The NHS in comparison to Spain is unfit for purpose . . .

[Lineofconcepcion]

My partner was taken ill a couple of weeks ago, we're on an extended holiday to Spain and Portugal. We went to the nearest public hospital in Oveido. Within 5 minutes he was triaged, examined within half an hour, given iv painkillers within 40 minutes, seen by an a & e doctor within the hour. Diagnosed, put on an iv drip for antibiotics within another half hour. Completed this, had the cannula removed, discharged with a prescription all within 2 hours. I was allowed with him during the whole of the treatment/examination. Treated amazingly well, faultless, lovely staff, who uploaded Google translate, to communicate better. All this on a GHIC card.

If it had been the NHS we would have waited 12 hours to be seen, denied my entry to be with him and generally be pissed off by the lack of care.

Where has it all gone so wrong?

For anyone who wishes to understand what happens in the NHS and the way whistle blowers are treated, they need to read "Whistle in the Wind" by respected surgeon Peter Duffy who was hounded out by the management of the Lancaster infirmary! They'd rather get rid of him rather than tackling his colleagues who were responsible for patient harm and in some cases, their deaths.

@Kione

"my daughter's father and I kept getting angry letters and phone calls because my daughter needed some medical care after birth and they wanted to charge us €1000s for it, which we didn’t have... (we were legal residents, paid taxes, etc). Maybe I just did healthcare in Spain wrong?"

I think you might have, I don't know how it works for non nationals, but nationals don't have to spend a penny. Never, ever, get a medical bill.

Even some medication is fully covered.

Frankly I don't know why we got a medical bill. I had a Tarjeta Sanitaria, I had never had a problem getting medical treatment for myself. But the treatment for my newborn daughter caused so many problems. My ex told me he got a phone call saying that if she came to the hospital they would refuse to treat her because she didn't have the right documents, and yet whenever I actually took her to appointments people seemed fine accepting the documents we had for her??

Because too many people go to A&E with colds and illnesses that they don't need to. Hence holding everybody else up. Try encouraging people arouns you not to go to A&E if it isn't an accident or emergency. Then you might see it improve. You also don't have to pay for it. Let's be grateful. Imagine paying for cancer care. It's not perfect but it's amazing in my eyes what it does do for us when we need it!

Around*

@user1497207191

For anyone who wishes to understand what happens in the NHS and the way whistle blowers are treated, they need to read "Whistle in the Wind" by respected surgeon Peter Duffy who was hounded out by the management of the Lancaster infirmary! They'd rather get rid of him rather than tackling his colleagues who were responsible for patient harm and in some cases, their deaths.

This is not the case in the trust I work at. They encourage people to alert when things are going wrong and they use it as an opportunity to learn.

@Opaljewel

Because too many people go to A&E with colds and illnesses that they don't need to. Hence holding everybody else up. Try encouraging people arouns you not to go to A&E if it isn't an accident or emergency. Then you might see it improve. You also don't have to pay for it. Let's be grateful. Imagine paying for cancer care. It's not perfect but it's amazing in my eyes what it does do for us when we need it!

It’s true I used to have a high level voluntary position at our local NHS trust We commissioned a study on how many people who attended A&E over a weekend genuinely needed to be there - it was around 20% So not based on anyone’s opinion of who looked ill etc but based on clinical assessment In many cases they were there because they had been let down by other services such as GPs, MH support etc. A lot were entitled arseholes, although we didn’t actually have a category on the study for that

@Opaljewel

Because too many people go to A&E with colds and illnesses that they don't need to. Hence holding everybody else up. Try encouraging people arouns you not to go to A&E if it isn't an accident or emergency. Then you might see it improve. You also don't have to pay for it. Let's be grateful. Imagine paying for cancer care. It's not perfect but it's amazing in my eyes what it does do for us when we need it!

This is hard though. We have had a situation this weekend with something which didn’t need A&E but did need prompt treatment. After waiting 8 hours for a call back on Saturday from 111 they told us to try painkillers or ‘go to A&E if worried’ , by Sunday morning he had high temperature , pain and was vomiting but honestly not A&E type emergency. Called 111 again, 50 minutes to answer , then call back from nurse an hour later ( who was lovely but said needed Doctor call back) then waited another hour to speak to Dr who prescribed antibiotics , he still hasn’t actually been seen by anyone, his advice ‘go to A&E if you are worried’. Wait time in A&E currently 6 hours . No walk in clinics in this area so it’s phone or A&E at the weekends. Anecdotally weekends the paeds A&E is heaving with things that only need a GP or nurse practitioner but there is nothing but .

LaMagdalena maybe someone was trying to scam you or you got referred to a private hospital?

