Page 23 | To ask what can be done immediately to take the pressure off the NHS?

Twinklenoseblows · 2023-01-02T22:46:34+00:00

I've been reading stories about people waiting 4 days in A&E, people being taken into A&E in the back of a van with a broken hip as there are no ambulances ,and doctors and nurses pleading for something to be done right now as lives are at risk. But what can be done that would make a difference within the next week or two? Promises of more money and more staff will presumably take years to filter through and make a difference. I guess what is worrying me beyond the immediate crisis is that some bright spark in government is going to say we need a circuit breaker lockdown to reduce flu and covid admissions for the next few months to take some immediate pressure off. The thought fills me with horror so I'm hoping there is something else. E.g. as a very short term measure could some people be diverted to make use of any spare private GP capacity to try to reduce the number of people going to A&E who could instead be dealt with by a GP if only they could get an appointment. Or is that madness?

DeadlyDragon · 04/01/2023 00:28

BradfordGirl · 04/01/2023 00:26

@LeccyBillShill NHS and medicare are not comparable. We have zero co pay. We do not have enough Drs and nurses but there are big regional variations. My family can get to see a GP very easily, in areas with shortages of GPs it is hard to see a GP. My father had amazing care in a hospital this year. I can't imagine how it could have been improved, everything from the ambulance to the ward was amazing. My dad kept saying I keep hearing about all of these issues so why am I getting such good treatment. We did not know the answer but we were very relieved. Literally the only way it could have been improved as a private hospital would have been fancy drinks for visitors and expensive art on the wall and expensive visitors chairs. We were just blown away.
But I know in some hospitals wards are understaffed and ambulances have long delays. So it really does vary.

I knows that I had to pay $70 before i could even see my doctor and $100 (with insurance) to see my gyno and then whatever treatment plan they chose I had to wait till next pay to get if I could afford it. A lot of my canadian friends were surprised when I told them this. If you don’t have the money then the doctor will refuse to see you. If you think it is serious then you will have to go to the ER.

knitnerd90 · 04/01/2023 00:28

LeccyBillShill · 04/01/2023 00:23

Ok so there is Medicaid and Medicare in the US:

”What's the difference between Medicare and Medicaid? Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that gives health coverage to some people with limited income and resources.”

and this:

“Most states — 38 and Washington, D.C. — have the same income limit of $2,523 per month for a single person for most types of Medicaid services. For a married couple, the limit increases to $5,046 in most cases.”

Also worth noting that these income limits are for childless adults with no qualifying conditions. For children or pregnant women the income limits can be as much as 400% of the federal poverty guideline for your family size. Over 40% of births are funded by Medicaid.

LeccyBillShill · 04/01/2023 00:29

BradfordGirl · 04/01/2023 00:26

@LeccyBillShill NHS and medicare are not comparable. We have zero co pay. We do not have enough Drs and nurses but there are big regional variations. My family can get to see a GP very easily, in areas with shortages of GPs it is hard to see a GP. My father had amazing care in a hospital this year. I can't imagine how it could have been improved, everything from the ambulance to the ward was amazing. My dad kept saying I keep hearing about all of these issues so why am I getting such good treatment. We did not know the answer but we were very relieved. Literally the only way it could have been improved as a private hospital would have been fancy drinks for visitors and expensive art on the wall and expensive visitors chairs. We were just blown away.
But I know in some hospitals wards are understaffed and ambulances have long delays. So it really does vary.

This is really heartening to hear and I’m glad your father had excellent care. The quality really does vary and we just have to hope for the best when our time comes for serious healthcare.

DeadlyDragon · 04/01/2023 00:29

Go to the ER and regardless of whether or not your problem is serious or not you will get a bill that could vary anywhere between $5000-40,000 depending on the hospital.

BradfordGirl · 04/01/2023 00:30

I have heard people I know in the US afraid to move far away as it would mean finding a Dr who would take medicare.
I guess it is like Britain where it is hard to find an NHS dentist.

DeadlyDragon · 04/01/2023 00:33

BradfordGirl · 04/01/2023 00:30

I have heard people I know in the US afraid to move far away as it would mean finding a Dr who would take medicare.
I guess it is like Britain where it is hard to find an NHS dentist.

I was only on medicaid for a very short time in university so I honestly don’t know. That’sa problem regardless though. A lot of insurance has something called networks. Basically only certain doctors will accept certain insurance plans. So it’s kind of luck of the draw who you will get if you change plans. I once got a doctor an hour drive away. He was the closest one covered even though there were technically several doctors just down the street from me. There’s a lot of annoying technicalities.

