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

[Newbutoldfather]

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.

Whenever people talk about paid-for services in the NHS they always want to exempt pensioners and children. It's obvious why this would be desirable but I do think it betrays a lack of understanding over just how huge a percentage of resources go to the elderly. Introducing more charges but only for working-age is a generational tax that seems hard to justify.

QueenCamilla I'm so so sorry you had to go through that it's absolutely shocking. I had a similar experience in A and E a few years back that I've never truly recovered from, I was also stepped over by nurses who treat me like a bit of dirt on the floor. Thankfully I've also met some wonderful compassionate nurses on the cancer wards which has balanced it out a bit. 💐

I called 999 last week with all the symptoms of a heart attack.
I was told to get to a hospital straightaway, by my own means, as there were no available ambulances.
I was triaged after a 20-minute wait, with crushing chest pain, nausea, and high blood pressure. Three hours later, I saw a doctor, and after another six hours, I had blood tests and an angiogram.
I was sent home and told to go to my gp for further referral. My GP has a constant recorded message saying they are at 'red capacity ' and unable to take calls or appointments.
Where I live, the system is broken beyond repair.

@Hardbackwriter well I guess you can't take money off people who don't earn.

A lot of the problem is that low/mid paid workers are really feeling the pinch. None of our wages have gone up in 15 years and although the income tax threshold has doubled we don't have the benefit of it in our pockets because wages are low and also because of the massive increase we've seen in council tax which is a regressive tax as it's not based on income. Increases in it hits low/mid waged workers harder.

Nevertheless I would still rather have some kind of hybrid system where if I have to pay extra it's part funded rather than forking out a day and a Half's wages to get a fucking coil took out of me.

Yeah, my GP gave me an urgent referral for a lump in my breast accompanied by itching and pain. It was fine which was great, what was not great was being laughed at for thinking it was anything to worry about. Given I lost mother to BC when I was a child - and live in fear of the same happening to my own children - I didn't laugh. I no longer check my breasts because it feels as if I'm setting myself up to be made a fool of again.

Vote Labour. It’s the party of public service and the NHS was in a decent state by the time they left.
⬆️⬆️⬆️

There aren’t fewer GPs in my area, but the population has hugely increased, so more people per GP and young people have enough GP appointments for it to have an impact.
I also remember a work colleague telling me her daughter had qualified as a GP but there were no jobs available so retrained as an accountant. This was back in the days of Blair, so I presume the number of GP positions available were capped by the government.

I can’t say I’m a Tory supporter, I’m not impressed by this government, I just don’t know why people think Labour are any better or going to solve anything. They’re all a bunch of self-serving shysters.

NoSweat Please keep checking as you would normally. You should never have been made to feel that way and considering your family history I'm astounded you had that experience. For your own piece of mind you need to raise concerns each and every time, although I sincerely hope you don't need to. I'm living with bc and couldn't pass your post without comment. 💐

I too had a traumatic birth slightly earlier than the pp. it was before 2010 but roughly after 10 years of a labour govt. My SIL had the same experience around the same time. This is not a Labour vs Tory situation IMO and for those of us who recall it, there was a very interesting documentary made by the BBC called ‘Can Gerry Robinson fix the NHS?’ as part of a series. It was shown in ‘07. His conclusion? That the NHS did not need more money, but needed a radical overhaul of organisation and the length of time change takes to happen in the NHS. He also cited that the clinically trained staff should be centre of the decision making processes not non medical management. It is well worth a watch. I belong to an NHS surgery in an area just outside of London in a not particularly salubrious area that embraces all of the technology available. It is incredibly efficient. Yes it is annoying to have to ring at 8am to get an appointment but in the 3 or so years I have belonged to it, I have never failed to get to speak to a Doctor the same day. It is also the fairest way for most patients to be seen. Test results are proactively dealt with and the Dr’s often phone you with the results or use the direct messaging system to communicate. Repeat prescriptions can be processed online to save calling the surgery. The comms between the indie pharmacy next door and the surgery is also excellent and because the practice has two branches within a 3 mile radius, they mobilise appointments and their staff as efficiently as possible. I cannot fault the service they provide and everyone at the surgery from the receptionists onwards seems to give a shit about the patient experience. I’d imagine they get far less complaints as a result but looking at the local FB page you’d think it was the worst surgery on God’s earth because someone tried to phone at 2pm, waited for a whole 10 rings and couldn’t get an appointment on the same day. My point is, if all parts of the NHS we use the most embraced the technology efficiently and we all accepted as a nation that change is inevitable how we interact with the NHS we might just make it work.

