Meet the Other Phone. A phone that grows with your child.

Meet the Other Phone.
A phone that grows with your child.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To think our NHS isn't working?

144 replies

Nhs2022 · 07/07/2022 18:40

In many ways I can't fault the NHS, they saved my son and my mum's lives. They gave my aunt 4 years longer than first predicted with AML.

However, I also think there needs to be a conversation about the less life threatening and more mundane services of the NHS. The ones that won't kill you but significantly impact quality of life. These have absolutely fallen apart and the system isn't sustainable.

Why is it so wrong to say key aspects of the NHS are no longer fit for purpose and adults and children are being left miserable but alive?

Is there any sensible solution?

I think I'd happily go for a part and part system.

OP posts:
Justthisonceharold · 08/07/2022 07:40

That's entirely usual

DillonPanthersFNL · 08/07/2022 07:46

@Justthisonceharold I literally went to a conference last week and spoke to nurses and hcps from different countries and they all said the same thing. The entire world is struggling essentially. But go ahead tell me all about how awesome France is

Baggingarea · 08/07/2022 07:49

I do find some defensiveness in the service hinders progress and conversation about how to improve.

Wrongkindofovercoat · 08/07/2022 07:50

Also a lot of people talk about the NHS and compare it to other European systems, but there is very rarely any mention of how social care for the elderly is managed in those countries ? Does anyone have any insight into that type of care in another European country ?

This link shows the level of hospital beds in countries per 1,000 people, you do need to scroll down quite a way to see the results for the UK.

en.wikipedia.org/wiki/List_of_countries_by_hospital_beds

Hooplapop · 08/07/2022 07:50

mumda · 07/07/2022 21:09

en.wikipedia.org/wiki/List_of_largest_employers

It's number 8 on that list.

Could it work better? Yes. Does it need more staff (not agency or doctors running private work at the same time), yes.

Should we just keep throwing money at it like a bottomless pit? No.

Can we remove some of the levels of bureaucracy that make it bloated? Maybe.

Can we remove some of the expenses?
We probably can't touch the pensions
www.nhsbsa.nhs.uk/sites/default/files/2021-07/CCS001_CCS0521624740-001_NHS%20Pension%20Accounts%202020-21_Web%20Accessible.pdf

Or the Compensation payouts
lordslibrary.parliament.uk/negligence-in-the-nhs-liability-costs/#:~:text=Annual%20cash%20payments%20have%20quadrupled,are%20forecast%20to%20continue%20rising.

Consequently, the wage bill for the NHS makes up a substantial proportion of its budget. In 2019/20, the total cost of NHS staff was £56.1 billion which amounted to 46.6 per cent of the NHS budget.

For an individual at a major A&E department who receives more complex investigation and treatment the costs start at £359.
Can we reverse the trend of people going to the A&E instead of a GP? Perhaps if we triage people off to a GP surgery at the door.

A recent study estimated that, in 2020, the average 9-minute GP consultation costs £39.23. (How do they calculate that cost? Rents/Bills/reception staff etc?)

n June 2021 there were 123,727 doctors, 332,341 nursing staff (including midwives and health visitors) and 33,907 managers in the NHS out of a total workforce of 1.2 million
So there's 710,025 other staff involved in getting the NHS to work. (Cleaners, porters, reception? who else. I would like a better breakdown of that)

All NHS hospitals are managed by acute, mental health, specialist or community trusts
Sounds like management speak for "have more bosses than workers" to me.

Allied health professionals (physiotherapists, radiographers, paramedics, podiatrists etc)
Estates staff (cleaners, caterers, maintenance, porters and postage, reception)
Support and corporate staff - this is the one where everyone gets very opinionated about ‘managers’ but frankly you can’t run the NHS without training and development; recruitment; payroll; IT and systems; infection prevention and control; complaints, governance, HR, etc etc etc.

The idea that the NHS boils down to just doctors and nurses and the way some posters undervalue the support and corporate staff that are essential to allow those doctors and nurses to actually do their jobs safely and be paid is infuriating.

Wrongkindofovercoat · 08/07/2022 07:53

@Justthisonceharold how much do you pay for your health insurance in France ? does your employer pay towards it too and if so how much ?

Sidge · 08/07/2022 07:54

It’s brilliant at times and shit at times.

