To be upset about my mum’s attitude to the NHS?

[Beautifulblues]

She’s turning 64 this year and so has benefited from the NHS all of her life.

She came from a fairly poor background, council house, working class, she had to leave school at 16 to get a job as they needed to contribute to the household. She shared a bedroom with her siblings until she was 14, very little in the way of luxuries.

Despite all of that she’s now a staunch conservative and she has said several times recently that she believes the NHS is no longer fit for purpose and we should be looking towards a health insurance system like other countries (she referenced France here but I have no idea of their healthcare system). I’m feeling very angry about it…she’s benefitted this long but doesn’t want me or her 4 year old grandson to benefit from the wonderful NHS as he gets older.

I'm not a Tory and I'm actually with your mother on this. Places like Germany and Netherlands do have a different insurance kind of scheme but it doesn't mean that lower income people don't get treatment. When you say insurance based people tend to think US type system. That is one vast money making cartel and not how these other country's work. The NHS isn't working properly because Brits aren't prepared to pay more tax and various decisions have been made over the years that mean there is insufficient local provision .

Unfortunately, the cost of government debt has skyrocketed because its credit rating has declined. So the taxes aren't paying for any services at all, they're merely servicing debt. Nobody has noticed that our rating dropped after Brexit, which means interest rates on government bonds (which, obviously, is money the government has to pay its creditors) has gone up significantly.
www.worldgovernmentbonds.com/credit-rating/united-kingdom/

Admittedly inflation erodes the value of debts, but that's then cancelled out by the additional cost of government salaries on rapidly falling economic growth. So none of the insane number of tax rises are actually going to improve services at all. The only way to fund what the population demands in services is to massively increase inward investment, which is the bit Liz Truss wasn't wrong about, but went about it entirely the wrong way.

I don't agree necessarily about immigration though being the main cause. In many parts of the country if you have a look in GP practices and A&E and it's not immigration that's an issue. It may well be in some areas, but in vast areas it really isn't.

Where has that debt come from? Living above our means for so long. The scythe should have been used years ago - but it wasn't. Not by either party, because they all prefer to buy votes now and leave the problems to the future.

"A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits from the public treasury.........."

The NHS in its current form is not sustainable. The reason it’s not sustainable is because of people like you, having children and expecting to live off social welfare.

I’m from Australia and we have a system which if funded through federal and State tax dollars.

If I want surgery I schedule it at a private hospital. Public hospitals are for when people have a heart attack, or a stroke or a major traffic accident. It’s not sustainable that people go to hospital to get antibiotics because your GP’s receptionist won’t make them an appointment because they phoned at the wrong time of the day or because the receptionist feels you don’t need an appointment.

In Australia you pay to see a GP. I can go to a place that is fully paid for by the government but I don’t like those places.

You don’t seem to understand that the NHS is not just publicly funded hospitals - it’s the entire system. It’s the social welfare system, it’s the local GP’s, it’s the nursing homes. You can’t not fund the social welfare programs and act surprised when elderly people are calling an ambulance because they are constipated.

Your mum is advocating for a system similar to the French one, which, despite some flaws, does work very well. A completely free NHS is no longer viable, but most people just can't see it and wouldn't be willing to pay anything beyond their national insurance contributions.

When DH and I lived in France, our healthcare cost around €2000 a year but we got 80% of that back from insurance.

Their system is very complicated, however, and would take years to implement here, even if the government decided to do it. The only thing they are doing is letting the NHS fall deeper into crisis, until people want to pay for private care. This is completely unfair, as most people can't afford it.

Some kind of sliding scale of contributions would be great.

This is what they're doing. Run it into the front so everyone says it's not fit for purpose, meanwhile they're privatising it by stealth.
I think the really big issue is social care. It's completely broken, nobody wants to pay for it and it's so unpopular with politicians as a potential vote loser they keep kicking it down the road. Has anyone seen Johnson's plan for fixing it? It's only going to get worse and it's dragging the NHS down with it.

ground. Where's the poxy edit button.