The thing with A&E though is that it's also used for admissions when there's no alternative admission pathway. I was once referred by my GP for an urgent abdominal ultrasound scan to the maternity unit (I wasn't pregnant and it was abdominal rather than gynae but GP said it was the only way to get a scan as only the maternity unit had a spare scan appointment!). GP told me I had to present at A&E and they'd know what I was there for and direct me to the maternity dept. In fact, I waited 4 hours in A&E as they insisted on normal triage, triage nurse couldn't see anything on file to confirm why I was there, and they claimed they had to do all the normal "opps", i.e. BP, heart scan, blood tests, etc., which all took time, only for the consultant to appear, query why I was there, and after again telling them what the GP said (must have been 4 or 5 times by then to different people), they finally told me to go to maternity. When I got to maternity, I was down as an admission rather than a scan only, so a maternity doctor had to take all my medical history, examined me, etc etc, even showed me to my "bed" and did a formal admission. Only after all that had been done, could I go for the actual scan itself which took about 10 minutes, and then I had to go back to the ward to be formally "discharged" which took another couple of hours after waiting for the doctor to sign off the discharge paperwork. So I was there best part of a full day, took up the time of several different nurses and doctors who filled in a lot of paperwork, all for a simple ultrasound scan. Then they wonder why they spend so much money and the staff are always too busy. They need to find quicker/more efficient ways of doing the simple stuff!

@Kione

LaMagdalena maybe someone was trying to scam you or you got referred to a private hospital?

It definitely wasn't a private hospital, and I still have one of the letters somewhere, I don't believe it was a scam. I don't know, I think the red tape got mixed up somewhere.

[quote Blossomtoes]@Fairyliz, Spain spends 8.9% of GDP on health. The UK spends 7.2%.[/quote]
According to wikipedia, in 2019, spending per person in Spain was $3,616 USD compared to $4,653 in the UK.

[quote Blossomtoes]@Fairyliz, Spain spends 8.9% of GDP on health. The UK spends 7.2%.[/quote]
But Spain's "per capita" GDP is a lot less than the UK's. I.e. Spain's financial productivity per person is less than the UK. In actual "pound note" terms, Spain spends less per person than the UK.

It's one of those statistically anomalies, where if the average UK person become less financially productive, we'd spend a bigger proportion of GDP on healthcare, even if we spent the same amount in pound note terms, so GDP isn't really a good indicator of spending.

@LaMagdalena How strange. Especially because minors in Spain have a right to health care whatever their immigration status. An illegal immigrant from Afghanistan, if a minor, has a right to be seen and treated and not just for emergency care, either.
I do know someone who swore blind she went to hospital in Spain and had to pay for her treatment and nobody would accept her EHIC card. Turns out she went to a private hospital, so no, the cards they accept there are VISA and Mastercard mate. (Not saying this is your case at all, by the way).
Someone wondered why so many Spanish nurses had had to move to Britain for work. Mainly because they are on short term contracts if they don´t have a public space earned through examination. So they have one short term contract after another for years. Starting a family and getting a mortgage is pretty tough like this.
Also someone wondered why do UK pensioners return to Britain for treatment if the Spanish system is ok. I can answer that one. Because many were not legal residents of Spain. My mom´s British partner was officially registered resident in Britain so as not to lose the extras on his pensions and stuff, so he was only entitled to emergency care in Spain, as officially a tourist. He had an inkling something was wrong non emergency but required longer treatment and has had to return to England. I know many in this situation. My mum´s best British friend is officially registered in Spain and gets all healthcare in Spain.

Yes, the contracts for doctors and nurses in Spain are totally shit. Nurses sometimes have contracts for just a couple of days. It's mad. So a lot of them went to the uk as the employment conditions were much better.

@OrangeBlossomsinthesun

Yes, the contracts for doctors and nurses in Spain are totally shit. Nurses sometimes have contracts for just a couple of days. It's mad. So a lot of them went to the uk as the employment conditions were much better.

There seems to be a staff merry go round. The NHS brings in foreign workers to replace the NHS workers who've left to move abroad. So why don't, say, the Spanish nurses/doctors go to work where the NHS nurses/doctors have left to go to? Are there different standards/qualifications in different countries which mean, say, a Spanish (or say Philipino) nurse can come and work for the UK NHS but wouldn't be able to get a job in say Canada or Australia?

Also to build up experience, because they will only employ staff with experience, to even get one of those shitty contracts.

I don't know about Filipinos but Spaniards historically needed visas and sponsorship for Australia and Canada, whilst it was a lot easier to work in the UK.
I am not sure how it is now post Brexit.

I too am very surprised by people working within the profession who choose to keep quiet about what is happening. In my profession, law, I am thoroughly ashamed by what this government has done to criminal legal aid and other social welfare legal aid, and the effect this has had on access to justice and resulting in the courts being not fit for purpose.

Another lawyer with similar concerns here. It brings into issue ethics. And permitting the practice of NHS employees to run a private practice, often using NHS facilities, one day per week, is such an obvious conflict of interest. I cannot imagine it being allowed in any other profession. You do have to question whether some consultants are inclined to refuse surgery required to maintain quality of life to some patients in the knowledge that they will pay to go private.