BradfordGirl · 04/01/2023 00:35

@LeccyBillShill Thanks. The care was really outstanding. It is not what I would have expected.
My husband has had to wait quite a bit for NHS physio but is now getting really good physio on the NHS. Stuff like this can have a long wait.
There are real problems with understaffing of the NHS, but there is lots of excellent care as well.

knitnerd90 · 04/01/2023 00:36

BradfordGirl · 04/01/2023 00:30

I have heard people I know in the US afraid to move far away as it would mean finding a Dr who would take medicare.
I guess it is like Britain where it is hard to find an NHS dentist.

Typically, most doctors take straight Medicare--something like 80%. Medicaid is trickier. But in some parts of the country there might be fewer doctors; the USA is also suffering from a shortage of primary care doctors. Canada has a harder time. The UK deals with GP shortages by making patient lists longer, letting them say everyone has a GP on paper. Canada lets family doctors cap their lists, leaving about 20% of Canadians without a regular family doctor (varies by province).

(You can also choose to receive your Medicare benefits via a Medicare advantage plan, which can give you more services but restricts your choice of provider.)

MintyFreshOne · 04/01/2023 00:37

BradfordGirl · 04/01/2023 00:17

@MintyFreshOne I just said my Aunt had to sell her house to pay for her amputation and sepsis treatment. She had insurance who would not cover it. The state, I don't know if that means medicare?, refused to pay as she owned a house and told her to sell her house. They told her they would have paid if she rented.
So please do not tell me it can't happen. it happened to my family and I was horrified as she told me all about it.

My understanding is that they aren’t allowed to take your primary home or force a sale when you live in it. Was it that they wanted to place a lien on the property? Was she going to go into a nursing home?

No question that paying for healthcare is a headache in the states and people can fall into the cracks.

Basically the US maintains overcapacity and the UK has undercapacity. Healthcare funding is a bottomless pit …

BradfordGirl · 04/01/2023 00:38

DeadlyDragon · 04/01/2023 00:33

I was only on medicaid for a very short time in university so I honestly don’t know. That’sa problem regardless though. A lot of insurance has something called networks. Basically only certain doctors will accept certain insurance plans. So it’s kind of luck of the draw who you will get if you change plans. I once got a doctor an hour drive away. He was the closest one covered even though there were technically several doctors just down the street from me. There’s a lot of annoying technicalities.

Show quote history

That is awful. I have always made sure I have a GP in walking distance. Here GPs are very reluctant to take you outside a small geographical area and if they do, they tell you they will not visit you at home. Very ill or housebound patients do get GP visits at home. My mum had the district nurse visit her at home to do wound dressings for a month. I had a home visit by a GP once who promptly called an ambulance for me.

BradfordGirl · 04/01/2023 00:40

@MintyFreshOne She was not going into a nursing home. I don't know if it was a lein being proposed just that the state refused to pay as she owned her own home.

Sarahcoggles · 04/01/2023 00:42

glasshole · 02/01/2023 23:09

Short term-

Extend gp days and/or add extra appointments at weekends. This will help people avoid going to AE as they can't get a GP appointment.

Medium term-
Nationwide campaign to encourage people to go to a pharmacy first. Even if it's just to get a blood pressure/blood sugar levels checked.
Make people aware of the vital roll that vitamin D and vitamins in general play in our overall health.
Encourage prayer in bariatric services to help proper lose weight as this is shown to save £££££ down the line AND improve health.

Long term-
Total restructure for the nhs.
Tax unhealthy processed food
Subsidise healthy whole foods
Increase exercise within schools
Improve grass roots sports

@glasshole extend GP days? How do you do that? Most GPs already work 14 hours a day. Do you want them to work more? Perhaps they don't need to see their families. Actually, maybe those lazy GPs should learn how to survive without ever sleeping, that would create more capacity.

MintyFreshOne · 04/01/2023 00:42

BradfordGirl · 04/01/2023 00:30

I have heard people I know in the US afraid to move far away as it would mean finding a Dr who would take medicare.
I guess it is like Britain where it is hard to find an NHS dentist.