The NHS has collapsed. We can argue about the reasons why (whether it was deliberate underfunding by government, or internal mismanagement, or the endless widening of scope until taxpayers are paying for unnecessary sex changes and endless treatments needed because of alcohol/drug abuse) but at the end of the day it has collapsed, and is currently in shards at your feet.

No point getting upset with your mum about it. Yes she has benefitted from
the time when it actually worked, but she is also heading into her least-healthy years and probably quite scared about eg if she needs an ambulance for a broken hip she’ll be left in agony waiting at home for 3 days.

I dunno what the answer is but it isn’t getting angry with your mum. An insurance-based system probably would work better from our current starting point.

(But yes, I do wish the Tories had thought a bit more about the human pain and loss of life caused by their ideological desire to force privatisation of the NHS by underfunding it. Almost like we’ve had dimwits in change since Gordon Brown left. 🤔)

What do you mean by underfunding though - Funding has gone up so how much extra are you talking?

she has said several times recently that she believes the NHS is no longer fit for purpose and we should be looking towards a health insurance system like other countries (she referenced France here but I have no idea of their healthcare system).

Can you explain what's so bad about the French healthcare system?
If healthcare is still free at the point of contact, would you still be against an insurance system?

OP, did you hear the word insurance and assume something like the US system? The French system is nothing like that- it’s based on public insurance not private en.m.wikipedia.org/wiki/Health_care_in_France Advocating a move to something like the French system isn’t about getting rid of free (at point of use) healthcare but moving to a less centralised system. You can agree or disagree but it’s not in itself an objectionable proposal. I’ve lived in a European country with a system like this and it works brilliantly.

NHS is sucking in money and ripping us off. Here are 2 graphs:

They have reduced beds year on year, despite taking in more and more money:
www.statista.com/statistics/473264/number-of-hospital-beds-in-the-united-kingdom-uk/

They don't have enough nurses? Well, what are they all doing given they have more than in the past
www.statista.com/statistics/679976/number-of-nurses-nhs-hchs-workforce-england/

NHS is ripping us off. Rather than being worshipped they need to be dealt with. See through their lies.

A professor who lectured at my uni was a total Labour supporting leftie who studied the NHS and healthcare systems in Europe at length (wrote books about it) and he didn’t think the NHS was fit for purpose even then.

It isn’t always the view of right wingers, plenty feel this way on the left too. Your Mum has a right to her own opinion, even if you disagree.

The MHS has been raped continuously by the Tories. Sorry to use that word but it has. Over worked and under paid medical staff. NHS is not on its knees, it’s on its stomach.

Somebody hit the nail on the head the other day
OP mums right the NHS hasn’t evolved enough to keep up with what’s expected
people live longer
complex expensive treatments
years ago some people wouldn’t of made it out of childhood now with medical advances the live long life but need lifelong medical care
the problem is it needs dismantling and starting again
tories won’t do it as labour would crucifie them
labour won’t do it as the unions and public would turn against them

we seem to be stuck in an endless loop of political bitching and back biting between the parties

and on top of that the general population are one of the unhealthiest and fastest in Europe
wi there a big mindset of an individual’s health isn’t there personal responsibility it the governments

Thanks for the numbers.

In 1999 the UK population was around 58 million and there were approx 264,800 nurses - 1 nurse per 219 people.

In 2022 the UK population is around 68 million and there are approx 395,700 nurses - 1 per 172 people.

That does seem like a pretty big shift, but the population is ageing rapidly, so you'd expect more people to need medical care. More treatments are offered and standards are not the same as they were 20 years ago.

And this is partly why the country is in such a state, older people vote Tory even though they will be adversely affected by their policies, does she read the Daily Mail? Where is she getting her opinions from?

I've just been reading about the French healthcare system and it honestly sounds really sensible to me. It's also consistently rated as one of the best in the world.

From what I can gather, 70% of healthcare costs are covered by the Government with the remaining 30% being paid for by citizens/residents. You can choose to purchase a monthly health insurance policy for about £30 to cover the 30% difference. Anyone who has chronic illnesses/unemployed etc is fully 100% covered by the government.

I might not have got all the details right but to me this sounds like a sensible way of managing the needs of a growing population. As everyone is fond of saying, the NHS was created at a time when it was impossible to predict what healthcare could look like today.

