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Am I being unreasonable in thinking that we are suffering from a collective Stockholm syndrome re the NHS

306 replies

Newbutoldfather · 31/03/2023 18:49

This is inspired by another thread about a mother with a child in pain being kept hours without painkillers without being triaged, and the responses on that thread. However I have also had an awful experience with my own child over the last year.

it seems amazing to me that in one of the richest countries in the world (we still are), people are content to accept substandard care which would embarrass a country with 10% of our GDP.

In France, MRI’s are standard for muscular injury or complex fractures. They happen within a few days and, often, on the day. ( my reference is Paris btw, not sure about rural France). In addition, you always get a same day GP appointment, regardless of seriousness, no hassle, no waiting for an hour at 8AM.

Finally, although there are some real heroes in the NHS, my own experience (and that of the other poster) are that many lack compassion, which is about culture, not money.

I don’t know the ‘solution’. Any solution is multifaceted and will take time. However, if we don’t admit the scale of the problem and continue to say how marvellous free-at-the-point-of-use is, we will never get acceptable medicine in this country for any but the rich.

OP posts:
justasking111 · 01/04/2023 12:58

Shelefttheweb · 01/04/2023 12:49

Unfortunately (and I’ll get my hard hat on here for the lefties…) a form of statutory public life insurance

We could call it ‘national insurance’

Nope the government would mismanage it.

KnittedCardi · 01/04/2023 12:59

make shifts & working hours more flexible and family friendly

A great idea, but the service by its very nature should be 24/7, 365. You cannot have part-time healthcare. It's bad enough now not having access at the evenings/weekends. What are your suggestions for more family friendly hours?

justasking111 · 01/04/2023 13:09

I was having trouble with my back again. Forty year old scoliosis problem so went back to chiropractor paid £35 a session for four months, back improved but it became apparent my hip was involved. Went to GP who agreed, sent me for x-ray. X-ray showed osteoarthritis in both hips and lower spine. So with my chimpanzee gait took myself off to the osteo recommended. £55 a session. Exercises given. I've had four sessions, am walking upright again. I'm joining a swimming place at £35 per month.

So I've cost the NHS one in person GP visit, one x-ray and one GP phone call .

The waiting list for a new hip is minimum three years. Self referral to physio six months. My friend got an email after six months with a sheet of exercises to follow from NHS physio.

If you can pay is my advice again.

Chocolatefreak · 01/04/2023 13:10

Just to add to my previous comment; one of the problems of having private healthcare or even quasi private is the unpredictability of costs; you can get by with cheap insurance for years and then something catastrophic happens eg an accident and it's not just the surgery etc but the aftercare - even in a ´sensibles European country and not the Wild West of the US system the cost of a hospital stay, consultant check ups etc gets into the tens of thousands very quickly.

The cost of healthcare can be as stressful as being sick in that situation. In the UK we want to avoid that at all costs. More investment and better preventative care will run for itself in the long run with a healthier more productive population.

GPTec1 · 01/04/2023 13:38

Shelefttheweb · 01/04/2023 12:45

Yes PFI is a disaster BUT where would the NHS now be without those Hospitals built under it? no one seems to want to answer that.

The NHS would have another £67 billion to build new ones

If you are going to comment, please be serious, that is £67bn over decades, so what your really saying is we should borrow to build hospitals, its not money available now or then.

PFI was also first used under the Tories and after the 2010 GE, the Tories carried on with it, plus most contracts have been renegotiated, bringing costs down.

Labour built the hospitals we needed in the 90s and 2000s, that money had to found somewhere & the choice was tax more, borrow more by adding to the national debt or PFI.

Without those Hospitals built in the 2000s the NHS would be in an even bigger mess than it is already.

Jellyheadbang · 01/04/2023 14:47

Mojoj · 31/03/2023 19:23

Maybe if rest of UK stopped voting fucking Tory......

