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.

Someone posted an article re not needing full reform - which is costly - but to emulate some parts of other systems

But it all comes down to who takes the extra cost, if that’s what people are for

It’s taxpayer money so the upside and detail would need to be sold in to those who pay. You also have income more divorced from user frequency. So it’s quite hard to tell some groups to pay more when they don’t use it as much

It has to be beneficial in other ways too

Even they can't defend specific accusations - like the waste and non-jobs and the wasted hours that must be incurred by their failures to keep antibiotics and oxygen cylinders on the shelves.

The problem specifically with regard to these are a combination of increased demand, Brexit, COVID in China, staffing issues in the distribution chain and short sighted contracting policy (government- led) where cost trumps robustness of supply. Only the latter can be significantly influenced by the NHS, but given the lack of funding it's easy to see why the cheapest options are chosen. There needs to be better contract management but
a) that costs money and b) we only get the service we pay for.

It's an omnishambles, don't get me wrong, but so many commented on here have absolutely so little idea what they are talking about it's difficult to respond.

I'm all for a national conversation. But whatever we choose will be more expensive than what we have now.

Also, the many other possible systems are an irrelevance right now - we are moving rapidly towards the US system. More and more people will go private over the next few years and very soon we will have a US style two tier insurance based system. No discussions, no votes in parliament required. This is what is happening right now. People need to wake up.

More importantly what do they do? Because the voice of people with lived experience of whatever - mental health issues, cancer, heart disease - should be heard by services to help improve those services. Certainly service user involvement in mental health services is important in helping to create services that people will actually engage with, given how many people have had a bad experience within them. Some changes can be free or 'cost neutral', yet give better outcomes.

@WiseUpJanetWeiss the nhs is massively inefficient. Many many MANY models are cheaper and more effecticd

Australia has a dual insurance/public model. Works a treat and there is a great minimum level of healthcare across the population (not perfect of course)

the biggest challenge to an effective healthcare system in this country is the poor education system which leads to ignorant comments like yours

People already know.

But when you have mantra that says Tory Bad Labour Good - and zero partisan approach within a government/opposition model - there isn’t a rational discussion to be had. Alas, the same lack of discussion is happening across lots of areas…. Nhs is just symptomatic of many areas, incl the Criminal Justice system. And as soon as you talk about the issues - you get restored to Tory bad Labour good mentality.

We wont have an NHS in a few years time, it will be pre NHS.

The NHS will cease to exist & will morph into a charity organisation... like Hospices.

Remember in the EU, the UK had to have a national health service... now we are outside.

Its all smoke and mirrors, we already have min staffing levels in all emergency services... yet apparently we need more laws :(

You'll have some evidence to back this up?

@Bard6817

Why is that surprising to you?

Who has been in power for the last 13 years?

This is why it comes down to Tory vs Labour, you are talking as if we had a coalition for the last decade plus.

@WiseUpJanetWeiss evidence of what?

that Australia has a good health care system thst is a private/public model?

evidence of per capita spending and health care outcomes?

the fact that you would even ask whether there is comparative analysis of different health care system very much is evidence re my point of the impact of poor education on peoples ability to understand and make meaningful contributions to important questions of public policy.

Yeah, fuck the disabled AND their carers. 🙄

Though, under this Government, I think your expectation is possibly accurate.

Evidence that there are other cheaper and more effective systems.

And please don't sling insults. You have no idea who I am and what I know any more than I know who you are or what you know.

Damn right!

I mean, why on earth would you want to train people who are responsible for people's lives?

95% of the people commenting on why the NHS is in trouble, haven’t got a clue really.

This is one the problems, governments have rearranged the structure to suit politics, re election and ‘what the public think’ and it’s a mess. A mess with really good people in it on the whole working miracles despite it.

I worked in the NHS for years, and I wouldn’t say I know how to fix it, apart from my own department. We were classed as managers but actually did nothing of the sort, we were specialists but just put in that category for pay scales. Once they tried to cut us back ‘because it looked bad’ as we were in management category. The department I was in was extremely efficient, we used money very well. Our Trust ran at a profit and had to prop up another trust who had historic debts when the government underfunded it.