People make an organisation and the NHS is no exception. For contrast, pre covid, in a much more salubrious area than mine 5 or so miles away a friend of mine joined as a GP in a surgery used to working (in her words) as if it was 1985. She too had come from a very efficient surgery and couldn’t believe it when one of her colleagues tried cancel over two hours worth of afternoon appointments because she could get a hair appointment at the local salon. Didn’t even try to hide it and seemed oblivious to the fact that patients might have taken time off work to make the appointment with her. She was so aghast she made every attempt to cover the appointments by adding them to her own list which was obviously a pretty tall order….Another pal is also a HCP at another local practice who advocates charging for GP appointments to prevent people abusing the system or wasting time and she absolutely hates the Tories. She recently had a woman demand appointments within the hour for all 3 of her school age children to be checked for Scarlet Fever and strep A despite none of them showing any symptoms at all. Absolutely kicked off at all staff members until she was seen. My pal is pretty sure that if she’d had to pay £25 per kid (or even £10) to be seen it wouldn’t have happened. I don’t think charging to get an appointment is the answer but I do think fining people for calling an ambulance for a broken nail or whatever should have consequences.

Finally, although there are some real heroes in the NHS, my own experience (and that of the other poster) are that many lack compassion

Cos they're burnt out. 3 years of Covid. Strikes for pay. A collapsing health service. Oversubscribed - you hear enough about taking ages to get a GP's appointment, 12-hour waits or more in A&E....

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)

There was an article in The Guardian months ago about no GP's left hardly at all in rural France. The old ones are retiring and the young ones don't want to be stuck in the middle of nowhere.

I live in a different EU country and pay a monthly health insurance. I do get excellent treatment for the price. You also get subsidised for it if on a low income.

Also, the answers are out there and easy to implement. The Ed at my hospital in Australia is chronically underfunded due to population growth.

Regardless, no person waits in pain as the nurse and consultants worked together to devise a graded response to a patient in pain.

Nurses can administer a number of different pain relieving medications without any need to consult medical staff.

There are measurement taken to ensure that no one waits without pain relief and the results are fed back to staff regularly.

It’s all well documented and perfectly safe, the NHS could implement the same protocols tomorrow and increase patient satisfaction, reduce ED aggression and make staff more satisfied.

No I am completely aware of what is happening to the NHS . A deliberate strategy by the Tory government to run it down and sell it off. I and many others knew this would happen when the Tories came into power. I never voted for this. The present model does work with adequate funding . Please vote the Tories out and Labour in. The NHS is the best thing this country has ever produced pretty much.

But this is the sad effect of a system where nurses are underpaid, not valued and have too much to do.

it’s not the case of the problem, it’s the result.

It should be means tested and those over a certain income should pay in. I agree, US is bashed a lot but I can see a paediatric doctor same day for an ear infection and a specialist ENT can see me within 4 weeks if I self refer. Who does not want that? Make that the norm, and make it subsidised only when means tested . For most, employers pay the lions share

"But this is the sad effect of a system where nurses are underpaid, not valued and have too much to do."

Disagree. You don't need to be paid a fortune to treat someone with respect, and to be polite.

