AIBU to ask how long the NHS has left?

[StrongCoffeeAvalanche]

Genuinely now have the mindset that's it's not 'will' the NHS go under but 'when'. I'm not in the NHS though so I guess I'm asking 2 questions here....

1. YABU the NHS will survive somehow or YANBU the NHS is going to go 100%

1. If IANBU when? How much longer do you think we have?

Thank you! It is a fantastic service and has been rolled out by NHS England nationally that not many of the public know about. The biggest problem is the usual, not enough staff to service it and so we feel a massive pressure and staff are leaving / we cannot recruit. The feedback is good though from patients who are mostly relieved that somebody has come to see them and usually within 2 hours.

we will all have to pay for private health insurance.

There's a middle ground though.

Health insurance paid per month, a nominal amount. Like we have in my country.

At least you are confident that you will be seen to.

I work in nhs A and E. Best place i've ever worked....and I've worked in a lot of places. We are busy but we cope. Amazing staff, patients and families. Patients mostly grateful. I hope it survives.

I think you are confusing the NHS with a hotel- why on earth would there be fruit or a choice of yoghurts?

In the future I suspect people will be asked to pay for their food from a reasonable priced menu.

@elm26 I've never worked on a ward where we had an option to give patients yogurt or fruit for breakfast.. also no toasters on most wards so the option is bread or cereal.

Agree that's a good idea, but already hearing the complaints and daily mail sad faces from the future!

I'm referring my son for some tests and going privately as can't even be bothered waiting for the referral letter which I know will be probably 6 months to a year away. More people will do that, go into debt to do that too as not everyone can afford it

I spent a night on the corridor of A&E recently. The care from the doctors and nurses was amazing but it was obvious just how stretched they were.
Behind me was a bloke who'd been drinking a litre of vodka a day, to the side was someone who'd overdosed on cocaine and in front of me was a drunk who's girlfriend had ended their relationship and he'd no where to stay.
Society is breaking down and the NHS takes the hit massively. Think of all the stabbings, injuries from fights and many accidents caused by dangerous drivers. This puts huge pressures on the NHS.
Having worked in the NHS most of my 30 years working life, I have also seen mismanagement, wasted money and staff taking the piss in my field of work.
I can only think that eventually it will become like the US and people will need to have health insurance with a core service for those who cannot afford.

I come from a culture were the young are responsible for the elders which I think should become a legal requirement."

How on earth would you enforce this, especially in a world where people don't always live near elderly parents?

In cultures where there is a strong social pressure to look after your parents in old age, women are increasingly going on marriage strike because they don't want the burden of aging inlaws.

You make it a law punishable by the costs being removed at source from your pay. No doubt countless private care companies will pop up claiming a top up off the family on top of the funded hours so DS doesn't have to look after DM or DDad which in turn will make it a better paid more attractive job.

I think the main problem is social care.
We need more...

• NH beds
• Rehab/Intermediate care/ step down units in nursing homes
• care in the community
• Senior and entry level care staff in both NHs and the community (seniors can do meds/further education)
• Mental health provision

That way, the people who don't need to be in hospital beds, wouldn't be there and nursing staff would have more time/ resources to look after people who really needed it.

My local trust is using a Nuffield private hospital for some elective surgery. They started doing it in the noughties, when Blair's government was prepared to spend to reduce waiting lists.

I had a partial knee replacement on the NHS done in the Nuffield just over a year ago, and a nurse told me that it was 50% NHS patients in there at the time.

Let’s see if/when Labour wins the next election. Maybe having a government that doesn’t ideologically hate the nhs will help somewhat. Probably can’t hurt.

I’d concentrate on social care too and overall population health.

With those two the NHS could be ok. On one hand I would miss it if it disappeared (not that I use it that much atm) but I appreciate the idea, oth meeting quite an unhealthy population’s healthcare needs in such an encompassing way does feel like it’s getting more onerous.

Delay in pre-discharge social care assessments is a massive issue where I live. The wait is sometimes several weeks. A friend's elderly mother was fit for discharge for 10-12 weeks before her care plan was in place.