So many people who vote tory, leave etc happily brag that they don't actually need the NHS if push comes to shove. And some crossover between those intimidating other people into clapping like mindless seals.
I've worked in the NHS, I've had amazing service from NHS, I've been disrespected, misdiagnosed, refused treatment and seen the same don't to my children, minimised, negated,vl discriminated against.
Recently I saw someone in an appointment who says she just cries at the state of the NHS and how people are treated
When I went for my next treatment she was leaving the service altogether.
In our NHS dentist the receptionist said it's too hard to keep hold of decent dentists because they all move into the private sector.
It's horrible as a disabled person seeing the service deteriorate so much and as ex NHS seeing so many friends, old colleagues etc end up sick and burnt out , even the ones who could retire at 50, 55 , many of them were on long term sick beforehand.

Chinchinchoroo · 01/04/2023 14:53

Labraradabrador · 01/04/2023 10:29

Yes, charge everyone something- a sliding scale based on means, but psychologically we need to move away from the idea that healthcare is ‘free’. Good quality healthcare is expensive, our current system is expensive (in absolute terms), but we hide the cost from those using the service. Charging a fee isn’t just about raising money, but also reducing demand . If I (a higher earner) had to pay £10/20 per visit I would probably think twice about whether I REALLY needed to see a GP for an infected toenail, or £2 might stop an elderly person from booking appointments out of loneliness rather than real medical need.

at the moment we place no value on healthcare because we see it as free

This idea is absolutely shocking to a lot of people but would result in a lot of of wasted NHS time being reduced.

I work in the NHS. There are huge amounts of people complaining about not being able to get an appointment who get one and then don't turn up.

Because it doesn't mean much to them. They think it's their right as taxpayers (or even not tax-payers) to an appointment and they're not paying for it and also not financially hurt for not turning up. So to them it's their right to use the NHS and there are no consequences for wasting clinic time.

Working in the NHS and having to provide evidence to commissioners about how much a DNA appointment costs opened my eyes.

Many, many people take the NHS for granted and in doing so, cost the NHS money. I'm not in favour of a privatised health system but if there was even a small cost for misusing it, a lot of people would reconsider and if not, the income would go towards underfunded services

QueueEtwo · 01/04/2023 15:01

KnittedCardi · 01/04/2023 12:59

make shifts & working hours more flexible and family friendly

A great idea, but the service by its very nature should be 24/7, 365. You cannot have part-time healthcare. It's bad enough now not having access at the evenings/weekends. What are your suggestions for more family friendly hours?

3 x 8 hour shifts per day rather 2x12 or let the work part-time - 2x 12 hour hour shifts instead of 3.
Because the standard contract is son inflexible lots of nurses choose to pick their shifts through the bank which costs the NHS more.
Just accept that the majority of their workforce are women who need childcare.

I read a thread on here recently about a trainee nurse on placement having to drive an hour and a half to her placement while another student was driving the same to her placement which was 10 mins from the original students house . They were refused a swop - that sort of thing is just ridiculous & needs to stop!

Alexandra2001 · 01/04/2023 19:23

QueueEtwo · 01/04/2023 15:01

3 x 8 hour shifts per day rather 2x12 or let the work part-time - 2x 12 hour hour shifts instead of 3.
Because the standard contract is son inflexible lots of nurses choose to pick their shifts through the bank which costs the NHS more.
Just accept that the majority of their workforce are women who need childcare.

I read a thread on here recently about a trainee nurse on placement having to drive an hour and a half to her placement while another student was driving the same to her placement which was 10 mins from the original students house . They were refused a swop - that sort of thing is just ridiculous & needs to stop!

Quite, to get family friendly hours you need far far more staff.... which thanks to Hunt, we don't have.

On your final point, placements.... my DD had exactly this, she suggested to the Uni they swap and told NO... however the reason being was due to the the placement types, they want the student to to experience a wide range of settings ie acute, neuro, community, AE etc if they'd swapped one or both students would of ended up doing back to back similar placements.... as it was because of Covid, she ended up doing 2 community placements out of the 3, if she'd swapped would have 3 community.