So many factors apply, it needs depoliticising and breaking down.

We need to stop pathologising normal human life and experiences.

We need to massively improve social care.

We need to take more responsibility for ourselves and our health.

We need to have some honest conversations about expectations and provision.

plugee · 08/07/2022 07:54

Go for it though! Pay for your own treatment

The NHS isn't free though. Systems like France are much better imo.

plugee · 08/07/2022 07:56

The fact is it's fucked, we haven't invested in it or anything for years. A huge demographic shift so the idea of free prescriptions at 60 will go. We all need to pay more tax, I say all because it cannot just be from income/workers as we don't have enough.

VincaBlue · 08/07/2022 07:56

cardibach · 07/07/2022 18:42

Anything that isn’t working is due to 12 years of neglect by Tories. It can work. It would with proper funding and leadership. We spend less than most as a % of GDP.

Agree

Hooplapop · 08/07/2022 08:00

Friendship101 · 08/07/2022 07:23

You’re absolutely right. I say that as an NHS nurse. Funding is dire. Yes wages account for a lot of the budget but that’s because NHS wages are low and so retention is poor so they use agency staff. I used to earn £14 an hour as a band 5 in theatres and could’ve earned £35 an hour on agency. 10 years ago when staffing wasn’t as bad.

There are so many managers I have no clue what they all do. What happened to just having a ward sister and a matron covering a directorate.

A&E is overwhelmed because of lack of GP services because there aren’t enough GP’s.

Unfortunately prioritising the life or death stuff is how it has to be in such a bad state.

A ward sister and matron covering a whole directorate? In the Trust I work for there are over 150 different services broken into two directorates. That equates to around 3,000 members of staff, split across sites over a 100 mile radius.

It’s easy to say there are too many managers and that they are the problem, when you’re only an expert in your specific area, service or ward. Having worked with many NHS managers over the last two years of pandemic I can assure everyone that they have worked just as hard, 7 days a week, 12+ hour shifts, for just as little recognition as everyone else. And I’m including both clinical and non-clinical ‘managers’ in that.

Justthisonceharold · 08/07/2022 08:10

DillonPanthersFNL · 08/07/2022 07:46

@Justthisonceharold I literally went to a conference last week and spoke to nurses and hcps from different countries and they all said the same thing. The entire world is struggling essentially. But go ahead tell me all about how awesome France is

The healthcare system in France is under pressure from covid, but it's nothing like the state of the NHS (I've worked in the NHS for 35 years). The system is not fundamentally broken in France.

Wrongkindofovercoat · 08/07/2022 08:16

Sorry just seen your update @Justthisonceharold , I thought you lived in France, not received treatment as a visitor.

user1497207191 · 08/07/2022 08:21

Ridingthegravytrain · 08/07/2022 07:37

I left the nhs 14 years ago. The tipping point for me was seeing one department doing totally unnecessary cosmetic work to use up its budget so it didn't lose it next year whilst critical care couldn't afford the life saving monitoring it needed to replace.

Pooling budgets in this scenario would make far more sense. Maybe things have changed now, but I doubt it

And my OH's oncologist and GP arguing between themselves (of course not directly, they use OH as the piggy in the middle), as to who's budget pays for blood tests, "routine" drugs, referrals for scans/MRIs, etc. They're a bloody nightmare.

Oncologist will do blood tests in her dept that she wants for the ongoing chemo treatment. But whenever there are any side effects, adverse blood test results (i.e. levels of iron, calcium etc etc), or OH reports suspicions of a lump (not directly connected with his current cancer), or other pains that aren't necessarily chemo related, she just refers him back to his GP for drugs, scan referrals, etc etc. GP just bats it back saying the oncologist should do it - via the receptionist of course, the GPs won't give a consultation (not even by phone), so it's basically a message back saying go back to oncologist.

Which is, of course, impossible because oncologist is uncontactable between routine appointments, so messages have to be left with her secretary which are never replied to until the next appt. There is, of course, the cancer nurses who are supposed to be the point of contact, but when you contact them, they just say it's something you need to talk to the oncologist about!