My DSIS has been in hospital for 6 weeks, I have seen all sorts on the ward. I also work for the NHS and go the extra mile. Salary is not the driving factor for good care, it's because there aren't enough 'boots on the ground' but also, individual personalities not suited to the job. Why some people go into nursing beats me, as the way they speak to patients makes me shudder...

the UK is getting what it pays for. A low tax economy with a poorly funded health service. If you want French or German services you need to pay French or German taxes.

Meanwhile Jeremy Hunt was presented with a plan to train more staff the NHS desperately needs, but he refuses to fund it. So things won't improve. It's impossible to run a proper service without staff; that doesn't change whether it's public or private. Going private in the UK doesn't magic up more staff; it's rearranging deck chairs on the Titanic. Why should nurses see a real terms pay cut? They'll go overseas or quit. GPs aren't as poorly paid but are expected to handle an impossible workload. Same outcome.

I have been a General Medicine consultant for 30 years. My random musings.

The service we offered has gone down greatly over the last ten years. For whatever reason. Pre-pandemic. I feel embarrassed.

It is partly due to worse social care and support services. People all-round are being neglected. And poor housing etc has its part to play. The NHS can’t be viewed in isolation.

Private healthcare too will be decimated if junior medical staff defect to Australia and drug companies. To work in the private sector you need to be a consultant. And that means rising through the NHS training ranks first.

The pandemic clapping was hideous and embarrassing. NHS staff are not heroes. We just had a job to do and were paid and had to get on with it. It was a truly stressful and shit time but few people were actually ‘heroes’.

There is waste. Whether that’s procurement rules meaning you have to pay £££ for stationery and basic stuff that’s cheaper on Amazon. Or inefficient IT systems resulting in duplication of work. Or management consultants being paid thousands to state the obvious. Tickbox training modules that are mandatory and an insult to trained clinicians’ time. Extra management roles which add little value. HR systems which are so slow that new recruits wait an age to start. So inefficient.

And the amount spent on agency staff is mind-boggling.

We need extra staff. We really do. Everything works better on a fully-staffed unit. Community services work better with smaller caseloads. That goes for social care too. More nurses, doctors, physios etc would make happier teams, improve morale and improve care.

We should have zero tolerance for rudeness. I have never been rude to a patient or relative in 30 years. However annoying they may be or tired I might be. Staff not showing basic kindness and compassion need to be pulled up on this asap. Hcps without sensitivity and people skills need to be made aware every time. I am appalled at stuff I see and hear. It’s not good enough. I don’t care how tired or stressed you are, don’t take it out on patients fgs.

I don’t know what to do about the sickness culture. I don’t take sick leave (well not for 20+ years) but at the other extreme some colleagues do take the piss.

I will never blame patients for the state of the NHS. People have always been flawed. Our health service needs to cater for everyone.

I think we need a mix of better funding and maybe some payment at the point of access. We cannot end up with healthcare going the same way as dentistry.

We should complain and not accept this. It’s not ok to wait hours and hours in A and E. It’s not ok to wait weeks for a scan. It’s not ok to wait months for an outpatient appt.

On a more positive note, I promise that some of us are trying. I will always call a patient or relative back within 24h. If I say I will do something for a patient, I am 100% reliable. I am always kind to the people I see. And many others around me are the same. There is still goodwill and hard work going on. But it’s easy to miss amongst all the crap.

Bring on retirement. I still have a long wait.

Thanks to stupid, self-interested Tory voters the NHS is a disgrace. The clapping for covid was likely a shrewd forward planning move to hopefully avoid the current surge in public sector striking & desertion. It didn't go well.

I've worked as a nurse in the NHS for almost 10 years. A month ago I went through hell in the form of a late miscarriage. I was in hospital for 3 days and although it was incredibly traumatic I honestly can't say a single bad thing about the staff. I was treated with compassion by everyone from the midwives, theatre staff, domestic staff and even students.