Nivgor · 01/04/2023 23:20

QueenCamilla · 01/04/2023 08:17

Thank you. I think you are right that I should seek mental health support. I get something similar to a panic-attack whenever I think back to that A&E trip and the surrounding days. I get that roller-coaster lurch in my stomach, the heart rate goes up and I start crying if I'm talking to someone. And then it's all wrapped up in that "but I should be grateful I'm alive" gift paper.

So much of trauma could be avoided (and I'm thinking back to the birth of my child too) if the NHS wouldn't be so shit with pain-management. It's awful to feel every second of your own slow, painful near-death!

@QueenCamilla if you are having physical symptoms and becoming emotionally overwhelmed then yes I think it would help you to look into therapy. For me it was also the prolonged and overwhelming pain that tipped me over the edge - I just couldn't get my head around the fact that I was experiencing that and that even though I was in hospital I wasn't getting medical assistance. I remember thinking, well, I've asked for help, I've been brought to the only place that can help, and I've not got it, and now I'm going to die. Which I nearly did, so it wasn't even an irrational thought, just genuinely a terrifying one. As were your fears. The thoughts you had were completely rational and your thinking was correct, but they were big thoughts, and sometimes when we have these big thoughts we need an extra pair of hands to fold them up, box them and put them away in the proper part of our memories so that they don't keep busting out unwanted and unneeded into the present.

I did also put in a complaint through PALS. It wasn't particularly coherent (this was before getting a PTSD diagnosis and while I was still recovering from the major surgery that I eventually had) but it did bring about a slight change in organisational processes so there was a 'result' of sorts and also now when I look back it's helpful for me to know that I've done what I could about the situation even though I can't control the bad actions of others.

Again I am sorry to hear about your experience and I wish you all the best in your process of moving beyond it.

Minierme · 01/04/2023 23:27

It’s a tried and tested Conservative tactic to run a public service to the ground so it becomes non-functioning and then argue we need to privatise it once the public get fed up.
Vote for Labour and let’s get social care, homelessness and mental health care sorted out. Then the NHS won’t have people harming themselves in order to get a place to sleep (the horrifying reality at the moment).

nolongersurprised · 01/04/2023 23:45

polka6 · 01/04/2023 11:57

@Newbutoldfather

Sorry I was exhausted and fell asleep last night after working a ridiculously long shift (+staying behind late).

What do you mean, wait for private ambulance services to emerge in affluent areas?
Ok so you pay £500-£1000, whatever it costs to actually have an ambulance sent out to you, pay for the paramedics urgent taxi service as well as their assessment and initiating immediate treatment. Then you get to this affluent private A&E. I suppose you're paying private rates for the service from the reception team booking you in, then the triage nurse as well as allied staff who may bring you a glass of water or a sandwich.
You will obviously needs obs doing, so paying for another private nurse? You'll almost definitely need some bloods, a cannula put in, probably IV treatment, an ECG (if you came in with chest pain) and a chest x-ray. Then a doctor to come take a history, examine and initiate their management plan.

Who's going to do all of this? Where are they coming? (when there's already major staffing issues in NHS hospitals). These jobs are generally done by "junior" doctors. I doubt there would be the infrastructure to have postgraduate doctors in training in a private set up. Consultants are no good at doing junior jobs (they havent done them for decades).

Do we also have a private path lab for your bloods to be processed and analysed? Do we have also have a private radiology department for your chest x-ray? Who's going to actually do the x-ray? Who will then report it? If you've had stroke-like symptoms you need a CT head. That's even harder. Who will do that and report on it? This is generally done my postgraduate doctors in radiology training.

So you've had a heart attack or a stroke (just using these 2 acute examples to keep life simple, which in reality it never is...) Now you need urgent care from a cath lab to take out that clot in your heart - do we also have that set up in this private care system? Or urgent neurointervention team for your clot in the brain, do we have the facilities for this on site? Or they being shipped off the NHS for urgent care when anything goes wrong in the private sector needing immediate attention?