This happens every sodding time. It's been nearly 9 months since the oncologists blood test showed a vit D deficiency (he was already on the highest does over the counter Vit D supplement), so she told him she couldn't prescribe anything and to get the GP to do it. GP glibly refused (via receptionist message) and told him to get the oncologist to prescribe. Cue more phone calls saying oncologist told GP to do it. Then we get a message saying GP needs blood test to see the levels (apparently they can't access oncology blood test results and "it's too much hassle" to contact oncology to ask them to send over the blood test results!). So OH has to have a GP surgery blood test. Then results come back, showing low Vit D (what a surprise, we knew that), via receptionist message with the advice of "go to the chemist to get Vit D supplement). That's despite OH already telling them he'd been on the highest strength OTT supplement and oncologist said prescription needed. GP then sends message via receptionist to say that he needed to refer to the practice's "prescription consultant" to ask for the best prescription as he's also already on other vitamin prescriptions and also iron/calcium supplements. A couple of weeks later, receptionist calls with a message from the "prescription consultant" to suggest he goes to the chemist and gets a Vit D supplement!

It's like they're all bloody zombies, completely incapable of reading the bloody notes or listening to you. Always wanting to fob you off onto someone else.

Nhs2022 · 08/07/2022 08:24

user1497207191 · 08/07/2022 08:21

And my OH's oncologist and GP arguing between themselves (of course not directly, they use OH as the piggy in the middle), as to who's budget pays for blood tests, "routine" drugs, referrals for scans/MRIs, etc. They're a bloody nightmare.

Oncologist will do blood tests in her dept that she wants for the ongoing chemo treatment. But whenever there are any side effects, adverse blood test results (i.e. levels of iron, calcium etc etc), or OH reports suspicions of a lump (not directly connected with his current cancer), or other pains that aren't necessarily chemo related, she just refers him back to his GP for drugs, scan referrals, etc etc. GP just bats it back saying the oncologist should do it - via the receptionist of course, the GPs won't give a consultation (not even by phone), so it's basically a message back saying go back to oncologist.

Which is, of course, impossible because oncologist is uncontactable between routine appointments, so messages have to be left with her secretary which are never replied to until the next appt. There is, of course, the cancer nurses who are supposed to be the point of contact, but when you contact them, they just say it's something you need to talk to the oncologist about!

This happens every sodding time. It's been nearly 9 months since the oncologists blood test showed a vit D deficiency (he was already on the highest does over the counter Vit D supplement), so she told him she couldn't prescribe anything and to get the GP to do it. GP glibly refused (via receptionist message) and told him to get the oncologist to prescribe. Cue more phone calls saying oncologist told GP to do it. Then we get a message saying GP needs blood test to see the levels (apparently they can't access oncology blood test results and "it's too much hassle" to contact oncology to ask them to send over the blood test results!). So OH has to have a GP surgery blood test. Then results come back, showing low Vit D (what a surprise, we knew that), via receptionist message with the advice of "go to the chemist to get Vit D supplement). That's despite OH already telling them he'd been on the highest strength OTT supplement and oncologist said prescription needed. GP then sends message via receptionist to say that he needed to refer to the practice's "prescription consultant" to ask for the best prescription as he's also already on other vitamin prescriptions and also iron/calcium supplements. A couple of weeks later, receptionist calls with a message from the "prescription consultant" to suggest he goes to the chemist and gets a Vit D supplement!

It's like they're all bloody zombies, completely incapable of reading the bloody notes or listening to you. Always wanting to fob you off onto someone else.

Argh I've had that argument over who pays with DC1.

Prescribed a medicine by consultant in hospital A. Hospital A now happy it can be overseen closer to home. Argument has taken 3.5 months over whether GP or Hospital B or even Hospital A should be paying and organising it.

OP posts:
Stompythedinosaur · 08/07/2022 08:25

It isn't so much that thr NHS isn't fit for purpose, as that the government who chooses to underfund the NHS isn't fit for purpose.

I imagine anyone who feels they'd be happy for a "part and part" system isn't someone who would experience their loved ones being left suffering because they are rich enough to be allowed to have their human rights met.

The NHS isn't just healthcare, it is a statement about out country and the values we hold - that all lives are equally valid and important regardless of income.

LeuvenMan · 08/07/2022 08:29

The NHS has the same business model effectively (free care at the point of delivery) as when it was founded 70 years ago.
No other organisations surviving today have an unchanged model, and it desperately needs to evolve.
All politicians know this, but they also know if they change it, they won't get re elected and stay on the gravy train, hence it lurches from minor reform to reform and is a political football.
Germany has great healthcare. I was working there during the last elections and it hardly got a mention. (Insurance backed system with the public paying a contribution)

Wrongkindofovercoat · 08/07/2022 08:42

No other organisations surviving today have an unchanged model, and it desperately needs to evolve.