We were constantly being reorganized, by governments to ‘streamline’ etc but all it usually resulted in was a big waste of energy and money. Recruitment was a big issue, not enough well trained nurses and doctors. Most departments know exactly what their problems are, but are not listened to centrally by government. A&E for example have been shouting about their needs for years and years. Simply put the problems are not resolved but instead it’s just political footballs.

Agree!!! Someone finally said it.

I hate it when my doctor is up to date in their training.

Next time I have surgery ill ask for the least trained doctor and tell them to just give it a go and figure it out on the fly.

Well, of course, she is completely correct in her beliefs because her age and experience have shown her the truth of what is needed.
But, regardless of that, she is entitled to her own opinion regardless of whether you agree with her.

I'm more pissed off at the waste, people not taking responsibility for their health and idiots who are getting their knickers in a twist about ways in which we can reform the service to be something which actually works OP.

Insurance in France always covers both existing and chronic conditions.
Also any terminal or lifelong illness eg cancer, diabetes etc is covered fully by the state.

My numbers aren't very up to date, but I think the French were spending around 11% GDP on healthcare at a point where we were spending 8%. That's a big difference. Their system requires a lot of admin - you pay for care and medicines up front then claim it back. There are different insurance systems offering different levels of funding, so you might find different standards applying. There's more direct access to specialists - I could just take myself off to a gynaecologist, for example, I didn't need to get an appointment via the GP. GPs were paid less compared to UK GPs and there were many more of them. But some of the structural problems - ageing populations, recruitment problems, social care gaps - are shared across both. On outcomes - cancer survival, stroke, cardiac, diabetes management, the big ones that kill and render unhealthy ageing populations - I don't know. You'd have to look at outcomes to see whether more expenditure was being used well, or being swallowed up in admin without any impact on health.

You're never going to have a business without management costs though.

And the French system is not complex.

YANBU. My MIL is the same. She’s worked full time a grand total of about 15 years in her life, but goes on about ‘paying taxes all my life and now those foreigners (who will work here a lot longer than 15 years) get it for free’ etc. Thinks the NHS ‘is where it is because of lazy GPs and selfish striking nurses’.

Honestly what’s wrong with them all. Never known people so proud yet so lacking in self awareness.

iea.org.uk/publications/wizards-of-oz-what-the-uk-can-learn-from-australias-healthcare-system/

@WiseUpJanetWeiss

spending lower and health care outcomes better in Australia v nhs 2018

"training courses" in quotes as it indicates silly woke courses they do. But you knew that, didn't you? Funny how the NHS can only be defended via deliberate misunderstandings.

The other thing which makes the French system interesting is that many perhaps most ‘ GP equivalents’ are really self employed, although the patient fees may be reimbursed by their insurance. So there is a degree of competition for patients which plays out well for them. Premises are also much cheaper , at least outside the big cities, although they are also much smaller and tend not to have the ancillaries that British GP surgeries have. Our doctor didn’t even have a receptionist, you made bookings via a centralised telephone answering service which was 60 km away and did nothing except keep the appointments book. The doctor buzzed you into the waiting room, and came out with you at the end and made out the bill.

Our small town (4500 inhabitants) had three or four gps and several specialists like paediatric and renal . Nurses were also independent self employed, you could for example hire a midwife or a general nurse (infirmary) . They advertised in the equivalent of the parish magazine.

'from a business perspective'

That's the problem..., it's not a business, and it shouldn't be considered as one.

If you're running a chippy and you run out of fish, no biggie, you just don't sell any more fish that day. Sure, if it happens a lot people may stop turning up.

In the NHS, if you run out of an antibiotic, or a chemo agent, or dressings, or stents to treat heart attacks, someone might die, or get an infection, so everything has to be overstocked at massive expense, on the off-chance it may get used, so 'efficiency' in business context of 100% utilisation of resources, is a total nonsense in any part of the NHS that has to deal with fluctuating demand.

If 15% of beds were usually empty, a business manager would see that as 15% of the resources being wasted for 99% of the time. As a trauma surgeon, I see that as the resource required to cope the next time a bomb goes off at a music venue, or a coach crashes or any other contingent possibility.