For the record, "junior" doctors do all of these things in the NHS. Consultants cant and wont be able to do it all alone. You need the postgrad drs in training. You need a multidisciplinary team, not just doctors and nurses. You need the whole infrastructure. Radiology and pathology are absolutely essential - when does anyone who's seriously ill not get bloods or a CT scan? Yet the public seem to forget about the doctors and allied staff working in these crucial departments. Nobody knows whats happening without blood results and imaging reports.

I don't think an private ambulance service/A&E will just pop up. People clearly haven't actually thought about it properly when they make these throwaway suggestions. We simply do not have the staff in NHS hospitals let alone setting up new private centers. We have a retention crisis.

Everyone has a personal and/or family life and own priorities. Working in the NHS is just not right anymore for many staff. Why shouldnt they be able to go work abroad in better conditions for better pay or change industries like everyone else is able to? Once upon a time, being a teenager aspiring to become a doctor was... aspirational. The smartest kids today just dont aspire to this. Nobody is impressed by little John(/etc) getting a job in the NHS as they are if their child got a good job in a top law/accounting firm etc. A career in the NHS is just not attractive. Those already here are unsurprisingly leaving.

I work in public and private hospitals in Australia and, yes, the private EDs are run by private ED consultants. Some work in the public as well.

They request their own imaging, bloods, do their own cannulas. I would have thought ED consultants in the UK also need to cannulate?

X-rays are on site, they are reported usually by the time the patient goes to the ward.

The private hospitals I’ve worked in also have a very efficient private phlebotomy service, with two major labs providing/competing for this service. They will promptly do bloods anywhere in the hospital, including paeds and neonates.

Absolutely, the most critically unwell get transferred out to public hospitals but most standard medical/surgical procedures are managed perfectly well. There are physios/OTs/pharmacists/dieticians just as in public hospitals.

The main difference in a private ED/inpatient ward is that it’s consultant-led, there’s no option for a consultant to be “no good” at junior doctor jobs. I’m not from Australia and I was sceptical about it all at first, but it’s efficient.

If one of our children was seriously unwell and needing ICU we’d go to a public hospital, for “usual” kids stuff like fractures, lacerations, 5 days of fevers and minimal fluids with the ‘flu etc we’ve gone private.

nolongersurprised · 01/04/2023 23:52

Should add as well - it’s perfectly easy to get a CT head as radiology are on site. You request it and it gets done. If required, the on call radiologist will report immediately.

I appreciate that this is only possible because the Australian government also funds the private hospitals, but the same inefficiencies that occur in an NHS hospital (junior doctors doing all the bloods, cannulas, consultants de skilled in practical jobs, delays in X-ray reporting, difficulties accessing CT scans/MRIs) aren’t carried over to a functioning private ED.

DdraigGoch · 02/04/2023 00:21

gerbilcrocus · 01/04/2023 07:28

Insufficient money has led to poor working conditions due to over-burdened staff, leading to staff leaving, creating a vicious spiral... to the point that the staff left can be crap and unprofessional because the system is too overwhelmed to manage it.

It's a broken system... Significant extra money isn't a silver bullet that will sort the issues, but it's a start, but it needs a proper workforce strategy that recognises the chronic i lack of staff and addresses that. It's a Herculean task though, and even with massive investment it would take a decade or more to make a real difference things are so broken.

I've done a lot of things when stressed and/or demoralised. Never have I laughed in the face of someone in serious pain. There's no excuse for that at all.

QueenCamilla · 02/04/2023 00:44

Amber53 · 01/04/2023 12:44

@QueenCamilla agree about Maternity wards. My experience was absolutely shocking!

And once again, the "resources" were not the problem, it was the people. Absolutely awful. On the hour 26 of me labouring, an Iranian doctor, a soft spoken, statuesque, woman arrived - like an actual angel to me. I over heard her say to the midwives referring to me: "why are you torturing this baby?"
At some point the midwives suggested forceps and the doctor reacted : "you can't just rip a baby out of her womb, you know!".

The same doctor organised an epidural I had been begging for and that was just on time for an emergency section as the need arose.
She also organised a private room for me to recover in as she found me on the common ward deteriorating rapidly with no sleep and she deemed that unacceptable.

Basically it was hell without her!

