To think our NHS isn't working?

[Nhs2022]

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.

Why do you think privatisation is the answer?

Countries with part private systems have almost double the amount of hospital beds and lots more staff than we do. They spend more than we do.

And they can't cope either. Health care is struggling in every country regardless of what the system looks like.

The answer isn't privatisation, although tbh I'd accept that if it meant people actually started understanding the real value of health care. If it meant they stopped expecting the nhs to cure their every ill for a few quid.

If you want an excellent standard of health care for every single possible condition and illness (on top of social and elderly care) You're going to have to pay for it. A lot more than we do now.

I work in the nhs in a cancer relayed department and we do get many compliments on our service. As a patient I do find it really difficult to get GP to refer and if they do it's often rejected anyway. It's definitely worse since covid. At least the urgent care and cancer care is good but it's a shame everything else is struggling. It sounds to me like the hospitals are extra busy since covid as anyone putting off problems is now wanting to sort it out so bug demand increase, and also short staffed as nobody wants to work in the nhs anymore as its low pay and tough conditions.
It's it a money pit? Well new technology leads ro better outcomes but is expensive. Staff want more pay so that's taking up money (and they should get more pay I think). Patients are getting more difficult - more comprbidities as more are overweight and obese. So it'll probably always be a bit of a money pit but underfunding it is causing bigger problems than ever

Good grief there are double the number of GP's in France compared to the number in the UK. Considering the populations are of a similar size, its hardly suprising its easier to get seen !

Isn’t that the point though, that we need more GPs as ours are leaving and haemorrhaging as they can’t cope any more with the expectations and not seeing their families working longer and longer hours?

I wonder how GP's are funded in France ? Is the same breadth of services also provided by them or is it shared across other specialists such as paediatricians etc ?

Here GP practices are private businesses that are commissioned by the NHS to provide certain core services, then there are additional income streams for providing other services/meeting certain health related targets. Why are there so few GP's here and why are so many choosing to leave now ?

Completely agree with @RedCardigan . It's the knock on effect of care being understaffed and underfunded. In some hospitals a 5th of patients are long stay patients awaiting çare in the community- whether a nursing home or just someone to provide regular care in their own home. Hospital is a terrible place for older people who do not need to be there- for someone with dementia for example, they are in a noisy, bright, unfamiliar environment with none of the enrichment activities you might get in a home. Wards are crowded and managing needs they are not trained for, A&E are unable to admit people into full wards and so cannot take people off ambulances, ambulances are queuing outside for hours and 999 calls are not being answered.

People don't want to work in care for what the government funds. Until that's fixed the NHS will continue to crumple under an unbearable weight.

This is exactly what the tories want you to think.

We have an ageing population with treatment for conditions that would have killed patients a few years back and that costs money.

Yes it needs a huge review to remove levels of bureaucracy but dont let the tories convince you that it can only work through privatisation.

Brexit has made recruitment a huge problem and is currently one of the most pressing issues within the NHS. We cannot make working in the NHS attractive when the costs and hurdles have been added in.

Sadly, I think we'll see the end of the NHS as we know it within a decade.

@sst1234
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?

Well, as inflation since 2010 has been 24.7%, then it had barely moved in real terms, Despite increased demand for its services, or do You think staff are not deserving of any pay rise?

I came in to say this.

We don't have endless money to throw at the national religion. Spending is up massively but outcomes are still dire in some areas.

The French system sounds great

I started work in the NHS in 1972, Finnished 2015,no point in throwing money at it....that's not the solution. I saw huge amount of waste, perfectly good uniforms changed and binned,bank holidays agency staff,on ridiculous wages who didn't want to actually work, while staff wages were reduced ie the extra for working in ITU the E.D. It was no different under labour government. I agree some responsibility lies with individuals to look after their own health

I went for a routine mammogram yesterday at my local failing hospital whose A&E have declared major emergencies more times than I'd care to count in the last 6 months. But - my last mammogram was 2019 - so inspite of Covid they seem to be running to schedule. So some aspects of the NHS are running fine. I did see 5 ambulances queued up outside A&E though!

We have some of the worst cancer results in the world.

We are not good on camera care at all .

We need to lift NHS out of politics and get business people running it properly.

We need. Special team looking at the best healthy care systems in the world and implementing them.

@nannybeach

The people I know who work in NHS say exactly the same thing.

Utterly wasteful, removing cleaning contracts to outside agency??

Massive drop in standard's.