I am fully in support of the concept of the NHS and believe medicine should not be 'big business' like it is in the US but at the same time, the world has changed massively and I think the NHS model is creaking because it hasn't adapted with the times. If the structure is broken, all the good will and great people in the world, will still struggle to turn it around.

From what I can see in the French healthcare system, if you have an insurance policy to offset your 30% contribution, you pay a small amount each time you access medical services, so a trip to A&E might cost you £25. To me, this would be a great way of helping people to decide if it really was an emergency or not. You'd pay £25 in a split second for a heart attack but you'd probably think twice before going with a bad cold or an ingrown toenail.

I 100% believe in majority state-funded healthcare but if the current system isn't coping, suspect we need to look at the underlying structure.

I spent many years on a reasonable salary but not one that reflected my vast knowledge experience and responsibility and trying with all my energy to do hands on care as well as lots of other stuff this mud working way over a 37.5 hour week. Totally burnt out I’ve recently moved to a job where the work load is realistic in that I’m actually to do the things I want to do for the patient but am worse off financially as I dropped down a band but the satisfaction of doing what I want I.e. giving highly quality care to patients makes it worth it.
The vast majority of HCPs are working their nuts off in often exceedingly stressful areas working way more hours than they are being paid to do and not able to give the patients the care they feel they should be giving. I’ve been in the NHS just shy of 40 years I accept there are areas for improvement but as said by the Kings Fund 8 years of underfunding by this government of below inflation rises in annual funding for the NHS because of austerity and an ever increasing aging population many with costly health needs and non existent social care is what is crippling the NHS.
This government’s decided during austerity to reduce funding by not increasing spending in line with inflation despite knowing that we were sitting on three demographic time bombs; a decline in the birth rate 18-30 years ago so less young people who might want to work in the NHS taking away the bursary for the nurses in England was the final straw, an aging work force apparently 45% of nurses are over 50 and many will retire at 55 others are just unable to physically manage the ridiculous work load so are looking for easier work and the last demographic time bomb more elderly who are living longer but not healthier lives so costing the NHS more a disaster when combined with the current (a predicted) social care crisis.
I agree Ppfi are a funking crap idea and is definitely not helping but this is only the tip of a very large iceberg when it comes to underfunding.

OP,

I am quite the leftie politically and formerly a huge fan of the NHS. Quick work on their part saved the life of my DH a few years ago.

But it is truly no longer fit for purpose and it is because I want all of us, including your DC’s generation, to regain and continue access to high quality care that changes are needed. I agree with PPs that @MissyB1 has a good plan, and that there is much to be said for the French system (which it seems to me many British almost deliberately misunderstand).

We’re going to pay for health care one way or another. I don’t understand why ‘free at the point of service’ is such a big deal, as long as the poor are not demotivated from accessing health care. But then I am not British.

YABU. Saying the NHS is not fit for purpose is not saying you shouldn't benefit from free healthcare. It's saying that the whole NHS needs to be looked at.

It was never envisioned or designed to do what it now does. Absolutely there should be access to all especially for emergency care but it needs to change.

From the little I know of French healthcare I believe it is a system with elements of free care and compulsory insurance via the social system ( though happy to be corrected).

Your mum isn't saying we should switch to the US model but we do need to look at other systems and adopt the best elements of some of the European models. It cannot continue to be a bottomless pit of money thrown at it.

It needs better investment - in IT, staff training and especially doctor / nurse wages but we also need to think about what should and shouldn't be provided free.

People don't want to pay more tax but a grown up approach to remodelling the system should be taken. It doesn't need to be privatised. But maybe it's time we as individuals started contributing towards NHS care in a more meaningful way.

And how many directors of lived experience are there?

The NHS has many problems, but I don’t think siphoning of cash for mates is one of them. You may perhaps have mistaken them for the government.

Anyway OP, your mum is entitled to an opinion. Something does have to change with the NHS and you mum may see that more clearly as she remembers it in less lean times.

Just because her opinion is different to yours, it doesn’t mean she’s wrong.

I agree with you

Although not sure who people think should be paying more when they say reform. Not you but just generally.