I only have one child and a large part of that is me not willing to risk another labour on the NHS.

Ingrowncrotchhair · 02/04/2023 01:10

QueenCamilla · 02/04/2023 00:44

And once again, the "resources" were not the problem, it was the people. Absolutely awful. On the hour 26 of me labouring, an Iranian doctor, a soft spoken, statuesque, woman arrived - like an actual angel to me. I over heard her say to the midwives referring to me: "why are you torturing this baby?"
At some point the midwives suggested forceps and the doctor reacted : "you can't just rip a baby out of her womb, you know!".

The same doctor organised an epidural I had been begging for and that was just on time for an emergency section as the need arose.
She also organised a private room for me to recover in as she found me on the common ward deteriorating rapidly with no sleep and she deemed that unacceptable.

Basically it was hell without her!

I only have one child and a large part of that is me not willing to risk another labour on the NHS.

I think I have heard about 1000 horror stories involving midwives and their behaviour. Why is that?

Tg2023 · 02/04/2023 01:51

@FixTheBone just wanted to say thank you 😊 thanks for caring & thanks for the brilliant job you do ❤️

QueenCamilla · 02/04/2023 03:02

@Nivgor

I was given the PALS forms by the ward nurses with a huge encouragement to complain and they seemed to be aware that there are issues within the A&E department.

Similarly to you, I was "out of it" to do the forms but I'm glad you did it anyway! It's never too late though - it has come to my attention that my particular A&E department is under measures/review for their failing care provisions (surprise!) so I might stick my boot in at exactly this time.

Nivgor, can I ask how did you go about getting PTSD help and/or counselling?

There was also a horrific post-op procedure that I had to perform on myself that looked (and felt) like Something out of The Saw. I fainted and threw up from the pain in knee-deep water in the hospital bath. That water was all filled with pus and blood and I was soaking there naked, all 45kg that was left of me.
I just can't stop ruminating about that. I feel sorry for myself and the one nurse who volunteered (everyone else ran horrified) to finish the procedure for me. Someone failed not just me but that nurse too. I'm pretty sure nurses didn't imagine their job will involve torturing fully conscious patients in a bath of blood and pus. I don't understand it. I just re-hash it over and over again and I just don't understand "why".
I was better after the surgery but that procedure tipped me back into a hole of pain. Just why. Wtf is wrong with the NHS and lack of pain-relief?
I wish I could do the same procedure on that person who decided that pulling 3 metres of gauze ribbon stuffed inside you somewhere between the intestines and the reproductive system via a small incision... Is a good idea. I felt every bloody milimetre of it. When the nurse pulled, my whole crotch was following that "stuffing"...So I was holding on to my nether regions as not to break the skin and on count three the nurse would pull an inch out... It's the worst thing I have ever had to feel. And the nurses had never seen something so bad or so much gauze inside someone. But the doctor who did the packing gauze knew - so why no anaesthetic? The morphine didn't touch the sides of it!

That was 8 months ago and I haven't not once touched that spot on my body where the incision was. I'm scared. I don't know what of. Scared to feel something.
I do think I lost my mind a bit in that hospital...

Nat6999 · 02/04/2023 04:12

I had a bad experience after having ds in hospital, like other posters I was left with PTSD & developed Fibromyalgia. Six years later I needed several operations which I had via NHS Choose & Book in my local private hospital. It was like night & day, I had a lovely room, the staff took time to explain everything that was going to happen, everything was on time, the nurses who cared for me were brilliant, they saw in my notes I had PTSD & were so caring, they got me sorted as soon as I came back from theatre, my discharge letter & drugs were ready for me & I was fit to be discharged less than 3 hours after coming out of theatre. If a private hospital can do it, why can't the NHS with all the billions of pounds it gets paid & the tens of thousands of staff? There needs to be a massive reorganisation, many hospitals are currently too big, we need step down care, special centres that stand alone for routine operations, then step down care for anyone who needs pure care who would otherwise end up bed blocking.