There needs to be better integration between ASC and the NHS, and more resources for ASC so that they can recruit and retain staff to get assessments done and care plans in place more quickly.

The NHS seems to be getting all the blame when a good proportion of the problem is down to local government.

The NHS gives us all of this for free. I cannot imagine having to even try and navigate a life for him without that.

Right now the NHS does not give many who need it anything at all, and "free" is its blessing and its curse.

Nothing in life is free. Someone somewhere is paying for that.

That's tough on those of us who've worked for 50 years or more and funded care for the generations that went before us, only to be told that we now have to pay for our own.

I could sell my house to fund mine, but people who are renting don't have that option.

If these reports, out today, are correct, the NHS is just falling apart. It needs urgent root and branch reform or there will be nothing left soon:

www.theguardian.com/society/2023/jan/01/up-to-500-deaths-a-week-due-to-ae-delays-says-senior-medic

There's no way my brother or I would have been in a position to provide care for my parents had it been necessary.

We both live a 3-hour drive from where they were living, I was working full-time and he has pretty severe MH problems. Many of my friends are in a similar position, living a long way away and/or working f/t.

And the notion that young people should care for older family members rather presupposes that they have the necessary skills and aptitude. Anyone dependent on me for care would be signing a DNR asap, I'd be utter shit at it.

Not that any of this is wrong - but there seems to be far less tolerance of 'human error' now

And rightly so, because "human error" is never a root cause - it's just a category of failure. However, if we're now blaming individuals for system failures (poor training, poor processes, poor management, poor culture, lack of capacity...) then we're going in the wrong direction.

I come from a culture were the young are responsible for the elders which I think should become a legal requirement.

You come from a culture where women are responsible for the elders.

You make it a law punishable by the costs being removed at source from your pay.

You're taking blinkered authoritarianism to extraordinary levels here.

"I come from a culture were the young are responsible for the elders which I think should become a legal requirement."

We are supposed to have this in the UK - at a society level. Younger people work and pay taxes which then go to fund pensions and health care for the elderly. Or at least that is what is meant to happen - the impact of this not working at the moment is the reason for this thread. What is needed is a way to get back to where this does work . Expecting young people in an individual family - who are already struggling with high housing costs and poor wages - to support their own elderly family members is ridiculous .

But it's not really fair to ask everyone else or the next generation to pay for it either. It's a catch 22 as someone is going to have to pay to increase socialcare as even if you privatise the NHS the companies aren't then going to tolerate bed blocking like the NHS does.

If you say increase tax by X percentage which cost the average person say 2k a year (likely to need to be much higher). Over a 50 year working life that's 100k at least as higher earners will once again be hit harder.

Now say you go down the family funding it, social care is usually a maximum of four visits a day. Say they cost £15 per visit, granny is moved near us so we do a morning visit to get her up at 6am before work (wifey as the husband is not a morning person I'm up at the crack of dawn).

We pay someone to come in at lunch time £15, husband can call in on his way home to make sure she okay then one of us can pop round at bed time to put her to bed. Cleaning is what an hour a week so can add that to our cleaners bill or do it on a weekend and the laundry can join my pile which is apply for its own postcode. She better have enough clothes as I wash once a week and it all goes through the dryer!

So say £15 a day x 7 that's £105 a week or £5460 a year some of which will be funded from their private pensions so we will say that includes cover for holidays etc. We could also make it tax free like childcare which makes it £4364 a year by the time my gran needed more than shopping picking up or the high dusting doing she lived a future two years so by having a busy few years we have saved 90k but most importantly we have done it which made her feel more comfortable which to me is priceless.

Problem is @Grumpybutfunny a significant portion will refuse to even pay out that £15, despite having it in private income or benefits because 'its their right' to get it for free. Attendance allowance is currently £60 week low £90 high at present and as far as I know that's on top of other benefits.

I think the way forward is health insurance. No one wants to pay more I get that but we don’t have the money in this country to provide a functioning NHS service. Plus a reform in care work. Pay care workers the wage they deserve to attract people back into the profession. Cheap labour from abroad has gone now we need to look to paying people a living wage ( not nmw which is not liveable) lots of elderly taking up beds because their is no where for them to go.