Not washing staff uniforms for them? I'e not many staff can or want to seperalty wash their uniform at 60 *

Omg Hyperion!

Google Tony Blair/NHS!!

My partner fell of his bike in France last week, ambulance took a few minutes, no queues at AE, patched up, x rayed, painkillers... we were out within the hour.

The hospital was very clean, modern and well staffed, no one was hanging around.

My DD works in the NHS, we told her and she was shocked that just a few miles away, a country with 67m people can have such a vastly different health service.

pre CV, France was doing operations for the NHS, so quick could they provide a slot that uk patients often didn't have time to book a hotel...... (for relatives)

We'd have that kind of service here if the public agreed to the NHS being outsourced. But no-one wants that, so 🤔

We'd have that kind of service here if the public agreed to the NHS being outsourced. But no-one wants that.

The vast majority of social care is outsourced as you put it , is that working out well ?

You're right, it is. But we're talking about the NHS.

A lot of the non medical areas of the NHS are already outsourced too, but if the health service provider had shareholders to be accountable to, like your mobile phone network provider does for example, it would become much more efficient and streamlined.

The other issue is that each NHS trust operates independently. Our North Wilts based GP said this very morning that getting updates on DH's treatment is great from the local (Swindon) hospital, but that when he has treatment at Oxford it takes a long time for the update letter (the letter!!!) to arrive - we usually take the paper copy we were given to the surgery for the receptionist to scan - it's quicker.
The Swindon hospital and the Oxford hospital's systems aren't integrated because they are in different trusts - although loads of patients from Swindon get referred to Oxford for specialist cancer treatment.

But "the public" don't want a national NHS database either.😩

The NHS needs a fully functioning social care sector to be able to function efficiently.

Although it sounds as though France is starting to go the same way as the NHS, lets see how things pan out for them.

www.connexionfrance.com/article/French-news/Why-has-France-lost-80-000-hospital-beds-in-20-years

My DH had an accident in Southern Spain few years ago which could have been life changing but thankfully wasn't.
The emergency services wouldn't come as we were at a villa 1/2 mile from the main road. The travel reps had to take him to the emergency clinic where a porter wouldn't get him out of the car until he'd seen our EU passports. They checked him over straight away and sent him away with paracetamol and instructions re concussion/head injuries. The reps offered to take him to the main hospital in Malaga for a 2nd opinion but told us I'd have to stay with him overnight to care for him and take our own water as this wouldn't be provided at the hospital.
I'd had vast experience of the NHS with it's strengths and weaknesses and was very surprised by the Spanish system and what it wouldn't do.

The managing of individual departments is appallingly bad. Poor Management is a British problem because almost nobody bothers to train for it. Managing people is a learned skill it is not some natural flair that a few people have. The very best managers might be 'naturals' but everyone can be 90% good.
There are some at Sister level that cannot understand that staff need to see rosters at least 2 weeks ahead. Sure things change at short notice but let's have a target that we all see.
Currently office is recruiting and signing up new staff from Philippines they need an induction and exam course. No one is rostered to do this. Any one from the office does what they can. Complain to Matron, shrugged shoulders "Do the best you can Love, we are all short staffed."

Some care (emergency for example) is covered by EHIC so no need to pay anything for that up front or ever. The rest of it we claim back the same percentage as a French person is entitled to. We can claim for GP appts, prescriptions, scans, surgery etc. We don't have private insurance, no. But we do have the means to cover any gaps, so for example we pay €25 for a GP appt, but we might only get back circa €20.

No idea how elderly and social care are managed, no. Presumably it works well, given how pivotal it is to a functioning health service.

I agree OP. Its interesting that polls on this subject on mumsnet always seem to be around the 70% mark agreeing that the NHS is not fit for purpose now. More people are talking about how poor the NHS is now.

Equally, there always seems to be 2 or 3 poster who come onto the post to speak in very psuedo authoritative tones about how the UK can't possibly have any other kind of health service and how every poster who has had poor experiences is wrong or misguided. Theres a particular poster who does this and constantly just asks questions of anyone who dislikes the NHS.

Then theres always the handful of posters who know of no other countries in the world than the UK and the US that have healthcare systems.

We have a short-term planning and strategic culture in the UK, across a lot of sectors actually (manufacturing etc) as well as healthcare. From government down to management level (so I'm not talking about the actual frontline workers here, to be clear).

Politicians never think beyond the next electoral cycle. So you end up with sticking plasters to fix broken legs, over and over again, for decades.

The state of the NHS now has been building since the 1970s.