Ritasueandbobtoo9 · 02/04/2023 05:32

The NHS in Wales is awful under Labour, huge waits for Ambulances, no dentists, massive waiting times. 1 bariatric weight loss service in the whole of Wales. People going abroad for basic surgery. GP’s overstretched with patients arriving at the surgery with conditions that need urgent hospital care because the hospitals are so far away.

GPTec1 · 02/04/2023 06:14

Ritasueandbobtoo9 · 02/04/2023 05:32

The NHS in Wales is awful under Labour, huge waits for Ambulances, no dentists, massive waiting times. 1 bariatric weight loss service in the whole of Wales. People going abroad for basic surgery. GP’s overstretched with patients arriving at the surgery with conditions that need urgent hospital care because the hospitals are so far away.

Its no different in England, look where all the maternity and mental health scandals have occurred.

Might suit Tories to blame Labour for health issues in Wales but thats just done to divert from the horror that the NHS is in England, it really is no better and in many ways worse, a 93 year recently waited 3 days for Ambulance after a fall and broken hip.

Ritasueandbobtoo9 · 02/04/2023 06:22

The point I am making is that it doesn’t matter who is in power, the current system isn’t working. I don’t believe in privatisation though, look at social care. Was all in house, now a shit show of private, self employed, in house etc…

The shit show isn’t the wonderful care staff, just the lack of proper support, pay and conditions and cost of sorting all of this out.

FallSpringing · 02/04/2023 07:43

Newbutoldfather · 01/04/2023 07:33

reading overnight replies. It does seem that I am not wrong judging by the close to 4:1 vote in favour of the question.

For what it is worth a few of my ideas would be:

Pay staff what they are worth (especially nurses).

Get rid of the nursing degree bar for a few specialist nurses. It is not really a degree (look at the A levels required to get on the course) and merely means nurses start their career in debt. It also seems to have made nurses process-focused rather than patient focused. In my week in hospital with my son, I saw a couple of genuinely nice nurses, most who really didn’t care and one who was downright cruel.

Give more money to a dramatically restructured NHS, but money is not a panacea. I think research showed that, of every £10 Labour pumped into the NHS, £3 went to improved NahS and £7 was wasted in health service inflation.

Introduce means-tested co payments. This would both stop time wasting by patients and make the staff and patients realise who the clients are.

Encourage well qualified medical staff to take more management roles by making them more flexible and making sure that those in the know were really the most important in the decision making process.

However, I do think we need to stop encouraging people to stop accepting where we are. In two threads recently, one breast-feeding mother was told she was ridiculous for not packing a picnic before taking her seriously I’ll child to hospital and another was told she should pop out to a shop to buy paracetamol for a child in agony with a fracture. Utterly ridiculous in the UK.

This. Better pay and scrap the degree. At my local university they don't even need A-levels or GCSE's to do it now with a foundation year. It's all about money, and doesn't attract enough people, or evidently the right kind of people with compassion. Also bring the focus of nursing back to actual hands on nursing care.

Hardbackwriter · 02/04/2023 08:21

FallSpringing · 02/04/2023 07:43

This. Better pay and scrap the degree. At my local university they don't even need A-levels or GCSE's to do it now with a foundation year. It's all about money, and doesn't attract enough people, or evidently the right kind of people with compassion. Also bring the focus of nursing back to actual hands on nursing care.

People who say nursing doesn't need to be a degree clearly have no idea of what's in a nursing degree and what students need to demonstrate at the end to meet the NMC standards. Nursing degrees require a large amount of placement-based learning anyway, but I don't think it would be at all possible or desirable to teach everything that's expected of a modern nurse on the job - nursing degree apprenticeships exist and I think they're great but they still, obviously, require degree-level classroom learning. I don't see why the entry requirements ascertain whether something is a 'real' degree - surely it should be about where the students are at the end of their course not where they are at the beginning if you think university is worthwhile in any way at all?

Botw1 · 02/04/2023 09:17

@Newbutoldfather

Should we scrap all other health care related degrees too?

If nurses don't need a degree then neither do physios or OTs or dietitians

Nor do doctors

Pretty sure they could benefit from much more hands on learning and being less process based