It has changed, it provides more to more people with less resources in so far as actual beds etc It is inextricbly linked to social care which is funded by local government, the amount of local council beds for long term/short term rehab/step down has reduced significantly and so people who would benefit from rehab are sent to private settings that do not have the staff ratio's or expertise to provide it, meaning poorer outcomes and a reduction in overall health for the poor patient.

Alexandra2001 · 08/07/2022 08:51

sst1234 · 07/07/2022 18:58

Would anyone care to explain what is ‘proper’ funding? This organization is spending 27% more this year compared with 2010. How much is enough? Or should we accept that it’s a bottomless pit?

Over 12 years, thats not really very much, medical inflation is higher than CPI and front line staff have taken a pay cut in real terms.

In the first 10 years, the NHS was funded at below historical averages.

We need to fund the NHS for the long term, remove tuition fees for AHP and nationalise Adult Social Care...

We have the lowest number of nurses/beds/doc's per capita then any EU country and this needs addressing.

Its very sad that we accept such low standards from our public services & not just NHS

Alexandra2001 · 08/07/2022 08:56

@LeuvenMan Not accurate. Germany, like all other EU countries uses a public funded model.... insurance, is a top up.
Of this health spending, 74 percent was publicly funded, and most of that spending (57% of total) went toward SHI. About 88 percent of the population receives primary coverage through sickness funds, and 11 percent through private insurance

Didiplanthis · 08/07/2022 08:58

I think its imploding... it was massively struggling and covid finished it. I'm a GP and am so sad about what has happened. We are still offering a good accessible face to face service and have done throughout as far as possible... but I cant access my own GP for me and my kids, but I know one of the GPs there and they are on their knees as doctors have left and they just can't recruit, there are no locums and so they literally have no one to see patients. Waiting lists at hospitals are now out of control, if we refer someone who needs specialist care its because they need more than we can do. But if they aren't getting seen for 9-12 months then we are having to do our best to keep them safe and stable way beyond our level of expertise.. this takes loads of time and appointments we can't offer to people who need the services we should and want to be offering, who then end up inappropriately in A+E, which can't cope. We get the biggest kicking as the front line, and because people quite reasonably don't understand what is going on behind the doors. I am going to work terrified every day, I am spinning so many plates and often way beyond what should be managed in primary care. I actively getting out... I'm planning on leaving very soon and have a NMW job lined up as i want to get far far away from medicine after 25 years. That's how bad it is and how much I need out 🤷‍♀️

Iwonder08 · 08/07/2022 09:09

They can triple the budget and it will still be crap. The problem is with the way it is managed and it can't be fixed with just money. Also it would be highly beneficial if people stop treating it like a holy cow. It is a service and it is substandard

HelloAllll · 08/07/2022 09:10

I was at a&e with dd last night. She was triaged within 5 minutes of arriving, havijg tests started within 30 minutes. The doctors were great at letting us know what was going on, and explained everything in much more depth than i would have expected. I honestly could not fault it one bit

Justthisonceharold · 08/07/2022 09:37

Wrongkindofovercoat · 08/07/2022 08:16

Sorry just seen your update @Justthisonceharold , I thought you lived in France, not received treatment as a visitor.

We live in France half the year, so not as visitors really. We self fund, then get reimbursed through the reciprocal agreement. A private consultant appointment costs €55.

In France the majority of care is state funded (between 70 - 100%). Complex illnesses eg cancer are fully funded. The gap for other conditions is funded by insurance, at least half of which is funded by employers if you work. If you are on a low income you pay nothing.

The GPs in our area tell us they love treating UK patients, because we're so grateful for how good the system is.

Wrongkindofovercoat · 08/07/2022 09:54

We live in France half the year, so not as visitors really. We self fund, then get reimbursed through the reciprocal agreement

So does that mean you don't have to pay for private health insurance in France ? You pay at point of contact and then claim it back when you are back in the UK ? Does the reciprical arrangement cover all your cost's or only treatment ?

Do you happen to know how elderly care/social care is managed in France ?