I know this isn't the same everywhere but most staff are really trying their best in a world of chronic staff shortage, budget cuts and fatigue from workloads through covid that have never let up. I work in primary care and my GP colleagues are drowning. They regularly work til midnight and over weekends just to keep on top of their weekly workload. We need a serious funding overhaul and a focus on retaining and looking after the staff we have.

Also- some comments on the nurses being able to give pain relief- not always true for children where doses are usually based on weight and need to be prescribed by a doctor. If you have only two doctors covering children's a&e, a children's ward and a neonatal unit (as is common in a district general hospital overnight), that might be part of the problem. Not an excuse as children should not be left in pain under any circumstances but sheds light on how it could have happened.

You're right OP and while it has got much worse under the Tories it was no great shakes under Labour either (at a time when IIRC the funding per patient was closer to what it would be in France or Germany) - I don't want to talk about my experiences in detail because I don't need some NHS fangirl coming in to tell me how that was actually great care and I'm just ungrateful, but I had recurrent miscarriage between 2008 and 2010 a I can tell you it was already inefficient and callous at that time. It's undoubtedly got worse since then but I think until the supporters of the NHS, Labour above all, start admitting that there us more wrong with the NHS than just lack of funding the UK will struggle to improve it because there are problems with its management and because there are more and more natural Tory voters (by which I mean older and better off than average) who as they age experience more of the NHS "care" from their own perspective and that of their parents who will be hearing the "God bless the NHS" rhetoric from the left and thinking "I'll be fucked if I'm giving any more money to an organisation that treats my loved ones like an inconvenience and then tries to tell us we should be grateful they bothered with us at all". I mean, it's the main reason I don't return to the UK. On Wednesday my daughter hurt her wrist in school. We phoned ahead to the GP and he saw us within 10 minutes of us arriving at the surgery. They have an x Ray machine so he could tell us there and then that it wasn't broken and he has some splints in his office so he gave us one then and there. We were back at work/school after lunch. Imagine that in the UK. You'd be packing fucking sleeping bags to take to minor injuries. Someone will be along to quote me the price for German health insurance soon and yeah it is expensive but if you're on a low income it's subsidised. Those of us on good money are paying enough that everyone can access the same high standard of healthcare. Our health service is more socialised than the UK's at this point.

The NHS has had its day. It is time that medical care in the UK goes back to self funding. Get this expensive yoke off of the taxpayer and back to those who use it.

I am a lifelong Labour voter, and whilst I do blame the Tories for some issues, I don’t think a Labour government is going to cure everything. It won’t and it can’t.

We need to look at our staffing, our ageing population and the cost of current medical interventions. And then work out how much money will actually be needed in the future.

I am not averse to a system any more where those who can, pay into an insurance system. But the problem is that no government wants to be responsible for ending the sacred NHS.

Voting labour won't change nurses refusing to get me some water after I gave birth (had a tear and an epidural to fix it so couldn't move).

Or not telling me where my son had gone for 8 hours after giving birth.

Or shouting in a room full of traumatised women 'you're pregnant not ill!'

Or during a separate time, leaving me on the bathroom floor when I was seriously ill for hours despite me ringing the bell and then laughing when finding me.

Or having their tv blaring all night when you're trying to sleep, asking them if they could possibly turn it down and getting an eye roll.

I spoke to one nurse who said she dreads the day she needs to go into hospital because she's seen first hand what the staff are like.

There's a culture in the NHS that no amount of money can fix. And it's leaving patients with PTSD and, for many mothers, PND.

I have no idea what the answer is to this, but more money isn't it.

Im no ideologue when it comes to public and privately run provision, but many services that were previously publicly run are now privately run, and i don't really see any real a difference in terms of quality and customer service, in fact the very opposite sometimes.

The main issue isn't efficiency (though of course the NHS could be more efficient), it's the chronic disparity between the demand and available resources (human and financial).

Thinking that some slick privately run business model could magically sort things out is naive.