This doesn’t sound quite right. I’ve heard maybe up to a third won’t accept Medicaid (reimbursement rates are lower iirc) but that still leaves a lot who do and really quite similar to private insurance in this sense

MintyFreshOne · 04/01/2023 00:44

BradfordGirl · 04/01/2023 00:40

@MintyFreshOne She was not going into a nursing home. I don't know if it was a lein being proposed just that the state refused to pay as she owned her own home.

How did she end up paying for it out of curiosity?

BradfordGirl · 04/01/2023 00:45

I agree with the NICE approach in the UK. So NICE assess the effectiveness of drugs against the cost and decide whether to approve them. It is transparent so charities and patient groups can lobby. But it does decide for example not to approve very expensive drugs that only prolong life on average by 3 months in terminally ill patients. Or to limit number of IVF attempts.
I accept there has to be some limitation on spending. But it should be evidence based and transparent.

BradfordGirl · 04/01/2023 00:46

@MintyFreshOne A relative helped out.

BradfordGirl · 04/01/2023 00:47

A relative gave them a place to stay. They only had to pay property taxes. My uncle still lives there.

MintyFreshOne · 04/01/2023 00:49

BradfordGirl · 04/01/2023 00:47

A relative gave them a place to stay. They only had to pay property taxes. My uncle still lives there.

Tbh a lot of people in this position would declare bankruptcy since you can usually keep the family home. Still sucks tho

MintyFreshOne · 04/01/2023 00:54

It’s really become a full time job to figure out how to pay for everything. The care is so much better than what you get at NHS but it’s anxiety inducing for sure and the insurers always make you fight for everything.

Angelil · 04/01/2023 02:25

FlorenceAndTheVendingMachine · 03/01/2023 21:51

Yes, I think most people will agree we need skilled labour from abroad, which will take many years to grow organically. However, these aren't the same immigrants which the gov is paying £6m a day to house in hotels, let's be honest.

Show quote history

My sister works for the NHS. She’ll tell you that £6m sounds like a lot but is a p*ss in a bucket in reality.

Angelil · 04/01/2023 02:27

LeccyBillShill · 03/01/2023 22:17

You make a good point. TB is rampant in certain London boroughs and all sorts of archaic diseases are making their way back to our shores.

I don’t see a way back for the NHS because anything we do would only be closing the stable door after the horse has bolted.

The NHS is in its death throes and the faster it signs a DNR request the faster we can get to a system that profits from preserving life (think USA) rather one which “saves money” by allowing people to die before their time.

Silly anecdote but I remember watching Sex & The City as a teen when Samantha found a lump in her breast. Of course I thought that was it, she was going to die. But no, the next day she was off for a biopsy and treatment began immediately. I know it’s only a TV show but the speed of treatment in the UK is dire. People die on waiting lists to be seen.

Show quote history

Why do people only ever cite IS models/examples, though? It’s not the only way or even the best way at all. I live in the Netherlands and when I found a breast lump a few months ago I had a radiology appointment within the week (and at my local GP practice too!) - and didn’t have to pay for it either. I also received the results of the scan on the spot.

Angelil · 04/01/2023 02:28

*US models

LetsDoThis2023 · 04/01/2023 02:53

We must sort out social care.
And stop voting Tory.

ToWhitToWhoo · 04/01/2023 03:06

Sarahcoggles · 04/01/2023 00:42

@glasshole extend GP days? How do you do that? Most GPs already work 14 hours a day. Do you want them to work more? Perhaps they don't need to see their families. Actually, maybe those lazy GPs should learn how to survive without ever sleeping, that would create more capacity.

Show quote history

Get more GPs, that's how. But that's also a long-term thing, given the length of time that medical training takes.

Gingernaut · 04/01/2023 03:36

Immediate actions

Lay off the booze

Cook all food properly

Maintain scrupulous hygiene

Stop spreading bugs - wear a mask if ill and work from home where you can

Keep a collection of loperamide, rehydration salts, cough and cold remedies and tissues at home

Unless there is an underlying condition, please stop coming to hospital with fucking norovirus - there's no fucking cure, you risk becoming the final deadly straw for vulnerable patients and you'll probably sicken medical and housekeeping staff who have to clean up after you.

Make as much use of your local pharmacies as you can - without being germ spreading twunts in the process.

Keep regular prescriptions up to date - don't leave it until you're on the last few tablets to order a refill

The rotten and debilitating cold that's going round initially mimics Strep A - sore and swollen throat, nausea and high temperature - don't automatically assume Strep A, if no one in your social circle and family has had it.