The other problem that the NHS causes is that it restricts the private sector in the UK, so that its less competitive and therefore offers less value to people and there are less treatments available. PP in the UK is also dependant on an NHS referral in the first place.

Not to mention how difficult it is to sue the NHS because its so difficult to prove that another doctor within the NHS wouldn't have offered similar negligent by any other measure treatment.

@Opaljewel

Because too many people go to A&E with colds and illnesses that they don't need to. Hence holding everybody else up. Try encouraging people arouns you not to go to A&E if it isn't an accident or emergency. Then you might see it improve. You also don't have to pay for it. Let's be grateful. Imagine paying for cancer care. It's not perfect but it's amazing in my eyes what it does do for us when we need it!

When my kids were little, their GP here in Germany told me that while he was quite impressed with how often I correctly called it as to whether the kids needed medical intervention or not, I should probably bring them in more often, as social services here might see it as a sign of neglect that I was only bringing then in when they were really sick. Their attitude is that medical professionals should be doing the triaging, not patients. So I think that "A&E time wasters" are unlikely to be the reason for the long waiting times in British A&Es compared to the continent.

@SucculentChalice

I too am very surprised by people working within the profession who choose to keep quiet about what is happening. In my profession, law, I am thoroughly ashamed by what this government has done to criminal legal aid and other social welfare legal aid, and the effect this has had on access to justice and resulting in the courts being not fit for purpose.

Another lawyer with similar concerns here. It brings into issue ethics. And permitting the practice of NHS employees to run a private practice, often using NHS facilities, one day per week, is such an obvious conflict of interest. I cannot imagine it being allowed in any other profession. You do have to question whether some consultants are inclined to refuse surgery required to maintain quality of life to some patients in the knowledge that they will pay to go private.

The other problem that the NHS causes is that it restricts the private sector in the UK, so that its less competitive and therefore offers less value to people and there are less treatments available. PP in the UK is also dependant on an NHS referral in the first place.

Not to mention how difficult it is to sue the NHS because its so difficult to prove that another doctor within the NHS wouldn't have offered similar negligent by any other measure treatment.

I agree with all that. Same with dentists who pick & choose which of their patients get NHS treatment. My sister works at a "private" practice who puts their pregnant "private" patients back on the NHS register so they can get the free treatment whilst they're eligible and then kicks them off back to private once the NHS treatment period expires. It's like having the best of both Worlds and really shouldn't be allowed.

I'm not trying to shut down a conversation I'm saying that it needs to be told to the only people that actually have power to change things. The NHS was run into the ground for years, then something like covid comes along and there was absolutely no capacity for it and whole thing crumbled. The clapping for the staff was offensive, and now that we are pretending covid doesn't exist anymore lots and lots of staff are ill and off sick, burned out, tired and there's no end in sight and instead of standing up for our health services and demanding better from the governments use of our money (PPE contracts, fraudulent bounce back loans, another mps pay rise, golden wallpaper, lunch and booze on expenses) we are blaming "waste" which as of yet I still haven't seen a definition. Lots of talk about managers and pointless staff but why would an organization that has 8 million employees not have a a lot of managers? NHS staff can't even park at their own place of work.

If you can afford to go private then go, but a lot of people cannot from some of the threads on here.
Genuinely, write to your MP, how many of them have shares in the private hospitals that are booming right now.

We have less GPs,Hospital Drs nurses and carers per patient than most other countries and then people wonder why there are waits.
Outcomes, however inost area are comparable.
If community care was better funded and staffed we could reduce many,many hospital visits.
But without investment in this isn't going to happen.
I've been a nurse now for 42 years and this is the worse it has ever been with moral at rock bottom
And canjust ask all of you to not criticise staff and care unless you took the time to write an official letter of complaint which is all management will respond to.

@BambinaJAS

Oviedo?

Thats pretty out there in Asturias so you won't have much congestion.

Very different situation in more urban areas with a higher % of sicker and older folks.

I live in a big densely populated city in Spain. When I broke my finger (not much pain, minor dislocation) I was in an out of A&E in the main hospital in 90 mins.

The NHS is set up to have primary care as gatekeepers, but don't fund it properly so you can't even get down the path, never mind through the gate.

A&E isn't funded properly, because it isn't meant to be so busy. (According to a team of useless management consultants I had an argument with many years ago). However it is overrun with people not receiving enough support from the places they should.

Mental Health Services are underfunded because they are an even lower priority than the other bits of the health service.

Social Care isn't anywhere near the priority list.

And all politicians ever want to do is reorganise it and move the deckchairs.

I don't pretend to have the answers, but the issues in accessing primary care will only get worse unless they can stop GPs leaving. Cynically, I honestly see this becoming a lever to introduce privatised GP care.