hear, but a different problem to the waiting list management issue that's being debated.

1 in 2 people get cancer though.
How do you fund a system that copes with that demand. Against a backdrop of accidents that happens to everyone of us and a dollop of ageing.

@Kendodd

Well what do people expect if they keep voting Tory? The Tories have always hated free at point of use NHS and did everything in the power to try to prevent it being set up in the first place.

No such thing exists. "Free at the point of use" is a euphemism for absurdly overpriced at the point it's paid for.

Having worked for the NHS for over 20 years in various positions it really pisses me off when people blame the government ( be that tory or Labour) for underfunding it. It was never ever designed to be used for the sheer amount of people who use it now. Its extremely badly managed and also top heavy with useless managers earning extortionate salaries. It's leaking money like water through a sieve, the sheer amount of wastage would make your average person sick! It doesn't matter how much money they throw at it because it will never be enough. We need a government that actually has the balls to rip it apart and completely rebuild it. I don't think it should be completely self funded but we should be charged a nominal fee for things such as GP visits and missing appointments without phoning to cancel, people would actually think twice about abusing the system then!

@OMG12

The NHS hasn’t been fit for purpose for years. Brexit/covid etc just shows how fucked it is.

We need to replace it with a different model (and no this doesn’t mean the U S one)

Absolutely spot on. Even if we were to mean the US system [ which it doesn't] I'll take that any day of the week over the shite we've got now. The money I pay through tax for the NHS would get me spectacular coverage in the US.

Here, it gets me an incompetent GP and jam packed hospitals that can't improve cancer survival rates regardless of how much money we sling at them. Unfortunately, we've trained our lefties that "universal" means the same thing as "free".

It’s not a model that is sustainable on what we pay towards the NHS and what we expect from the NHS (which is unrecognisable from 1948). The percentage of what is paid into the NHS has over doubled when people are living longer costs of treatments are vastly more expensive how can it be

We need to look at France and Germany and not be afraid to move on from the NHS

The waste is extortionate and it’s a political football that neither party will completely drop what is needed is a cross party team to look into ways of how we move on

Their is so much waste and so much dodging accountability it’s become cultural and needs to be broken

@wanttomarryamillionaire

Having worked for the NHS for over 20 years in various positions it really pisses me off when people blame the government ( be that tory or Labour) for underfunding it. It was never ever designed to be used for the sheer amount of people who use it now. Its extremely badly managed and also top heavy with useless managers earning extortionate salaries. It's leaking money like water through a sieve, the sheer amount of wastage would make your average person sick! It doesn't matter how much money they throw at it because it will never be enough. We need a government that actually has the balls to rip it apart and completely rebuild it. I don't think it should be completely self funded but we should be charged a nominal fee for things such as GP visits and missing appointments without phoning to cancel, people would actually think twice about abusing the system then!

Hear hear. Well said you.

The basis of the NHS is the Marxist presumption that you can somehow get more out than is put in, and that's crackpot magical thinking of the first order.

We could pour the nation's entire GDP into the NHS - annually. It will just gobble it up and hold out its hand for more. Because expecting everyone to receive exactly the same service from the NHS, and expecting that service to be high quality as if everyone had paid, is simply magical thinking. It can't be done.

The NHS is based on an irrational premise and is bound to fail.

@OhWhyNot

It’s not a model that is sustainable on what we pay towards the NHS and what we expect from the NHS (which is unrecognisable from 1948). The percentage of what is paid into the NHS has over doubled when people are living longer costs of treatments are vastly more expensive how can it be

We need to look at France and Germany and not be afraid to move on from the NHS

The waste is extortionate and it’s a political football that neither party will completely drop what is needed is a cross party team to look into ways of how we move on

Their is so much waste and so much dodging accountability it’s become cultural and needs to be broken

Too practical OhWhyNot.

Why be rational and reasonable and strive for better, when you can just generate hatred for the dreaded Tories?

Well the hatred for Tories on MN doesn’t reflect society hence why they have an 80 seat majority

It’s not a party issue it’s simply not sustainable